OBJECTIVES: To investigate the ethnic origin of Chuanqing people, one of the largest unidentified ethnic groups in Guizhou, China, and analyze its genetic relationships with surrounding populations. METHODS: Based on a self-developed microhaplotype system, we conducted genotyping and analyzed the genetic distribution of microhaplotype loci and their forensic applicability in Chuanqing population in Guizhou Province. Using the microhaplotype data from different intercontinental populations and previously reported data from Han population living in Guizhou Province, we systematically investigated the genetic background of Chuanqing people through population genetic approaches, including genetic distance estimation, principal component analysis, and phylogenetic tree construction. RESULTS: Among the studied population, the number of haplotype per microhaplotype ranged from 6 to 25. The average expected heterozygosity (He), observed heterozygosity (Ho), power of discrimination (PD), and probability of exclusion (PE) were 0.8291, 0.8301, 0.9387, and 0.6593, respectively. The cumulative power of discrimination (CPD) and cumulative probability of exclusion (CPE) for these 33 loci were 1-2.62×10^-41 and 1-7.64×10^-17, respectively. Population genetic analyses revealed that the Chuanqing population had close genetic relationships with the East Asian populations, especially the local Guizhou Han population, Beijing Han population and the Han populations living in southern China. CONCLUSIONS The 33 microhaplotypes exhibit high levels of genetic diversity in the Guizhou Chuanqing population, highlighting their potentials for both forensic identification and parentage testing. The Han populations might have contributed a significant amount of genetic material to the Chuanqing population during the formation and development of the latter.
Humans ; China/ethnology* ; Ethnicity/genetics* ; Forensic Genetics/methods* ; Genetics, Population ; Genotype ; Haplotypes ; Phylogeny ; East Asian People/genetics*

Objective:To investigate the perioperative safety, short-term and long-term efficacy, and surgical strategy of laparoscopic partial gastrectomy for gastrointestinal stromal tumors at the esophagogastric junction.Methods:Seventy-eight patients with mesenchymal tumors in the esophagogastric junction were retrospectively enrolled from September 2018 to August 2023 in which the upper edge of the tumor is less than 2 cm from the Z-line or has invaded the Z-line <1/2 circumference. There were 31 males (39.7%) and 47 females (60.3%), with an average age of (57.2±11.8) years and an average body mass index of (24.5±3.5) kg/m 2. All cases were divided into the wedge resection (WR) group ( n=51) and the resection by opening all of the layers of the stomach wall (RASW) group ( n=27) according to the surgical methods. Surgical outcomes, complications, recover and postoperative gastroesophageal reflux of both groups were compared. The measurement data with a normal distribution were represented by mean±standard deviation ( ± s), and values were compared using the independent sample t-test. The measurement data with a skewed distribution were represented by median (interquartile range) [ M( Q1, Q3)], and values were compared using the Mann-Whitney U test. Count data were expressed as examples (percentages) [ n(%)], and the χ2 test was used to compare countable data. A non-parametric test was used to compare the grade data. Results:The WR group had shorter operation time [(97.1±32.6) min vs (149.9±54.9) min, t=-5.33, P<0.001], less intraoperative blood loss [15(10, 20) mL vs 20(10, 50) mL, z=-2.47, P=0.014], shorter postoperative exhaust time [2(1, 3) d vs 3(2, 3) d, z=-2.49, P=0.013], shorter postoperative oral intake time [2(2, 3) d vs 4(2, 5) d, t=-3.70, P<0.001], shorter postoperative semi-liquid diet time[5(4, 6) d vs 7(5, 8) d, z=-3.57, P<0.001], and shorter postoperative hospital stay [5(4, 6) d vs 7(6, 8) d, z=-4.16, P<0.001] than the RASW group, with statistically significant differences. There was no significant difference in short-term (≤30 days) complications between the two groups (2.0% vs 3.7%, z=-0.46, P=0.648). No cases of cardia stenosis occurred in either group. In the WR group, 3 patients developed gastroesophageal reflux at 6 months postoperatively, with 2 patients relieved after taking acid-suppressing drugs and 1 patient not completely relieved. In the RASW group, 1 patient developed gastroesophageal reflux at 6 months postoperatively and was not completely relieved after taking acid-suppressing drugs. No other patients had gastroesophageal reflux. No other patients have gastroesophageal reflux. Conclusions:WR and RASW are safe and feasible for mesenchymal tumors at the esophagogastric junction in which the upper edge of the tumor is less than 2 cm from the Z-line or has invaded the Z-line <1/2 circumference, and has achieved an excellent short-term effect. The choice of surgical approach can be determined based on varions factors such as the location of the tumor, the relationship of the position between the tumor and the cardia, and whether the tumor is exophytic growth.

Objective:To explore the factors influencing lymph node metastasis and prognosis in patients with Siewert type Ⅱ/Ⅲ adenocarcinoma of the esophagogastric junction (AEG).Methods:A retrospective analysis was conducted on clinical data of 239 patients with Siewert Type Ⅱ/Ⅲ adenocarcinoma of the esophagogastric junction who underwent surgical treatment at Beijing Friendship Hospital, Capital Medical University, from July 2013 to December 2022. Among them, there were 204 males and 35 females. The patients′ ages ranged from 27 to 83 years, with a mean age of 63.1 years. Statistical analysis was performed using SPSS 26.0 software, with categorical data presented as n(%) and compared using χ2 tests, corrected χ2 tests, or Fisher′s exact tests. Ordinal data were expressed as frequencies and percentages and compared using rank-sum tests. Multivariate analysis was conducted using Logistic regression, and survival analysis was performed using the Cox regression model. Follow-up was conducted every 6 months, with the last follow-up conducted in November 2023. Results:Multivariate analysis identified infiltration depth ( OR=0.038, 95% CI: 0.011-0.139, P<0.001), tumor deposit ( OR=0.101, 95% CI: 0.011-0.904, P=0.040) and intravascular cancer embolus ( OR=0.234, 95% CI: 0.108-0.507, P<0.001) as independent predictors of LNM. Lymph nodes No. 1, 2, 3, 4, 7, 10, and 11 were more prone to metastasis in the abdominal cavity. Notably, Siewert Ⅲ AEG patients showed a higher metastatic rate in nodes No. 5 and No. 6 compared to Siewert Ⅱ. Mediastinal LNM was predominantly found in nodes No. 110 and No. 111 for Siewert Ⅱ AEG, with rates of 5.45% and 3.64%, respectively. A three-year survival analysis underscored LNM as a significant prognostic factor ( P=0.001). Conclusions:Siewert Ⅱ AEG patients should undergo removal of both celiac and mediastinal lymph nodes, specifically nodes No. 1, 2, 3, 4, 7, 10, 11, 110, and 111. Dissection of nodes No. 5 and No. 6 is not indicated for these patients. In contrast, Siewert Ⅲ AEG patients do not require mediastinal LND, but pyloric lymphadenectomy for nodes No.5 and No.6 is essential. The presence of LNM is associated with poorer long-term prognosis. Perioperative chemotherapy may offer a survival advantage for AEG patients.

Objective:To survey the post competency of general practitioners who completed residency training in Suzhou Municipal Hospital.Methods:A questionnaire survey on post competency of general practitioners was conducted from January to March 2022. General practitioners who completed standardized residential training in Suzhou Municipal Hospital from 2009 to 2021 were randomly selected for the survey. The self-designed questionnaire included the basic information and post competency in terms of clinical, public health, research and teaching abilities as well as medical ethics and humanism. A self-evaluation was also performed and the abilities were graded (A 86-100, B 70-85, C 55-69, D 0-54), and grade A was classified as excellent.Results:A total of 163 questionnaires were distributed and 157 valid ones were collected with a recovery rate of 96.3%. Among 157 respondents 62 (39.5%) were males. The participants mainly worked in urban community health service institutions (78 (49.7%)), and most of them worked as general practice (119 (75.8%)). For the self-assessment of clinical skills, the proportion of respondents with excellent abilities in history taking, basic drug use, diagnosis and treatment of common diseases, and chronic disease management was 58.8% (70/119), 57.1% (68/119), 54.6% (65/119) and 54.6% (65/119), respectively. The proportion of respondents with excellent abilities in evidence-based clinical decision making, physical examination, tests interpretation, referral services, family medical services, rehabilitation services, first aid, and psychological counseling and treatment was 43.7% (70/119), 42.9% (52/119), 38.7% (46/119), 37.8% (45/119), 33.6% (40/119), 22.7% (27/119), 21.0% (25/119), and 16.8% (20/119), respectively. For the self-assessment of basic public health service ability, the proportion of respondents with excellent abilities in health education, disease prevention and control, health management, health care for key and special groups, handling public health emergencies, management of infectious diseases, epidemiology-based community diagnosis and community health leadership was 38.7% (46/119), 33.6% (40/119), 33.6% (40/119), 26.1% (31/119), 25.2% (30/119), 2.7% (27/119), 22.7% (27/119), and 21.0% (25/119), respectively. For humanistic literacy, the proportion of respondents with excellent abilities in privacy protection, sense of responsibility for patients, understanding patients′ needs, effective communication and cooperation with patients was 82.4% (98/119), 73.9% (88/119), 61.3% (73/119), 55.5% (66/119) and 2.1% (62/119), respectively. For research and teaching, the proportion of respondents with excellence abilities in continuous learning and innovation, training and teaching and literature retrieval was 47.9% (57/119), 10.9% (13/119), 10.1% (12/119), respectively. In addition 56.3% (67/119) of respondents were interested in scientific research, 23.5% (28/119) had published articles as the first author or correspondence author, and only 6.7% (8/119) had scientific research projects in the last 5 years.Conclusion:The post competency of general practitioners who received standardized residency training in our hospital varies in different aspects, their abilities in basic public health service, scientific research and teaching are relatively low, which need to be strengthened.

Objective:To investigate the risk factors for bleeding and thrombosis during extracorporeal membrane oxygenation (ECMO) therapy in critically ill patients and determine the best predictors of coagulation-related complications.Methods:A retrospective analysis was performed on patients who received ECMO for respiratory or circulatory failure at Xiangya Hospital of Central South University from January 2020 to December 2022. The outcome was whether bleeding or thrombosis occurred from 24 h after ECMO insertion to before weaning. The differences in demographic characteristics, weaning conditions, prognosis, routine blood tests, organ function, coagulation and blood product transfusion of each group were compared. Logistic regression analysis was used to evaluate the risk factors for bleeding and thrombosis, and ROC curve evaluation was used to assess their capacity to predict complications.Results:A total of 61 patients with ECMO were enrolled, with 21 cases of bleeding and 14 cases of thrombosis during ECMO. Compared with the nonbleeding group, the activated partial thromboplastin time, thromboplastin time (TT), and transfusions of frozen plasma and red blood cells were higher in the bleeding group (all P<0.05). Compared with the nonthrombotic group, the increase in body weight, D-dimer (DD), fibrinogen degradation product (FDP), and improvement of arterial oxygen partial pressure (ΔPO 2) within 24 h were significantly higher in the thrombotic group (all P<0.05). Logistic regression analysis revealed that TT ( OR=1.039, 95% CI: 1.006~1.072, P=0.018) and frozen plasma transfusion volume ( OR=1.046, 95% CI: 1.010-1.083, P=0.012) were risk factors for bleeding events. FDP ( OR=1.030, 95% CI: 1.009-1.051, P=0.005), DD ( OR=1.181, 95% CI: 1.044-1.336, P=0.008), and ΔPO 2 ( OR=1.007, 95% CI: 1.002-1.012, P=0.006) were risk factors for thrombosis. According to ROC curve analysis, the AUCs of TT, frozen plasma transfusion, and combined indexes for predicting bleeding were 0.712, 0.690, and 0.816, respectively. The combined indices had a cut-off value of 0.273, a sensitivity of 75.61%, and a specificity of 80.00%. The AUCs of FDP, DD, ΔPO 2, and combined FDP with ΔPO 2 for predicting thrombosis were 0.778, 0.748, 0.786, and 0.868, respectively. The cut-off value of the combined index was 0.157, the sensitivity was 68.09%, and the specificity was 92.86%. Conclusions:TT combined with frozen plasma transfusion volume predicted bleeding optimally, while FDP plus ΔPO 2 predicted thrombotic events better during ECMO treatment in critically ill patients.

Pain caused by surgery is an important clinical issue that seriously affects postoperative rehabilitation and health-related quality of life. Failure to effectively manage postoperative pain not only leads to a decrease in patient quality of life, increases medical expenses, but also has a negative impact on patient recovery. Therefore, it is of great clinical significance to address the challenges of acute postoperative pain management, find effective management strategies, and improve the quality of pain management. This article summarizes the current status of acute postoperative pain management in recent years, including the mechanism of pain occurrence, pain assessment methods, drug and non drug management strategies, and predictive factors for chronic postoperative pain. It also looks forward to future research directions and application prospects.

Objective:To investigate the clinical effect of deep brain stimulation (DBS) in the treatment of Parkinson′s disease (PD).Methods:32 PD patients treated in Hunan Brain Hospital from January 2016 to December 2018 were selected for the study. Guided by MRI and supplemented by electrophysiological stimulation to correct the target, PD patients were treated with DBS for the nucleus accumbens. Based on Webster and Unified Parkinsons Disease Rating Scale (UPDRS) scores before and after DBS treatment, the clinical treatment effects were evaluated. And the content of Aβ1-42, interleukin (IL)-1β, IL-6, uric acid (UA), malondialdehyde (MDA), homocysteine (Hcy), S-nitrosylated dynamin-relatedprotein 1 (SNO-Drp1) and Drp1 was measured before and after DBS treatment. The ratio of SNO-Drp1/Drp1 was also measured.Results:The Webster score and UPDRS score of PD patients after DBS treatment were lower than those before DBS treatment ( P<0.05). The Aβ1-42 and Drp1content of PD patients after DBS treatment was higher than that before DBS treatment ( P<0.05), while the content of IL-1β, UA, MDA, Hcy and the ratio of SNO-Drp1/Drp1 were lower than before treatment ( P<0.05). Conclusions:DBS has confirmed a good clinical effect in the treatment of PD patients and significantly improved the quality of life of patients.

Objective:To analyze the relationship between antithrombin Ⅲ(AT-Ⅲ) activity and survival, bleeding and thrombosis complications in patients with acute-on-chronic liver failure (ACLF), and to explore the prediction value of AT-Ⅲ activity in the prognosis of ACLF patients.Methods:The clinical data of 130 hospitalized patients with ACLF were retrospectively collected in Wuxi No.5 People′s Hospital from January 1, 2013 to April 1, 2019. The liver function, international normalized ratio (INR), and 90-day survival rate were detected. The AT-Ⅲ activity values at admission, week two, week four, and week eight of hospitalization were recorded, and the occurrences of fecal occult blood and femoral vein thrombosis were also recorded. The measurement data were compared by t test, analysis of variance, or rank sum test, and the categorical data were compared by chi-square test. The risk factors affecting the survival of ACLF patients were analyzed by Cox regression. The survival analysis was performed using the Kaplan-Meier method. Results:At the end of 90-day follow-up of 130 patients, 56 patients died, 20 patients (15.38%) were fecal occult blood positive and 15 (11.54%) had femoral vein thrombosis. The baseline AT-Ⅲ activity in the death group was lower than that in the survival group ((17.89±13.68)% vs (36.03±11.96)%), and the difference was statistically significant ( t=-8.045, P<0.01). The baseline AT-Ⅲ activities in fecal occult blood positive and negative patients were (18.26±11.52)% and (25.06±10.97)%, respectively, and in femoral vein thrombosis and non-thrombotic patients were (17.55±10.33)% and (32.48±11.88)%, respectively. The differences were both statistically significant ( t=8.746 and 8.090, respectively, both P<0.01). Through dynamic monitoring of AT-Ⅲ, the AT-Ⅲ activity showed a downward trend in the death group, while that showed an upward trend in the survival group, but the differences were not statistically significant ( F=0.282 and 0.401, respectively, both P>0.05). The Cox regression analysis suggested INR (odds ratio ( OR)=1.364, 95% confidence interval ( CI) 1.078-1.726, P=0.010) and AT-Ⅲ activity ( OR=0.930, 95% CI 0.906-0.954, P<0.01) were the independent factors affecting the survival of patients with ACLF. The area under the receiver operator characteristic curve of the AT-Ⅲ activity for predicting 90-day survival outcome of the patient was 0.706 (95% CI 0.773-0.952, P<0.01), and the cut-off value was 25%. Patients with AT-Ⅲ activity ≥ 25% had a higher survival rate than those with AT-Ⅲ activity <25% ( χ2=58.20, P<0.01). Conclusions:AT-Ⅲ activity is associated with fecal occult blood positive and femoral vein thrombosis in ACLF patients. The AT-Ⅲ activity is an independent influencing factor for predicting the prognosis of ACLF patients. Patients with AT-Ⅲ activity less than 25% have the higher mortality rate.

OBJECTIVE: To explore the effect of dust exposure, type of work, age, length of service and duration of dust exposure on pulmonary function in coal miners by pulmonary function tests.
 METHODS: A total of 1 953 coal miners, who received occupational healthy examination and pulmonary function tests during June, 2013 and August, 2014 in Hunan Prevention and Treatment Institute, were enrolled for this study.
 RESULTS: A total of 1 302 miners (66.7%) displayed pulmonary dysfunction, including 1 139 with mild dysfunction (58.3%) and 163 with moderate or more serious dysfunction (8.3%). The risk factors for pulmonary dysfunction were age (OR=1.329, 95% CI: 1.196-1.620), dust exposure duration (OR=1.267, 95% CI: 1.136-1.413) and type of works (mining workers OR=1.156, 95% CI: 1.033-1.293; all P<0.05).
 CONCLUSION The incidence rate of pulmonary dysfunction in coal miners is relatively high in Hunan Province. Most of them are mild dysfunction. The incidence rate of pulmonary dysfunction in mining works is statistically higher than that in other work types. Older workers and long duration-exposed workers are more likely to have pulmonary dysfunction.
China ; Coal Mining ; Dust ; Humans ; Incidence ; Lung ; physiopathology ; Lung Diseases ; epidemiology ; Occupational Exposure ; Respiratory Function Tests ; Risk Factors

OBJECTIVE: To study the effect of underground work on cardiovascular system health in coal miners.
 METHODS: Male coal miners, who received electrocardiographic examinations between June, 2013 and August, 2014 in Hunan Prevention and Treatment Institute for Occupational Diseases to exclude pneumoconiosis, were enrolled for this study (n=3 134). Miners with 2 years or more underground work experience were selected as the exposed group (n=2 370), while miners without underground work experience were selected as the control group (n=764). The prevalence of electrocardiographic abnormalities and the influential factors were compared between the 2 groups.
 RESULTS: The prevalences of electrocardiographic abnormalities, hypertension, heart rate abnormalities and cardiovascular system abnormalities in the exposed group vs the control group were 37.6% vs 25.4%, 20.5% vs 13.4%, 5.7% vs 6.0%, 49.8% vs 35.2%, respectively. The cardiovascular system abnormalities were correlated with the underground work (OR=3.128, 95% CI: 1.969-4.970), the underground work experience (OR=1.205, 95% CI: 1.070-1.358) and the type of works (mining worker OR=1.820, 95% CI: 1.527-2.169; auxiliary worker OR=1.937, 95% CI: 1.511-2.482; other worker OR=3.291, 95%CI: 2.120-5.109).
 CONCLUSION Underground work may increase the prevalence of cardiovascular system abnormalities for coal miners. The longer the coal miners work in underground, the higher the risk of the cardiovascular system abnormalities they are.
Cardiovascular System ; physiopathology ; Case-Control Studies ; Coal Mining ; Electrocardiography ; Humans ; Male ; Miners ; Occupational Diseases ; epidemiology ; Pneumoconiosis ; Prevalence