Causal effect analysis of estrogen receptor associated breast cancer and clear cell ovarian cancer.

BACKGROUND: Evidence indicates that the risk of developing a secondary ovarian cancer (OC) is correlated with estrogen receptor (ER) status. However, the clinical significance of the relationship between ER-associated breast cancer (BC) and clear cell ovarian cancer (CCOC) remains elusive. METHODS: Independent single nucleotide polymorphisms (SNPs) strongly correlated with exposure were extracted, and those associated with confounders and outcomes were removed using the PhenoScanner database. SNP effects were extracted from the outcome datasets with minor allele frequency > 0.01 as the filtration criterion. Next, valid instrumental variables (IVs) were obtained by harmonizing exposure and outcome effects and further filtered based on F-statistics (> 10). Mendelian randomization (MR) assessment of valid IVs was carried out using inverse variance weighted (IVW), MR Egger (ME), weighted median (WM), and multiplicative random effects-inverse variance weighted (MRE-IVW) methods. For sensitivity analysis and visualization of MR findings, a heterogeneity test, a pleiotropy test, a leave-one-out test, scatter plots, forest plots, and funnel plots were employed. RESULTS: MR analyses with all four methods revealed that CCOC was not causally associated with ER-negative BC (IVW results: odds ratio (OR) = 0.89, 95% confidence interval (CI) = 0.66-1.20, P = 0.431) or ER-positive BC (IVW results: OR = 0.99, 95% CI = 0.88-1.12, P = 0.901). F-statistics were computed for each valid IV, all of which exceeded 10. The stability and reliability of the results were confirmed by sensitivity analysis. CONCLUSIONS: Our findings indicated that CCOC dids not have a causal association with ER-associated BC. The absence of a definitive causal link between ER-associated BC and CCOC suggested a minimal true causal influence of ER-associated BC exposure factors on CCOC. These results indicated that individuals afflicted by ER-associated BC could alleviate concerns regarding the developing of CCOC, thereby aiding in preserving their mental well-being stability and optimizing the efficacy of primary disease treatment.

The efficacy and safety of thalidomide in the treatment of refractory Crohn's disease in adults: a double-center, double-blind, randomized-controlled trial.

Background: Thalidomide is applied in therapy for refractory Crohn's disease (CD) in adults, but systematic and rigorous clinical evidence is scant. The aim was to provide theoretical references for the efficacy of thalidomide in the therapy for refractory CD in adults. Methods: A double-center, double-blind, placebo-controlled, randomized clinical trial of refractory CD in adults in two inflammatory bowel disease centers in China. In the double-blind trial, patients were randomly assigned to 100 mg of thalidomide or placebo daily for 8 weeks. The primary outcome was considered as the clinical remission rate calculated based on the Crohn's disease activity index at the eighth week following thalidomide or placebo treatment. In open label, non-response to placebo was additionally treated with 8 weeks of thalidomide; all responders were continuously treated with thalidomide until the 48th week. Results: Twenty-five patients were randomly assigned to each group. At the eighth week, the clinical remission rate in the thalidomide group was significantly higher than that in the placebo group (68.0% [17/25] vs 16.0% [4/25]; relative risk, 4.2; 95% confidence interval, 1.8-10.9, P < 0.001). After a 48-week follow-up, the continuous treatment rate of thalidomide was 46.3% (19/41). Adverse events during the whole process were reported in 58.5% of patients, mainly involving drowsiness, rash, and peripheral neuropathy that were mild and tolerable. Conclusion: Thalidomide can be used in the induction and maintenance therapy of refractory CD in adults. And it could be one of the treatment options for refractory CD.

Vitamin D Deficiency Is Associated with Endoscopic Severity in Patients with Crohn's Disease.

BACKGROUND AND AIMS: Vitamin D deficiency is common in patients with Crohn's disease and is associated with disease activity. Relationship between vitamin D and endoscopic disease activity is unknown. The aim of the study is to determine the association between vitamin D status and endoscopic disease activity in CD patients. METHODS: Consecutive hospitalized CD patients from 2014 to 2016 who received vitamin D assessment and colonoscopy were retrospectively evaluated. Clinical disease activity was assessed by Crohn's disease activity index and C-reactive protein. Endoscopic activity was calculated using simple endoscopic score for Crohn's disease. RESULTS: Median serum 25OHD level of 131 patients was lower than healthy controls [21.1 nmol/L (11.8-32.3) versus 49.9 nmol/L (44.9-57.4), P = 0.007]. 125 (95%) patients had vitamin D deficiency and the rest (5%) had vitamin D insufficiency. Serum 25OHD was inversely correlated with CRP (r = -0.308, P < 0.001), CDAI (r = -0.582, P < 0.001), SES-CD (r = -0.294, P = 0.001), and endoscopic severity stratified by SES-CD (P = 0.001). CONCLUSION: Vitamin D deficiency was prevalent among hospitalized CD patients. Vitamin D levels were inversely correlated with endoscopic disease activity. Vitamin D status could be a biomarker in assessing disease activity among hospitalized CD patients in addition to CDAI and CRP.

Accumulation of mercury in rice grain and cabbage grown on representative Chinese soils.

A pot culture experiment was carried out to investigate the accumulation properties of mercury (Hg) in rice grain and cabbage grown in seven soil types (Udic Ferrisols, Mollisol, Periudic Argosols, Latosol, Ustic Cambosols, Calcaric Regosols, and Stagnic Anthrosols) spiked with different concentrations of Hg (CK, 0.25, 0.50, 1.00, 2.00, and 4.00 mg/kg). The results of this study showed that Hg accumulation of plants was significantly affected by soil types. Hg concentration in both rice grain and cabbage increased with soil Hg concentrations, but this increase differed among the seven soils. The stepwise multiple regression analysis showed that pH, Mn(II), particle size distribution, and cation exchange capacity have a close relationship with Hg accumulation in plants, which suggested that physicochemical characteristics of soils can affect the Hg accumulation in rice grain and cabbage. Critical Hg concentrations in seven soils were identified for rice grain and cabbage based on the maximum safe level for daily intake of Hg, dietary habits of the population, and Hg accumulation in plants grown in different soil types. Soil Hg limits for rice grain in Udic Ferrisols, Mollisol, Periudic Argosols, Latosol, Ustic Cambosols, Calcaric Regosols, and Stagnic Anthrosols were 1.10, 2.00, 2.60, 2.78, 1.53, 0.63, and 2.17 mg/kg, respectively, and critical soil Hg levels for cabbage are 0.27, 1.35, 1.80, 1.70, 0.69, 1.68, and 2.60 mg/kg, respectively.