To investigate the causal association between estrogen and breast cancer incidence and mortality risk.

Using summary data from genome-wide association studies, with estradiol representing estrogen, genetic variants associated with estradiol were utilized as instrument variables.Employing the univariate Mendelian randomization method, the causal association between estradiol and the risk ofincidence (4 outcomes), as well as the risk of mortality (6 outcomes) of female breast cancer and its subtypes, were assessed by the inverse variance-weighted method.

The results revealed that elevated levels of estradiol (≥175 pmol/L)were associated with an increased risk of overall breast cancer (OR=1.43,95% CI:1.27-1.60,P=2.92×10^-9), estrogen receptor-negative breast cancer (OR=1.41, 95% CI:1.25-1.60, P=2.16×10^-8), and estrogen receptor-positive breast cancer (OR=1.49, 95% CI:1.29-1.72, P=6.92×10^-8) incidence. However, there was no evidence that elevated levels of estradiol were the risk factors for triple-negative breast cancer incidence. Moreover, overall breast cancer and its subtypes mortality risks were not shown to be causally related to estradiol.

Elevated estrogen levels (≥175 pmol/L) are associated with an increased risk of overall breast cancer, estrogen receptor-negative breast cancer, and estrogen receptor-positive breast cancer incidence.

To investigate the relationship between 24-hour urinary sodium, urinary potassium, sodium-potassium ratio and microalbuminuria among people in elderly care institutions.

Questionnaire survey, physical examination, blood and 24 h urine samples collection were carried out in the elderly people of 16 elderly care institutions in southeastern Shanxi from September 2017 to November 2017, which were selected using the random cluster sampling method. A multivariate logistic regression model was used to analyze the association between 24 h urinary sodium excretion, urinary potassium excretion, sodium-potassium ratio and MAU.

A total of 502 subjects including 467 males (93.03%) and 33 MAU (6.57%) were included in this study (average age: 65.77±8.54 years old). The 24 h urinary sodium excretion was (193.02±87.64) mmol, urinary potassium excretion was (27.95±15.02) mmol, and the sodium-potassium ratio was (7.44±2.62), respectively. Multivariate logistic regression analysis showed that group with the highest urinary sodium excretion and the sodium-potassium ratio (Q4) compared to the lowest group (Q1) was associated with an increased risk of MAU (OR=4.026, 95% CI: 1.045-15.515; OR=4.043, 95% CI: 1.252-13.057).

The 24-hour urinary sodium and sodium-potassium ratio are positively associated with the prevalence of MAU, while 24-hour urinary potassium is not related to the prevalence of MAU.

To explore the longitudinal bidirectional relationship between depressive symptoms and HIV infection risk behaviors among young men who have sex with men (YMSM).

A longitudinal study design was used to recruit 489 YMSM from September 2017 to January 2018 (T1), and two follow-up surveys were completed from July to September 2018 (T2) and from June to July 2019 (T3), respectively. The cross-lagged path analysis model was used to analyze the causality, time series relationship and interactive direction between depressive symptoms and HIV infection risk behaviors.

Data of 347 YMSM were analyzed using cross-lagged path analysis. The results showed that T1 depressive symptoms significantly and positively predicted T2 HIV infection risk behaviors (β=0.071, 95% CI: 0.000-0.142), and T2 depressive symptoms significantly and positively predicted T3 HIV infection risk behaviors (β=0.072, 95% CI: 0.000-0.143). However, T1 HIV infection risk behaviors did not significantly predict T2 depressive symptoms and T2 HIV infection risk behaviors did not significantly predict T3 depressive symptoms.

Depressive symptoms among YMSM significantly and positively predicted HIV infection risk behaviors, with a unidirectional causal temporal relationship. Therefore, the level of depressive symptoms should be considered as an essential factor in HIV infection risk behavior interventions for YMSM.

To evaluate the dose-response relationship between obesity indicators and cholelithiasis in minority populations in Qiannan and Qiandongnan regions of Guizhou Province.

Based on the cross-sectional survey data of the "China Multi-ethnic Cohort Study", 17 084 adults aged 30-79 from the Buyi, Dong and Miao ethnic groups in Qiannan and Qiandongnan regions of Guizhou Province were included. The association between obesity indicators and cholelithiasis was analyzed using logistic regression models, and their dose-response relationship with cholelithiasis was studied using restricted cubic spline models.

The overall prevalence of cholelithiasis in Qiannan and Qiandongnan regions was 9.0%, with women at 9.6% higher than men at 7.5%. There were statistically significant differences between the cholelithiasis group and the non-cholelithiasis group in terms of gender, age, ethnicity, smoking history, hypertension, hyperlipidemia, BMI, LAP, VAI, WHtR, WHR, WC, weight, TG, HDL-C and GLU (P<0.001). Compared to the non-cholelithiasis group, the cholelithiasis group had higher age, weight, TG, GLU, BMI, VAI, LAP, WHtR, WHR, WC. In the logistic regression model, after adjusting for confounding factors, BMI, WC, WHtR, LAP, WHR were all statistically significant. As the values of obesity indicators increased, the risk of cholelithiasis also increased. Further analysis of their dose-response relationship revealed a nonlinear increasing trend in the association strength with cholelithiasis as the levels of BMI (P Nonlinear=0.004 6), LAP (P Nonlinear=0.000 4), WC (P Nonlinear=0.042 2), WHR (P Nonlinear=0.021) increased. As the level of WHtR (P Nonlinear=0.210 7) increased, the association strength with cholelithiasis showed a linear increasing trend.

Among the ethnic minorities in the Qiannan and Qiandongnan regions of Guizhou, there is a linear and nonlinear dose-response relationship between obesity indicators and gallstone disease. Advocating for residents to strengthen obesity control and prevention is an important means to reduce the incidence of gallstone disease.

To explore the bidirectional causal relationship between multiple sclerosis (MS) and inflammatory bowel disease (IBD).

The dataset was pooled by genome-wide association studies (GWAS), of which MS data contained 14 498 samples and IBD data contained 24 865 samples, including 6 968 cases of ulcerative colitis (UC) and 17 897 cases of Crohn’s disease (CD). Random effect inverse variance weighting (IVW), weighted median (WME), MR-Egger regression, and weighted model were used for MR Analysis.

MS was found to increase the risk of UC (IVW: OR=1.108; 95% CI: 1.012-1.213; P<0.05), but not associated with the risk of CD (IVW: OR=1.021; 95% CI: 0.926-1.127; P>0.05); UC also increased the risk of MS, and the two were causal (IVW: OR=1.096; 95% CI: 1.027-1.169; P<0.05), and CD was associated with an increased risk of MS (IVW: OR=1.133; 95% CI: 1.003-1.279; P<0.05). After the MR-Egger regression intercept item test, it was found that there was no horizontal pleiotropy (P>0.05). The heterogeneity test results were all <0.001, so we should pay more attention to the random effects IVW model.

MS is associated with an increased risk of UC, but the effect on CD is not significant. IBD increases the risk of developing MS.

To comprehensively evaluate the vulnerability level of elderly farmers and herdsmen’s family old-age pension and analyze the obstacle factors.

Based on the vulnerability framework, we constructed a family old-age pension vulnerability assessment index system, and selected 2 594 research subjects for questionnaire survey by multi-stage random cluster sampling. We applied entropy-weight-TOPSIS method to comprehensively evaluate the level of elderly farmers and herdsmen’s family old-age pension vulnerability, and explored the obstacle factors.

60.14% of the elderly farmers and herders in the southern mountainous pastoral areas of Xinjiang had medium or high levels of vulnerability to old age; the three dimensions of vulnerability to old age and their degree of obstacles were sensitivity (47.59%), adaptive capacity (27.73%), and exposure (25.58%); the top five obstacles and their degree of obstacles were hospitalization due to illness (11.86%), physical fitness index (10.86%), and physical health index (11.86%); and the top five obstacles and their degree of obstacles were hospitalization due to illness (11.86%). The top five barriers and their degree of obstacles were hospitalization due to illness (11.86%), body mass index (10.17%), debt (10.06%), caring for grandchildren (9.16%), and self-care ability (5.70%); and the degree of obstacles to care for the elderly was the fourth highest among elderly farmers (8.62%) and the fourteenth highest among elderly pastoralists (2.69%).

There are differences in vulnerability levels and obstacles between elderly farmers and herders. It is recommended to pay attention to the differences in the characteristics of elderly farmers and herders themselves and their pension resources, so as to formulate more accurate pension strategies.

To explore the association of different glycemic measures and the risk of cancer.

A prospective cohort study conducted in Pudong New Area was used to solve the question. Cox proportional hazard model and Restricted cubic spline (RCS) regression model were used to explore the associations between different glycemic measures and the risk of cancer.

A total of 411 new cancer patients were observed after median 7.78 years follow-up, accumulative person-year incidence rates were 7.12/1 000. After multi-variable adjustment, the HR (95% CI) of elevated FPG and 2hPG were 1.10 (1.03~1.18) and 1.11 (1.02~1.20), respectively. The association between FPG and cancer risk showed a linear dose-response relationship; the association between 2hPG and cancer risk showed a trend toward a U-shaped dose-response relationship.

FPG and 2hPG are important risk factors for cancer, attention should be paid in the prevention and intervention of cancer.

To identify the types of social networks of the elderly in China, to analyze their population distribution characteristics, and to explore the association between different social network types and health behaviors, so as to provide reference for developing personalized health intervention strategies.

Using the data from the 2018 Chinese Longitudinal Healthy Longevity Survey, latent class analysis was used to identify the types of social networks in the elderly. The Multinomial Logistic Regression Analysis and Apriori algorithm were used to analyze the association between different social network types and health-related behaviors.

A total of 6 184 elderly people was included in this study. The social network types of the elderly in China were divided into family type (45.97%), couple type (41.91%) and widowed type (12.12%).Results from the Multinomial Logistic Regression Analysis showed that the elderly who were older (OR=1.141, 95% CI: 1.132-1.149), female (OR=4.472, 95% CI: 3.846-5.201), in ethnic minority (OR=1.454, 95% CI:1.037-2.040), and had sufficient sleep (OR=1.158,95% CI: 1.010-1.328) were more likely of the family-oriented social network. The elderly who were older (OR=1.120, 95% CI: 1.109-1.131), female (OR=4.913, 95% CI: 4.007-6.026) and had sufficient sleep (OR=1.247,95% CI:1.039-1.498) were more likely of the widowed-like social network.Strong association rules of the association rule is: drinking, smoking, and exercise of the elderly social network for couples.

The couple type is more likely to have unhealthy behaviors in the elderly in China, and its social network is smaller and its social support is single. Therefore, it is necessary to enrich the social network, enhance social support, and carry out intergenerational intervention to improve the healthy behavior of the elderly.

To investigate the effect and mechanism of HBV-stimulated HTR8-S/Vneo mitochondrial antiviral signaling protein (MAVS) signaling pathway on the immune response of peripheral blood mononuclear cell (PBMC) to hepatitis B vaccine.

The HTR8-S/Vneo were co-incubated with serum of HBV-DNA positive patients. MAVS siRNA transfection was hereby applied for silencing of MAVS and MAVS plasmid transfection was applied for overexpression of MAVS in HTR8-S/Vneo. We then cocultured them with human immune cells assembly PBMC and subsequently stimulated with hepatitis B vaccine. The mRNA and protein expression levels of MAVS, NF-κB, pNF-κB, IRF3 and pIRF3 in HTR8-S/Vneo were detected by reverse transcription-quantitative real-time PCR (RT-qPCR) and flow cytometry (FCM). The levels of IL-2, IL-6, IFN-β and IL-17 were detected by enzyme-linked immunosorbent assay (ELISA), and the proportion of CD4⁺T cell were detected by flow cytometry. The data were analyzed for t test.

HBV down-regulated the mRNA expression levels of MAVS, NF-κB, IRF3 (t=6.66, P=0.003; t=14.18, P<0.001; t=3.70, P=0.021) and the protein expression levels of MAVS, NF-κB, pNF-κB (t=3.42, P=0.042; t=4.23, P=0.013; t=4.86, P=0.008), and inhibited the production of IFN-β (t=9.83, P=0.010). Silencing MAVS down-regulated the mRNA and protein expression of MAVS (t=31.20, P<0.001; t=6.53, P=0.023), inhibited the expression of IFN-β (t=5.46, P=0.032), and reduced the proportion of CD4⁺T cells in PBMC (t=9.07, P=0.001). Overexpression of MAVS induced IFN-β production (t=-34.26, P<0.001; t=-5.11, P=0.036), but the proportion of CD4⁺T cells did not show significant effect (t=-0.73, P=0.506).

HBV can inhibit the MAVS signaling pathway in HTR8-S/Vneo. Overexpression of MAVS could promote the immune response to hepatitis B vaccine in PBMC.

To explore the causal relationship between type 2 diabetes mellitus (T2DM) and the risk of lung cancer (LC) (including three subtypes: lung adenocarcinoma (LAC), lung squamous cell carcinoma (LSCC), and small cell lung carcinoma (SCLC)) using a two-sample Mendelian randomization approach (MR).

The analysis was performed using summary datasets of genome-wide association studies (GWAS) conducted in European ancestry. Using 380 genome-wide significant single nucleotide polymorphic loci (SNP) associated with type 2 diabetes mellitus as instrumental variables (IV), the primary analysis used inverse variance weighted (IVW) method, MR-Egger regression and weighted median estimator method to investigate the causal association between type 2 diabetes mellitus and lung cancer and its subtypes. Sensitivity analyses were performed including MR-Egger regression intercept test, removing SNPs associated with potential confounding traits, excluding palindromic SNPs, and “leave one out” method.

IVW method showed that genetically predicted type 2 diabetes mellitus was not associated with the risk of lung cancer and its subtypes (LC OR: 1.003, 95% CI: 0.974-1.034; LAC OR: 0.981, 95% CI: 0.943-1.021; LSCC OR: 1.043, 95% CI: 0.995-1.093; SCLC OR: 0.988, 95% CI: 0.921-1.061, respectively). The results remained consistent by using MR-Egger method and weighted median estimator method. The robustness of results was collaborated by several sensitivity analyses. Conclusions This study dosen’t provide evidence supporting the causal relationship between type 2 diabetes mellitus and the risk of overall lung cancer and its subtypes.