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Abstract Kmeria septentrionalis is a critically endangered tree endemic to Guangxi, China, and is listed on the International Union for Conservation of Nature’s Red List. The lack of genetic information and high-quality genome data has hindered conservation efforts and studies on this species. In this study, we present a chromosome-level genome assembly of K. septentrionalis. The genome was initially assembled to be 2.57 Gb, with a contig N50 of 11.93 Mb. Hi-C guided genome assembly allowed us to anchor 98.83% of the total length of the initial contigs onto 19 pseudochromosomes, resulting in a scaffold N50 of 135.08 Mb. The final chromosome-level genome, spaning 2.54 Gb, achieved a BUSCO completeness of 98.9% and contained 1.67 Gb repetitive elements and 35,927 coding genes. This high-quality genome assembly provides a valuable resource for understanding the genetic basis of conservation-related traits and biological properties of this endangered tree species. Furthermore, it lays a critical foundation for evolutionary studies within the Magnoliaceae family.

Anal adenocarcinoma combined with perianal Paget’s disease (PPD) involving the vulva is rare, and there is no established standard treatment. We present the case of a 69-year-old woman with symptoms of intermittent hematochezia and perianal discomfort for 7 months. Upon examination, we discovered a plaque-like hard mass on the right posterior wall of the anal canal, which extended to encompass the anus and dentate line. The lesion skin also extended forward from the gluteal groove, involving the bilateral labial area. Colonoscopy revealed an extensive protruding lesion on the dentate line, which was confirmed as anal adenocarcinoma (mrT4N0M0). The presence of Paget’s cells in perianal and vulvar skins led to the diagnosis of PPD. The strategy of neoadjuvant chemoradiotherapy (nCRT) followed by radical surgery was then made after multi-disciplinary discuss. The scope and extent of perianal and vulvar disease were significantly diminished after nCRT. The patient underwent laparoscopic abdominoperineal resection and vulvar lesion resection, confirming the diagnosis of anal adenocarcinoma (ypT2N0). No evidence of tumor cells was found in perianal and vulvar skin, indicating a complete response. The patient is regularly monitored without recurrence or metastasis.

Background There is an issue of mismatch between supply and demand of medical care resources in China. The implementation of contracted family doctor services is an effective measure to address the issue, and to improve the hierarchical diagnosis and treatment system. Therefore, it is urgent to speed up the training and ensure the training quality of general practice workforce. Objective To develop a comprehensive and systematic general practitioner (GP) competency model after analyzing the concept and structural domains of competencies (including inner competencies) required for GPs to deliver contracted healthcare services, providing insights into the realization of training eligible GPs in terms of quantity and quality, and the improvement of quality and efficiency of contracted services. Methods From December 2020 to September 2021, we conducted in-depth, semi-structured interviews with 38 GPs from 10 medical institutions in four cities (Zhenjiang, Taizhou and Suzhou in Jiangsu Province, and Foshan in Guangdong Province) , then treated the interview results applying the three-level coding and theoretical saturation used in the grounded theory. After that, we developed a General Practitioner Competency Model. Results The model consists of 10 items, which belong to four domains: general care capability, humanistic practice capability, team cooperation capability, learning and development capability. General care capability and learning and development capability belong to external competencies, which represent the external performance and driving force of competencies, and determine the level of competencies of GPs to provide contracted services. Humanistic practice capability and team cooperation capability reflect the internal traits and competencies, which belong to the inner competencies, and determine the potential of GPs to provide contracted services. Conclusion The model developed by us is complete and comprehensive, in which the inner competencies of GPs have been fully explored, which may be contributive to the training of GPs delivering contracted services, and to the development of a GP competency assessment system using quantitative empirical methods.

Background The competencies of general practitioners (GPs) have become a basis for promoting the implementation of tiered diagnosis and treatment, and effective supply of primary healthcare services against the backdrop of the initiation and implementation of contracted services provided by GPs in primary care in China. The regular competency-based assessment systems with clear objectives and strong operability can positively stimulate GPs to provide contracted services with higher quality and efficiency. Objective To develop a competency rating scale for GPs, providing a tool applicable to scientific evaluation of GPs' competencies in China. Methods By use of a GP competency model, and review results of relevant studies and competency scales, the measurement items and the draft of the scale were developed, then were revised according to the results of a questionnaire survey conducted with GPs in primary care in major provincial administrative regions from April to August 2021. Among the 402 responders, the answers of 201 cases (sample A) were used for exploratory factor analysis, and those of the other 210 cases (sample B) were used for confirmatory factor analysis. Based on this, the reliability and validity of the final scale were tested. Results The final General Practitioner Competency Rating Scale includes four dimensions (general service competency, humanistic competency during practice, teamwork and cooperation competency, learning and development competency) and 21 items. The Cronbach's α for the scale, and the afore-mentioned four dimensions was 0.929, 0.877, 0.850, 0.812, and 0.811, respectively. The P-value of Bartlett's test of sphericity was less than 0.001 (approximate χ2=2 319.759, P

Abstract Background Rectal cancer (RC) is one of the most common malignant tumors. Ferroptosis is an iron-dependent form of cell death, which plays an important role in various cancers. However, the correlation between ferroptosis-related genes (FRGs) and prognosis in RC remains unclear. Methods Gene expression data from The Cancer Genome Atlas Rectum adenocarcinoma (TCGA-READ) and GSE87211 were downloaded. Clustering and functional enrichment were evaluated. A FRGs risk score was established based on the univariate Cox analysis and the Least absolute shrinkage and selection operator (LASSO) analysis. K-M analysis and ROC analysis were conducted to determine prognostic values. qRT-PCR was performed to validate levels of mRNA expression. Multivariate Cox analysis was used to build a prognostic prediction model based on the risk score. Results Based on FRGs, RC patients were grouped into two clusters. In the functional enrichment of differentially expressed genes between the two clusters, immune-related pathways dominated. A novel FRGs signature with 14 genes related to the overall survival (OS) of RC was established. qRT-PCR of the 14 genes identified TP63, ISCU, PLIN4, MAP3K5, OXSR, FANCD2 and ATM were overexpressed in RC tissue; HSPB1, MAPK1, ABCC1, PANX1, MAPK9 and ATG7 were underexpressed; TUBE1 had no difference. The high-risk group had a significantly lower OS than the low-risk group (P