1.Gallstones, cholecystectomy, and cancer risk: an observational and Mendelian randomization study.
Yuanyue ZHU ; Linhui SHEN ; Yanan HUO ; Qin WAN ; Yingfen QIN ; Ruying HU ; Lixin SHI ; Qing SU ; Xuefeng YU ; Li YAN ; Guijun QIN ; Xulei TANG ; Gang CHEN ; Yu XU ; Tiange WANG ; Zhiyun ZHAO ; Zhengnan GAO ; Guixia WANG ; Feixia SHEN ; Xuejiang GU ; Zuojie LUO ; Li CHEN ; Qiang LI ; Zhen YE ; Yinfei ZHANG ; Chao LIU ; Youmin WANG ; Shengli WU ; Tao YANG ; Huacong DENG ; Lulu CHEN ; Tianshu ZENG ; Jiajun ZHAO ; Yiming MU ; Weiqing WANG ; Guang NING ; Jieli LU ; Min XU ; Yufang BI ; Weiguo HU
Frontiers of Medicine 2025;19(1):79-89
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
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Mendelian Randomization Analysis
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Gallstones/complications*
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Female
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Male
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Cholecystectomy/statistics & numerical data*
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Middle Aged
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Risk Factors
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Aged
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Adult
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Neoplasms/etiology*
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Stomach Neoplasms/epidemiology*
2.Dietary nutrition status and nutritional intervention strategy of 1302 patients with Alzheimer's disease
Yufang WANG ; Yuanfang ZHAO ; Xiaomei HAO ; Yining LIANG
Journal of Public Health and Preventive Medicine 2025;36(2):47-51
Objective To explore the dietary nutrition status and nutritional intervention strategy of patients with Alzheimer’s disease (AD). Methods Among the 1 332 patients with AD diagnosed at Xijing Hospital from January 2021 to December 2023 were enrolled as the study subjects. The dietary intake data of patients were collected through questionnaire surveys and dietary reviews. During the study period, 30 patients did not complete the intervention due to withdrawal or loss of follow-up. Based on the actual number of people who completed the intervention, AD patients were randomly divided into intervention group (n=651, individualized nutritional intervention strategy) and control group (n=651, routine nutritional intervention), and both groups were intervened for 3 months. The cognitive function (MMSE score and MoCA score), nutritional status (MNA scale, NRS-2002 scale), and quality of life (GQOL-74) of the two groups of AD patients were compared to evaluate the effectiveness of the intervention strategies. Results A total of 1 332 questionnaires were distributed, and 1 302 valid questionnaires were finally recovered, with an effective recovery rate of 97.75% (1 302/1 332). The survey results showed that there were no statistical differences in baseline characteristics and dietary nutrition status between the two groups of AD patients before intervention (P>0.05). After nutritional intervention, the cognitive function, quality of life, and nutritional status of patients in the intervention group were significantly improved. The MMSE score, MoCA score, MNA score, and GQOL-74 score of the intervention group were significantly higher than those of the control group, while the NRS-2002 score was lower than that of the control group (P<0.05). Conclusion Nutritional intervention strategy has a significant effect on improving nutritional status, cognitive function, and quality of life of AD patients.
3.A survey on the current status of gynecological and breast diseases among 13 031 women in Pudong New Area, Shanghai in 2023
Lu LI ; Xichang ZHAO ; Yuwei ZHANG ; Yufang YE
Shanghai Journal of Preventive Medicine 2025;37(2):160-163
ObjectiveTo investigate the prevalence of gynecological and breast diseases among retired or economically disadvantaged women in part of Pudong New Area of Shanghai under the policy support of screening gynecological diseases and breast diseases for retired and women with economic difficulties in life in Shanghai, to analyze the characteristics of these diseases, so as to provide a scientific basis for the improvement of relevant prevention and treatment strategies. MethodsBased on the gynecological census data of 13 031 cases in five towns, including Xinchang Town, Xuanqiao Town, Laogang Town, Wanxiang Town and Shuyuan Town, conducted by Shanghai Pudong Hospital in 2023, descriptive analysis methods were used to explore the prevalence and age characteristics of common gynecological and breast diseases. ResultsThe total detection rate of gynecological and breast diseases among women in the screening area in this study was 68.29%, with uterine fibroid (22.35%), sarcoidosis of the breast (17.06%), cervicitis (15.37%), vaginitis (8.39%) and ovarian cyst (2.61%) ranking the top 5 in the detection rate among the screening population. The differences of the detection rates in the four major diseases [uterine fibroid (χ2=233.217, P<0.001), breast nodules(χ2=169.896, P<0.001), cervicitis (χ2=388.683, P<0.001), and ovarian cysts (χ2=72.298, P<0.001)] by different age groups were statistically significant (P<0.05) . Moreover, the results of pairwise comparison of different age groups showed that the detection rates in the age group under 45 years old and 45‒55 years old were higher than that in the age group of 55‒65 years old and over 65 years old. ConclusionThe detection rate of gynecological and breast diseases in the younger age group was higher, indicating a certain trend of younger onset of diseases. Uterine fibroid, sarcoidosis of the breast , and reproductive tract diseases such as cervicitis, vaginitis, and ovarian cyst are the main diseases affecting the research subjects. Therefore, medical institutions can combine routine work in screening diseases and carry out corresponding health education and health promotion activities for these key diseases to improve women’s health.
4.Guideline for Adult Weight Management in China
Weiqing WANG ; Qin WAN ; Jianhua MA ; Guang WANG ; Yufan WANG ; Guixia WANG ; Yongquan SHI ; Tingjun YE ; Xiaoguang SHI ; Jian KUANG ; Bo FENG ; Xiuyan FENG ; Guang NING ; Yiming MU ; Hongyu KUANG ; Xiaoping XING ; Chunli PIAO ; Xingbo CHENG ; Zhifeng CHENG ; Yufang BI ; Yan BI ; Wenshan LYU ; Dalong ZHU ; Cuiyan ZHU ; Wei ZHU ; Fei HUA ; Fei XIANG ; Shuang YAN ; Zilin SUN ; Yadong SUN ; Liqin SUN ; Luying SUN ; Li YAN ; Yanbing LI ; Hong LI ; Shu LI ; Ling LI ; Yiming LI ; Chenzhong LI ; Hua YANG ; Jinkui YANG ; Ling YANG ; Ying YANG ; Tao YANG ; Xiao YANG ; Xinhua XIAO ; Dan WU ; Jinsong KUANG ; Lanjie HE ; Wei GU ; Jie SHEN ; Yongfeng SONG ; Qiao ZHANG ; Hong ZHANG ; Yuwei ZHANG ; Junqing ZHANG ; Xianfeng ZHANG ; Miao ZHANG ; Yifei ZHANG ; Yingli LU ; Hong CHEN ; Li CHEN ; Bing CHEN ; Shihong CHEN ; Guiyan CHEN ; Haibing CHEN ; Lei CHEN ; Yanyan CHEN ; Genben CHEN ; Yikun ZHOU ; Xianghai ZHOU ; Qiang ZHOU ; Jiaqiang ZHOU ; Hongting ZHENG ; Zhongyan SHAN ; Jiajun ZHAO ; Dong ZHAO ; Ji HU ; Jiang HU ; Xinguo HOU ; Bimin SHI ; Tianpei HONG ; Mingxia YUAN ; Weibo XIA ; Xuejiang GU ; Yong XU ; Shuguang PANG ; Tianshu GAO ; Zuhua GAO ; Xiaohui GUO ; Hongyi CAO ; Mingfeng CAO ; Xiaopei CAO ; Jing MA ; Bin LU ; Zhen LIANG ; Jun LIANG ; Min LONG ; Yongde PENG ; Jin LU ; Hongyun LU ; Yan LU ; Chunping ZENG ; Binhong WEN ; Xueyong LOU ; Qingbo GUAN ; Lin LIAO ; Xin LIAO ; Ping XIONG ; Yaoming XUE
Chinese Journal of Endocrinology and Metabolism 2025;41(11):891-907
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.
5.Role of ferroptosis in reduction of intestinal ischemia-reperfusion injury by sodium butyrate pretreatment in mice
Zicen ZHAO ; Yufang LENG ; Liya CHANG ; Yu WANG ; Dongbin LI ; Yang XING ; Yuxuan WU
Chinese Journal of Anesthesiology 2025;45(2):203-207
Objective:To evaluate the role of ferroptosis in reduction of intestinal ischemia-reperfusion injury (IRI) by sodium butyrate pretreatment in mice.Methods:Thirty SPF healthy male C57BL/6 mice, aged 6-8 weeks, weighing 20-23 g, were divided into 5 groups ( n=6 each) using a random number table method: sham operation group (S group), intestinal IRI group (IR group), intestinal IRI + sodium butyrate pretreatment group (IN group), intestinal IRI + sodium butyrate pretreatment+ FER-1 group (INF group), and intestinal IRI + sodium butyrate pretreatment + Erastin group (INE group). The intestinal IRI model was established by occluding the superior mesenteric artery for 45 min followed by reperfusion for 30 min in S group. In IN, INF and INE groups, sodium butyrate was administered by gavage at a dose of 500 mg/kg daily at 1 week before developing the model, while the equal volume of normal saline was given by gavage in the other two groups. The ferroptosis inhibitor FER-1 5 mg/kg and ferroptosis agonist Erastin 30 mg/kg were intraperitoneally injected at 1 h prior to ischemia in INF and INE groups. Mice were sacrificed after anesthesia at the end of reperfusion to obtain small intestinal tissues for examination of the pathological changes (using light microscopy) which were scored according to Chiu and for determination of the contents of Fe 2+, malondialdehyde (MDA), glutathione (GSH) and glutathione disulfide(GSSG) (by enzyme-linked immunosorbent assay), expression of glutathione peroxidase 4 (GPX4), solute carrier family 7 member 11 (SLC7A11), and ferritin heavy chain 1 (FTH1) (by Western blot). The ratio of GSH to GSSG was calculated. Results:Compared to S group, Chiu′s scores and contents of MDA and Fe 2+ were significantly increased, the expression of GSH, GPX4, FTH1 and SLC7A11 was down-regulated, and the GSH/GSSG ratio was decreased in IR group ( P<0.001). Compared to IR group, Chiu′s scores and contents of MDA and Fe 2+ were significantly decreased, the expression of GSH, GPX4, FTH1 and SLC7A11 was up-regulated, and the GSH/GSSG ratio was increased in IN and INF groups ( P<0.001). Compared to IN group, Chiu′s scores and contents of MDA and Fe 2+ were significantly increased, the expression of GSH, GPX4, FTH1 and SLC7A11 was down-regulated, and the GSH/GSSG ratio was decreased in INE group ( P<0.001). Conclusions:Ferroptosis is involved in sodium butyrate pretreatment-induced reduction of intestinal I/RI in mice.
6.Sinicization and psychometric properties of adolescent personality structure questionnaire among Chinese adolescents
Ling ZHANG ; Meng LI ; Yufang ZHAO ; Keyu PU ; Jie LUO
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(11):1043-1050
Objective:To sinicize the adolescent personality structure questionnaire(APS-Q), and to examine the psychometric properties of APS-Q among Chinese adolescents.Methods:APS-Q was sinicized and the Chinese version of APS-Q was used for investigation.A sample of 1 207 adolescents were investigated firstly and randomly divided into sample 1 ( n1=590) and sample 2 ( n2=617) for exploratory factor analysis and confirmatory factor analysis, respectively. Moreover, the sample 3 ( n3=420) was collected to conduct confirmatory factor analysis for the second time.Sample 4( n4=83) was used to assess the test-retest reliability of APS-Q. The Chinese big five personality inventory-15 (CBF-PI-15), generalized anxiety disorder-7 (GAD-7) and patient health questionnaire-9 (PHQ-9) were used as criterion tools. Both SPSS 21.0 and Mplus 7.4 software were used for the data analysis. Results:Item analysis showed that the CITCs for items 27, 31 and 35 were low.Exploratory factor analysis suggested that after deleting items 3, 4, 21, 22, 24, 25, 26, 27, 31 and 35, the revised APS-Q was consisted with 25 items, covering 6 dimensions, which were investment and goals, aggression, sense of self, relationship with family, relationship with friends, and self-acceptance, respectively. Confirmatory factor analysis supported the six-factor model fitted well (sample 2: χ2/ df=1.94, RMSEA=0.04, CFI=0.94, TLI=0.93, and SRMR=0.05; sample 3: χ2/ df=2.12, RMSEA=0.05, CFI=0.95, TLI=0.92, and SRMR=0.06). Multigroup CFA indicated that the six-factor structure of APS-Q had strict measurement invariance across sex. The scores of APS-Q were significantly correlated with big five personality, depression, and anxiety(all P<0.05). The total score of APS-Q demonstrated satisfactory internal consistency (α=0.90, ω=0.90, split-half reliability=0.82, MIC=0.27) and test-retest reliability ( r=0.84), while the subscale scores of APS-Q showed acceptable internal consistencies (α=0.71-0.82, ω=0.72-0.82, split-half reliabilities=0.60-0.79, MIC=0.36-0.52) and test-retest coefficients ( r=0.66-0.77). Conclusion:The Chinese version of APS-Q can be used as a reliable and valid measurement to assess personality function for Chinese adolescents.
7.Sinicization and psychometric properties of adolescent personality structure questionnaire among Chinese adolescents
Ling ZHANG ; Meng LI ; Yufang ZHAO ; Keyu PU ; Jie LUO
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(11):1043-1050
Objective:To sinicize the adolescent personality structure questionnaire(APS-Q), and to examine the psychometric properties of APS-Q among Chinese adolescents.Methods:APS-Q was sinicized and the Chinese version of APS-Q was used for investigation.A sample of 1 207 adolescents were investigated firstly and randomly divided into sample 1 ( n1=590) and sample 2 ( n2=617) for exploratory factor analysis and confirmatory factor analysis, respectively. Moreover, the sample 3 ( n3=420) was collected to conduct confirmatory factor analysis for the second time.Sample 4( n4=83) was used to assess the test-retest reliability of APS-Q. The Chinese big five personality inventory-15 (CBF-PI-15), generalized anxiety disorder-7 (GAD-7) and patient health questionnaire-9 (PHQ-9) were used as criterion tools. Both SPSS 21.0 and Mplus 7.4 software were used for the data analysis. Results:Item analysis showed that the CITCs for items 27, 31 and 35 were low.Exploratory factor analysis suggested that after deleting items 3, 4, 21, 22, 24, 25, 26, 27, 31 and 35, the revised APS-Q was consisted with 25 items, covering 6 dimensions, which were investment and goals, aggression, sense of self, relationship with family, relationship with friends, and self-acceptance, respectively. Confirmatory factor analysis supported the six-factor model fitted well (sample 2: χ2/ df=1.94, RMSEA=0.04, CFI=0.94, TLI=0.93, and SRMR=0.05; sample 3: χ2/ df=2.12, RMSEA=0.05, CFI=0.95, TLI=0.92, and SRMR=0.06). Multigroup CFA indicated that the six-factor structure of APS-Q had strict measurement invariance across sex. The scores of APS-Q were significantly correlated with big five personality, depression, and anxiety(all P<0.05). The total score of APS-Q demonstrated satisfactory internal consistency (α=0.90, ω=0.90, split-half reliability=0.82, MIC=0.27) and test-retest reliability ( r=0.84), while the subscale scores of APS-Q showed acceptable internal consistencies (α=0.71-0.82, ω=0.72-0.82, split-half reliabilities=0.60-0.79, MIC=0.36-0.52) and test-retest coefficients ( r=0.66-0.77). Conclusion:The Chinese version of APS-Q can be used as a reliable and valid measurement to assess personality function for Chinese adolescents.
8.Role of ferroptosis in reduction of intestinal ischemia-reperfusion injury by sodium butyrate pretreatment in mice
Zicen ZHAO ; Yufang LENG ; Liya CHANG ; Yu WANG ; Dongbin LI ; Yang XING ; Yuxuan WU
Chinese Journal of Anesthesiology 2025;45(2):203-207
Objective:To evaluate the role of ferroptosis in reduction of intestinal ischemia-reperfusion injury (IRI) by sodium butyrate pretreatment in mice.Methods:Thirty SPF healthy male C57BL/6 mice, aged 6-8 weeks, weighing 20-23 g, were divided into 5 groups ( n=6 each) using a random number table method: sham operation group (S group), intestinal IRI group (IR group), intestinal IRI + sodium butyrate pretreatment group (IN group), intestinal IRI + sodium butyrate pretreatment+ FER-1 group (INF group), and intestinal IRI + sodium butyrate pretreatment + Erastin group (INE group). The intestinal IRI model was established by occluding the superior mesenteric artery for 45 min followed by reperfusion for 30 min in S group. In IN, INF and INE groups, sodium butyrate was administered by gavage at a dose of 500 mg/kg daily at 1 week before developing the model, while the equal volume of normal saline was given by gavage in the other two groups. The ferroptosis inhibitor FER-1 5 mg/kg and ferroptosis agonist Erastin 30 mg/kg were intraperitoneally injected at 1 h prior to ischemia in INF and INE groups. Mice were sacrificed after anesthesia at the end of reperfusion to obtain small intestinal tissues for examination of the pathological changes (using light microscopy) which were scored according to Chiu and for determination of the contents of Fe 2+, malondialdehyde (MDA), glutathione (GSH) and glutathione disulfide(GSSG) (by enzyme-linked immunosorbent assay), expression of glutathione peroxidase 4 (GPX4), solute carrier family 7 member 11 (SLC7A11), and ferritin heavy chain 1 (FTH1) (by Western blot). The ratio of GSH to GSSG was calculated. Results:Compared to S group, Chiu′s scores and contents of MDA and Fe 2+ were significantly increased, the expression of GSH, GPX4, FTH1 and SLC7A11 was down-regulated, and the GSH/GSSG ratio was decreased in IR group ( P<0.001). Compared to IR group, Chiu′s scores and contents of MDA and Fe 2+ were significantly decreased, the expression of GSH, GPX4, FTH1 and SLC7A11 was up-regulated, and the GSH/GSSG ratio was increased in IN and INF groups ( P<0.001). Compared to IN group, Chiu′s scores and contents of MDA and Fe 2+ were significantly increased, the expression of GSH, GPX4, FTH1 and SLC7A11 was down-regulated, and the GSH/GSSG ratio was decreased in INE group ( P<0.001). Conclusions:Ferroptosis is involved in sodium butyrate pretreatment-induced reduction of intestinal I/RI in mice.
9.Guideline for Adult Weight Management in China
Weiqing WANG ; Qin WAN ; Jianhua MA ; Guang WANG ; Yufan WANG ; Guixia WANG ; Yongquan SHI ; Tingjun YE ; Xiaoguang SHI ; Jian KUANG ; Bo FENG ; Xiuyan FENG ; Guang NING ; Yiming MU ; Hongyu KUANG ; Xiaoping XING ; Chunli PIAO ; Xingbo CHENG ; Zhifeng CHENG ; Yufang BI ; Yan BI ; Wenshan LYU ; Dalong ZHU ; Cuiyan ZHU ; Wei ZHU ; Fei HUA ; Fei XIANG ; Shuang YAN ; Zilin SUN ; Yadong SUN ; Liqin SUN ; Luying SUN ; Li YAN ; Yanbing LI ; Hong LI ; Shu LI ; Ling LI ; Yiming LI ; Chenzhong LI ; Hua YANG ; Jinkui YANG ; Ling YANG ; Ying YANG ; Tao YANG ; Xiao YANG ; Xinhua XIAO ; Dan WU ; Jinsong KUANG ; Lanjie HE ; Wei GU ; Jie SHEN ; Yongfeng SONG ; Qiao ZHANG ; Hong ZHANG ; Yuwei ZHANG ; Junqing ZHANG ; Xianfeng ZHANG ; Miao ZHANG ; Yifei ZHANG ; Yingli LU ; Hong CHEN ; Li CHEN ; Bing CHEN ; Shihong CHEN ; Guiyan CHEN ; Haibing CHEN ; Lei CHEN ; Yanyan CHEN ; Genben CHEN ; Yikun ZHOU ; Xianghai ZHOU ; Qiang ZHOU ; Jiaqiang ZHOU ; Hongting ZHENG ; Zhongyan SHAN ; Jiajun ZHAO ; Dong ZHAO ; Ji HU ; Jiang HU ; Xinguo HOU ; Bimin SHI ; Tianpei HONG ; Mingxia YUAN ; Weibo XIA ; Xuejiang GU ; Yong XU ; Shuguang PANG ; Tianshu GAO ; Zuhua GAO ; Xiaohui GUO ; Hongyi CAO ; Mingfeng CAO ; Xiaopei CAO ; Jing MA ; Bin LU ; Zhen LIANG ; Jun LIANG ; Min LONG ; Yongde PENG ; Jin LU ; Hongyun LU ; Yan LU ; Chunping ZENG ; Binhong WEN ; Xueyong LOU ; Qingbo GUAN ; Lin LIAO ; Xin LIAO ; Ping XIONG ; Yaoming XUE
Chinese Journal of Endocrinology and Metabolism 2025;41(11):891-907
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.
10.Analysis of gemcitabine adverse drug reactions and risk factors in Inner Mongolia
Shengnan YANG ; Wei SHI ; Yufang ZHAO ; Zhien LIU ; Wenpu LEI ; Yanan ZHANG ; Ke ZHAO ; Hao GUO
China Pharmacy 2025;36(4):486-490
OBJECTIVE To analyze the occurrence characteristics and risk factors of adverse drug reactions(ADR)of gemcitabine for injection in national centralized volume-based procurement(hereinafter referred to as"centralized procurement"),and provide reference for clinical safe drug use.METHODS A retrospective study was conducted to collect the relevant case reports of gemcitabine for injection reported to the National Adverse Drug Reaction Monitoring System by Inner Mongolia Autonomous Region from January 2022 to December 2023;basic information of patients,drug use status,patient outcomes,rational drug use and other information were collected,and the occurrence characteristics of ADRs with leukopenia,myelosuppression,neutropenia,thrombocytopenia and liver dysfunction were analyzed.Univariate analysis and multivariate Logistic regression were used to analyze the correlation of gender,age,combination of antitumor drugs,original malignant tumor and drug dose with ADR.RESULTS A total of 315 cases reports(315 patients)of gemcitabine-induced ADR were included in this study,with a male-to-female ratio of 1.42∶1 and age of(61.17±9.13)years.The primary malignant tumor was pancreatic cancer(73 cases,23.17%).Leukopenia,myelosuppression and nausea were the most common ADR,followed by neutropenia,thrombocytopenia,liver dysfunction and so on.The severity grade of ADR was mainly 1-2,and the outcome of most ADR was good.Multivariate Logistic regression analysis showed that combination of antitumor drugs was a risk factor for myelosuppression and neutropenia(RR=2.154,95%CI:1.218-3.807,P=0.008;RR=3.099,95%CI:1.240-7.744,P=0.016);gender(female)was a risk factor for leukopenia and liver dysfunction(RR=0.508,95%CI:0.302-0.853,P=0.010;RR=0.301,95%CI:0.102-0.887,P=0.029).In terms of drug use rationality,there were 143 cases(45.40%)of drug use in accordance with the indications of the label,and 172 cases(54.60%)of off-label drug use.Among them,the primary malignant tumors were bladder cancer,bile duct cancer and ovarian cancer,which ranked the top three off-label drug use.CONCLUSIONS The ADR caused by gemcitabine in Inner Mongolia is mainly in the blood and digestive systems.The severity of ADRs is mainly classified as 1-2 levels,and most ADRs have good outcomes.Gender(female)and combination medication are risk factors for gemcitabine-induced ADR.Appropriate chemotherapy regimen should be selected according to the patient's condition and physical condition,and ADR monitoring in blood and digestive systems should be strengthened during medication of gemcitabine.


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