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Rongqian Wu,1– 3 Junping Zhang,1– 3 Guilin Zou,1– 3 Shanshan Li,1 Jinying Wang,1 Xiaoxinlei Li,1 Jixiong Xu1– 3 1Department of Endocrinology and Metabolism, The 1st Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, People’s Republic of China; 2Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Nanchang, People’s Republic of China; 3Jiangxi Branch of National Clinical Research Center for Metabolic Disease, Nanchang, People’s Republic of ChinaCorrespondence: Jixiong Xu, Email Jixiong.Xu@ncu.edu.cnAbstract: The incidences of thyroid cancer and diabetes are rapidly increasing worldwide. The relationship between thyroid cancer and diabetes is a popular topic in medicine. Increasing evidence has shown that diabetes increases the risk of thyroid cancer to a certain extent. This mechanism may be related to genetic factors, abnormal thyroid-stimulating hormone secretion, oxidative stress injury, hyperinsulinemia, elevated insulin-like growth factor-1 levels, abnormal secretion of adipocytokines, and increased secretion of inflammatory factors and chemokines. This article reviews the latest research progress on the relationship between thyroid cancer and diabetes, including the association between diabetes and the risk of developing thyroid cancer, its underlying mechanisms, and potential anti-thyroid cancer effects of hypoglycemic drugs. It providing novel strategies for the prevention, treatment, and improving the prognosis of thyroid cancer.Keywords: diabetes, thyroid cancer, underlying mechanisms, hypoglycemic drugs

Zhongyue Huang,1,&ast; Gaoqiong Yao,2,&ast; Chengzhi Zhang,2 Xin Zhou,2 Guanyang Zou,3,&ast; Chao Zhuo4,&ast; 1Institute of Medical Information/Medical Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China; 2Department of Pharmacy, First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 3School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, People’s Republic of China; 4State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Guanyang Zou, No. 232, Waihuan East Road, Panyu District, Guangzhou, Guangdong Province, 510006, People’s Republic of China, Email zgy1021@hotmail.com Chao Zhuo, 195 Dongfeng West Road, Yuexiu District, Guangzhou, Guangdong Province, 510030, People’s Republic of China, Email chaosheep@gzhmu.edu.cnPurpose: With the increasing frequency and intensity of carbapenem consumption, carbapenem-resistant organisms (CRO) have become a focus of anti-infection research. This study aimed to evaluate the rationality of the clinical use of carbapenems among inpatients in the surgical departments of a tertiary hospital in southwest China.Patients and methods: A point-score system was established for evaluation based on the clinical practices in surgical departments and selected carbapenem prescriptions from June 2020 to June 2021 for hepatobiliary surgery, gastrointestinal surgery, and neurosurgery in the study hospital. Prescriptions with a total score ≥ 270 were defined as rational. Descriptive statistics were used to describe the characteristics and rationality of the prescriptions. The chi-square test, Mann–Whitney U-test, and Kruskal–Wallis H-test were used to compare characteristics between rational and irrational prescriptions. Linear regression analysis was used to determine the factors affecting the rationality of carbapenem prescriptions.Results: According to 192 carbapenem prescription records, the median age of patients was 62 years [IQR, 48.0– 73.0], and 20% of patients had abdominal infections, 10% had lung infections, 14% had intracranial infections, and 3% had urinary tract infections. 56% of carbapenem prescriptions were irrational. Compared with rational carbapenem prescriptions, irrational prescriptions had a higher proportion of those with inappropriate indications (49% vs 0%, p < 0.05), incorrect variety selection (15% vs 0%, p< 0.05), and unreasonable assessment of etiology and efficacy (46% vs 8%, p < 0.05). Linear regression analysis suggested that the diagnosis of cholecystitis (standardized regression coefficient=0.183, p< 0.05) and replaced medication (standardized regression coefficient = 0.154, p< 0.05) influenced the rationality of carbapenem prescriptions.Conclusion: Our study shows that the irrational use of carbapenems deserves attention, especially in surgical departments. Interventions for carbapenem use that are based on evaluation criteria should be developed to reduce the emergence and spread of carbapenem-resistant bacteria.Keywords: carbapenem, prescription review, surgery

Guoying Zou,1 Qing Zhu,1 Biqiong Ren,1 Qi Guo,1 Yuanyuan Wu,1 Junyu He,1 Ying Wu,1 Zhihong Luo2 1Department of Clinical Laboratory, The Second People’s Hospital of Hunan Province, Changsha, Hunan, 410007, People’s Republic of China; 2Office of the Party Committee, The Second People’s Hospital of Hunan Province, Changsha, Hunan, 410007, People’s Republic of ChinaCorrespondence: Zhihong Luo, Office of the Party Committee, The Second People’s Hospital of Hunan Province, Furong Middle Road 427, Yuhua District, Changsha, Hunan, 410007, People’s Republic of China, Tel +86 19848029533, Email lzh3068@sina.comPurpose: To determine the levels of serum HDL-associated apolipoproteins (apoM and apoC) and HDL-binding receptor (scavenger receptor BI, SR-BI) in patients with gram-negative bacteria sepsis (G-sepsis) and to evaluate the value of lipoproteins in the diagnosis, severity and prognosis of G-sepsis.Patients and Methods: A total of 128 patients with sepsis, 40 patients with system inflammatory reaction syndrome (SIRS) and 40 healthy subjects were enrolled in the Second People’s Hospital of Hunan Province from September 2019 to September 2020. The levels and the correlation of lipoproteins were detected and dynamically monitored by enzyme-linked adsorption method, ROC curve for the diagnostic, severity and prognostic value of lipoproteins in G-sepsis.Results: The levels of serum HDL-associated lipoproteins in patients with G-sepsis were significantly decreased (P < 0.05), and the ROC curve showed that HDL-C, SR-BI, apoM and apoC had cut-off values of 0.915 mmol/L, 122.100 pg/mL, 102.400 ug/mL and 17.55 mg/mL, respectively, for the diagnosis of G-sepsis, with the sensitivity was 85.56%, 97.78%, 93.33% and 73.03%, and the specificity was 95.0%, 82.50%, 61.54% and 82.50%, respectively. There was a correlation between HDL-associated apolipoproteins. Changes in serum HDL-associated lipoproteins were more obvious in shock group than classic inflammation indicators, such as PCT, IL-6 and CRP. They showed a trend change on day 3, with the levels of SR-BI and apoC changing 2– 3 times, and the sensitivity of HDL-C, SR-BI, apoM and apoC for the diagnosis of G-septic shock were 32.43%, 72.97%, 65.75%, and 43.24%, and specificity of 94.34%, 81.13%, 83.07%, and 86.79%, respectively. The AUC, sensitivity and specificity of apoM combined with SR-BI were improved.Conclusion: HDL-associated lipoproteins were correlated with bacterial-infected types, and serum levels of HDL-associated lipoproteins can be used as potential biomarkers for early diagnosis and progress of G-sepsis. ApoM combined with SR-BI could improve the sensitivity and specificity of prognosis assessment.Keywords: apolipoprotein, high-density lipoprotein, gram-negative sepsis, biomarker, prognosis

Ying Hu,1– 3 Jiancheng Wang,1– 3 Sha Zeng,1– 3 Mengxia Chen,1– 3 Guilin Zou,1– 3 Yuxia Li,1– 3 Lingyan Zhu,1– 3 Jixiong Xu1– 3 1Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of China; 2Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Nanchang, Jiangxi, 330006, People’s Republic of China; 3Jiangxi Branch of National Clinical Research Center for Metabolic Disease, Nanchang, JIangxi, 330006, People’s Republic of ChinaCorrespondence: Jixiong Xu; Jiancheng Wang, Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, No. 17, Yongwaizheng Street, Nanchang, Jiangxi, 330006, People’s Republic of China, Tel/Fax +86-791-86836960, Email Jixiong.Xu@ncu.edu.cn; jasonwong2015@163.comBackground: The role of serum albumin in the risk of diabetic peripheral neuropathy (DPN) remains unclear. This study aimed to explore the relationship between serum albumin level and DPN, and to examine any possible effect modifiers among patients with type 2 diabetes mellitus.Methods: This cross-sectional study was conducted in Jiangxi, China, from May 2012 to December 2014. Serum albumin levels were determined in 523 subjects, and the association between serum albumin level and DPN was evaluated using linear regression models (odds ratio [OR] and corresponding 95% confidence interval [CI]).Results: There was a significant inverse association between serum albumin level (per 1 g/L increment, OR 0.95 [95% CI 0.92– 0.98]) and the risk of DPN. Accordingly, when serum albumin was assessed as quartiles, a significantly lower risk of DPN was found in participants in quartile 4 (OR 0.49 [95% CI 0.25– 0.95]), compared with those in quartile 1. Consistently, higher albumin levels (≥ 35 g/L) were associated with decreased odds for DPN (OR 0.36 [95% CI 0.17– 0.74]) compared with lower levels. Furthermore, the albumin–DPN association was significantly stronger in patients with a relatively high body mass index (BMI; ≥ 24 kg/m2; OR 0.91 [95% CI 0.85– 0.98]) than in those with a low BMI (< 24 kg/m2; OR 0.99 [95% CI 0.94– 1.04]; P for interaction = 0.042).Conclusion: These data suggest that serum albumin level could be a novel risk factor for DPN among patients with type 2 diabetes and relatively high BMI (> 24 kg/m2).Keywords: serum albumin, BMI, diabetic peripheral neuropathy, type 2 diabetes mellitus

Lu Li,1,&ast; Gaorui Zou,2,&ast; Jie Liu1 1Department of Nephrology, The First People’s Hospital of Jiangxia District, Wuhan, 430299, People’s Republic of China; 2Department of Anesthesiology, Wuhan No. 1 Hospital, Wuhan, 430022, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jie LiuDepartment of Nephrology, The First People’s Hospital of Jiangxia District, No. 1 of Cultural Avenue, Wuhan, 430299, People’s Republic of ChinaTel +86 27-87958740Email 314088359@qq.comBackground: We aimed to investigate the association between preoperative glucose-to-lymphocyte ratio (GLR) and cardiac surgery associated with acute kidney injury (CSA-AKI) in patients in the intensive care unit (ICU).Methods: The Medical Information Mart for Intensive Care IV (MIMIC-IV version 1.0) database was used to identify adults’ patients who performed cardiac surgery during ICU stay. The primary outcome was the development of AKI based on the KDIGO criteria. Multivariable logistic regression was applied to investigate the association between GLR and clinical outcomes, and propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were also used to validate our findings.Results: The optimal cut-off value for GLR was 1.28. Among the 7181 patients who conducted cardiac surgery, 2072 high-GLR group (≥ 1.28) patients and 2072 low-GLR group (< 1.28) patients, had similar propensity scores were included in this study. After matching, the high-GLR group had a significantly higher incidence of AKI (odds ratio, OR, 3.28, 95% confidence index, 95% CI, 2.81– 3.84, P < 0.001) even after adjustment for confounding factors. Moreover, the performance of GLR was superior to that of SOFA scores and GLR plus clinical model could add more net benefit for CSA-AKI than clinical model alone.Conclusion: Preoperative GLR could serve as a good predictor for CSA-AKI in patients in ICU.Keywords: glucose to lymphocyte, cardiac surgery, acute kidney injury, Medical Information Mart for Intensive Care, propensity score matching

Jingjing Wan,1,* Gaorui Zou,2,* Bo He,1 Chao Zhang,3 Yanfang Zhu,1 Lan Yin,3 Zhibing Lu1 1Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, People’s Republic of China; 2Department of Anesthesiology, Wuhan No. 1 Hospital, Wuhan, 430022, People’s Republic of China; 3Department of Cardiology Electrocardiogram, Zhongnan Hospital of Wuhan University, Wuhan, 430071, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhibing Lu; Lan YinDepartment of Cardiology, Zhongnan Hospital of Wuhan University, No. 169 Donghu Road, Wuhan, 430071, People’s Republic of ChinaTel +86 27-67812999Email zhibinglu123@126.com ; 779367161@qq.comPurpose: We aimed to evaluate the predictive ability of an integrated score based on several inflammatory indices of acute kidney injury (AKI) in patients in the intensive care unit (ICU).Patients and Methods: In this observational study, 2555 patients from the Medical Information Mart for Intensive Care III database were randomly assigned to the test set (n=1599) and internal validation set (n=656). Moreover, 412 coronary care unit patients from Zhongnan Hospital, Wuhan University were also included in the external validation set. The AKI-specific inflammatory index (ASII) was created using various inflammatory indices significantly associated with AKI. We further developed and validated two nomograms based on the ASII and other informative clinical features of AKI and prognosis.Results: The ASII was calculated as 2.317×MLR+0.417×GPS+0.007×ALRI. In the training set, patients with a high ASII had a higher risk of incident AKI (odds ratio [OR], 5.33; 95% confidence index [CI], 3.60– 7.88; P< 0.001) than those with a low ASII with or without pre-existing chronic kidney disease. The nomograms for AKI and prognosis based on the ASII and other significant clinical characteristics had high predictive value in the prediction of AKI and prognosis in patients in the ICU. Moreover, the results in the internal validation set and in the external validation cohort were almost consistent with those in the training set.Conclusion: The ASII is an AKI-specific tool based on the combination of available inflammatory indices. A high ASII is a strong predictor of a higher risk of AKI and worse survival outcomes in patients in the ICU.Keywords: acute kidney injury, inflammation, AKI-specific inflammatory index, intensive care unit, nomogram

Zhen Su,1,* Guo-rong Zou,1,* Jie Tang,1 Xiu Yue Li,1 Fang-Yun Xie2 1Panyu Central Hospital, Cancer Institute of Panyu, Guangzhou, People’s Republic of China; 2Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, People’s Republic of China*These authors contributed equally to this workCorrespondence: Fang-Yun XieDepartment of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, People’s Republic of ChinaTel +86 20 87343484Email xiefy0758@sina.comBackground: The aim of this study was to evaluate the efficacy of induction chemotherapy (IC) in nasopharyngeal carcinoma (NPC) patients with moderate-risk treated with intensity-modulated radiotherapy (IMRT).Methods: We retrospectively assessed 506 patients with T1-2N1M0 or T3-4N0-1M0 NPC (according to the 2010 UICC/AJCC staging system) who received concurrent chemoradiotherapy (CCRT) with or without IC at a single center in China between 2005 and 2010. Survival outcomes were compared between the IC + CCRT and CCRT groups using the Kaplan–Meier method, Log-rank test and a Cox regression model.Results: Among the 506 patients, CCRT alone resulted in equivalent overall survival (86.8% vs 88.5%, p=0.661), progression-free survival (79.6% vs 79.6%, p=0.756), locoregional relapse-free survival (90.2% vs 87.0%, p=0.364) and distant metastasis-free survival (88.0% vs 89.8%, p= 0.407) to IC plus CCRT. In multivariate analysis, IC did not lower the risk of death (HR 0.76, 95% CI 0.46– 1.25, p= 0.278), progression (HR 0.78, 95% CI 0.51– 1.19, p= 0.244), locoregional relapse (HR 1.06, 95% CI 0.81– 1.42, p= 0.651) or distant metastasis (HR 0.66, 95% CI 0.38– 1.15, p= 0.140) in the entire cohort; similar results were obtained in stratified analysis based on N category (N0 vs N1) and EBV DNA (< vs ≥ 4000 copies/mL).Conclusion: Addition of IC to CCRT does not improve survival outcomes in moderate-risk NPC; the use of IC should be carefully considered in these patients, though additional prospective trials are warranted to confirm the conclusions of this study.Keywords: nasopharyngeal carcinoma, induction chemotherapy, prognosis, survival

Lingtong Tang, 1, 2 Wei Shen, 2, 3 Zhikun Zhang, 2 Jingping Zhang, 2 Guangxi Wang, 2 Li Xiang, 2 Junping She, 2 Xiaoyan Hu, 2 Guoyuan Zou, 4 Baoli Zhu, 5 Yingshun Zhou 2 1Department of Clinical Laboratory, The People’s Hospital of Gao County, Sichuan 644000, People’s Republic of China; 2Department of Pathogenic Biology, School of Basic Medicine, Southwest Medical University, Luzhou, Sichuan, People’s Republic of China; 3Department of Clinical Laboratory, The First People’s Hospital of Yibin, Yibin 644000, Sichuan, People’s Republic of China; 4Institute of Plant Nutrition and Resources, Beijing Academy of Agriculture and Forestry Science, Beijing, People’s Republic of China; 5Key Laboratory of Pathogenic Microbiology & Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, People’s Republic of ChinaCorrespondence: Yingshun ZhouDepartment of Pathogenic Biology, School of Basic Medicine, Southwest Medical University, No. 319, Zhongshan Road, Luzhou 646000, Sichuan, People’s Republic of ChinaTel +86– 0830– 3160073Email yingshunzhou@swmu.edu.cnGuoyuan ZouInstitute of Plant Nutrition and Resources, Beijing Academy of Agriculture and Forestry Science, Beijing, People’s Republic of ChinaEmail gyzou@163.comPurpose: To characterize the genetic feature of the carbapenems resistant Acinetobacter johnsonii strain Acsw19 isolated from municipal sludge. This strain was found to carry two copies of blaNDM-1, cmlB1-like gene, and blaOXA-211-like gene along with other 8 antimicrobial resistance genes, 3 plasmids, 15 genomic islands and 8 prophages.Methods: A carbapenem-resistant Acinetobacter johnsonii strain Acsw19 isolated from municipal sludge was subjected to whole-genome sequencing (WGS) via the PacBio and Illumina MiSeq platforms. Thereafter, the characteristic was analyzed by a series of bioinformatics software.Results: The results showed that the genome of Acsw19 was consisted of a 3,433,749 bp circular chromosome and 3 circular plasmids, pAcsw19-1 (11,161 bp), pAcsw19-2 (351,885 bp) and pAcsw19-3 (38,391bp), respectively. Resistome analysis showed that Acsw19 carried 12 antimicrobial resistance genes, including 6 [cmlB1-like, blaNDM-1, blaOXA-58, aph ( 3ʹ)-VIa, msr(E) and mph(E)] in the plasmid pAcsw19-2 and 6 (blaOXA-211-like, blaNDM-1, aph(3")-Ib, aph(6)-Id, sul2, and floR) in the chromosome genome. Specifically, the cmlB1-like gene shared 86.33%, 71.7% and 71.9% similarities with the cmlB1, cmlA4 and cmlA8 gene, and the blaOXA-211-like gene shared 94.4%, 95.39% and 96.36% similarities with blaOXA-211, blaOXA-643 and blaOXA-652, at the nucleotide level, respectively. Phylogenetic analysis showed that the blaOXA-211-like gene and cmlB1-like gene had the closest evolutionary relationship with blaOXA-643 and cmlB1, respectively. These results indicated that the blaOXA-211-like and cmlB1-like genes identified in the current study should be the novel variant resistance genes.Conclusion: Carrying of two copies of blaNDM-1, cmlB1-like, blaOXA-211-like and along with other 8 antimicrobial resistance genes, 3 plasmids, 15 genomic islands and 8 prophages Acinetobacter johnsonii strain might increase the possibility of spreading of resistance genes.Keywords: Acinetobacter johnsonii, blaNDM-1, blaOXA, genomic island

Tian-Hong Zhu,1 Gen Zou,1 Shao-Jie Ding,1 Tian-Tian Li,1 Li-Bo Zhu,1 Jian-Zhang Wang,1 Yong-Xing Yao,2 Xin-Mei Zhang11Department of Obstetrics and Gynecology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 2Department of Anesthesia, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of ChinaPurpose: This study aimed to investigate the effect of oral treatment with ketotifen, a mast cell (MC) stabilizer, in a rat model of surgically induced endometriosis.Methods: At 14 days after Sprague–Dawley rats had surgery, they were treated with ketotifen (1 or 10 mg/kg/day). Pain behaviors were evaluated 3 days prior to surgery and then at 7, 14, 21, and 28 days after surgery. At day 28, rats were sacrificed and all samples were then processed for biochemical studies.Results: We found that ketotifen-treated rats showed significantly shorter duration of hyperalgesia (p

BACKGROUND/OBJECTIVES: CAN-THUMBS UP is designed as a comprehensive and innovative fully remote program to 1) develop an interactive and compelling online Brain Health Support Program intervention, with potential to positively influence dementia literacy, self-efficacy and lifestyle risk factors; 2) enroll and retain a community-dwelling Platform Trial Cohort of individuals at risk of dementia who will participate in the intervention; 3) support an open platform trial to test a variety of multidomain interventions that might further benefit individuals at risk of dementia. This manuscript presents the Brain Health Support Program Study protocol. DESIGN/SETTING: Twelve-month prospective multi-center longitudinal study to evaluate a fully remote web-based educational intervention. Participants will subsequently be part of a Platform Trial Cohort and may be eligible to participate in further dementia prevention clinical trials. PARTICIPANTS: Three hundred fifty older adults who are cognitively unimpaired or have mild cognitive impairment, with at least 1 well established dementia risk factor. INTERVENTION: Participants engage in the Brain Health Support Program intervention for 45-weeks and complete pre/post intervention measures. This intervention is designed to convey best available evidence for dementia prevention, consists of 181 chapters within 8 modules that are progressively delivered, and is available online in English and French. The program has been developed as a collaborative effort by investigators with recognized expertise in the programs content areas, along with input from older-adult citizen advisors. MEASUREMENTS: This study utilizes adapted remote assessments with accessible technologies (e.g. videoconferencing, cognitive testing via computer and mobile phone, wearable devices to track physical activity and sleep, self-administered saliva sample collection). The primary outcome is change in dementia literacy, as measured by the Alzheimers Disease Knowledge Scale. Secondary outcomes include change in self-efficacy; engagement using the online program; user satisfaction ratings; and evaluation of usability and acceptance. Exploratory outcomes include changes in attitudes toward dementia, modifiable risk factors, performance on the Neuropsychological Test Battery, performance on self-administered online cognitive assessments, and levels of physical activity and sleep; success of the national recruitment plan; and the distribution of age adjusted polygenic hazard scores. CONCLUSIONS: This fully remote study provides an accessible approach to research with all study activities being completed in the participants home environment. This approach may reduce barriers to participation, provide an easier and less demanding participant experience, and reach a broader geography with recruitment from all regions of Canada. CAN-THUMBS UP represents a Canadian contribution to the global World-Wide FINGERS program (alz.org/wwfingers).

Towards the improved preservation and management of high-quality germplasm resources for Alnus nepalensis, a total of 84 samples from 28 superior A. nepalensis trees were used as an original germplasm collection. An optimal strategy for the creation of a core collection of superior A. nepalensis trees was devised by comparing the validity of 18 germplasm subsets. Each of these germplasm subsets was configured using unweighted average clustering and improved minimum distance stepwise sampling methods that integrated six sampling proportions, three data types, and three genetic distance methods. The germplasm subsets for the original germplasm collection were evaluated by quantitative and qualitative trait independence tests according to the data types. The results revealed that the developed germplasm subsets based on phenotype data and Euclidean genetic distances at 55, 45, 35 and 25% sampling proportions; molecular marker data and Nei's genetic distances at 55, 45, 35, 25 and 15% sampling proportions; and combined phenotype and molecular marker data and mixed genetic distances at 55, 45, 35 and 25% sampling proportions could represent the original germplasm collection. The strategy of phenotype values and Euclidean genetic distance were more appropriate than integrating the phenotype and molecular markers data and mixed genetic distance for the creation of a core collection for superior A. nepalensis trees.Considering the effectiveness, practicability, and cost of the development of a core collection for superior A. nepalensis trees, an optimal strategy included an unweighted average technique, improved minimum distance stepwise sampling method, SRAP markers data, Nei's genetic distance, and a 15% sampling proportion. [ABSTRACT FROM AUTHOR]