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 To construct a quality evaluation index system for emergency triage and form a quality evalua-tion table for application,it provides a reference basis for the supervision of the quality of emergency triage.Methods Based on the Donabedian structural model and referring to the latest released relevant policies and stan-dards,a Delphi method were used to determine the quality evaluation indicators of emergency triage,as well as the scores and evaluation methods of each level of indicators.The convenience sampling method was applied to seven tertiary hospitals in Jiangsu Province to test the reliability and validity of the emergency triage quality evaluation scale and to analyze the application.Results The effective recovery rate of the two rounds of expert correspondence ques-tionnaires was 100％,and the expert authority coefficients were 0.869 and 0.927,respectively,and the resulting emergency triage quality evaluation index system included 3 first-level indexes,12 second-level indexes,and 43 third-level indexes.The Cronbach coefficient of the emergency triage quality evaluation table was 0.719,and the average score of emergency triage quality of the seven hospitals was 93.36 points,which was at a good level.Conclusions The constructed emergency triage quality evaluation index system has good expert recognition,specialty and good reliability and validity,and the contents included are reasonable and clear with feasibility.

Objective To construct a quality evaluation index system for emergency triage and form a quality evalua-tion table for application,it provides a reference basis for the supervision of the quality of emergency triage.Methods Based on the Donabedian structural model and referring to the latest released relevant policies and stan-dards,a Delphi method were used to determine the quality evaluation indicators of emergency triage,as well as the scores and evaluation methods of each level of indicators.The convenience sampling method was applied to seven tertiary hospitals in Jiangsu Province to test the reliability and validity of the emergency triage quality evaluation scale and to analyze the application.Results The effective recovery rate of the two rounds of expert correspondence ques-tionnaires was 100％,and the expert authority coefficients were 0.869 and 0.927,respectively,and the resulting emergency triage quality evaluation index system included 3 first-level indexes,12 second-level indexes,and 43 third-level indexes.The Cronbach coefficient of the emergency triage quality evaluation table was 0.719,and the average score of emergency triage quality of the seven hospitals was 93.36 points,which was at a good level.Conclusions The constructed emergency triage quality evaluation index system has good expert recognition,specialty and good reliability and validity,and the contents included are reasonable and clear with feasibility.

Objective To construct a quality evaluation index system for emergency triage and form a quality evalua-tion table for application,it provides a reference basis for the supervision of the quality of emergency triage.Methods Based on the Donabedian structural model and referring to the latest released relevant policies and stan-dards,a Delphi method were used to determine the quality evaluation indicators of emergency triage,as well as the scores and evaluation methods of each level of indicators.The convenience sampling method was applied to seven tertiary hospitals in Jiangsu Province to test the reliability and validity of the emergency triage quality evaluation scale and to analyze the application.Results The effective recovery rate of the two rounds of expert correspondence ques-tionnaires was 100％,and the expert authority coefficients were 0.869 and 0.927,respectively,and the resulting emergency triage quality evaluation index system included 3 first-level indexes,12 second-level indexes,and 43 third-level indexes.The Cronbach coefficient of the emergency triage quality evaluation table was 0.719,and the average score of emergency triage quality of the seven hospitals was 93.36 points,which was at a good level.Conclusions The constructed emergency triage quality evaluation index system has good expert recognition,specialty and good reliability and validity,and the contents included are reasonable and clear with feasibility.

Objective To construct a quality evaluation index system for emergency triage and form a quality evalua-tion table for application,it provides a reference basis for the supervision of the quality of emergency triage.Methods Based on the Donabedian structural model and referring to the latest released relevant policies and stan-dards,a Delphi method were used to determine the quality evaluation indicators of emergency triage,as well as the scores and evaluation methods of each level of indicators.The convenience sampling method was applied to seven tertiary hospitals in Jiangsu Province to test the reliability and validity of the emergency triage quality evaluation scale and to analyze the application.Results The effective recovery rate of the two rounds of expert correspondence ques-tionnaires was 100％,and the expert authority coefficients were 0.869 and 0.927,respectively,and the resulting emergency triage quality evaluation index system included 3 first-level indexes,12 second-level indexes,and 43 third-level indexes.The Cronbach coefficient of the emergency triage quality evaluation table was 0.719,and the average score of emergency triage quality of the seven hospitals was 93.36 points,which was at a good level.Conclusions The constructed emergency triage quality evaluation index system has good expert recognition,specialty and good reliability and validity,and the contents included are reasonable and clear with feasibility.

Objective To construct a quality evaluation index system for emergency triage and form a quality evalua-tion table for application,it provides a reference basis for the supervision of the quality of emergency triage.Methods Based on the Donabedian structural model and referring to the latest released relevant policies and stan-dards,a Delphi method were used to determine the quality evaluation indicators of emergency triage,as well as the scores and evaluation methods of each level of indicators.The convenience sampling method was applied to seven tertiary hospitals in Jiangsu Province to test the reliability and validity of the emergency triage quality evaluation scale and to analyze the application.Results The effective recovery rate of the two rounds of expert correspondence ques-tionnaires was 100％,and the expert authority coefficients were 0.869 and 0.927,respectively,and the resulting emergency triage quality evaluation index system included 3 first-level indexes,12 second-level indexes,and 43 third-level indexes.The Cronbach coefficient of the emergency triage quality evaluation table was 0.719,and the average score of emergency triage quality of the seven hospitals was 93.36 points,which was at a good level.Conclusions The constructed emergency triage quality evaluation index system has good expert recognition,specialty and good reliability and validity,and the contents included are reasonable and clear with feasibility.

Objective To construct a quality evaluation index system for emergency triage and form a quality evalua-tion table for application,it provides a reference basis for the supervision of the quality of emergency triage.Methods Based on the Donabedian structural model and referring to the latest released relevant policies and stan-dards,a Delphi method were used to determine the quality evaluation indicators of emergency triage,as well as the scores and evaluation methods of each level of indicators.The convenience sampling method was applied to seven tertiary hospitals in Jiangsu Province to test the reliability and validity of the emergency triage quality evaluation scale and to analyze the application.Results The effective recovery rate of the two rounds of expert correspondence ques-tionnaires was 100％,and the expert authority coefficients were 0.869 and 0.927,respectively,and the resulting emergency triage quality evaluation index system included 3 first-level indexes,12 second-level indexes,and 43 third-level indexes.The Cronbach coefficient of the emergency triage quality evaluation table was 0.719,and the average score of emergency triage quality of the seven hospitals was 93.36 points,which was at a good level.Conclusions The constructed emergency triage quality evaluation index system has good expert recognition,specialty and good reliability and validity,and the contents included are reasonable and clear with feasibility.

Objective To construct a quality evaluation index system for emergency triage and form a quality evalua-tion table for application,it provides a reference basis for the supervision of the quality of emergency triage.Methods Based on the Donabedian structural model and referring to the latest released relevant policies and stan-dards,a Delphi method were used to determine the quality evaluation indicators of emergency triage,as well as the scores and evaluation methods of each level of indicators.The convenience sampling method was applied to seven tertiary hospitals in Jiangsu Province to test the reliability and validity of the emergency triage quality evaluation scale and to analyze the application.Results The effective recovery rate of the two rounds of expert correspondence ques-tionnaires was 100％,and the expert authority coefficients were 0.869 and 0.927,respectively,and the resulting emergency triage quality evaluation index system included 3 first-level indexes,12 second-level indexes,and 43 third-level indexes.The Cronbach coefficient of the emergency triage quality evaluation table was 0.719,and the average score of emergency triage quality of the seven hospitals was 93.36 points,which was at a good level.Conclusions The constructed emergency triage quality evaluation index system has good expert recognition,specialty and good reliability and validity,and the contents included are reasonable and clear with feasibility.

Objective To construct a quality evaluation index system for emergency triage and form a quality evalua-tion table for application,it provides a reference basis for the supervision of the quality of emergency triage.Methods Based on the Donabedian structural model and referring to the latest released relevant policies and stan-dards,a Delphi method were used to determine the quality evaluation indicators of emergency triage,as well as the scores and evaluation methods of each level of indicators.The convenience sampling method was applied to seven tertiary hospitals in Jiangsu Province to test the reliability and validity of the emergency triage quality evaluation scale and to analyze the application.Results The effective recovery rate of the two rounds of expert correspondence ques-tionnaires was 100％,and the expert authority coefficients were 0.869 and 0.927,respectively,and the resulting emergency triage quality evaluation index system included 3 first-level indexes,12 second-level indexes,and 43 third-level indexes.The Cronbach coefficient of the emergency triage quality evaluation table was 0.719,and the average score of emergency triage quality of the seven hospitals was 93.36 points,which was at a good level.Conclusions The constructed emergency triage quality evaluation index system has good expert recognition,specialty and good reliability and validity,and the contents included are reasonable and clear with feasibility.

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.