Objective:To explore the causal association between insulin-like growth factor-1(IGF-1)and colorectal cancer(CRC)based on two sample Mendelian randomization(MR)analysis.Methods:A bidirectional two sample MR analysis was conducted based on publicly aggregated data from the IEU OpenGWAS project.The inverse variance weighted(IVW)method was used as the main analysis model to assess the causal relationship between IGF-1 and CRC.Additional analyses were performed using weighted median(WM),MR-Egger regression,weighted mode estimator(WME),and simple mode(SM)methods.Sensitivity analysis was performed to assess the robustness of the results.Results:A total of 386 single nucleotide polymorphisms(SNPs)were selected as instrumental variables(IVs)with IGF-1 as the exposure factor.The MR analysis results revealed a positive causal association between IGF-1 and the risk of CRC[odds ratio(OR)=1.178,95％confidence interval(CI):1.092-1.272)](P＜0.001),and the association remained significant after adjusting for height[OR(95％CI)=1.214(1.111,1.327)](P＜0.001).Cochran's Q-test showed heterogeneity among the IVs(P＜0.05),while the horizontal pleiotropy of IV was not detected by the MR-Egger regression(P＞0.05).The leave-one-out analysis showed that the MR results were robust.Reverse MR analysis indicated no reverse causal relationship between IGF-1 and CRC[OR(95％CI):1.017(0.997,1.037)](P=0.103).Conclusion:There is a causal relationship between IGF-1 level and CRC,and elevated IGF-1 level could be a risk factor for CRC.

Objective:To discuss the clinical efficacy of recombinant human growth hormone(rhGH)in the treatment of the pediatric patients with growth hormone deficiency(GHD)and idiopathic short stature(ISS),and to clarify its clinical application value in the pediatric patients with short stature of different etiologies.Methods:The clinical data of 132 children with short stature who treated with rhGH from January 2018 to January 2023 were collected.They were divided into GHD group(n=70)and ISS group(n=62)based on different etiologies.The bone age,target height(TH),body mass index(BMI),height standard deviation score(HtSDS),changes in height standard deviation scores(ΔHtSDS)before treatment and 6 months after treatment,and growth velocity(GV)of the pediatric patients were calculated.Propensity score matching(PSM)and inverse probability of treatment weighting(IPTW)were used to balance the confounding factors between the pediatric patients in two groups and the efficacy and safety of the pediatric patients in two groups were evaluated.Results:There were significant differences in whether children were full-term,bone age,bone age maturity,and TH of the pediatric patients between two groups(P<0.05).Compared with before treatment,the height and HtSDS of the pediatric patients in both GHD and ISS groups were significantly increased after treated for 6 months(P<0.05).Before matched by PSM,there were significant differences in full-term,bone age,bone age maturity,and TH of the pediatric patients between two groups(P<0.05).After matched by PSM,there were no significant differences in gender,region,term birth status,mode of delivery,feeding method,age,bone age,height,BMI,TH,and pretreatment HtSDS of the pediatric patients between two groups(P>0.05);the standardized mean difference(SMD)differences of covariates except for region were<0.2.After weighted by IPTW,there were no significant differences in gender,region,term birth status,mode of delivery,feeding method,age,bone age,height,BMI,TH,and pretreatment HtSDS of the pediatric patients between two groups(P>0.05);all SMD of covariates except for term birth status were<0.2.Before balancing covariates,after meatched by PSM matching,and after weighted by IPTW weighting compared with GHD group,the GV and ΔHtSDS of the pediatric patients in ISS group were slightly increased,but the difference was not significant(P>0.05).In terms of adverse reactions,2 cases(2.68%)of fasting hyperglycemia and 7 cases(10.00%)of hypothyroidism occurred in GHD group;3 cases(4.84%)of fasting hyperglycemia and 2 cases(3.23%)of hypothyroidism occurred in ISS group.Conclusion:rhGH can promote the height increase in the patients with GHD and ISS,and there is no significant difference in the height-increasing efficacy between GHD and ISS children.The incidence of adverse reactions is relatively low during treatment,indicating good overall safety.

Objective To screen differentially expressed genes in lung adenocarcinoma by constructing Lasso-Cox model to provide potential gene targets for the research of lung adenocarcinoma and new directions for clinical diagnosis,treatment and prognosis by calculating patient risk score and constructing prediction model of lung adenocarcinoma.Methods The gene expression and clinical data of lung adenocarcinoma were downloaded from the Cancer Genome Atlas(TCGA)and Gene Expression Omnibus database(GEO).The TCGA database was used to train model,and the two databases were combined for model validation.The screened differentially expressed genes(DEGs)of lung adenocarcinoma were analyzed by univariate Cox and multivariate Lasso-Cox to construct a risk score prognosis model.Risk score from the final Cox prediction model and clinical data were combined to determine independent prognostic factors.GO enrichment analysis,KEGG pathway analysis and CIBERSORTx immunoassay were used to evaluate the biological interpretation of differentially expressed genes in the risk model.Results The analysis using univarate Cox and Lasso-Cox regreesion identified 9 differentially expressed genes associated with the prognosis of lung adenocarcinoma.Multivariate Cox regression analysis,incorporating clinical data,revealed that a history of malignant tumors,N stage,T stage,and the risk score were independent prognostic factors.Conclusion The prognositic model of lung adenocarcinoma can effectively predict the prognosis risk and provide a theoretical basis for clinical decision-making and personalized treatment.

Objective To explore the prognostic factors of colorectal cancer patients in gene data using random survival forest model.Method The differentially expressed genes were screened using the gene expression data of colorectal cancer in TCGA database,and combined with clinical and survival information.The RSF model is constructed and compared with the traditional Lasso-Cox regression model.Results The RSF model obtained 13 important factors affecting the prognosis of colorectal cancer patients,including HAND1(VIMP=0.090)and PCOLCE2(VIMP=0.075)genes,and analyzed the interaction between pathological N,PCOLCE2 gene and IGSF9 gene variables.Compared with Lasso-Cox model,the RSF model has better model calibration(IBS:training set:0.205 vs.0.214;test set:0.210 vs.0.221)although its prediction error rate is slightly higher(1-C-index:training set:0.296 vs.0.213;test set:0.369 vs.0.332).Conclusion RSF model has a good performance in processing the analysis of right censored survival data,can find important influencing factors and the interaction between variables,and provide scientific basis for the improvement of prognosis and quality of life of colorectal cancer patients.