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Scientific Reports Jul 2024Analyze the relationship between genetic variations in the MTHFR gene at SNPs (rs1801131 and rs1801133) and the therapy outcomes for Iraqi patients with rheumatoid...
Analyze the relationship between genetic variations in the MTHFR gene at SNPs (rs1801131 and rs1801133) and the therapy outcomes for Iraqi patients with rheumatoid arthritis (RA). The study was conducted on a cohort of 95 RA Iraqi patients. Based on their treatment response, the cohort was divided into two groups: the responder (47 patients) and the nonresponder (48 patients), identified after at least three months of methotrexate (MTX) treatment. A polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was employed to analyze the MTHFR variations, specifically at rs1801133 and rs1801131. Overall, rs1801131 followed both codominant and dominate models, in which in the codominant model, GG [OR (95% CI) 0.11 (0.022-0.553)] and TG [OR (95% CI) 0.106 (0.021-0.528)] predict responders compared to the TT genotype; meanwhile, for the dominate model, the presence of both GG and TG genotypes [OR (95% CI) 0.108 (0.023-0.507)] together predict responders compared to the TT genotype. The AG haplotype was significantly associated with responders [OR (95% CI): 0.388 (0.208-0.723)], while the GT haplotype was associated marginally with nonresponders [OR (95% CI) 1.980 (0.965-4.064)]. In the final multivariate analysis, GG/TG genotypes were independently related to responders after adjustment for patients, disease, and treatment characteristics, while TT genotypes were associated with nonresponders. The Iraqi RA patients showed genetic polymorphism in MTHFR gene rs1801131 with T carrier allele associated with nonresponders to MTX therapy. The rs1801131 followed both codominant and dominant models. The G-carried allele for rs1801131 showed an independent association with responder to MTX therapy after adjustment for patients, disease, and treatment characteristics.
Topics: Humans; Methylenetetrahydrofolate Reductase (NADPH2); Arthritis, Rheumatoid; Methotrexate; Male; Female; Polymorphism, Single Nucleotide; Iraq; Middle Aged; Adult; Treatment Outcome; Antirheumatic Agents; Genotype
PubMed: 38956106
DOI: 10.1038/s41598-024-65199-7 -
Scientific Reports Jul 2024Antibiotic resistance is a worldwide problem that imposes a devastating effect on developing countries and requires immediate interventions. Initially, most of the...
Antibiotic resistance is a worldwide problem that imposes a devastating effect on developing countries and requires immediate interventions. Initially, most of the antibiotic drugs were identified by culturing soil microbes. However, this method is prone to discovering the same antibiotics repeatedly. The present study employed a shotgun metagenomics approach to investigate the taxonomic diversity, functional potential, and biosynthetic capacity of microbiomes from two natural agricultural farmlands located in Bekeka and Welmera Choke Kebelle in Ethiopia for the first time. Analysis of the small subunit rRNA revealed bacterial domain accounting for 83.33% and 87.24% in the two selected natural farmlands. Additionally, the analysis showed the dominance of Proteobacteria representing 27.27% and 28.79% followed by Actinobacteria making up 12.73% and 13.64% of the phyla composition. Furthermore, the analysis revealed the presence of unassigned bacteria in the studied samples. The metagenome functional analysis showed 176,961 and 104, 636 number of protein-coding sequences (pCDS) from the two samples found a match with 172,655 and 102, 275 numbers of InterPro entries, respectively. The Genome ontology annotation suggests the presence of 5517 and 3293 pCDS assigned to the "biosynthesis process". Numerous Kyoto Encyclopedia of Genes and Genomes modules (KEGG modules) involved in the biosynthesis of terpenoids and polyketides were identified. Furthermore, both known and novel Biosynthetic gene clusters, responsible for the production of secondary metabolites, such as polyketide synthases, non-ribosomal peptide synthetase, ribosomally synthesized and post-translationally modified peptides (Ripp), and Terpene, were discovered. Generally, from the results it can be concluded that the microbiomes in the selected sampling sites have a hidden functional potential for the biosynthesis of secondary metabolites. Overall, this study can serve as a strong preliminary step in the long journey of bringing new antibiotics to the market.
Topics: Soil Microbiology; Metagenomics; Microbiota; Multigene Family; Secondary Metabolism; Metagenome; Farms; Bacteria; Ethiopia; Phylogeny
PubMed: 38956049
DOI: 10.1038/s41598-024-63254-x -
GeroScience Jul 2024There is abundant evidence that bone mineral content is highly heritable, while the heritability of bone quality (i.e. trabecular bone score [TBS] and quantitative...
There is abundant evidence that bone mineral content is highly heritable, while the heritability of bone quality (i.e. trabecular bone score [TBS] and quantitative ultrasound index [QUI]) is rarely investigated. We aimed to disentangle the role of genetic, shared and unique environmental factors on TBS and QUI among Hungarian twins. Our study includes 82 twin (48 monozygotic, 33 same-sex dizygotic) pairs from the Hungarian Twin Registry. TBS was determined by DXA, QUI by calcaneal bone ultrasound. To estimate the genetic and environmental effects, we utilized ACE-variance decomposition. For the unadjusted model of TBS, an AE model provided the best fit with > 80% additive genetic heritability. Adjustment for age, sex, BMI and smoking status improved model fit with 48.0% of total variance explained by independent variables. Furthermore, there was a strong dominant genetic effect (73.7%). In contrast, unadjusted and adjusted models for QUI showed an AE structure. Adjustments improved model fit and 25.7% of the total variance was explained by independent variables. Altogether 70-90% of the variance in QUI was related to additive genetic influences. We found a strong genetic heritability of bone quality in unadjusted models. Half of the variance of TBS was explained by age, sex and BMI. Furthermore, the adjusted model suggested that the genetic component of TBS could be dominant or an epistasis could be present. In contrast, independent variables explained only a quarter of the variance of QUI and the additive heritability explained more than half of all the variance.
PubMed: 38955996
DOI: 10.1007/s11357-024-01265-2 -
Environmental Science and Pollution... Jul 2024The removal of dyes from the aquatic ecosystem is necessary being a major threat to life. For enhanced remediation of methylene blue (MB) dye, a new ternary...
The removal of dyes from the aquatic ecosystem is necessary being a major threat to life. For enhanced remediation of methylene blue (MB) dye, a new ternary biopolymer-geopolymer-surfactant composite adsorbent is synthesized by combining phosphoric acid geopolymer (PAGP), calcium alginate (Alg), and sodium lauryl sulfate (SLS). During the synthesis of the composites, PAGP and SLS were mixed with the alginate matrix, producing porous hybrid beads. The PAGP-SLS-alginate (PSA) beads prepared were characterized using different analytical tools, i.e., scanning electron microscopy (SEM), Fourier transform infrared spectrophotometry (FTIR), X-ray diffractometry (XRD), surface area and porosimetery (SAP), and thermogravimetric analysis (TGA). To ascertain the ideal conditions for the adsorption process, a batch reactor procedure was used to investigate the effects of several parameters on MB adsorption, including pH (2, 4, 6, 8, 10), PSA adsorbent dosage (0.06-0.12 g), MB concentration (50-500 mg/L), contact time (15 to 300 min), and temperature (25, 35, and 45 °C). The SEM investigation indicated that ~ 1860 μm-sized PSA beads with 6-8 μm voids are generated. Based on XRD, FTIR, and SAP examinations, the material is amorphous, having numerous functional groups and an average pore size of 6.42 nm. Variation of pH has a little effect on the adsorption process, and the pH of 7.44 was found to be the pH of the PSA beads. According to the findings of the batch study, equilibrium adsorption was obtained in 270-300 min, showing that the adsorption process was moderately slow-moving and effective. The dye adsorption linearly increased with initial dye concentration over concentration range of 50-500 mg/L and reciprocally decreased with rise in temperature. 0.06 g adsorbent dose, 25 °C, pH10, and 270 min were found to be the better conditions for adsorption experiments. Langmuir isotherm fitted well compared to Freundlich, Temkin, and Dubinin-Radushkevich (DR) isotherm models on the experimental data, and the maximum adsorption capacity(q) calculated was 1666.6 mg. g. Pseudo-second-order (PSO) kinetics model and multi steps (two) intra particle diffusion (IPD) model fitted well on the adsorption kinetics data. The system's entropy, Gibbs free energy, and change in enthalpy were measured and found to be -109.171 J. mol. K, - 8.198 to - 6.014 kJ. mol, and - 40.747 kJ. mol. Thermodynamics study revealed that adsorption process is exothermic, energetically favorable and resulting in the decrease in randomness. Chemisorption is found to be the dominant mechanism as confirmed by pH effect, Langmuir isotherm, PSO kinetics, IPD model, and thermodynamics parameters. PSA beads were successfully regenerated using ethanol in a course of 120 min and re-used for five times. To sum up, the PSA adsorbent's impressive adsorption capability of 1666.66 mg/g highlights its potential as a successful solution for methylene blue removal. The results of this study add to the expanding corpus of information on sophisticated adsorption materials and demonstrate PSA's potential for real-world uses in wastewater treatment and environmental clean-up.
PubMed: 38955975
DOI: 10.1007/s11356-024-33573-7 -
Journal of Molecular Modeling Jul 2024This study investigates the impact of arsenic doping on the optical characteristics and electronic structure of zigzag (8, 0) and armchair (4, 4) gallium phosphide...
CONTEXT
This study investigates the impact of arsenic doping on the optical characteristics and electronic structure of zigzag (8, 0) and armchair (4, 4) gallium phosphide nanotubes using first-principles calculations based on the GaPAs system, where x = 0, 0.25, 0.5, 0.75, and 1. The electronic calculations showed that doping more arsenic atoms reduces the energy band gap for zigzag and armchair GaPAs nanotubes. PDOS analysis indicates that Ga-4p and P-3p orbitals play a significant role in determining the electronic properties of the GaP nanotube. The dominance of Ga-4p and P-3p orbitals in both the valence and conduction bands indicates their importance across the energy spectrum of the material. The complex dielectric function and absorption coefficient of zigzag and armchair GaPAs nanotubes are calculated for incident radiation with energies ranging from 1 to 6.2 eV. Optical results revealed that both zigzag and armchair GaPNTs exhibit strong absorption in the UV-visible regions due to electronic transitions between different Van Hove singularities. Also, due to quantum confinement effects, pure zigzag gallium phosphide nanotube exhibited two absorption edges at wavelengths (273 and 375 nm). These edges stand from the energy level's quantization in the nanotube construction, affecting the absorption characteristics. Substitutional doping by arsenic atoms changes the absorption edge to the long wavelengths due to decreased bandgap energy. Investigating electronic structures and optical properties of nanotubes proposes several advantages, such as understanding the doping effects on the nanotube structure and contributing to the direction of the experimental studies. These computational studies play a key role in developing the applications of nanomaterials.
METHODS
Calculations of density functional theory (DFT) are achieved via the SIESTA package. SIESTA is a powerful and effective tool for executing DFT calculations on a large system of atoms. It generates numerous output files covering detailed information about the electronic structure, optical properties, total energy, optimized geometry, and other computed properties. The generalized gradient approximation GGA with Perdew-Burke-Ernzerhof PBE functional was used. A vacuum region of 10 A was applied to avoid the interactions of adjacent nanotubes.
PubMed: 38955842
DOI: 10.1007/s00894-024-06047-3 -
Journal of Food Science Jul 2024The wide biological activity of the Moringa oleifera represents a potential opportunity for developing selective cancer treatment drugs. The bioactive phytochemicals in...
The wide biological activity of the Moringa oleifera represents a potential opportunity for developing selective cancer treatment drugs. The bioactive phytochemicals in Moringa seed extract (MSE) indicated large numbers of phytochemicals (21 compounds) with dominant abundance for cycloisolongifolene, 8,9-dehydro-9-vinyl, and chamazulene accounting for 12.7% and 12.19% of the total detected compounds. The MSE showed a potent anticancer effect toward Caco-2, MDA, and HepG-2 cells with half-maximal inhibitory concentration (IC) values of 9.15 ± 1.18, 4.85 ± 0.11, and 7.36 ± 0.22 µg/mL, respectively, with higher safety (≥31-folds) toward normal human cells (IC of 150.7 ± 11.11 µg/mL). It appears that MSE stimulates selective-dose-dependent cell shrinkage, and nuclear condensation in the tumor cells, which finally induces the apoptosis pathway to increase its anticancer action. Additionally, MSE showed a potent capability to stimulate cell cycle arrest in both main checkpoint phases (G0/G1 and G2/M) of cell population growth. The apoptotic death stimulation was confirmed through upregulation of tumor protein p53 (p53) and cyclin-dependent kinase inhibitor p21 (p21) expression by more than three- to sixfold and downregulation of B-cell lymphoma 2 expression (threefold) in MSE-treated cells compared to 5-fluorouracil (5-FU)-treated tumor cells. Furthermore, the MSE revealed strong anti-inflammatory activity with significant antioxidant activity by lowering nitric oxide levels and enhancing the superoxide dismutase activity. On the other hand, the MSE revealed broad-spectrum antibacterial activity in a dose-dependent manner against Staphylococcus aureus minimum inhibitory concentration (MIC of 1.25 mg/mL), followed by Salmonella typhimurium (MIC of 1.23 mg/mL), whereas Escherichia coli was the least sensitive to MSE activity (MIC of 22.5 mg/mL) with significant antibiofilm activity against sensitive pathogens.
PubMed: 38955793
DOI: 10.1111/1750-3841.17223 -
[Zhonghua Yan Ke Za Zhi] Chinese... Jul 2024To explore the characteristics of refractive parameters and retinal and choroidal blood flow in dominant and non-dominant eyes. A cross-sectional study. Students who...
To explore the characteristics of refractive parameters and retinal and choroidal blood flow in dominant and non-dominant eyes. A cross-sectional study. Students who were 18 to 32 years old and had emmetropia or myopia but no systemic diseases were recruited from universities in Wuhu, Anhui Province from April 2019 to August 2023. They were divided into 4 groups based on the difference in spherical equivalent between two eyes:<0.50 D (group A), 0.50 to 1.74 D (group B), 1.75 to 2.49 D (group C), and≥2.50 D (group D). The card hole method was used to determine the dominant eye. The refractive parameters of both eyes were recorded, including spherical equivalent, myopia degree, astigmatism degree, axial length, and corneal curvature difference (K2-K1). Optical coherence tomography angiography was performed to measure the blood flow density of the superficial retinal capillaries, deep retinal capillaries (DVC), avascular layer (AC), entire retina, choroidal capillaries, and choroidal vessels, as well as the retina and choroid as a whole. Statistical analysis was conducted using the paired sample -test, chi square test, and variance analysis. A total of 78 eligible subjects, aged (24.50±2.36) years old, 28 males and 50 females, were included. Fifty subjects had the right eye and 28 had the left eye as the dominant eye. Forty-two subjects had high myopia in the dominant eye, and 30 had high myopia in the non-dominant eye. There were statistically significant differences (all <0.05) in the spherical equivalent [(-4.588±2.534) D . (-4.058±2.453) D], myopic spherical power [(-4.253±2.504) D . (-3.779±2.425) D], and axial length [(25.531±1.212) mm . (25.256±1.238) mm] between dominant and non-dominant eyes among all subjects, as well as in the astigmatism degree of groups A and C, spherical power of groups B to D, and spherical power and axial length of groups C and D. There were also statistically significant differences (all <0.05) in the blood flow density of the DVC [(0.291±0.130) . (0.257±0.148)], AC [(0.347±0.118) . (0.326±0.126)], and overall retina and choroid [(0.385±0.102) . (0.349±0.084)] between dominant and non-dominant eyes among all subjects, as well as in the blood flow density of the superficial retinal capillaries, DVC, AC, choroidal capillaries, and overall retina and choroid of groups C and D, density of the choroidal vessels of group C, and density of the entire retina of group D. In young individuals with emmetropia or near vision, the degree of myopia in dominant eyes is higher than that in non-dominant eyes. When the difference in the spherical equivalent between two eyes is ≥1.75 D, the blood flow density of the retina and choroid in the dominant eye is greater than that in the non-dominant eye.
Topics: Humans; Male; Female; Cross-Sectional Studies; Adult; Young Adult; Refraction, Ocular; Myopia; Choroid; Adolescent; Retina; Retinal Vessels; Astigmatism; Regional Blood Flow
PubMed: 38955761
DOI: 10.3760/cma.j.cn112142-20240205-00066 -
Zhonghua Yu Fang Yi Xue Za Zhi [Chinese... Jun 2024This study was to investigate the relationship between spring pollen distribution concentration, species and the detection results of air-borne pollen allergens in...
This study was to investigate the relationship between spring pollen distribution concentration, species and the detection results of air-borne pollen allergens in Taiyuan City, Shanxi Province during March to May 2022 and March to May 2023.A retrospective study was conducted in the Otorhinolaryngology Head and Neck Surgery Clinic of the First Hospital of Shanxi Medical University.Pollen particles will be monitored by gravity sedimentation method on the roof of the outpatient department of the First Hospital of Shanxi Medical University in downtown Taiyuan from March to May 2022-2023, and pollen species and quantity will be observed and recorded under an optical microscope.The air-borne pollen allergen detection results of all allergic rhinitis patients in the otolaryngology Head and Neck surgery Department of the First Hospital of Shanxi Medical University were extracted from the relevant outpatient system. SPSS software and Pearson correlation analysis were used to compare the correlation between the allergens and the dominant air-borne pollen monitoring results. Results are as follows: (1)A total of 18 species of spring pollen in Taiyuan City were monitored in 2022-2023, with 101 177.5 grains, and the dominant airborne pollen was poplar (16.69%) and pine (29.06%) pollen. The pollen of poplar (11.96%), elm (7.89%) and cypress (8.68%) were dominant in early spring; Pine (25.16%) pollen predominated in late spring. The two peaks of pollen dispersal in Taiyuan were in late March (15 479 grains) and early and mid May (15 094/15 343 grains).(2) The positive rates of allergens in serum specific IgE detection were: wormwood (46%, 248/541 cases), tree combination (26%, 143/541 cases), ragweed (19%, 101/541 cases), humulus scandens (9%, 49/541 cases).(3)There was a linear positive correlation between the positive rate of air-borne pollen allergens in allergic rhinitis patients in the Department of Otolaryngology Head and Neck Surgery in the First Hospital of Shanxi Medical University and the dominant air-borne pollen concentration in the same period (0.05, =0.999). In conclusion, two spring pollen dispersal peaks were formed in late March and early to mid May in Taiyuan City, and the dominant air-borne pollens were poplar and pine pollens. The positive rate of air borne pollen allergen sIgE showed that wormwood allergy was the highest.There was a positive correlation between the concentration of air-borne pollen and the positive rate of air-borne pollen allergens in patients with allergic rhinitis in the Department of otorhinolaryngology and head and neck surgery in Taiyuan in 2022 and 2023.The monitoring of pollen distribution in spring can provide an important scientific basis for clinical workers to formulate prevention and treatment plans for patients with allergic rhinitis in the season, and provide data reference for the epidemiological investigation of allergic diseases in Taiyuan in the future.
Topics: Humans; Pollen; China; Retrospective Studies; Allergens; Immunoglobulin E; Seasons; Rhinitis, Allergic; Rhinitis, Allergic, Seasonal
PubMed: 38955729
DOI: 10.3760/cma.j.cn112150-20231213-00442 -
Zhonghua Yu Fang Yi Xue Za Zhi [Chinese... Jun 2024To investigate the distribution rules of artemisia pollen and the clinical sensitization characteristics of allergic rhinitis (AR) induced by artemisia pollen in three...
To investigate the distribution rules of artemisia pollen and the clinical sensitization characteristics of allergic rhinitis (AR) induced by artemisia pollen in three urban and rural areas of Inner Mongolia. From March to October 2019, in 3 central cities (Chifeng, Hohhot, Ordos) and rural areas of Inner Mongolia, an epidemiological investigation method combining multi-stage stratified random sampling and face-to-face questionnaire survey was adopted to screen suspected AR patients, and skin prick test (SPT) was applied for diagnosis. At the same time, pollen monitoring was carried out in 3 areas to analyze the distribution and clinical sensitization characteristics of artemisia pollen.SPSS26.0 statistical software was used to process all the data. Chi-square test was used to compare rates among different age, sex, region and nationality, Spearman test was used to describe correlation analysis, and pairwise comparison of positive rates among multiple samples was used Bonferroni method. Among the 6 393 subjects, 1 093 cases were diagnosed with AR, and the prevalence of AR was 17.10% (1 093/6 393). Among them, pollen-induced allergic rhinitis, the prevalence of PiAR was 10.97% (701/6 393), accounting for 64.14%(701/1 093).The highest incidence was in the youth group (20-39 years old), accounting for 46.94% (329/701).The diagnosed prevalence was higher in females than in males (11.35% 10.64%, value 12.304, <0.001).The prevalence rate of ethnic minority was higher than that of Han nationality (13.01% 10.65%, value 6.296, =0.008).The prevalence in urban areas was also significantly higher than that in rural areas (18.40% 5.50%, value 10.497, <0.001).There was significant difference in prevalence rate among the three regions in Inner Mongolia (6.06% in Chifeng, 13.46% in Hohhot, 16.39% in Ordos, value 70.054, <0.001).The main clinical symptoms of artemisia PiAR were sneezing (95.58%), nasal congestion (91.73%) and nasal itching (89.30%).Allergic conjunctivitis accounted for 79.60% (558/701), chronic sinusitis for 55.63% (390/701), asthma for 23.25% (163/701).The pattern of artemisia pollen sensitization was mainly multiple sensitization, and the frequency of clinical symptoms and clinical diseases induced by hypersensitization with other allergens accounted for more than that caused by single artemisia pollen. The spread period of Artemisia pollen in the three regions was from June to October, and the peak state was in August in summer. The peak time of clinical symptoms in artemisia PiAR patients was about 2 weeks earlier than the peak time of pollen concentration, and the two were significantly positively correlated (=0.7671, <0.001). Artemisia pollens are the dominant pollens in late summer and early autumn in Inner Mongolia, and the prevalence of artemisia PiAR is high. Controlling the spread of Artemisia pollens is of great significance for the prevention and treatment of AR.
Topics: Humans; Artemisia; Pollen; Rural Population; China; Prevalence; Urban Population; Skin Tests; Rhinitis, Allergic; Surveys and Questionnaires; Allergens; Rhinitis, Allergic, Seasonal; Male; Female; Adult; Young Adult
PubMed: 38955727
DOI: 10.3760/cma.j.cn112150-20230927-00228 -
Zhonghua Bing Li Xue Za Zhi = Chinese... Jul 2024To investigate the clinicopathological characteristics and prognostic factors of sporadic mismatch repair deficient (dMMR) colorectal cancer. A total of 120 cases of...
To investigate the clinicopathological characteristics and prognostic factors of sporadic mismatch repair deficient (dMMR) colorectal cancer. A total of 120 cases of sporadic dMMR colorectal cancer from July 2015 to April 2021 were retrospectively collected in Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. Patients with Lynch syndrome; synchronous multiple colorectal cancers; preoperative anti-tumor treatments such as chemotherapy and radiotherapy; and those with incomplete follow-up information were excluded based on family history and next-generation sequencing (NGS) test results. Immunohistochemical stains were used to detect the expression of mismatch repair proteins, methylation-specific PCR for methylation testing, and fluorescent PCR for BRAF V600E gene mutation detection. The clinical and pathological data, and gene mutation status were analyzed. Follow-up was done to assess survival and prognosis including progression-free survival and overall survival rate. Sporadic dMMR colorectal cancer occurred more frequently in the right side of the colon, in females, and in the elderly. Morphologically, it was mostly moderately-differentiated, and most patients had low-grade tumor budding. In terms of immunohistochemical expression, MLH1 and PMS2 loss were dominant, and there were age and location-specificities in protein expression. MLH1 methylation was commonly detected in elderly female patients and rare in young male patients; while MLH1 and PMS2 deficiency, and BRAF V600E mutation occurred more often on the right side (<0.05). The 3-year and 5-year progression-free survival rates were 90.7% and 88.7% respectively, and the 3-year and 5-year overall survival rates were 92.8% and 90.7% respectively. Tumor budding status was an independent risk factor affecting patient recurrence (hazard ratio=3.375, 95% confidence interval: 1.060-10.741, 0.039), patients with low-grade tumor budding had better prognosis, and those with medium or high-grade tumor budding had poor prognosis. For dMMR colorectal cancer patients, tumor budding status is an independent risk factor for recurrence.
Topics: Humans; Colorectal Neoplasms; Male; Female; Prognosis; Retrospective Studies; DNA Mismatch Repair; Proto-Oncogene Proteins B-raf; MutL Protein Homolog 1; Mutation; Survival Rate; Middle Aged; Aged; DNA Methylation; Adult; Colorectal Neoplasms, Hereditary Nonpolyposis
PubMed: 38955702
DOI: 10.3760/cma.j.cn112151-20240307-00152