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 analyze the prevalence and related factors of depression symptom among middle-aged and older adults belonging to Zhiguo ethnic minority groups,who experienced relative isolation prior to mod-emization and bypassed the transitional period associated with feudal monarchy in Yunnan Province.Methods:Using stratified cluster sampling,a total of 1 035 individuals from Zhiguo ethnic minority groups were investigated with the 9-item Patient Health Questionnaire(PHQ-9)to measure depression symptom scores(a total score≥5 was considered indicative of depression symptom).A self-administered questionnaire was utilized to investigate 24 cova-riates across five dimensions:sociodemographic,social-interpersonal network,mental health status,physical health status,and health behaviors.Results:Among the surveyed participants,231 individuals(22.32％)exhibited depres-sion symptoms.The logistic regression analysis showed that middle-aged and elderly people belonging to Zhiguo ethnic minority groups with occupations as laborers(OR=8.73),farmers(OR=7.34),and other professions(OR=7.13),those who reported feeling stressed or anxious in the last month(OR=5.43),those suffering from one(OR=2.81)or more chronic illnesses(OR=2.14),experiencing sleep problems(OR=3.74)/debilitating(OR=1.69)/mild-moderate pain(OR=2.23,4.37),and engaging in sedentary behavior(OR=2.27)were at higher risk for depressive symptoms.The risk of depressive symptoms was lower among middle-aged and elderly people be-longing to Zhiguo ethnic minority groups with higher social support scores(OR=0.96)and meaning in life scores(OR=0.96).Conclusion:The prevalence of depressive symptoms among middle-aged and elderly individuals of Zhiguo ethnic minorities is substantial,influenced by multiple factors.

Lymphatic metastasis is the main metastatic route for colorectal cancer, which increases the risk of cancer recurrence and distant metastasis. The properties of the lymph node metastatic colorectal cancer (LNM-CRC) cells are poorly understood, and effective therapies are still lacking. Here, we found that hypoxia-induced fibroblast activation protein alpha (FAPα) expression in LNM-CRC cells. Gain- or loss-function experiments demonstrated that FAPα enhanced tumor cell migration, invasion, epithelial-mesenchymal transition, stemness, and lymphangiogenesis via activation of the STAT3 pathway. In addition, FAPα in tumor cells induced extracellular matrix remodeling and established an immunosuppressive environment via recruiting regulatory T cells, to promote colorectal cancer lymph node metastasis (CRCLNM). Z-GP-DAVLBH, a FAPα-activated prodrug, inhibited CRCLNM by targeting FAPα-positive LNM-CRC cells. Our study highlights the role of FAPα in tumor cells in CRCLNM and provides a potential therapeutic target and promising strategy for CRCLNM.

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 investigate the prevalence of suicidal behaviors and their associated risk factors among adolescent inpatients with depression.Methods:A retrospective analysis of the medical records of 442 adolescent inpatients diagnosed with depression at Shenzhen Kangning Hospital from January 2016 to December 2022 was conducted. Among them, 64 were male and 358 were female. They range in age from 10 to 17. The MINI suicidal module assessment on the day of admission was employed. Based on the presence or absence of suicidal behavior in the past month, patients were divided into the attempted suicide group ( n=140) and the non-attempted suicide group ( n=302). Comparative analysis was performed on the sociodemographic characteristics, clinical features, endocrinological indices, and scores from the Eysenck Personality Questionnaire (EPQ), Short Form of the Family Environment Scale (FES-F), Adolescent Self-Rating Life Events Checklist (ASLEC), Childhood Trauma Questionnaire (CTQ), Multidimensional Anxiety Scale for Children (MASC), and Child Depression Inventory (CDI) between the two groups. Logistic regression was utilized to identify risk factors associated with suicidal behavior. Results:The prevalence of suicidal behavior in the past month among adolescent inpatients with depression was 31.67% (140/442), and the lifetime prevalence was 53.8% (238/442). Compared to patients in the non-suicidal attempt group, those in the suicidal attempt group showed higher occurrences of psychotic symptoms, comorbid physical diseases, and past suicidal behaviors, respectively, at 46% (64/140) vs 26%(77/302), 34%(47/140) vs 21%(65/302), and 81% (114/140) vs 32%(98/302) (χ 2=18.00, 7.34, 91.94; all P<0.05). In terms of scale scores, patients in the suicidal attempt group, compared to those in the non-suicidal attempt group, had higher scores in the health adaptation factor in ASLEC, with[ M( Q1, Q3)] 6 (4, 9) vs 5(3, 8) (χ 2=2.13, P<0.05); higher scores in the somatic symptom factor in MASC, with 26 (19.25, 31) vs 24 (16, 29) (χ 2=2.50; P<0.05); and higher scores in the negative emotions, low self-esteem, interpersonal problems factors, and overall CDI score (χ 2=2.35; P<0.05). Regression analysis showed that psychotic symptoms ( OR=1.85, 95% CI: 1.13-3.02), comorbid physical illnesses ( OR=1.85, 95% CI: 1.09-3.14), and past suicidal behaviors ( OR=8.34, 95% CI: 5.01-13.88) were risk factors for recent suicidal behavior (all P<0.05). Conclusions:Among adolescent inpatients with depression, the past-month suicidal behavior and any suicidal behaviors in the past are pretty high. Previous suicidal behavior, presence of psychotic symptoms, and comorbid physical disease could be the risk factors for near-future suicidal behavior.

Objective:To investigate the prevalence of suicidal behaviors and their associated risk factors among adolescent inpatients with depression.Methods:A retrospective analysis of the medical records of 442 adolescent inpatients diagnosed with depression at Shenzhen Kangning Hospital from January 2016 to December 2022 was conducted. Among them, 64 were male and 358 were female. They range in age from 10 to 17. The MINI suicidal module assessment on the day of admission was employed. Based on the presence or absence of suicidal behavior in the past month, patients were divided into the attempted suicide group ( n=140) and the non-attempted suicide group ( n=302). Comparative analysis was performed on the sociodemographic characteristics, clinical features, endocrinological indices, and scores from the Eysenck Personality Questionnaire (EPQ), Short Form of the Family Environment Scale (FES-F), Adolescent Self-Rating Life Events Checklist (ASLEC), Childhood Trauma Questionnaire (CTQ), Multidimensional Anxiety Scale for Children (MASC), and Child Depression Inventory (CDI) between the two groups. Logistic regression was utilized to identify risk factors associated with suicidal behavior. Results:The prevalence of suicidal behavior in the past month among adolescent inpatients with depression was 31.67% (140/442), and the lifetime prevalence was 53.8% (238/442). Compared to patients in the non-suicidal attempt group, those in the suicidal attempt group showed higher occurrences of psychotic symptoms, comorbid physical diseases, and past suicidal behaviors, respectively, at 46% (64/140) vs 26%(77/302), 34%(47/140) vs 21%(65/302), and 81% (114/140) vs 32%(98/302) (χ 2=18.00, 7.34, 91.94; all P<0.05). In terms of scale scores, patients in the suicidal attempt group, compared to those in the non-suicidal attempt group, had higher scores in the health adaptation factor in ASLEC, with[ M( Q1, Q3)] 6 (4, 9) vs 5(3, 8) (χ 2=2.13, P<0.05); higher scores in the somatic symptom factor in MASC, with 26 (19.25, 31) vs 24 (16, 29) (χ 2=2.50; P<0.05); and higher scores in the negative emotions, low self-esteem, interpersonal problems factors, and overall CDI score (χ 2=2.35; P<0.05). Regression analysis showed that psychotic symptoms ( OR=1.85, 95% CI: 1.13-3.02), comorbid physical illnesses ( OR=1.85, 95% CI: 1.09-3.14), and past suicidal behaviors ( OR=8.34, 95% CI: 5.01-13.88) were risk factors for recent suicidal behavior (all P<0.05). Conclusions:Among adolescent inpatients with depression, the past-month suicidal behavior and any suicidal behaviors in the past are pretty high. Previous suicidal behavior, presence of psychotic symptoms, and comorbid physical disease could be the risk factors for near-future suicidal behavior.

Objective:To provide a promising and optimal laboratory susceptibility-testing method for the clinical usage of antibiotic (polymyxin), four susceptibility-testing methods were performed and the broth microdilution (BMD) was chosen as the gold standard.Methods:A total number of eighty-eight nonduplicate clinical Enterobacteriaceae specimes were collected from January to December of 2019 in the First Affiliated Hospital, Fujian Medical University. Among the clinical specimens, of which six strains were positive for mcr-1. The minimal inhibitory concentration (MIC) of polymyxin of the clinical specimens were examined by the following methods: (1) broth microdilution, (2) colistin broth disk elution, (3) Vitek-2?, (4)BD PhoenixTM,(5)commercial broth microdilution. With BMD as reference, essential agreement (EA), categorical agreement(CA), very major error(VME) and major error (ME) of polymyxins for different methods were analyzed. The Kappa-consistency testing, paired Chi-square testing and the Spearman-rank correlation testing were used to analyze the consistency between the four antimicrobial susceptibility testing methods and the gold standard.Results:Taking broth microdilution as reference, the EA of colistin broth disk elution, Vitek-2?, BD PhoenixTM, commercial broth microdilution were 94.32% (83/88), 92.05% (81/88), 90.90% (80/88), and 96.59%(85/88), respectively. The CA of all the four methods were 100% (88/88). No VME and ME were recorded for four methods. Moreover, the consistency between four susceptibility testing methods and the gold standard is acceptable (Kappa values=1, P<0.001, McNemar test P=1 and r>0.5, P<0.05). Conclusions:In the present work, four susceptibility testing methods all met the standards recommended jointly by the Clinical and Laboratory Standards Institute and European Committee on Antimicrobial Susceptibility Testing, of which the performance of the commercial broth microdilution and CBDE fared relatively well. Thus, these four methods could be routinely used in clinical microbiology laboratory of our hospital for colistin and polymyxin B susceptibility testing.

OBJECTIVE：To reference for the rational use of sodium va lproate in clinic. METHODS ：By retrospective analysis，blood concentration monitoring results of sodium valproate and medical record data in 856 patients were collected from the Affiliated Tianyou Hospital of Wuhan University of Science and Technology during Jan. 2016-Dec. 2018. The dosage form of sodium valproate ，monitoring times of therapeutic drugs ，monitoring results of steady-state blood concentration of sodium valproate up to the standard ，dosage adjustment and the combination with carbamazepin ，fluconazol and carbapenem drugs were analyzed. Fisher exact test was used to analyze the factors influencing the steady-state blood concentration of sodium valproate up to the standard. RESULTS ：A total of 1 270 cases of sodium valproate were monitored in 856 patients，involving 407 males and 449 females，with age of （38.2±13.8）years and body mass of （52.3±10.0）kg. Among 1 270 cases of monitoring ，steady-state blood concentration of sodium valproate in 554 cases were in the range of 50-100 µg/mL，and 43.6％ of which reached the standard. The rate of reaching the standard in patients with multiple monitoring was higher than patients with single monitoring ；the dosage of patients with last monitoring reaching the standard was higher than that of patients with the first monitoring reaching the standard. The rate of reaching the standard in Sodium valproate sustained-release tablet group was higher than general Sodium valproate tablet group；the carbamazepin/fluconazol free group was higher than the carbamazepin combination group and fluconazol combination group；the carbapenem free group was higher than the carbapenem combination group （all P＜0.05）. CONCLUSIONS ：Clinical pharmacists should pay attention to the monitoring of sodium valproate treatment drugs ， strengthen the publicity and 3551851542@qq.com education of patients and their families ，and try to use Sodium valproate sustained-release tablets. When patients additionally receive carbapenem drugs like carbamazepin or fluconazol ， the standard level of sodium valproate will be reduced ，then the dosage of sodium valproate should be adjusted.

Objective: To understand the relationship between screen time and dietary behaviors among urban middle school students in Guangzhou, and to provide scientific evidence for improving students’ health. Methods: Based on the regular medical examinations for elementary and middle school students in Guangzhou, a total of 12 357 middle school students (grade 7 and grade 10) were investigated by using a cross-sectional study. The physical indicators and daily routine were collected by physical examination and questionnaire survey. Multiple Logistic regression analysis was used to explore the association between screen time and dietary behaviors among students. Results: The proportion of excessive screen time was 18.80% (2 323). There was no significant difference between boys (18.52%, 1 165/6 292) and girls (19.09%, 1 158/6 065) (χ2=0.67, P>0.05). Logistic regression results showed that excessive screen time was negatively associated with consumption of vegetables and fruits, with the aORs of 0.50 (95%CI=0.42-0.58) and 0.64 (95%CI=0.58-0.70) respectively, and positively associated with consumption of fried food (OR=1.90, 95%CI=1.70-2.09), western fast food (OR=1.90, 95%CI=1.65-2.19), sweets (OR=1.36, 95%CI=1.25-1.49) and sugar-sweetened beverage (OR=1.70, 95%CI=1.57-1.84). Conclusion Excessive screen time was associated with unhealthy dietary behaviors among middle school students in Guangzhou. Intervention should be tailored to screen time as well as dietary behaviors.