Mongolian Patients Research Articles

Genetic Basis of Hearing Loss in Mongolian Patients: A Next-Generation Sequencing Study.

The genetic landscape of sensorineural hearing impairment (SNHI) varies across populations. In Mongolia, previous studies have shown a lower prevalence of GJB2 mutations and a higher frequency of variants in other deafness-related genes. This study aimed to investigate the genetic variants associated with idiopathic SNHI in Mongolian patients. We utilized the next-generation sequencing for investigating the causative mutations in 99 Mongolian patients with SNHI. We identified pathogenic variants in 53 of the 99 SNHI patients (54%), with SLC26A4 being the most frequently mutated gene. The c.919-2A>G variant in SLC26A4 was the most prevalent, accounting for 46.2% of the mutant alleles. In addition, we identified 19 other known and 21 novel mutations in a total of 21 SNHI genes in autosomal recessive or dominant inheritance patterns. Our findings expand the understanding of the genetic landscape of SNHI in Mongolia and highlight the importance of considering population-specific variations in genetic testing and counseling for SNHI.

Fusion Genes Landscape of Lung Cancer Patients From Inner Mongolia, China.

Lung cancer is the leading cause of cancer-related deaths globally. Gene fusion, a key driver of tumorigenesis, has led to the identification of numerous driver gene fusions for lung cancer diagnosis and treatment. However, previous studies focused on Western populations, leaving the possibility of unrecognized lung cancer-associated gene fusions specific to Inner Mongolia due to its unique genetic background and dietary habits. To address this, we conducted DNA sequencing analysis on tumor and adjacent nontumor tissues from 1200 individuals with lung cancer in Inner Mongolia. Our analysis established a comprehensive fusion gene landscape specific to lung cancer in Inner Mongolia, shedding light on potential region-specific molecular mechanisms underlying the disease. Compared to Western cohorts, we observed a higher occurrence of ALK and RET fusions in Inner Mongolian patients. Additionally, we discovered eight novel fusion genes in three patients: SLC34A2-EPHB1, CCT6P3-GSTP1, BARHL2-APC, HRAS-MELK, FAM134B-ERBB2, ABCB1-GIPC1, GPR98-ALK, and FAM134B-SALL1. These previously unreported fusion genes suggest potential regional specificity. Furthermore, we characterized the fusion genes' structures based on breakpoints and described their impact on major functional gene domains. Importantly, the identified novel fusion genes exhibited significant clinical and pathological relevance. Notably, patients with SLC34A2-EPHB1, CCT6P3-GSTP1, and BARHL2-APC fusions showed sensitivity to the combination of chemotherapy and immunotherapy. Patients with HRAS-MELK, FAM134B-ERBB2, and ABCB1-GIPC1 fusions showed sensitivity to chemotherapy. In summary, our study provides novel insights into the frequency, distribution, and characteristics of specific fusion genes, offering valuable guidance for the development of effective clinical treatments, particularly in Inner Mongolia.

The Metabolic Functional Feature of Gut Microbiota in Mongolian Patients with Type 2 Diabetes.

The accumulating evidence substantiates the indispensable role of gut microbiota in modulating the pathogenesis of type 2 diabetes. Uncovering the intricacies of the mechanism is imperative in aiding disease control efforts. Revealing key bacterial species, their metabolites and/or metabolic pathways from the vast array of gut microorganisms can significantly contribute to precise treatment of the disease. With a high prevalence of type 2 diabetes in Inner Mongolia, China, we recruited volunteers from among the Mongolian population to investigate the relationship between gut microbiota and the disease. Fecal samples were collected from the Volunteers of Mongolia with Type 2 Diabetes group and a Control group, and detected by metagenomic analysis and untargeted metabolomics analysis. The findings suggest that Firmicutes and Bacteroidetes phyla are the predominant gut microorganisms that exert significant influence on the pathogenesis of type 2 diabetes in the Mongolian population. In the disease group, despite an increase in the quantity of most gut microbial metabolic enzymes, there was a concomitant weakening of gut metabolic function, suggesting that the gut microbiota may be in a compensatory state during the disease stage. β-Tocotrienol may serve as a pivotal gut metabolite produced by gut microorganisms and a potential biomarker for type 2 diabetes. The metabolic biosynthesis pathways of ubiquinone and other terpenoid quinones could be the crucial mechanism through which the gut microbiota regulates type 2 diabetes. Additionally, certain Clostridium gut species may play a pivotal role in the progression of the disease.

Higher disease burden and lower utilization in Mongolian with breast cancer: a 9-year retrospective cohort study of 18.19 million adults in China.

Whether health inequalities of disease burden and medical utilization exist by ethnicity in Asian breast cancer (BC) patients remains unclear. The authors aim to measure ethnic disparities in disease burden and utilization among Mongolian and Han female BC patients in China. Based on data extracted from Inner Mongolia Regional Health Information Platform, a retrospective cohort study was established during 2012-2021. Disease burden including incidence, 5-year prevalence, mortality, survival rate, and medical cost were analyzed and compared between Han and Mongolian patients. A total of 34878 female patients [mean (SD) age, 52.34 (10.93) years] were included among 18.19 million Chinese, and 4315 (12.03%) participants were Mongolian. Age-standardized rates of incidence are 32.68 (95% CI: 20.39-44.98) per 100000. Higher age-specific incidence and 5-year prevalence were observed in Mongolian than in Han. The cost of BC annually per capita was significantly lower for Mongolian than Han [$1948.43 (590.11-4 776.42) vs. $2227.35 (686.65-5929.59), P <0.001]. Mongolian females showed higher all-cause mortality [30.92 (95% CI: 28.15-33.89) vs. 27.78 (95% CI: 26.77-28.83) per 1000, P =0.036] and BC-specific mortality [18.78 (95% CI: 16.64-21.13) vs. 15.22 (95% CI: 14.47-16.00) per 1000, P =0.002] than Han females. After adjusting covariates, Mongolian were associated with increased all-cause mortality [HR, 1.21, (95% CI: 1.09-1.34); P <0.001] and BC-specific mortality [HR, 1.31, (95% CI: 1.14-1.49); P <0.001]. The findings of this cohort study highlight a higher level of disease burden with unmet medical demand in Mongolian patients, suggesting that more practical efforts should be made for the minority. Further research is needed to explore the concrete mechanisms of the disparities as well as eliminate health disproportion.

Risk factors associated with hepatitis D virus infection and preventive strategies in Mongolia.

Hepatitis D virus (HDV) infection is highly prevalent in Mongolia. We aimed to identify the risk factors associated with HDV infection, propose preventive strategies, and evaluate the outcomes of a 3-year collaborative project between Taiwan and Mongolia. In 2016 and 2018, we conducted onsite visits to Mongolia. Mongolian investigators collected questionnaires focusing on risk factors, demographic characteristics, and serum samples for acute HDV infections. Furthermore, 19 Mongolian seed teachers participated in a 1-week workshop on infection control in Taiwan. Subsequently, these seed teachers trained more than 400 medical personnel in Mongolia. To assess secular changes in acute HDV infection, we reviewed the registration data from the National Center for Communicable Disease (NCCD) in Mongolia between 2011 and 2021. Among the 194 Mongolian patients, 108 had dual infection with hepatitis B virus (HBV) and HDV, while 86 had acute hepatitis B (AHB). Patients with HBV/HDV dual infections were older (28.6 vs 25.5 years, p = 0.030) and had lower rates of positive hepatitis B e antigen in their sera, lower rates of serum HBV DNA exceeding 2000 IU/mL, and higher rates of having received dental treatment (59.4% vs 40.5%, p = 0.014) and injection therapy (64.2% vs 44.0%, p = 0.009) compared with those with AHB. Analysis of NCCD data revealed that new HDV infection cases were more prevalent between 2011 and 2015 (111.20 ± 29.79 cases/y) and decreased to 54.67 ± 27.34 cases/y between 2016 and 2021 ( p = 0.010). Dental treatment and injections were associated with a higher risk of acute HDV infections in Mongolia. Through collaborative efforts, the incidence rate of HDV infection has declined in recent years.

Analysis of the Correlation between FH and PCSK9 and APOB Gene Mutations in Han and Mongolian Populations of the Hulunbuir.

The goal of the study was to provide an individual and precise genetic and molecular biological basis for the early prevention, diagnosis, and treatment of local FH by analyzing the risk factors for the development of FH in Han and Mongolian patients in the Hulunbuir, comparing the lipid levels of FH patients of the two ethnicities, and assessing differences in mutations to two genes between the two ethnic groups. Twenty cases each of Han Chinese and Mongolian healthy controls and fifty patients who each met the inclusion criteria from November 2021 to December 2022 in five general hospitals in Hulunbuir were selected. Multifactor logistic analysis was used to analyze the risk factors associated with the development of FH. We used t-tests to analyze statistical differences in lipid levels between the groups, and Sanger sequencing to detect the dis-tribution of common mutation sites of PCSK9 and APOB in all study subjects. The mutation rates and differences between regions and ethnic groups were summarized and compared. 1) Gender, age, alcohol consumption, dietary status, and a family history of FH were risk factors associated with the development of FH. 2) TC, LDL-C, and APOB were significantly higher in Mongolian cases than Han cases (p < 0.05). sdLDL-C was not statistically different between the two ethnicities (p > 0.05). 3) We detected four (8%) heterozygous mutations at the PCSK9 gene E670G mutation site in the Han case group and a total of nine (18%) mutations at this site in the Mongolian cases, including one (2%) homozygous and eight (16%) heterozygous mutations. One case of a heterozygous mutation was detected in the Mongolian control group. We detected a total of ten (20%) mutations at the APOB gene rs1367117 mutation site in the Han case group, including eight (16%) heterozygous and two (4%) homozygous mutations, 11 cases (22%) of heterozygous mutations in the Mongolian case group, two cases of heterozygous mutations in the Han control group, and one case of a heterozygous mutation in the Mongolian control group. 4) The D374Y and S127R mutation sites of PCSK9 and the R3500Q mutation site of APOB were not detected in any of the study subjects. The mutation sites of the PCSK9 and APOB genes in FH patients in Hulunbuir are different from other regions, and the mutation rate is higher than in other regions. Therefore, we recommend that the mutation sites of the PCSK9 and APOB genes described herein be used as clinical detection indicators to assist the diagnosis of FH in this region.

Comparison of outcome after thrombolytic therapy between young and old Mongolian patients with acute ischemic stroke

Comparison of outcome after thrombolytic therapy between young and old Mongolian patients with acute ischemic stroke

Corneal characteristics of Mongolian population with type 2 diabetic peripheral neuropathy in inner Mongolia, China: an assessment using corneal confocal microscopy

ObjectiveTo quantify corneal nerve fiber parameters in a Mongolian population with diabetic peripheral neuropathy (DPN) by corneal confocal microscopy.MethodsThis study conducted a comprehensive evaluation of 114 participants from Hulunbuir between January 2020 and December 2021. The participants included healthy controls, Mongolian and Han patients with type 2 diabetes mellitus. Demographic, medical, and laboratory data were collected, and neuropathy was evaluated by confocal corneal microscopy. And compare various parameters between Han and Mongolian were performed using SPSS software.ResultsThe average waist circumference of Mongolian diabetic patients was larger than that of Han diabetic patients (P < 0.05). The mean HbA1c of Mongolian was 9.30 (8.15, 10.30) %, and that of Han was 8.30 (7.20, 9.40) % (P = 0.023). The average values of Corneal Nerve Fiber Density (CNFD), Corneal Nerve Fiber Length (CNFL) and corneal nerve branch density (CNBD) in Mongolian diabetic patients were significantly lower than those in Han diabetic patients (P < 0.05). The correlation coefficient between CNFL and age was − 0.368. ROC results show that CNBD has a certain diagnostic value for DPN in Mongolian patients with type 2 diabetes and the optimal cut-off point value is 24.99(no./mm2), the sensitivity is 80.0%, and the specificity is 77.8%.ConclusionThe corneal confocal microscopy could possibly represent a promising adjuvant technique for the early diagnosis and assessment of PDN in Mongolian T2DM patients.

Assessment of Laser in Situ Keratomileusis Flap Predictability by Laser and Moria Microkeratome

Objective: In the present study, we compared LASIK flap thickness predictability created by a FS laser versus a Moria microkeratome in Mongolian patients. Methods: A total of ninety-six candidates for the LASIK procedure were stratified into two groups: FS laser-assisted and MK flap creation. Flap thickness was determined at five points. The side-cut angle was measured in three directions at the margin interface. LASIK flap assessment was performed one month postoperatively by Spectralis anterior segment optical coherence tomography. Results: Ninety-five participants (190 eyes) were recruited; 190 eyes were stratified to the FS group and 78 eyes to the MK group. The FS group had relatively even flap configurations, and the MK group had meniscus-shaped flaps. Regarding CR-sphere and cylinder, there was significant difference between 2 groups. The mean cylinder was -1.216 ± 0.924 in FS group while it was -0.730 ± 0.738 in MK group. Similarly, the mean sphere was -3.635 ± 2.031 in FS-LASIK group and -2.984 ± 1.502 in MK-LASIK group. The side-cut architecture varied among the two groups. OCT-C and OCT1Temporal values were significantly different between two groups. Conclusion: Improving the predictability of LASIK flap thickness and morphology is significantly important.

Latent TB Infection, Vitamin D Status and COVID-19 Severity in Mongolian Patients.

We aimed to determine potential risk factors for COVID-19 severity including serum vitamin D levels and latent TB infection among Mongolian inpatients diagnosed with COVID-19, and to study the effects of disease complications and treatment outcomes. This study included patients admitted to the Mongolian National Center for Communicable Disease, a main referral center for infectious disease in Mongolia, with COVID-19 ascertained by a positive PCR test. Patients' demographic, clinical, and laboratory data were analyzed. Of the 270 patients enrolled, 125 (46%) had mild-to-moderate illness, 86 (32%) had severe illness, and 59 (22%) had critical illness. Ten (91%) of the 11 patients who had active TB were hospitalized with severe or critical COVID-19, suggesting that they had a higher risk of falling into the severe category (OR = 10.6 [1.2; 92.0] 95% CI). Severe vitamin D deficiency (25(OH)D < 10 ng/mL) was present in 32% of the patients, but was not significantly associated with the severity of illness (p = 0.65). Older age, being male, having active TB and/or COPD were associated with greater COVID-19 severity, whereas a history of COVID-19 vaccination and the presence of a BCG vaccination scar were protective in terms of disease severity.

Gut microbiota characteristics of Mongolian and Han populations in anti-tuberculosis drug-induced liver injury: a population-based case–control study

BackgroundThe pathogenesis of anti-tuberculosis (TB) drug-induced liver injury (ADLI) is complicated and remains unclear. We aimed to analyse the relationship between the characteristics of gut microbiota and ADLI in Mongolian and Han patients with pulmonary TB and identify the most notable bacteria related to the occurrence of liver injury in those populations.MethodsPatients with concurrent liver injury (LI) and no liver injury (ULI) before receiving first-line anti-TB drug treatment (T1) from the Han population in Tangshan and the Mongolian population in Inner Mongolia were selected as research subjects. At the time of liver injury (T2), stool samples were measured by bacterial 16S rRNA gene high-throughput sequencing to analyse and compare the differences in the gut microbiota of the LI and ULI Mongolian and Han patients at T1 and T2 and identify the differences between those patients.ResultsA total of 45 Mongolian and 37 Han patients were enrolled in our study. A dynamic comparison from T1 to T2 showed that the microbiota of the LI and ULI groups changed significantly from T1 to T2 in both the Mongolian and Han populations. However, there were commonalities and personality changes in the microbiota of the two ethnic groups.ConclusionDifferences in gut microbes in ADLI were found among the Han and Mongolian patients in our study. Ekmania and Stenotrophomonas were related to the occurrence of ADLI in Mongolian patients, while Ekmania and Ruminococcus__gnavus_group were related to the occurrence of ADLI in the Han population.

Efficacy of Intravitreal Bevacizumab in Neovascular Age-Related Macular Degeneration

Objective: To study the effect of cataract surgery with intravitreal bevacizumab therapy on visual and anatomical outcomes in patients with neovascular age-related macular degeneration (AMD) in Mongolian patients. Methods: A retrospective analysis of 72 eyes of 36 patients with neovascular AMD evaluated intravitreal bevacizumab (1or2.5 mg) injections. Retreatment was performed following an optical coherence tomography (OCT)-based regimen. Ophthalmic examination included best-corrected visual acuity (BCVA), dilated fundus examination, and OCT image analysis. Results: A total of 11 patients received cataract surgery. We could not observe statistical significance between the two groups. The BCVA of the right eye of patients having cataract surgery improved by 0.21 ± 0.29, while the corresponding value for patients without surgery was 0.32 ± 0.32. The mean central retinal thickness (CRT) of patients with refraction was decreased from 264.4 ± 82.32 μm at baseline to 244.55 ± 52.59 μm for the right eye, while it was 275.4 ± 96.4 μm at baseline to 276.36 ± 68.22 μm for the left eye. Conclusion: Cataract surgery with intravitreal bevacizumab therapy in eyes with neovascular AMD in aged patients was performed.

Minimal Stimulation Using Gonadotropin Combined with Clomiphene Citrate or Letrozole for Intrauterine Insemination

Objective: In this study we aimed to evaluate the administration efficiency of first-line drugs such as clomiphene citrate (CC), letrozole (L), and the gonadotropin follicle stimulating hormone (FSH) to be used in ovulation induction for intra uterine induction (IUI) in Mongolian patients. Methods: In this prospective single center study we recruited 158 infertile women with polycystic ovarian syndrome (PCOS). Results: In the FSH group, 15 patients (31.2 %) had mycoplasma. On the other hand, the group CC and the L group had a significantly higher number of pregnancies compared than the FSH group. Moreover, there was a trend for an increasing volume of menstruation in the CC group. 38.6 % having a medium volume of menstruation, while 59.6 % had a big volume of menstruation. Stimulation characteristics of patients shows that estradiol on started day (SE2) was significantly higher in the FSH group (768.91 ± 575.64), while it was 523.66 ± 435.84 and 419.36 ± 326.30 in the CC and the L groups, respectively. Conclusions: A minimal stimulation protocol using FSH, CC and L separately was done in Mongolian women with polycystic ovarian syndrome (PCOS). Clinical pregnancy rates were 1.46 ± 0.50 in the FSH group, 1.35 ± 0.48 in CC group, and 1.38 ± 0.49 in L group.

Post-Cesarean Sepsis Causes and Biomarkers

Objective: The determination of procalcitonin and lactate levels in the early diagnosis of sepsis is clinically significant and the higher the lactate level increases the greater the risk of mortality. In order to improve prevention and treatment of post-caesarean sepsis, in the present study we aimed to determine the serum biomarkers of Mongolian patients undergoing a cesarean section. Methods: Procalcitonin was determined by “E - 411” which is a fully automated analyzer and also by enzyme binding assay. Lactate, C-reactive protein, and lactate dehydrogenase was determined by “E - 411 only. Statistical analysis was performed by a SPSS - 20 software program, and statistics process by the chi-square test, Fisher test, and t-test. The confirmation rate was 95 % p &lt; 0.05. Results: Women who gave childbirth in 2016 - 2020 and women who developed sepsis and who did not develop sepsis following C-section in the Clinical Maternity Hospital No.1 and in the Maternal and Child Health National Center were compared and studied. A total of 361 mothers were involved in the study. Conclusions: E. coli 29,4 %, intestinal bacteria 9,1 %, Staphylococcus epidermidis 8,9 %, Staphylococcus aureus 7,2 %, gram-negative bacteria 6,6 %, Streptococcus 5,3 %, gram-positive bacteria 2,8 %, Candida albicans 1,4 %, and Mycoplasma 1,1 % were responsible for bacteremia. Infection was caused by one bacterium in 141 cases (39,1 %), by two germs in 56 cases (15,5 %), by three microbes in 2 cases (0,6 %), and without any detection of bacteria in 162 cases (44,9 %).

Association of Ethnicity, Sex, and Age With Cancer Diagnoses and Health Care Utilization Among Children in Inner Mongolia, China

China is experiencing a sustained increase in childhood cancer. However, whether differences exist in disease burden by ethnicity remains unclear. To compare differences in cancer diagnoses and health care utilization in Inner Mongolia among children subgrouped by ethnicity (Han vs Mongolian), sex, and age. This retrospective cohort study in Inner Mongolia, China, used data on children aged 0 to 14 years with cancer from the Inner Mongolia Regional Health Information Platform, which comprises the National Basic Medical Insurance database and the Inner Mongolia cause-of-death reporting system, from January 1, 2013, to December 31, 2019. Ethnicities analyzed included Han and Mongolian; patients of other ethnicities were not included in the analysis because of the small sample size. Cancer was broadly defined as a primary malignant tumor or hematologic cancer; benign central nervous system tumors were also included. A 2-year washout period was used to exclude prevalent cases. After diagnosis, the patients were followed up until the date of death or the end of the insured status, whichever came first. Ethnicity (Han vs Mongolian), sex (male vs female), and age (0-4, 5-9, and 10-14 years). Crude incidence, 5-year prevalence, and survival rates at 1 year and 3 years after diagnosis; health care utilization, represented by medical costs during the first year and first 3 years after diagnosis; and hospital attendance with level (tertiary vs secondary and lower-level hospitals) and location of each unique visit. From 2013 to 2019, 1 106 684 (2013), 1 330 242 (2014), 1 763 746 (2015), 2 400 343 (2016), 2 245 963 (2017), 2 901 088 (2018), and 2 996 580 (2019) children aged 0 to 14 years were registered in the NBMI database. Among the 2 996 580 children enrolled in 2019, the mean (SD) age was 6.8 (4.3) years, of whom 1 572 096 (52.5%) were male, 2 572 091 (85.8%) were Han, and 369 400 (12.3%) were Mongolian. A total of 1910 patients with cancer were identified (1048 were male [54.9%]; 1559 were Han [81.6%], and 300 were Mongolian [15.7%]). There were 764 hematologic cancers (40.0%) and 1146 solid tumors (60.0%). The overall crude incidence of cancer from 2015 to 2019 was 129.85 per million children (95% CI, 123.63-136.06), with a higher incidence among Mongolian than among Han children (155.12 [95% CI, 136.81-173.43] vs 134.39 [95% CI, 127.46-141.32]). The 5-year prevalence was 428.97 per million (95% CI, 405.52-452.42) in 2020, with a higher prevalence among Mongolian than among Han children (568.49 [95% CI, 91.62-645.36] vs 404.34 [95% CI, 379.77-428.91]). The combined 1-year (2015-2019) and 3-year (2015-2017) survival rates were 72.5% (95% CI, 67.5%-77.5%) and 66.8% (95% CI, 61.6%-71.9%), respectively. The 1-year (median [IQR], $1991 [$912-$10 181] vs $3991 [$1171-$15 425]) and 3-year (median [IQR], $2704 [$954-$13 909] vs $5375 [$1283-$22 466]) postdiagnosis costs were lower among Mongolian than among Han children. A higher proportion of Mongolian patients attended low-level hospitals (45.9% vs 17.4%). In this cohort study, Mongolian children had a higher incidence and prevalence of cancer but a lower demand for medical care, suggesting that further investigations are needed to identify mechanisms underlying ethnic disparities and ensure that care is equitable.

Analysis of the difference in SLCO1B1 and APOE gene polymorphisms between Mongolian and Han populations.

Objective: To analyze SLCO1B1 and APOE polymorphisms and their clinical significance in the Mongolian and Han populations in Ordos, Inner Mongolia. Methods: Mongolian patients (n = 200)with cardiovascular disease admitted to our hospital from January 2018 to December 2020 were selected as the Mongolian population group. Han patients (n = 200) with cardiovascular diseases admitted during the same period were selected as the Han population group. Mutations in SLCO1B1 and APOE were detected by real-time fluorescence qPCR, and the differences between the two groups were analyzed. Results: The nucleotide polymorphisms of SLCO1B1 and APOE in the Mongolian and Han populations were consistent with the Hardy-Weinberg law. There were significant differences in gender, age, BMI, hypertension, alcohol consumption, dyslipidemia and low-density lipoprotein cholesterol levels between the two groups. APOE genotypes were classified according to those related to the efficacy of statins and the risk of atherosclerosis, and there was a significant difference between the two groups. Conclusion: There were differences in SLCO1B1 and APOE polymorphisms between the Mongolian and Han populations in Ordos. These may explain the differences in the incidence of cardiovascular diseases and the lipid-lowering efficacy of statins between the two populations.

Hepatocellular Carcinoma in Mongolia Delineates Unique Molecular Traits and a Mutational Signature Associated with Environmental Agents.

Mongolia has the world's highest incidence of hepatocellular carcinoma (HCC), with ∼100 cases/100,000 inhabitants, although the reasons for this have not been thoroughly delineated. We performed a molecular characterization of Mongolian (n = 192) compared with Western (n = 187) HCCs by RNA sequencing and whole-exome sequencing to unveil distinct genomic and transcriptomic features associated with environmental factors in this population. Mongolian patients were younger, with higher female prevalence, and with predominantly HBV-HDV coinfection etiology. Mongolian HCCs presented significantly higher rates of protein-coding mutations (121 vs. 70 mutations per tumor in Western), and in specific driver HCC genes (i.e., APOB and TSC2). Four mutational signatures characterized Mongolian samples, one of which was novel (SBS Mongolia) and present in 25% of Mongolian HCC cases. This signature showed a distinct substitution profile with a high proportion of T>G substitutions and was significantly associated with a signature of exposure to the environmental agent dimethyl sulfate (71%), a 2A carcinogenic associated with coal combustion. Transcriptomic-based analysis delineated three molecular clusters, two not present in Western HCC; one with a highly inflamed profile and the other significantly associated with younger female patients. Mongolian HCC has unique molecular traits with a high mutational burden and a novel mutational signature associated with genotoxic environmental factors present in this country.

Distribution of hepatitis C virus genotype and subtype between Mongolian and Han in Inner Mongolia.

Hepatitis C is a serious infectious disease caused by the hepatitis C virus (HCV). HCV genotypes (GT) and subtypes are closely related to geographical distribution. Studies on the distribution of HCV genotypes can help to understand the regional epidemiology and genotype distribution and provide benefits in the treatment for hepatitis C. To provide information about the distribution of HCV genotypes as well as improved prevention and treatment of hepatitis C, we aimed to classify the distribution of HCV genotypes among Mongolian and Han patients with hepatitis C in Inner Mongolia over the past 5 years. Peripheral blood samples of patients with HCV were collected for gene sequencing. To analyze the HCV genotype distribution and possible influencing factors, we determined the viral load and ratios of various genotypes. We found that the most prevalent genotype in Inner Mongolia was 1b, followed by GT2a, GT3a, GT3b, and GT6a. The prevalence of HCV among Mongolian patients was significantly higher than the prevalence in their Han counterparts (χ2 = 16.64, P = .000). There was no significant difference in viral load according to sex among HCV genotypes. However, the viral load of GT 1b was significantly higher than that of GT 2a (F = 3.51, P = .008). The viral load of GT 1b among ethnic Mongolians was significantly higher than that among Han patients (t = 2.28, P = .044). The present study's findings can serve as a basis for developing a personalized treatment for hepatitis C among patients in Inner Mongolia.

Effects of S-Amlodipine in the Management of Hypertension in Mongolian Patients

Objective: To evaluate the efficacy and safety of S-Amlodipine in patients suffering from hypertension.&#x0D; Materials and Methods: A multicenter, prospective, open-label, non-comparative, clinical trial was conducted on 364 patients with hypertension in Mongolia. All these patients were treated with S- Amlodipine 2.5 mg or 5 mg orally once daily for a duration of 8 weeks.&#x0D; Results: S-Amlodipine treatment resulted in a considerable drop in blood pressure from baseline. After 8 weeks of treatment, the mean systolic blood pressure had decreased by 12.06 mmHg and the mean diastolic blood pressure had decreased by 8.77 mmHg. Furthermore, both physicians and patients assessed the overall efficacy and rated it as good. Also, during the therapy period, 6 individuals (1.7%) experienced minor or slight adverse symptoms such as cough and headache.&#x0D; Conclusion: The current study confirms that treatment with S-Amlodipine was effective and well-tolerated in the management of hypertension.

Comparison of Iris Calved IOL and LASIK Surgery Outcome in Mongolian Patients

Objective: There are significantly few studies which have introduced the comparison intra ocular lens (IOL) outcome with conventional phacoemulsification surgery. Thus, in the present study, we aimed to compare anterior chamber intra ocular lens (AC IOL) and LASIK surgery in Mongolian patients. Methods: This study was conducted on 67 participants. Females comprised 58.8 % in the IOL patients and 72.0 % in the LASIK groups. The mean age of the participants was 32.06 ± 9.29 in IOL and 29.4 ± 6.59 in the LASIK group. Results: Pre operative uncorrected visual activity (UCVA) was 7.94 ± 6.56 in IOL patients, and 2 weeks after surgery, UCVA had increased to 61.18 ± 21.18. In the case of LASIK, pre-operative UCVA was 20.56 ± 17.20, and the value was 86.8 ± 18.23 after surgery. Pre-operative best-corrected visual acuity (BCVA) IOL and LASIK group were 37.65 ± 18.38 and 97.6 ± 4.31, respectively. However, only IOL patients had significantly improved BCVA after surgery (71.76 ± 22.97 at post-operative 2nd week). Conclusions: The best-corrected visual acuity and was better for AC IOL than LASIK surgery.