Clinical Characteristics and Genetic Analysis of Klippel-Feil Syndrome / 中国医学科学院学报

Objective To summarize clinical characteristics and investigate possible pathogenic gene of Klippel-Feil syndrome(KFS)by the self-designed multigene panel sequencing,so as to decipher the molecular basis for early diagnosis and targeted therapy.Methods From January 2015 to December 2018,we consecutively recruited 25 patients who were diagnosed with KFS in Peking Union Medical College Hospital.The demographic information,clinical manifestations,physical examination and radiological assessments were analyzed.Multigene panel sequencing was performed after DNA extraction from peripheral blood.The possible pathogenic mutations of KFS were explored on the basis of bioinformatics analysis.Results The KFS cohort consisted of 25 patients,including 15 males and 10 females,with a mean age of(12.9±7.3)years.Limited cervical range of motion was the most common clinical feature(12 cases,48%).Based on the Samartzis classification,the proportion of patients suffered from short neck(P=0.031)and limited cervical range of motion(P=0.026)in type Ⅲ KFS was significantly higher than that in type Ⅱ and type Ⅰ KFS.Panel sequencing detected a total of 11 pathogenic missense mutations in eight patients,including COL6A1,COL6A2,CDAN1,GLI3,FLNB,CHRNG,MYH3,POR,and TNXB.There was no pathogenic mutation found in five reported pathogenic genes(GDF6,MEOX1,GDF3,MYO18B and RIPPLY2)associated with KFS.Conclusions Our study has shown that patients with multiple contiguous cervical fusions are more likely to manifest short neck,limited cervical range of motion,and clinical triad.Therefore,these patients need additional attention and follow-up.Our analysis highlights novel KFS-related genetic variants,such as COL6A and CDAN1,extending the spectrum of known mutations contributing to this syndrome and providing a basis for elucidating the pathogenesis of KFS.

Analysis of the endoplasmic reticulum stress in non-ablative skin rejuvenation using Q-switched 1064nm Nd:YAG laser / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the effect of Q-switched 1 064 nm Nd:YAG laser treatment on the proliferation of dermal collagen and expression of immunoglobulin binding protein/glucose related protein 78 (BiP/GRP78) in rats' skin and the mechanism of endoplasmic reticulum stress.</p><p><b>METHODS</b>Dorsal skin of 25 Wistar rats was divided into two parts equally after hair removal. Q-switched 1 064nm Nd:YAG laser was applied to treat rats' dorsal skin for 4 times at an interval of 2 days in the experiment part. The control part received no laser treatments. The rats' dorsal skin samples were taken on the 14th and 30th day after laser treatment to measure the dermis thickness and collagen bundles under HE stain and to measure the hydroxyproline content by alkaline hydrolysis method after laser treatment. The expression of BiP/GRP78 was also detected by immunohistochemical method. Statistics was used to analyze the data.</p><p><b>RESULTS</b>The dermis thickness increased by 29. 6% on the 14th day and 16.7% on the 30th day after laser treatment. The collagen bundles became thicker and denser. The hydroxyproline in the skin was also raised after laser treatment (P < 0.05). The immunohistochemical result showed the expression of BiP/GRP78 increased to 100% after laser treatment, showing a significant difference from the control group(X2 = 28.76, P < 0.01).</p><p><b>CONCLUSIONS</b>The Q-switched 1064 nm Nd:YAG laser treatment can induce endoplasmic reticulum stress, so as to enhance the protein folding and synthesizing precisely. The proliferation of dermis collagen is the base of effect of non-ablative skin rejuvenation.</p>