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:A C57/BL6 mouse model of traumatic temporomandibular joint ankylosis (TTMJA) was established through composite trauma to lay the foundation for studying the pathophysiology of TTMJA.Methods:This study was conducted from January 2024 to February 2025. Forty-two 4-weeks old C57/BL6 mice, numbered 1 to 42, are randomly assigned to a control group ( n=21) and an experimental group ( n=21) using a computer-generated random number sequence. The experimental group undergoes modeling surgery on the left temporomandibular joint (TMJ), while the control group is routinely raised without special treatment. At 12 weeks post-surgery, the TMJ complex of both groups is assessed via body weight and mouth opening measurements, gross observation, micro-CT, and histological staining to evaluate model establishment. Results:At 12 weeks post-operation, in the experimental group, the body weight of mice [(27.75±1.08) g] did not show a significant difference compared with that of the control group [(30.80±0.29) g]( t=0.54, P=0.610). The maximum vertical passive mouth opening [(1.70±0.26) mm] in the experimental group was significantly lower than that in the control group [(3.43±0.21) mm]( t=8.92, P<0.001). Gross observation indicated that the right TMJ structure of the experimental-group mice was normal, while irregular hyperplasia occurred in the left TMJ complex. Micro-CT revealed that at 12 weeks post-operation, the right joint structure of the experimental-group mice was normal, with regular condyles and glenoid fossae. On the left side, a large amount of bone hyperplasia occurred on the lateral side of the joint in the condyles and glenoid fossae, forming two irregular bone masses, and there was an uncalcified radiolucent zone between the bone masses. In histological staining, no new cartilage or bone tissue was observed in the left joint space of the control-group mice, and the articular disc structure was normal. In the experimental-group mice, obvious new cartilage and calcified bone tissue were visible on the lateral side of the left joint space. A bone bridge was formed between the condyles and glenoid fossae, the articular disc structure disappeared, and bony ankylosis occurred. Conclusions:In this experiment, a TTMJA model of C57/BL6 mice was initially established by removing the articular disc and damaging part of the fibrous cartilage of the glenoid fossae and condyles, providing an experimental platform for further research on the pathogenesis of TTMJA.

Objective:To evaluate the role of stimulator of interferon genes (STING) in postoperative cognitive dysfunction (POCD) and the relationship with pyroptosis in hippocampal cells in aged mice.Methods:Forty-eight SPF healthy male C57BL/6 mice, aged 18 months, weighing 23-28 g, were assigned to 4 groups ( n=12 each) using a random number table method: control group (C group), POCD group (P group), STING inhibitor C-176 group (PC group), and C-176 solvent group (PV group). The mice underwent Morris water maze training for 4 days prior to model establishment. Mice in P, PC and PV groups underwent tibial fracture and intramedullary pin fixation under sevoflurane anesthesia to establish the POCD model, while mice in C group received no treatment. The STING inhibitor C-176 (750 nmol/200 μl) and an equal volume of C-176 solvent were intraperitoneally injected at 30 min before establishment of the model in PC and PV groups, respectively. The open field test was performed on the 5th day after model preparation, the novel object recognition test was conducted on the 6th day, and the Morris water maze test was performed on the 7th day. Mice were sacrificed under anesthesia to collect the hippocampus for determination of the expression of STING, phosphorylated STING (p-STING), nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3), cleaved caspase-1, and gasdermin-D (GSDMD)-NT by Western blot. Results:There were no statistically significant differences in the parameters of the training phase of the Morris water maze test and the open field test among the four groups ( P>0.05). Compared with C group, the recognition index in the novel object recognition test was significantly decreased, the number of crossing the original platform was reduced and the duration spent in the target quadrant was shortened in the Morris water maze test, and the expression of STING, NLRP3, cleaved caspase-1, and GSDMD-NT in hippocampal neurons was up-regulated in P, PC and PV groups, and the expression of p-STING was significantly up-regulated in P and PV groups ( P<0.05). Compared with P group, the recognition index in the novel object recognition test was significantly increased, the number of crossing the original platform was reduced and the duration spent in the target quadrant was prolonged in the Morris water maze test, and the expression of p-STING, NLRP3, cleaved caspase-1, and GSDMD-NT in hippocampal neurons was down-regulated in PC group ( P<0.05). Compared with PC group, the recognition index in the novel object recognition test was significantly decreased, the number of crossing the original platform was reduced and the duration spent in the target quadrant was shortened in the Morris water maze test, and the expression of p-STING, NLRP3, cleaved caspase-1 and GSDMD-NT was up-regulated in PV group ( P<0.05). Conclusions:STING is involved in the development of POCD in aged mice, and the mechanism may be related to promotion of pyroptosis in hippocampal cells.

Objective To systematically evaluate and analyze qualitative studies of parental engagement in kangaroo mother care experiences for preterm infants in the NICU,aiming to provide references for promoting the early recovery of preterm infants in NICU and improving the quality of nursing services.Methods Relevant were searched for qualitative studies of parental engagement in kangaroo mother care for preterm infants in NICU.The search time limit was from the construction of the database to July 19,2024.The quality of the included literature was assessed using the Joanna Brigg Institute's(JBI)Australian Centre for Evidence-Based Health Care's Quality Assessment Criteria for Qualitative Research,and the results were integrated using the meta-integration methods.Results A total of 17 papers were included in the literature,and 61 findings were extracted,grouped into 10 new categories.These were further synthesized into 4 integrated findings:physical and psychological perceptions of participation in kangaroo mother care;challenges to participation in kangaroo mother care;facilitators of participation in kangaroo mother care;expectations and suggestions for kangaroo mother care.Conclusion Hospital administrators should further improve the management specifications of kangaroo mother care for preterm infants in NICU,optimize resource allocation and strengthen publicity.At the same time,healthcare professionals should actively promote the establishment of peer and family support systems and increase participation in kangaroo mother care to facilitate early recovery of preterm infants in NICU and to continuously promote the improvement of nursing service quality.

Objective:To explore screening pathways and practical implementation strategies for primary care disease groups un-der the Diagnosis-Intervention Packet(DIP)payment.Methods:Matching and expert consultation methods were used to select primary care conditions,and experts included DIP National Steering Group experts,DIP experts from a sample municipal health-care security bureau,health policy researchers,coders from a tertiary hospital in Beijing,and big data engineers.Results:The DIP primary disease of"conservative treatment groups"in primary and secondary medical institutions were 104 and 105,repective-ly.The DIP primary disease of"primary can be completed groups"were 74 and 171,respectively.The final number of primary diseases in primary and secondary hospital was determined to be 178 and 276,respectively.Conclusions:The number of primary care disease groups varies from place to place,but it still needs to be dynamically adjusted and optimized in conjunction with big data methods and expert consultation,evaluated and corrected in a timely manner to ensure scientificity and effectiveness.The pri-mary care disease groups implement"same price for the same disease"across different levels of medical institutions,eliminating the differentiation of medical institution grade coefficients to promote hierarchical diagnosis and treatment.Cost-value measurement of disease group,scientific development of payment criteria for disease group,lack of regulatory tools for big data,and high sets of codes are key barriers to primary care implementation.

Objective:To investigate the influencing factors of mucosal healing under endoscopy in patients with Crohn′s disease (CD) and to establish a predictive model.Methods:From January 1, 2023 to August 31, 2024, 124 patients with CD were hospitalized at the Department of Gastroenterology, Renmin Hospital of Wuhan University were retrospectively enrolled as the modeling group. And from January 1, 2021 to December 31, 2022, 88 patients with CD were hospitalized at the Department of Gastroenterology in the same hospital were collected as the validation group. The data including simple Crohn′s disease activity index (CDAI) scores, serological markers such as fibrinogen (FIB), and medication regimens (including ustekinumab) of the patients in the modeling group were collected. Multivariate logistic regression analysis was used to screen the independent predictors of mucosal healing in CD patients, and the nomogram predictive model was established. The receiver operating characteristic curve (ROC) was plotted to evaluate the predictive performance, and calibration curve was drawn for validation. Mann-Whitney U test and Chi-square test were used for statistical analysis. Results:According to the simple endoscopic score for CD and endoscopic findings, among the 124 patients in the modeling group, 92 cases were diagnosed as mucosal healing, while 32 cases did not. The simple CDAI and FIB of patients with mucosal healing were lower than those of patients without mucosal healing (2.00(2.00, 3.00) vs. 3.00(2.25, 4.00), 2.37(2.03, 2.88) g/L vs.2.92(2.40, 4.40) g/L); the proportion of patients who used ustekinumab in mucosal healing patients was higher than that of patients without mucosal healing (62.0%, 57/92 vs. 31.2%, 10/32), and the differences were statistically significant ( Z=-2.98 and -3.57, χ2=9.01; all P<0.01).The results of multivariate logistic regression analysis showed that low simple CDAI score ( OR=0.560, 95% confidence interval (95% CI): 0.343 to 0.913), low FIB ( OR=0.475, 95% CI: 0.302 to 0.747), and ustekinumab usage ( OR=4.218, 95% CI: 1.621 to 10.977) were independent predictive factors of mucosal healing under endoscopy in CD patients (all P<0.05). The regression equation was derived as ln( p/(1- p)) mucosal healing=4.215-0.580×simple CDAI score -0.745×FIB(g/L)+ 1.439×ustekinumab usage(1 for use, 0 for unused), and the nomogram model was established. The results of ROC demonstrated that the area under the curve of the nomogram model in the modeling and validation group were 0.791(95% CI: 0.700 to 0.883) and 0.781 (95% CI: 0.666 to 0.895), with the sensitivity of 0.859 and 0.868, and with the specificity of 0.688 and 0.650, respectively. The results of calibration curve analysis showed that the average absolute errors of the nomogram model in the internal and external validation were 0.032 and 0.039, respectively, indicating a good consistency between the predicted and actual probability. Conclusions:Low simple CDAI score, low FIB, and ustekinumab usage are the independent predictive factors of mucosal healing under endoscopy in CD patients. The predictive model has certain reference value for CD management.

Objective:A C57/BL6 mouse model of traumatic temporomandibular joint ankylosis (TTMJA) was established through composite trauma to lay the foundation for studying the pathophysiology of TTMJA.Methods:This study was conducted from January 2024 to February 2025. Forty-two 4-weeks old C57/BL6 mice, numbered 1 to 42, are randomly assigned to a control group ( n=21) and an experimental group ( n=21) using a computer-generated random number sequence. The experimental group undergoes modeling surgery on the left temporomandibular joint (TMJ), while the control group is routinely raised without special treatment. At 12 weeks post-surgery, the TMJ complex of both groups is assessed via body weight and mouth opening measurements, gross observation, micro-CT, and histological staining to evaluate model establishment. Results:At 12 weeks post-operation, in the experimental group, the body weight of mice [(27.75±1.08) g] did not show a significant difference compared with that of the control group [(30.80±0.29) g]( t=0.54, P=0.610). The maximum vertical passive mouth opening [(1.70±0.26) mm] in the experimental group was significantly lower than that in the control group [(3.43±0.21) mm]( t=8.92, P<0.001). Gross observation indicated that the right TMJ structure of the experimental-group mice was normal, while irregular hyperplasia occurred in the left TMJ complex. Micro-CT revealed that at 12 weeks post-operation, the right joint structure of the experimental-group mice was normal, with regular condyles and glenoid fossae. On the left side, a large amount of bone hyperplasia occurred on the lateral side of the joint in the condyles and glenoid fossae, forming two irregular bone masses, and there was an uncalcified radiolucent zone between the bone masses. In histological staining, no new cartilage or bone tissue was observed in the left joint space of the control-group mice, and the articular disc structure was normal. In the experimental-group mice, obvious new cartilage and calcified bone tissue were visible on the lateral side of the left joint space. A bone bridge was formed between the condyles and glenoid fossae, the articular disc structure disappeared, and bony ankylosis occurred. Conclusions:In this experiment, a TTMJA model of C57/BL6 mice was initially established by removing the articular disc and damaging part of the fibrous cartilage of the glenoid fossae and condyles, providing an experimental platform for further research on the pathogenesis of TTMJA.

Objective:To explore the current status of presenteeism among ICU nurses and its correlation with resilience-related practice environment.Methods:Convenience sampling was adopted to select 434 ICU nurses from Beijing Tiantan Hospital, Capital Medical University in October 2022 as study subjects. An online questionnaire was conducted using the General Information Questionnaire, Chinese version of the Standford Presenteeism Scale-6 (SPS-6), and Nurse Resilience-related Practice Environment Factor Assessment Scale. Pearson correlation and multiple linear regression analysis were used to explore the relationship between ICU nurses' resilience-related practice environment and presenteeism.Results:Among ICU nurses, the total score on the Nurse Resilience-related Practice Environment Factor Assessment Scale was (122.71±26.14) and the SPS-6 score was (16.11±4.66). Presenteeism was negatively correlated with total scores on the Nurse Resilience-related Practice Environment Factor Assessment Scale and scores on career support and development, practice support and development, and personal support and development ( r=-0.494, -0.471, -0.444, and -0.476; P<0.001). Regression analysis showed that resilience-related practice environment negatively predicted presenteeism in nurses ( P<0.001) . Conclusions:ICU nurses are at a high level of presenteeism, and total scores on the Nurse Resilience-related Practice Environment Factor Assessment Scale are negatively correlated with presenteeism. Nursing administrators should emphasize the psychological state of ICU nurses and improve the resilience-related practice environment in ICUs, thereby reducing the incidence of presenteeism among ICU nurses.

Objective:To explore screening pathways and practical implementation strategies for primary care disease groups un-der the Diagnosis-Intervention Packet(DIP)payment.Methods:Matching and expert consultation methods were used to select primary care conditions,and experts included DIP National Steering Group experts,DIP experts from a sample municipal health-care security bureau,health policy researchers,coders from a tertiary hospital in Beijing,and big data engineers.Results:The DIP primary disease of"conservative treatment groups"in primary and secondary medical institutions were 104 and 105,repective-ly.The DIP primary disease of"primary can be completed groups"were 74 and 171,respectively.The final number of primary diseases in primary and secondary hospital was determined to be 178 and 276,respectively.Conclusions:The number of primary care disease groups varies from place to place,but it still needs to be dynamically adjusted and optimized in conjunction with big data methods and expert consultation,evaluated and corrected in a timely manner to ensure scientificity and effectiveness.The pri-mary care disease groups implement"same price for the same disease"across different levels of medical institutions,eliminating the differentiation of medical institution grade coefficients to promote hierarchical diagnosis and treatment.Cost-value measurement of disease group,scientific development of payment criteria for disease group,lack of regulatory tools for big data,and high sets of codes are key barriers to primary care implementation.

Objective:To evaluate the role of stimulator of interferon genes (STING) in postoperative cognitive dysfunction (POCD) and the relationship with pyroptosis in hippocampal cells in aged mice.Methods:Forty-eight SPF healthy male C57BL/6 mice, aged 18 months, weighing 23-28 g, were assigned to 4 groups ( n=12 each) using a random number table method: control group (C group), POCD group (P group), STING inhibitor C-176 group (PC group), and C-176 solvent group (PV group). The mice underwent Morris water maze training for 4 days prior to model establishment. Mice in P, PC and PV groups underwent tibial fracture and intramedullary pin fixation under sevoflurane anesthesia to establish the POCD model, while mice in C group received no treatment. The STING inhibitor C-176 (750 nmol/200 μl) and an equal volume of C-176 solvent were intraperitoneally injected at 30 min before establishment of the model in PC and PV groups, respectively. The open field test was performed on the 5th day after model preparation, the novel object recognition test was conducted on the 6th day, and the Morris water maze test was performed on the 7th day. Mice were sacrificed under anesthesia to collect the hippocampus for determination of the expression of STING, phosphorylated STING (p-STING), nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3), cleaved caspase-1, and gasdermin-D (GSDMD)-NT by Western blot. Results:There were no statistically significant differences in the parameters of the training phase of the Morris water maze test and the open field test among the four groups ( P>0.05). Compared with C group, the recognition index in the novel object recognition test was significantly decreased, the number of crossing the original platform was reduced and the duration spent in the target quadrant was shortened in the Morris water maze test, and the expression of STING, NLRP3, cleaved caspase-1, and GSDMD-NT in hippocampal neurons was up-regulated in P, PC and PV groups, and the expression of p-STING was significantly up-regulated in P and PV groups ( P<0.05). Compared with P group, the recognition index in the novel object recognition test was significantly increased, the number of crossing the original platform was reduced and the duration spent in the target quadrant was prolonged in the Morris water maze test, and the expression of p-STING, NLRP3, cleaved caspase-1, and GSDMD-NT in hippocampal neurons was down-regulated in PC group ( P<0.05). Compared with PC group, the recognition index in the novel object recognition test was significantly decreased, the number of crossing the original platform was reduced and the duration spent in the target quadrant was shortened in the Morris water maze test, and the expression of p-STING, NLRP3, cleaved caspase-1 and GSDMD-NT was up-regulated in PV group ( P<0.05). Conclusions:STING is involved in the development of POCD in aged mice, and the mechanism may be related to promotion of pyroptosis in hippocampal cells.