Clinical and genetic characteristics of 9 rare cases with coexistence of dual genetic diagnoses / 中华儿科杂志

Objective: To analyze the clinical and genetic characteristics of pediatric patients with dual genetic diagnoses (DGD). Methods: Clinical and genetic data of pediatric patients with DGD from January 2021 to February 2022 in Peking University First Hospital were collected and analyzed retrospectively. Results: Among the 9 children, 6 were boys and 3 were girls. The age of last visit or follow-up was 5.0 (2.7,6.8) years. The main clinical manifestations included motor retardation, mental retardation, multiple malformations, and skeletal deformity. Cases 1-4 were all all boys, showed myopathic gait, poor running and jumping, and significantly increased level of serum creatine kinase. Disease-causing variations in Duchenne muscular dystrophy (DMD) gene were confirmed by genetic testing. The 4 children were diagnosed with DMD or Becker muscular dystrophy combined with a second genetic disease, including hypertrophic osteoarthropathy, spinal muscular atrophy, fragile X syndrome, and cerebral cavernous malformations type 3, respectively. Cases 5-9 were clinically and genetically diagnosed as COL9A1 gene-related multiple epiphyseal dysplasia type 6 combined with NF1 gene-related neurofibromatosis type 1, COL6A3 gene-related Bethlem myopathy with WNT1 gene-related osteogenesis imperfecta type XV, Turner syndrome (45, X0/46, XX chimera) with TH gene-related Segawa syndrome, Chromosome 22q11.2 microduplication syndrome with DYNC1H1 gene-related autosomal dominant lower extremity-predominant spinal muscular atrophy-1, and ANKRD11 gene-related KBG syndrome combined with IRF2BPL gene-related neurodevelopmental disorder with regression, abnormal movement, language loss and epilepsy. DMD was the most common, and there were 6 autosomal dominant diseases caused by de novo heterozygous pathogenic variations. Conclusions: Pediatric patients with coexistence of double genetic diagnoses show complex phenotypes. When the clinical manifestations and progression are not fully consistent with the diagnosed rare genetic disease, a second rare genetic disease should be considered, and autosomal dominant diseases caused by de novo heterozygous pathogenic variation should be paid attention to. Trio-based whole-exome sequencing combining a variety of molecular genetic tests would be helpful for precise diagnosis.

Effects of Rho-associated coiled-coil-forming kinase inhibitor Y27632 on mouse preantral follicles development in vitro / 解剖学报

Objective To investigate the effects of Rho-associated coiled-coil-forming kinase (ROCK) inhibitor Y27632 on the development of mouse preantral follicles in vitro. Methods The ovaries of 12.5-day-old mice were collected and single preantral follicle was isolated by mechanical method to culture Nunclon Sphera 96-well U-bottom 3D cell culture plate in vitro. Set up a control group and treated group containing Y27632, and evaluate the overall development of the follicles through follicular morphology, follicle diameter, the number of mature follicles, and changes in oocyte spindles. The expression of oocytes [bone morphogenetic protein 15(BMP 15), growth differentiation factor 9(GDF9)], granulosa cells [follicle stimulating hormone receptor (FSHR)] and apoptosis related genes (Bad, Bax and Caspase-3) were also assessed by the Real-time PCR technique. Meanwhile, the follicle viability was detected by follicular activity test during follicular development. Results Rock inhibitor Y27632 had no significant effect on the growth diameter and basic development indicators (follicle survival rate, cavity formation rate and maturation rate) (P>0.05). And abnormal spindle assembly occurred during follicle development in the control group. After 8 days of culture, compared with the control group, the granulosa cell-specific gene FSHR was up-regulated in the experimental group; As well as the oocyte-specific genes BMP 15 and GDF9 were up-regulated, while forkhead box 03(Fox03) was down-regulated; The apoptosis genes Bax, Bad and Caspase-3 were also showed down-regulated. And the granulosa cell apoptosis in the experimental group was significantly less than that in the control group. Conclusion ROCK inhibitor Y27632 can inhibit the apoptosis of granulosa cells and prevents the abnormal assembly of oocyte spindles to improve the quality of follicle development in vitro.

Therapeutic Effect of Carboxyamidotriazole on Adjuvant Arthritis in Rats / 中国医学科学院学报

<p><b>OBJECTIVE</b>To study the effect of carboxyamidotriazole (CAI) on adjuvant arthritis (AA) in rats.</p><p><b>METHODS</b>The rats were randomly divided into normal group,two vehicle groups (polyethylene glycol 400 control and normal sodium control group), CAI-treated groups (10, 20, and 40 mg/kg) and positive control dexamethasone group. Freund's completed adjuvant was used to induce AA in rats. The arthritis index (AI) was scored, and X-ray check of the hind limbs and histopathological examination were performed. The levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6 in the inflamed paw tissues were measured.</p><p><b>RESULTS</b>The administration of CAI significantly decreased the AI, restored the body weights, and ameliorated the radiological and histopathological features of joint destruction in AA rats (P<0.05, P<0.01). In addition, CAI reduced the TNF-α, IL-1β, and IL-6 levels in the inflamed paw tissues (P<0.05, P<0.01).</p><p><b>CONCLUSION</b>CAI has therapeutic effect on AA rats, which may be achieved by decreasing the pro-inflammatory cytokines at the site of inflammation.</p>

High performance preparation and structural confirmation of lignans from Schisandrae chinensis fructus by using HSCCC combined with ESI-MSn method / 药学学报

High-speed counter-current chromatography (HSCCC) was used to high performance separate and prepare lignans from Schisandrae chinensis fructus. The solvent system is composed of n-hexane-ethyl acetate-methanol-water (9 : 1 : 5 : 5) and n-hexane-ethyl acetate-methanol-water (9 : 1 : 9 : 5), speed is at 900 r.min-1, and flow rate is at 2.0 mL.min-1. Five fractions from Schisandrae chinensis fructus extract were separated and prepared with one HSCCC process. They were identified as schisandrin, gomisin J, schisandrol B, schisantherin A and deoxyschizandrin by electrospray ionization-multiple tandem mass spectrometry (ESI-MSn), respectively. Their contents were obtained in 98.74%, 94.32%, 99.53%, 94.23% and 98.68% by ultra high performance liquid chromatography (UPLC), separately. The rapid and simple method can be applied for the preparation of lignans from Schisandrae chinensis fructus.

Analysis on risk factors for type 1 diabetic peripheral neuropathy in children / 中华实用儿科临床杂志

Objective To investigate the risk factors for type 1 diabetic peripheral neuropathy(DPN) in children,in order to provide a basis for its prevention.Methods The clinical data of 119 patients with type 1 diabetes in Tianjin Children's Hospital,including sex,age,course of diabetes,body mass index(BMI),blood pressure (Bp),plasma glucose,glycosylated hemoglobin,blood gasses,plasma lipid and islet β cell function were reviewed and analyzed.The patients were divided into 2 groups according to the neuro-electrophysiology features:DPN group (68 cases) and nonDPN group(51 cases).The risk factors in statistical significance were subjected to multiple Logistic regression analysis to screen for the risk factors for DPN.Results The inspection analysis,including the course of disease,BMI,plasma glucose,glycosylated hemoglobin,rate of ketoacidosis,plasma lipid and C-peptide,showed obvious differences (all P ＜0.01,0.05) between 2 groups of patients.There was no significant difference in sex,age,Bp,and plasma insulin between 2 groups of patients(all P ＞ 0.05).Multiple Logistic regression analysis revealed that the occurrence of DPN was correlated with the course of DPN (Estimate =0.73,Se =0.29,Wald =6.29,OR =2.07,95 ％ CI:1.17-3.66,P =0.01),plasma glucose (Estimate =0.86,Se =0.42,Wald =4.15,OR =2.37,95 ％ CI:1.03-5.44,P =0.04) and Cpeptide(Estimate =1.74,Se =0.44,Wald =15.93,OR =5.69,95％ CI:2.42-13.37,P =0.01).Conclusions There are many factors that may affect DPN.The course of disease,plasma glucose and C-peptide are major risk factors for DPN.Effective blood glucose control can effectively prevent the occurrence of DPN.

Prognostic scoring system for locoregional control among the patients with nasopharyngeal carcinoma treated by intensity-modulated radiotherapy / 癌症

The prognostic value of T category for locoregional control in patients with nasopharyngeal carcinoma (NPC) has decreased with the extensive use of intensity-modulated radiotherapy (IMRT). We aimed to develop a prognostic scoring system (PSS) that incorporated tumor extension and clinical characteristics for locoregional control in NPC patients treated with IMRT. The magnetic resonance imaging scans and medical records of 717 patients with nonmetastatic NPC treated with IMRT at Sun Yat-sen University Cancer Center between January 2003 and January 2008 were reviewed. Age, pathologic classification, primary tumor extension, primary gross tumor volume (GTV-p), T and N categories, and baseline lactate dehydrogenase (LDH) level were analyzed. Hierarchical cluster analysis as well as univariate and multivariate analyses were used to develop the PSS. Independent prognostic factors for locoregional relapse included N2-3 stage, GTV-p ≥26.8 mL, and involvement of one or more structures within cluster 3. We calculated a risk score derived from the regression coefficient of each factor and classified patients into four groups: low risk (score 0), intermediate risk (score >0 and ≤1), high risk (score >1 and ≤2), and extremely high risk (score >2). The 5-year locoregional control rates for these groups were 97.4%, 93.6%, 85.2%, and 78.6%, respectively (P < 0.001). We have developed a PSS that can help identify NPC patients who are at high risk for locoregional relapse and can guide individualized treatments for NPC patients.

Long-term outcome and late toxicities of simultaneous integrated boost-intensity modulated radiotherapy in pediatric and adolescent nasopharyngeal carcinoma / 癌症

The application of simultaneous integrated boost-intensity modulated radiotherapy (SIB-IMRT) in pediatric and adolescent nasopharyngeal carcinoma (NPC) is underevaluated. This study aimed to evaluate long-term outcome and late toxicities in pediatric and adolescent NPC after SIB-IMRT combined with chemotherapy. Thirty-four patients (aged 8-20 years) with histologically proven, non-disseminated NPC treated with SIB-IMRT were enrolled in this retrospective study. The disease stage distribution was as follows: stage I, 1 (2.9%); stage III, 14 (41.2%); and stage IV, 19 (55.9%). All patients underwent SIB-IMRT and 30 patients also underwent cisplatin-based chemotherapy. The prescribed dose of IMRT was 64-68 Gy in 29-31 fractions to the nasopharyngeal gross target volume. Within the median follow-up of 52 months (range, 9-111 months), 1 patient (2.9%) experienced local recurrence and 4 (11.8%) developed distant metastasis (to the lung in 3 cases and to multiple organs in 1 case). Four patients (11.8%) died due to recurrence or metastasis. The 5-year locoregional relapse-free survival, distant metastasis-free survival, disease-free survival, and overall survival rates were 97.1%, 88.2%, 85.3%, and 88.2%, respectively. The most common acute toxicities were grades 3-4 hematologic toxicities and stomatitis. Of the 24 patients who survived for more than 2 years, 16 (66.7%) and 15 (62.5%) developed grades 1-2 xerostomia and ototoxicity, respectively. Two patients (8.3%) developed grade 3 ototoxicity; no grade 4 toxicities were observed. SIB-IMRT combined with chemotherapy achieves excellent long-term locoregional control in pediatric and adolescent NPC, with mild incidence of late toxicities. Distant metastasis is the predominant mode of failure.

Construction of a lentiviral vector containing human NESG1 gene and its expression in 293FT cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To construct a lentiviral vector carrying human NESG1-EGFP gene and observe its expression in 293FT cells.</p><p><b>METHODS</b>The CDS region of NESG1 gene was amplified from a plasmid containing the full-length NESG1 sequence and cloned into the lentiviral vector pGC-FU-EGFP by restriction endonuclease AgeI digestion and T(4) DNA ligase ligation. After transformation into competent E. coli cells, the candidate clones were identified by PCR and sequencing. The recombinant plasmid and the two packaging plasmids were co-transfected into human embryonic kidney cell line 293FT cells by lipofectamine 2000 to produce the lentiviral particles, and the viral titer was determined. The 293FT cells were infected by the lentiviral particles obtained and the transfection efficiency was assessed under fluorescent microscope. Western blotting was used to detect the expression of NESG1 protein in the transfected cells.</p><p><b>RESULTS</b>The lentiviral vector pGC-FU-NESG1-EGFP for NESG1 gene was constructed successfully. Strong green fluorescence was observed in 293FT cells under fluorescent microscope after co-transfection of the cells with the 3 plasmids of lentiviral vector. The virus in the supernatant reached a titer of 2×10(7) TU/ml. The transfection efficiency of the collected virus exceeded 90% in 293FT cells with a multiplicity of infection of 1. Western blotting identified the presence of NESG1 expression in the transfected 293FT cells.</p><p><b>CONCLUSION</b>The lentiviral vector for NESG1 has been successfully constructed with a high yield of lentivirus, which facilitate further investigation of the roles of NESG1 gene in the development and progression of nasopharyngeal carcinoma.</p>

Anti-inflammatory and analgesic potency of carboxyamidotriazole, a tumoristatic agent / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the potential anti-inflammatory and analgesic activities of carboxyamidotriazole (CAI).</p><p><b>METHODS</b>A variety of animal models, including the croton oil-induced ear edema, the cotton-induced granuloma, the rat adjuvant-induced arthritis, were used to evaluate anti-inflammatory effect of CAI. Vascular endothelial growth factor (VEGF)--or histamine-stimulated local vascular permeability in mouse modulated by CAI was also determined. In addition, we assessed the effect of CAI on the levels of proinflammatory cytokines tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 beta (IL-beta) at the site of inflammation and in sera. Moreover, antinociceptive effect of CAI on inflammatory pain was assessed using acetic acid-induced writhing model and the formalin test.</p><p><b>RESULTS</b>CAI significantly inhibited acute and chronic phases of inflammation, reduced VEGF or histamine-induced vascular permeability, and showed marked inhibition of proinflammatory cytokines such as TNF-alpha and IL-1 beta. CAI also showed potential therapeutic effect on peripheral inflammatory pain.</p><p><b>CONCLUSION</b>CAI is a promising anti-inflammatory and analgesic agent.</p>

Experimental study of replacement of an esophageal segment with an nitinol alloy composite artificial esophagus / 中华外科杂志

<p><b>OBJECTIVE</b>To observe the feasibility of a segment thoracic esophagus replaced by using a nitinol alloy composite artificial esophagus.</p><p><b>METHODS</b>A nitinol alloy composite artificial esophagus was made of a nitinol tube coated with a silicone membrane with a dacron flange 1 cm proximal to each end. There were ten pigs for the models of experimental animal. The models of experimental animal were established by excised a segment of 7 cm long thoracic esophagus and replaced with the graft. In accordance with the different anastomosis connective way 10 pigs were divided into group I and group II, every group had 5 pigs. In group I monolayer end-to-end anastomosis was used with this prosthesis. In group II monolayer end-to-end anastomosis was used with this prosthesis and above the site of anastomosis adding dacron strip fixed. After operation the operate animals were observed for eating and health. Esophagography and flexible esophagoscopy were performed once a month at the first, second, and third postoperatively month. Three pigs of the grafted prostheses sloughed out spontaneously at different postoperatively period were killed for autopsy and pathologic examination of the neoesophagus.</p><p><b>RESULTS</b>All pigs had no leakage at the site of anastomosis and survived over 6 months. The longest survival was 20 months. Seven of 10 pigs the grafted prostheses sloughed out spontaneously at 2 to 6 months after the operation (4 in group I and 3 in group II). The grafted prostheses sloughed out spontaneously less than 3 months after operation, marked neoesophageal stenosis in the grafted portion was recognized (3 in group I). They displayed serious difficulty in eating. But the prostheses sloughed out spontaneously more than 3 months after operation, neoesophageal stenosis was increased slightly and the stenosis was only temporary and gradually resolved. (1 in group I, 3 in group II) They lived in good health and without difficulty in eating. Three of 10 pigs the grafted prosthesis still stayed in the grafted place over 10 months (1 in group I, 2 in group II). The neoesophageal had no stenosis. They were perfectly well in eating.</p><p><b>CONCLUSIONS</b>A segment excised pig esophagus replaced with a nitinol alloy composite artificial esophagus is feasible and takes a better result.</p>

Effect of G protein in the dual regulation of opioid receptor agonist on the delayed rectified potassium channels / 中国医学科学院学报

<p><b>OBJECTIVE</b>To observe the role of G protein in the dual regulation of opioid receptor agonist on the delayed rectified potassium channels.</p><p><b>METHODS</b>Using whole-cell patch-clamp techniques applied to NG108-15 cells, investigate the effect of opioid receptor agonist on the delayed rectified potassium channels by administration of Guanosine-5'-0'-2-thiociphosphate (GDP beta S), Pertusis Toxin (PTX), Tetroacetic acid nueleoside diphosphate kinase (NDPK) and Adenosine-3' 5' cyclic monophosphate cAMP in the pipette solution.</p><p><b>RESULTS</b>(1) GDP beta S could block the changes induced by both high and low concentration of (D-Pen2.5)-enkephalin (DPDPE) (P < 0.05). (2) PTX could inhibit the excitative regulation on K+ channel by high concentration of DPDPE (P < 0.05). But CTX had no effect on K+ channel caused by DPDPE. (3) UDP could block the excitative effect of K+ channel by high concentration of NDPK, while have no changes on the inhibitory effect caused by low concentration of opioid agonists. (4) cAMP took part in the regulation in high concentration of agonist administration (P < 0.05), while no changes for low concentration of agonists.</p><p><b>CONCLUSIONS</b>Dual changes were observed on delayed rectifier potassium channel by agonist treatment on NG108-15 cells. The excitative effect was Gi/o coupled in high concentration of agonist incubation, related to cAMP. While the inhibitory effect was possibly induced by G protein beta gamma subunit directly.</p>

Dual regulation by delta opioid receptor agonists on the delayed rectified potassium channels in NG108-15 cells / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the dual effects by the delta opioid receptor agonists DPDPE on the delayed rectified potassium channels in NG108-15 cells.</p><p><b>METHODS</b>A series of outward currents were evoked in NG108-15 cells by depolarizing voltage from -50 mV to +80 mV at holding potential of -90 mV. These currents were delayed rectified potassium currents. Relatively selected delta opioid receptor agonists DPDPE of higher and lower concentrations were used to modulate the delayed rectified K+ current in NG108-15 cells. Opioid receptor antagonist Naloxone (NAL) and relatively selected delta opioid receptor antagonist Naltrindole (NTI) were used in the present experiments for the characterization of the actions of opioid receptors.</p><p><b>RESULTS</b>The relatively higher concentrations of delta opioid receptor agonist DPDPE (> or = 10(-6) mol/L) significantly increased the amplitude of the delayed rectified K+ current. On the contrary, the relatively lower concentrations of DPDPE (< or = 10(-12) mol/L) decreased the amplitude of the delayed rectified K+ current (P < 0.05). Furthermore both the increase and decrease were time-dependent.</p><p><b>CONCLUSIONS</b>delta opioid receptor agonist has dual regulatory effects on the delayed rectified potassium channels in NG108-15 cells.</p>