Recurrence of common bile duct stones after choledocholithotomy in elderly patients: risk factor analysis and clinical prediction model development.

Background: The reasons for the recurrence of common bile duct stones (CBDS) in elderly patients after choledocholithotomy are still unclear. This study aims to establish a prediction model for CBDS recurrence by identifying risk factors. Methods: We conducted a retrospective analysis of 1804 elderly patients aged 65 years and above who were diagnosed to have CBDS and were admitted to Nanjing First Hospital between January 1, 2010, and January 1, 2021. According to inclusion and exclusion criteria, 706 patients were selected for the final analysis. The patients were assigned to two groups according to the presence or absence of CBDS recurrence, and their clinical data were then statistically analyzed. Subsequently, a prediction model and nomogram were developed, evaluating effectiveness using the concordance index (C-index). Results: Of the 706 elderly patients, 62 patients experienced CBDS recurrence after surgery, resulting in a recurrence rate of 8.8%. The multivariate Cox analysis showed that prior history of cholecystectomy (hazard ratio [HR] = 1.931, 95% confidence interval [CI]: 1.051-3.547, p = 0.034), white blood cell (WBC) count ≥11.0 × 109/L (HR = 2.923, 95% CI: 1.723-4.957, p < 0.001), preoperative total bilirubin (TBIL) level ≥ 36.5 mmol/L (HR = 2.172, 95% CI: 1.296-3.639, p = 0.003), number of stones ≥2 (HR = 2.093, 95% CI: 1.592-5.294, p = 0.001), maximum stone diameter ≥ 0.85 cm (HR = 1.940, 95% CI: 1.090-3.452, p = 0.024), and T-tube drainage (HR = 2.718, 95% CI: 1.230-6.010, p = 0.013) were independent risk factors of CBDS recurrence in elderly patients after choledocholithotomy. A postoperative CBDS recurrence prediction model was constructed with a C-index value of 0.758 (95% CI: 0.698-0.818) and internal validation value of 0.758 (95% CI: 0.641-0.875). Conclusion: A history of cholecystectomy, WBC count ≥11.0 × 109/L, preoperative TBIL level ≥ 36.5 mmol/L, number of stones ≥2, maximum stone diameter ≥ 0.85 cm, and T-tube drainage are the independent risk factors of CBDS recurrence after choledocholithotomy in elderly patients. Our developed prediction model for CBDS recurrence has good predictive ability and can help predict the prognosis of patients with CBDS.

Low-Temperature Curable Negative-Tone Photosensitive Polyimides: Structure and Properties.

Low-temperature curable negative-tone photosensitive polyimide (n-LTPI) viscous solutions were prepared by dissolving photo-crosslinkable poly (amic ester) (pc-PAE) resin, photophotocrosslinker, photoinitiator, and the heteroaromatic base as curing catalysts, and other additives in organic solvents. Among them, the pc-PAE resin was synthesized by polycondensation of aromatic diacid chloride and diester of 2-ethoxymathacrylate, aromatic diamines in aprotic solvents. After being spun-coated on a silicon wafer surface, soft-baked, exposed to UV light, and developed, the n-LTPI with 2% of imidazole (IMZ) as a curing catalyst produced high-quality photo-patterns with line via resolution of 5 µm at 5 µm film thickness. The photo-patterned polymer films thermally cured at 230 °C/2 h in nitrogen showed 100% of the imidization degree (ID) determined by in situ FT-IR spectroscopy. The thermally cured polymer films exhibited great combined mechanical and thermal properties, including mechanical properties with tensile strength of as high as 189.0 MPa, tensile modulus of 3.7 GP, and elongation at breakage of 59.2%, as well as glass transition temperature of 282.0 °C, showing great potential in advanced microelectronic packaging applications.

Recyclable magnetic Fe3O4@C for methylene blue removal under microwave-induced reaction system.

The reclamation and removal of organic pollutants are difficult issues of world concern. In this study, a microwave-induced reaction system (MIRS) is applied to synthesize the multifunctional composite of Fe3O4@C, which is employed to adsorb, separate and catalytic oxide the typical organic dye of methylene blue (MB). SEM, TEM, VSM, XPS, pHpzc, and N2 adsorption performances are carried out to characterize the Fe3O4@C. Results show that the Fe3O4@C mainly consists of activated Fe-O-C microspheres, which possess plentiful mesopore and macropore structures on surfaces. Batch adsorption experiments were carried out by varying key reaction conditions to optimize these. The maximum adsorption capacity of MB onto the Fe3O4@C was 305.0 mg g-1 in 120 min, at pH 10, and at a temperature of 323 K. MIRS was also assisted to regenerate the spent Fe3O4@C which presented good regeneration efficiency by sustaining 16 regeneration cycles without any oxidizing agent. SEM images and FTIR spectrum verified that MB would translate into greater or smaller-sized carbon microspheres. What's more, the adsorption of MB onto both initial and the 16th regenerated Fe3O4@C obeyed the Langmuir isotherm model and followed the pseudo-second-order adsorption kinetics, indicating the adsorptive stability after regeneration. In this study, the Fe3O4@C combined with MIRS may be one innovative strategy for organic pollutants' complete removal in the future.

Improved Melt Processabilities of Thermosetting Polyimide Matrix Resins for High Temperature Carbon Fiber Composite Applications.

With the goal of improving processability of imide oligomers and achieving of high temperature carbon fiber composite, a series of Thermosetting Matrix Resin solutions (TMR) were prepared by polycondensation of aromatic diamine (3,4'-oxybisbenzenamine, 3,4-ODA) and diester of biphenylene diacid (BPDE) using monoester of 4-phenylethynylphthalic acid (PEPE) as end-capping agent in ethyl alcohol as solvent to afford phenylethynyl-endcapped poly(amic ester) resins with calculated molecular weight (Calc'd Mw) of 1500-10,000. Meanwhile, a series of reactive diluent solutions (RDm) with Calc'd Mw of 600-2100 were also prepared derived from aromatic diamine (4,4'-oxybisbenzenamine, 4,4-ODA), diester of asymmetrical biphenylene diacid (α-BPDE) and monoester of 4-phenylethynylphthalic acid (PEPE) in ethyl alcohol. Then, the TMR solution was mixed with the RDm solution at different weight ratios to afford a series of A-staged thermosetting blend resin (TMR/RDm) solutions for carbon fiber composites. Experimental results demonstrated that the thermosetting blend resins exhibited improved melt processability and excellent thermal stability. After being thermally treated at 200 °C/1 h, the B-staged TMR/RDm showed very low melt viscosities and wider processing window. The minimum melt viscosities of ≤50 Pa·s was measured at ≤368 °C and the temperature scale at melt viscosities of ≤100 Pa·s were detected at 310-390 °C, respectively. The thermally cured neat resins at 380 °C/2 h showed a great combination of mechanical and thermal properties, including tensile strength of 84.0 MPa, elongation at breakage of 4.1%, and glass transition temperature (Tg) of 423 °C, successively. The carbon fiber reinforced polyimide composite processed by autoclave technique exhibited excellent mechanical properties both at room temperature and 370 °C. This study paved the way for the development of high-temperature resistant carbon fiber resin composites for use in complicated aeronautical structures.

Correlation of myopia onset and progression with corneal biomechanical parameters in children.

BACKGROUND: Recent epidemiological studies have shown that general eye measurement parameters and corneal biomechanical properties can predict the speed of myopic progression in children. AIM: To investigate the correlation between the onset and progression of myopia and corneal biomechanical parameters in children. METHODS: The study included 102 cases in the emmetropia group, 207 cases in the myopic group, and 109 cases in the hyperopic group. The correlation between the change in corneal biomechanical indexes and the change in general ocular measurement parameters was analyzed. A one-way ANOVA test compared general ocular measurement and corneal biomechanical parameters. Pearson's correlation coefficient was analyzed to correlate corneal biomechanical and general ocular measurement parameters. RESULTS: The general ophthalmometric parameters: Spherical equivalent (SE), intraocular pressure (IOP), and axial length (AL), differed significantly among subjects in myopia, emmetropia, and hyperopic groups. Children's SE positively correlated with corneal biomechanical parameters: Second velocity of applanation (A2V), peak distance (PD), and deformation amplitude (DA) (P < 0.05), and second applanation length (A2L) (P < 0.05). But it was negatively correlated with PD, DA and integral radius (IR) (P < 0.05). Also, IOP was negatively correlated with A2L and IR (P < 0.05). AL positively correlated with A2V and negatively correlated with second applanation time (A2T), highest concavity, and PD. Central corneal thickness positively correlated with first applanation length, first applanation time, first applanation deformation amplitude, A2V, A2L, A2T, second applanation deformation amplitude, central curvature radius at highest concavity (HCR), PD, DA, IR, ambrosia relational thickness-horizontal, first applanation stiffness parameter, corvis biomechanical index, topographic and biomechanics index and the first velocity of applanation. The general ocular Km in children positively correlated with corneal biomechanical parameters DA and IR and negatively correlated with A2L, HCR, and PD. There was a positive correlation between the general ocular measurement parameters ΔSE and corneal biomechanical parameters ΔA2V and ΔA2L, and a negative correlation with ΔIR. The increase in general ocular measurement parameter ΔKm positively correlated with changes in corneal biomechanical parameters, ΔDA and ΔIR, and negatively correlated with ΔHCR and ΔPD. CONCLUSION: Myopia development in children was associated with multiple corneal biomechanical parameters.

Dielectric Properties of Fluorinated Aromatic Polyimide Films with Rigid Polymer Backbones.

Fluorinated aromatic polyimide (FAPI) films with rigid polymer backbones have been prepared by chemical imidization approach. The polyimide films exhibited excellent mechanical properties including elastic modulus of up to 8.4 GPa and tensile strength of up to 326.7 MPa, and outstanding thermal stability including glass transition temperature (Tg) of 346.3-351.6 °C and thermal decomposition temperature in air (Td5) of 544.1-612.3 °C, as well as high colorless transmittance of >81.2% at 500 nm. Moreover, the polyimide films showed stable dielectric constant and low dielectric loss at 10-60 GHz, attributed to the close packing of rigid polymer backbones that limited the deflection of the dipole in the electric field. Molecular dynamics simulation was also established to describe the relationship of molecular structure and dielectric loss.

The Relationship Between Physical Exercise and Subjective Well-Being in College Students: The Mediating Effect of Body Image and Self-Esteem.

This research examines the relationship between physical exercise and subjective well-being via the mediation of body image and self-esteem, thereby providing some suggestions on the improvement of subjective well-being in college students. A total of 671 college students from three universities of science and engineering in Sichuan, China voluntarily participated in the survey. Descriptive statistics, Pearson's product-moment correlation, and mediation model analysis were conducted using the SPSS statistics 19.0. The results showed that (1) the physical exercise level was positively and significantly correlated with the subjective well-being level in each dimension (R = 0.12-0.64, p < 0.01) (2) college students with the medium and high level of exercise have higher subjective well-being than those with the low level of exercise, and (3) body image and self-esteem played a complete mediation role between physical exercise and subjective well-being. The mediation analysis revealed two paths: first, the single mediating path via self-esteem [indirect effect = 0.087, 95% CI: (0.037, 0.141)] and second, the serial mediating path via body image and self-esteem [indirect effect = 0.038, 95% CI: (0.021, 0.158)]. Some practical implications have been discussed on the physical exercise intervention for promoting the subjective well-being level in college students.

The Effect of Social Support on Athlete Burnout in Weightlifters: The Mediation Effect of Mental Toughness and Sports Motivation.

Objectives: Athlete burnout is a crucial concern affecting the development and athletic performance of young weightlifters. To reduce or relieve the prevalence of athlete burnout, this study examined the relationship across social support, sports motivation, mental toughness, and athlete burnout in weightlifters. Methods: A total of 315 weightlifters aged 17-28 years old (151 males, 164 females; M age = 18.89 years, SD = 3.66) from Sichuan, Chongqing, and Shanxi in China participated in this survey. The Perceived Available Support in Sport Questionnaire (PASS-Q), Sports Motivation Questionnaire (SMQ), Sports Mental Toughness Questionnaire (SMTQ), and Athlete Burnout Questionnaire (ABQ) were used in this study. SPSS Statistics 19.0, AMOS 21.0, and PROCESS 3.0 macro were used to analyze the collected data. Results: The results indicated that weightlifters' social support could negatively significantly affect athlete burnout [beta = -0.398; 95% confidence interval (CI): -0.3699, -0.2184; P < 0.05) via mental toughness and sports motivation. The mediation analysis revealed that they had partial mediating effect, including three paths: First, social support had a direct effect on athlete burnout (beta = -0.150; 95% CI: -0.1824, -0.0397; P < 0.05); second, sport mental toughness had a mediating effect on athlete burnout (beta = -0.113; 95% CI: -0.1703, -0.0631; P < 0.05); and finally, sports motivation had a mediating effect on athlete burnout (beta = -0.124; 95% CI: -0.1751, -0.0793; P < 0.05). Conclusion: The findings revealed that social support could inhibit or prevent athlete burnout via mental toughness and sports motivation; thus, to decrease or relieve the prevalence of burnout in weightlifters, it is an important solution to enhance their social support.

Determination of submaximal exercise tolerance in athletes using a method to predict cardiac patient conditions during rehabilitation.

Many professional athletes, after the end of their careers, cannot fully carry out daily social activities due to problems with health. The main problem is a significant rate of cardiovascular diseases. Therefore, the choice of rehabilitation techniques for former athletes is of primary importance. The aim of the paper is to create a model that increases the ability to predict both relapses and remissions during rehabilitation in cardiovascular diseases. The model takes into account the features of the cardiovascular function in athletes and their recovery. The article shows that the reliability of the implemented model can predict both necessary rehabilitation duration and time to complete recovery of an athlete's functional condition. The novelty of this study is that rehabilitation is based on the approximation of exercise load to the optimal levels during disease monitoring. The practical significance of the study is that during the rehabilitation of athletes, the obtained model to predict the course of the disease is aimed at the minimization of negative consequences for the athlete's cardiovascular system following professional activities. This model is recommended for use in medical prediction.

Behavioral Evidence and Olfactory Reception of a Single Alarm Pheromone Component in Halyomorpha halys.

Halyomorpha halys is a major herbivore insect in the fruit orchards of China that has become a devastating invasive pest in North America and Europe since its accidental introductions in the 1990s and 2000s, respectively. Like other hemipteran insects, H. halys releases defensive chemicals against natural enemies, including (E)-2-decenal, which is an aldehyde associated with alarm pheromones. In this study, a series of electrophysiological and behavioral tests were conducted to characterize the alarm functions of (E)-2-decenal among H. halys adults and nymphs. An antennal transcriptome was obtained from a Chinese H. halys population, and 44 odorant-binding protein (OBP) genes were annotated. Among them, five putative alarm pheromone-binding proteins were screened and were extremely consistent with their homologs from US populations. These five OBPs were later expressed in a heterologous expression system, harvested, and then challenged with (E)-2-decenal in a binding assay. All five OBPs showed high binding activities to (E)-2-decenal, which demonstrated its behavioral significance as a defensive component in H. halys, as well as being the first report of its olfactory reception. These findings will help develop behavioral-mediating tools as part of integrated pest management approaches to control this invasive pest.

Population genetic analysis of aquaculture salmonid populations in China using a 57K rainbow trout SNP array.

Various salmonid species are cultivated in cold water aquaculture. However, due to limited genomic data resources, specific high-throughput genotyping tools are not available to many of the salmonid species. In this study, a 57K single nucleotide polymorphism (SNP) array for rainbow trout (Oncorhynchus mykiss) was utilized to detect polymorphisms in seven salmonid species, including Hucho taimen, Oncorhynchus masou, Salvelinus fontinalis, Brachymystax lenok, Salvelinus leucomaenis, O. kisutch, and O. mykiss. The number of polymorphic markers per population ranged from 3,844 (O. kisutch) to 53,734 (O. mykiss), indicating that the rainbow trout SNP array was applicable as a universal genotyping tool for other salmonid species. Among the six other salmonid populations from four genera, 28,882 SNPs were shared, whereas 525 SNPs were polymorphic in all four genera. The genetic diversity and population relationships of the seven salmonid species were studied by principal component analysis (PCA). The phylogenetic relationships among populations were analyzed using the maximum likelihood method, which indicated that the shared SNP markers provide reliable genomic information for population genetic analyses in common aquaculture salmonid fishes. Furthermore, this obtained genomic information may be applicable for population genetic evaluation, marker-assisted breeding, and propagative parent selection in fry production.

Erratum to: Effects of dietary supplementation of golden apple snail (Pomacea canaliculata) egg on survival, pigmentation and antioxidant activity of Blood parrot.

[This corrects the article DOI: 10.1186/s40064-016-3051-2.].

Effects of dietary supplementation of golden apple snail (Pomacea canaliculata) egg on survival, pigmentation and antioxidant activity of Blood parrot.

This study aims to evaluate the effects of supplementing golden apple snail (Pomacea canaliculata) eggs powder (EP) in the diet as a source of natural carotenoids on survival, pigmentation and antioxidant activity of Blood parrot. A total of 90 fish were divided into three treatment groups with three replicates per treatment. Blood parrot were fed with diets containing 0 (control), 5 % (EP 5 %), and 15 % (EP 15 %) dry powder of golden apple snail egg for 60 days, and nine fish per group were sampled at 20, 40, and 60 days. No differences in survival of the fish among treatments were found throughout the experiment. The body coloration of Blood parrot was enhanced in the skin and caudal fin with increasing content of golden apple snail egg powder in the diet. At the end of the experiment, the carotenoid content in the caudal fin and the number of scale chromatophores of the fish fed dietary with EP were higher (P < 0.05) than those of the control group. The EP 15 % treated fishes showed a significant higher (P < 0.05) in the activities of SOD after 60 days, but we could not observe significant changes (P > 0.05) in CAT activities. Results demonstrated that golden apple snail eggs can be used as a colorant to promote the pigmentation efficacy of Blood parrot.

The expression of hepatic carboxypeptidase E is decreased in patients with cholesterol gallstone.

BACKGROUND/AIMS: Decreased carboxypeptidase E (CPE) expression is associated with numerous pathophysiological conditions. This study aimed to investigate the potential function of hepatic CPE in cholesterol gallstone formation. PATIENTS AND METHODS: Patients with cholesterol gallstone (CGS group) and patients without cholesterol gallstones (non-CGS group) were enrolled. The serum total cholesterol, triglyceride, and biliary composition were analyzed. Eight liver samples from two patients without CGS and six patients with CGS were subjected to cDNA microarray analysis. Hepatic CPE expression was detected by quantitative real-time polymerase chain reaction (qRT-PCR), Western blot, and immunohistochemical analysis. Plasma CCK level was measured by ELISA. RESULTS: cDNA microarray identified CPE as a gene downregulated in the CGS group. RT-PCR showed that CPE mRNA level was lower in CGS group than in control (P < 0.05, t-test). Moreover, Western blot and immunohistochemistry analysis showed that CPE protein level was significantly lower in CGS group than in the control group. In addition, plasma CCK level was lower in CGS group than in the control group. A positive correlation was found between serum CCK level and hepatic CPE mRNA level (r2 = 0.713, P = 0.003). CONCLUSIONS: Down-expression of liver CPE may reduce the secretion of serum CCK and contribute to the formation of cholesterol gallstone.

Prognostic value of microRNA-145 in patients with various cancers: a meta-analysis.

BACKGROUND: MicroRNA-145 (miR-145) plays a crucial role in cancer prognosis. OBJECTIVE: This study aimed to investigate the prognostic value of miR-145 in patients with various cancers. METHODS: We pooled published literature from PubMed, EMBASE, Web of Science and Cochrane Database of Systematic Reviews and calculated the hazard ratios (HRs) with 95% confidence intervals (CIs) to estimate the correlation between miR-145 expression levels and survival of patients with general cancers. RESULTS: A total of 615 cases from 8 studies of multiple cancers were examined in this meta-analysis. The HR for overall survival (OS) of low miR-145 expression in multiple cancers was 1.80 (95% CI = 1.19-2.70). Furthermore, after excluding 1 study for its potential heterogeneity, the results suggested an increasing prognostic value of low miR-145 expression (HR = 2.20, 95% CI = 1.63-1.97). In addition, there was no significant difference between miR-145 expression levels and recurrence-free survival (RFS). CONCLUSION: In conclusion, our findings suggest that miR-145 expression is associated with OS in cancer patients and can serve as a promising biomarker for monitoring prognosis.

Surgical treatment of giant aneurysm of hepatic artery: report of three cases.

BACKGROUND/AIMS: To explore the surgical way of treating giant hepatic artery aneurysm(HAA). METHODOLOGY: Three hepatic artery aneurysm patients who were performed aneurysm resection without revascularization of the hepatic artery were reviewed. After surgery, the values of liver function and enhanced CT scan of the patients were followed. RESULTS: All the three patients were recovered well postoperatively and only several values of biochemistry marks of liver function as ALT, AST, TBIL and DB in one case with liver cirrhosis were elevated and decreased to normal ranges in a few days postoperatively. The values of biochemistry marks of liver function in other two cases were within normal limits. The enhanced CT scan also showed arteries in the liver after hepatic artery aneurysm resection. CONCLUSIONS: Giant HAA may be safely removed without revascularization of the hepatic artery.

RC-3095, a gastrin-releasing peptide receptor antagonist, synergizes with gemcitabine to inhibit the growth of human pancreatic cancer CFPAC-1 in vitro and in vivo.

OBJECTIVES: Pancreatic cancer remains a lethal disease. In this study, we investigated the efficacy of a combination of gastrin-releasing peptide receptor antagonist RC-3095 and gemcitabine on pancreatic cancer CFPAC-1. METHODS: The antiproliferation effects of RC-3095, gemcitabine, or the combination on pancreatic cancer were monitored in vitro. Nude mice bearing xenografts of CFPAC-1 cell received injections of the vehicle (control), RC-3095 (20 µg, subcutaneously, daily), gemcitabine (15 mg/kg, intraperitoneally, every 3 days), or the combination of RC-3095 and gemcitabine for 4 weeks. The histological changes and protein expression were tested using immunohistochemistry and Western blotting. RESULTS: Treatment with the combination in culture exhibited a powerful inhibition effect on CFPAC-1 cell proliferation. In xenograft mice model, RC-3095 or gemcitabine significantly reduced the volume and weight of tumors after 4 weeks of treatment, as compared with controls. The combination more potently inhibited the tumor growth than either agent used individually. Immunohistochemistry and Western blotting showed gastrin-releasing peptide receptor/bombesin receptor subtype-3 positive cells and protein expression in tumors decreased by treatment with RC-3095 or gemcitabine alone or greater in combination. CONCLUSIONS: Our data suggested that the combination could be considered for the possible new approaches for treatment of pancreatic cancers.

Effects of hypoxia-inducible factor-1α silencing on drug resistance of human pancreatic cancer cell line Patu8988/5-Fu.

The present study aimed to investigate the mechanism and the possible approaches of solving drug resistance by silencing hypoxia-inducible factor-1 alpha of human pancreatic cancer cell line Patu8988/5-Fu cultured in hypoxia. The effective jamming fragment screened by RT-PCR for silencing HIF-1α gene was transfected into pancreatic cancer cells Patu8988/5-Fu through lentivirus. RT-PCR results showed that the effective jamming fragments for HIF-1α in lentivirus transfection was Wtl-mus-1202(C546). Combined MTT with JC-1 fluorescence staining flow cytometric analysis, the concentration of 200 µmol/L CoCl2 for 8 h was chosen to mimic hypoxia cell environment. The drug resistance significantly enhanced in response to hypoxia in Patu8988/5-Fu (p<0.05), and silence HIF-1α could reverse the multidrug resistance (P<0.05). In the Patu8988/5-Fu cells, HIF-1α and MDR1 significantly increased in response to hypoxia (p<0.05). The inhibition of HIF-1α expression synergistically downregulated the expression of the MDR1 gene in Patu8988/5-Fu cells (p<0.05). HIF-1α expression was positively correlated with the MDR1 expression (p<0.05). The upregulation of the HIF-1α and MDR1 gene expression caused by hypoxia was related with the generation of multi-drug resistance of Patu8988/5-Fu, targeted silencing HIF-1α may be a kind of way to reverse the chemotherapy drug resistance.

2-(4-{4-[4-(Oxiran-2-ylmeth-oxy)phen-oxy]phen-yl}phen-oxy-meth-yl)oxirane.

In the title ep-oxy monomer, C(24)H(22)O(5), the dihedral angle in the biphenyl residue is 3.34 (19)°, indicating a nearly coplanar conformation; this residue is not planar with the adjacent benzene ring [dihedral angle = 58.93 (14)°]. Each of the epoxide rings is disordered. Each epoxide ring was resolved over two alternative positions with site-occupancy ratios of 0.638 (10):0.362 (10) and 0.797 (9):0.203 (9).

[Risk factors of familial gallstone disease: study of 135 pedigrees].

OBJECTIVE: To explore the role of both inheritable and epidemiological factors in the pathogenesis of familial gallstone disease in pedigrees. METHODS: 135 pedigrees, with 695 members aged > or = 18 (18 - 83, with a mean of 50 +/- 14), 282 males and 413 females, including 370 patients, at least one patient existing in every generation, were investigated. Inquiry was carried out to collect the personal and medical history. Physical examination and ultrasonography were conducted. Blood samples were collected to detect the total cholesterol (TCh), triglyceride (TG), high-density lipoprotein cholesterol (HDL-Ch), and apolipoprotein (Apo) A1 and ApoB. The concentration of low-density lipoprotein cholesterol (LDL-Ch) was calculated by the formula: Tch-TG/5 + HDL-Ch. The inheritable characteristics and heritability were analyzed. RESULTS: The prevalence of gallstone disease was 53.24%, 56.66% among the females, significantly higher than that among the males (48.23%, P = 0.03). The heritability in the first-degree relatives was 138% +/- 7%, and the concordance rate of monozygotic twins was 100%. The significant risk factors were female gender (P = 0.03), body mass index (P < 0.01) and diet (P < 0.008). The history of hypertension, hyperlipidemia, and diabetes were correlated to gallstone disease (P = 0.008, < 0.008, and 0.03 respectively). Serum HDL-Ch and ApoA1 concentrations were lower in the stone group than in the non-stone group (P = 0.003 and 0.005 respectively). There were no significant differences in TCh, TG, LDL-Ch, and ApoB between the 2 groups. CONCLUSION: Genetic factors play a major role in the pathogenesis of familial gallstone disease, characterized by autosomal dominant inheritance. Female gender, obesity, diet, hypertension, hyperlipidemia, diabetes may be the risk factors of gallstone disease. Dyslipidemia is a characteristic of gallstone disease.