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*

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To explore predictive value of quantitative evaluation of shear wave ultrasonic elastography(SWUE)on the hardness of soleus muscle for short-term progress of the distal deep venous thrombosis(DVT)of lower extremities.Methods:A total of 100 DVT patients who admitted to the second hospital of Zhangjiakou from January 2021 to December 2023 were retrospectively selected,and they were divided into group with progress(n=45)and group without progress(n=55)according to the results of the ultrasonic reexamination of blood vessels of lower extremities at the 2nd week after they were confirmed.Univariate and multivariate logistics regression analysis were used to analyze the influencing factors for short-term progress of DVT patients.Receiver operating characteristic(ROC)curve was drawn to analyze the applied value of SWUE quantitative assessment for the hardness of soleus muscle in predicting the short-term progress of DVT patients.The coagulation indicators of the two groups before and after treatment were further compared.Results:There were no significant differences between the two groups in cholesterol,neutrophil count,platelet count,central venous catheterization,bed rest,history of thrombosis,injury of vascular wall,and history of surgery for lower limb(P>0.05).The average hardness values of soleus muscle of group with progress and group without progress were respectively(6.46±1.15)kPa and(5.42±1.13)kPa,and the difference of that between two groups was significant(t=4.542,P<0.05).Multivariate logistics regression analysis showed that hardness of soleus muscle was the independent risk factor for short-term progress of DVT patients(OR=3.135,P<0.05).The results of ROC analysis showed that the area under curve(AUC)value of the hardness of soleus muscle in predicting short-term progress of DVT patients was 0.9074(95%CI:0.8175～0.9972),and the best cutoff value was 0.70,and the sensitivity and the specificity were respectively 78.26%and 91.30%at this time.Before treatment,there were no significant differences in the comparison of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT)and D-dimer(D-dimer)between the two groups of patients(P>0.05).After treatment,the PT,APTT and TT levels of patients in the group without progress were respectively higher than those in the group with progress,and the D-dimer level was lower than that in the group with progress,there was a statistically significant difference between the two groups(t=3.568,15.176,4.091,9.981,P<0.05),respectively.Conclusion:SWUE quantitative evaluation for the hardness of soleus muscle has a favorable predictive value for the short-term progress of distal DVT of lower extremities,which is contribute to early find the DVT short-term progress,thus can timely adopt intervention measure,and reduce the risk of complication,and improve the prognosis.

Objective To understand the current status of knowledge-attitude-practice(KAP)regarding risk of medication safety behavior among cancer patients in western Yunnan and the related influencing factors,and to provide a basis for conducting rational medication education.Methods Using an approximate random sampling method,a KAP survey on medication safety behavior was conducted among inpatients and outpatients with cancer(aged over 18 years)in multiple hospitals in western Yunnan through online and offline questionnaires.Multiple linear regression analysis was used to explore the impact of different characteristics of the research objects on the KAP scores concerning medication knowledge,behavior,and attitude.Results A total of 512 valid questionnaires were collected.The average scores of medication knowledge,attitude,and behavior among cancer patients were(82.53±23.07),(41.98±8.64),and(67.88±10.08),respectively.Medication knowledge and behavior were at a good level,while medication attitude was at a qualified level.The multiple linear regression results showed that the educational level was a significant influencing factor of the medication knowledge and attitude scores(P＜0.001).Conclusion The overall medication safety among cancer patients in western Yunnan is in a good state,however,there is a need for improvement in medication attitudes.Educational level is the main factor affecting medication safety risk.Pharmacy services should be focused on cancer patients with lower educational levels to enhance their medication safety.

Objective To understand the current status of knowledge-attitude-practice(KAP)regarding risk of medication safety behavior among cancer patients in western Yunnan and the related influencing factors,and to provide a basis for conducting rational medication education.Methods Using an approximate random sampling method,a KAP survey on medication safety behavior was conducted among inpatients and outpatients with cancer(aged over 18 years)in multiple hospitals in western Yunnan through online and offline questionnaires.Multiple linear regression analysis was used to explore the impact of different characteristics of the research objects on the KAP scores concerning medication knowledge,behavior,and attitude.Results A total of 512 valid questionnaires were collected.The average scores of medication knowledge,attitude,and behavior among cancer patients were(82.53±23.07),(41.98±8.64),and(67.88±10.08),respectively.Medication knowledge and behavior were at a good level,while medication attitude was at a qualified level.The multiple linear regression results showed that the educational level was a significant influencing factor of the medication knowledge and attitude scores(P＜0.001).Conclusion The overall medication safety among cancer patients in western Yunnan is in a good state,however,there is a need for improvement in medication attitudes.Educational level is the main factor affecting medication safety risk.Pharmacy services should be focused on cancer patients with lower educational levels to enhance their medication safety.

Objective:To explore predictive value of quantitative evaluation of shear wave ultrasonic elastography(SWUE)on the hardness of soleus muscle for short-term progress of the distal deep venous thrombosis(DVT)of lower extremities.Methods:A total of 100 DVT patients who admitted to the second hospital of Zhangjiakou from January 2021 to December 2023 were retrospectively selected,and they were divided into group with progress(n=45)and group without progress(n=55)according to the results of the ultrasonic reexamination of blood vessels of lower extremities at the 2nd week after they were confirmed.Univariate and multivariate logistics regression analysis were used to analyze the influencing factors for short-term progress of DVT patients.Receiver operating characteristic(ROC)curve was drawn to analyze the applied value of SWUE quantitative assessment for the hardness of soleus muscle in predicting the short-term progress of DVT patients.The coagulation indicators of the two groups before and after treatment were further compared.Results:There were no significant differences between the two groups in cholesterol,neutrophil count,platelet count,central venous catheterization,bed rest,history of thrombosis,injury of vascular wall,and history of surgery for lower limb(P>0.05).The average hardness values of soleus muscle of group with progress and group without progress were respectively(6.46±1.15)kPa and(5.42±1.13)kPa,and the difference of that between two groups was significant(t=4.542,P<0.05).Multivariate logistics regression analysis showed that hardness of soleus muscle was the independent risk factor for short-term progress of DVT patients(OR=3.135,P<0.05).The results of ROC analysis showed that the area under curve(AUC)value of the hardness of soleus muscle in predicting short-term progress of DVT patients was 0.9074(95%CI:0.8175～0.9972),and the best cutoff value was 0.70,and the sensitivity and the specificity were respectively 78.26%and 91.30%at this time.Before treatment,there were no significant differences in the comparison of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT)and D-dimer(D-dimer)between the two groups of patients(P>0.05).After treatment,the PT,APTT and TT levels of patients in the group without progress were respectively higher than those in the group with progress,and the D-dimer level was lower than that in the group with progress,there was a statistically significant difference between the two groups(t=3.568,15.176,4.091,9.981,P<0.05),respectively.Conclusion:SWUE quantitative evaluation for the hardness of soleus muscle has a favorable predictive value for the short-term progress of distal DVT of lower extremities,which is contribute to early find the DVT short-term progress,thus can timely adopt intervention measure,and reduce the risk of complication,and improve the prognosis.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To investigate the diagnostic value of superb microvascular imaging(SMI)grading,CT angiography(CTA),and serum small and dense low-density lipoprotein cholesterol(sdLDL-C)in elderly hypertension patients with acute cerebral infarction(ACI).Methods A ret-rospective study was conducted on 180 elderly hypertension patients admitted to our hospital from June 2021 to June 2023,and those admitted due to ACI were assigned into ACI group(95 cases)and those without into non-ACI group(85 cases).The SMI grade,CTA,and serum sdLDL-C level were compared between the two groups.ROC curve was plotted to analyze the diagnostic value of SMI grading and CTA combined with serum sdLDL-C for ACI in patients with hyperten-sion.Multivariate logistic regression analysis was employed to analyze the factors affecting the oc-currence of ACI in the patients.Results The ACI group had significantly larger proportion of hy-perlipidemia,and higher DBP,SBP,and HDL-C,and LDL-C than the non-ACI group(P＜0.05).The proportion of SMI grade 2 and grade 3 and serum sdLDL-C level were also greatly higher[35.79％vs 10.59％,43.16％vs 8.24％,(1.62±0.25)mmol/L vs(1.35±0.19)mmol/L,P＜0.01],and the proportion of SMI grade 0 and grade 1 was lower(11.58％vs 51.76％,9.47％vs 29.41％,P＜0.01)in the ACI group than the non-ACI group.ROC curve analysis showed that the AUC value of SMI grade and CTA combined with serum sdLDL-C in diagnosing ACI in patients with hypertension was 0.934(95％CI:0.897-0.972).Multivariate logistic regression analysis in-dicated that SMI grade,CTA,and sdLDL-C were risk factors for ACI in hypertensive patients(P＜0.01).Conclusion Combination of carotid artery plaque SMI grading,CTA,and serum sdLDL-C has high auxiliary diagnostic value for elderly hypertension patients with ACI.

Objective To explore the role of breast/ovarian cancer susceptibility gene 1 associated protein 1(BAP1)in the occurrence and progression of human malignant glioma and the feasibility of BAP1 as a clinical diagnostic marker for malignant glioma.Methods The differential expression of BAP1 in normal and glioma tissue was analyzed based on the GSE4290 and GSE90598 sub-datasets from the gene expression omnibus(GEO)database.Receiver operating characteristic(ROC)curve analysis was conducted to assess the early diagnostic value of BAP1 for malignant glioma.Primary lesion tissues from 28 nonpaired malignant glioma patients and non-tumor brain tissues removed by internal decompression surgery in 5 patients with traumatic brain injury collected independently were collected,and the expression levels of BAP1 were measured using quantitative real-time polymerase chain reaction(qRT-PCR).Specific small interfering RNAs(siRNAs)targeting BAP1 were transiently transfected into U251 cells to further evaluate their interference efficiency.Flow cytometry was employed to analyze changes in the cell cycle and apoptosis of U251 cells with BAP1 knockdown.Results The results of bioinformatics showed that the expression of BAP1 in malignant glioma tissues was lower than that in normal brain tissues(GSE 4290:1 209±18.49 vs 1 476±53.90,GSE 90598:5.19±0.10 vs 5.65±0.21),and the differences were significant(t=5.115,2.267,all P<0.05).ROC curve showed that BAP1 could efficiently differentiate malignant glioma tissue from normal brain tissue(GSE4290:AUC=0.78,GSE90598:AUC=0.75,all P<0.05).The expression level of BAP1 in primary malignant glioma tissue was lower than that in normal brain tissue(0.27±0.04 vs 1.06±0.07),and the difference was significant(t=10.22,P<0.001).After down-regulating the expression of BAP1 in U251 cells,the proportion of S phase cells increased from 17.59%to 27.21%(siBAP1-1)and 25.79%(siBAP1-2),respectively,and the differences were significant(t=6.576,6.642,all P<0.01).However,the apoptosis levels decreased from 10.17%to 2.70%(siBAP-1)and 3.00%(siBAP-2),respectively,and the differences were significant(t=10.31,9.428,all P<0.01).Conclusion Histone H2A deubiquitinase BAP1 could exert the function of tumor suppressor genes by inhibiting rapid cell cycle progression and promoting apoptosis in malignant glioma,and could serve as a potential clinical diagnostic biomarker for malignant glioma.

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.