Current status of animal models of cataract classified by etiology / 国际眼科杂志(Guoji Yanke Zazhi)

Cataract is one of the major causes of vision loss and even blindness in patients, and surgery is the only effective method to treat it. The pathogenesis and precaution of cataract remain hot issues in ophthalmological research. With the maturation of biotechnology in recent years, modeling methods and species of experimental animals have become more diverse, which are still the mainstay of cataract mechanism research. However, the ideal animal model of cataract has yet to be constructed due to the complexity of human cataract etiology. Herein, the modeling principles, in vivo or in vitro modeling methods, characteristics, and existing problems of animal models of cataract are summarized according to etiology, providing the theoretical foundation for the construction of a comprehensive animal model that more closely resembles the human cataract.

Prenatal diagnosis and pregnancy outcome of increased nuchal translucency with or without nuchal cystic hygroma in fetuses during first trimester / 中华围产医学杂志

Objective:To compare the prenatal diagnosis and pregnancy outcome of increased nuchal translucency (NT) with or without nuchal cystic hygroma (CH) in fetuses with first-trimester NT ≥5 mm.Methods:Data from 131 fetuses with NT ≥5 mm who received invasive prenatal diagnosis at Guangzhou Women and Children's Medical Center from July 2017 to December 2020 were retrospectively collected and analyzed. Those with a septum in the cyst were grouped as NT with CH group ( n=57), and those without as increased NT without CH group ( n=74). Genetic test results, incidence of structural malformations, survival rate after birth were compared using Chi-square test or Fisher's exact test and non-parametric test. Results:There was no significant difference in the incidence of fetal genetic abnormalities[67.6%(50/74) vs 61.4%(35/57), χ 2=0.54, P=0.464], ultrasonic structural malformations [21.6%(16/74) vs 33.3%(19/57), χ 2=2.26, P=0.133], or in the survival rate (12/14 vs 3/8, P=0.053) between increased NT without CH group and NT with CH group. Conclusions:For increased NT with or without CH, although the two groups had different spectrum of disease, they had a high incidence of chromosomal abnormalities and structural malformations, and both groups had a certain healthy survival rate after birth.

Prenatal genetic diagnosis of the fetuses with isolated corpus callosum abnormality / 中华妇产科杂志

Objective:To explore the application value of chromosome karyotype analysis, chromosomal microarray analysis (CMA) and whole exome sequencing (WES) in prenatal diagnosis of isolated corpus callosum abnormality (CCA) fetus.Methods:Fetuses diagnosed with isolated CCA by ultrasound and MRI and receiving invasive prenatal diagnosis in Guangzhou Women and Children′s Medical Center and Qingyuan People′s Hospital from January 2010 to April 2021 were selected. Karyotype analysis and/or CMA [or copy number variation sequencing (CNV-seq)] were performed on all fetal samples, and WES was performed on fetal samples and their parents whose karyotype analysis and/or CMA (or CNV-seq) results were not abnormal.Results:Among 65 fetuses with isolated CCA, 38 cases underwent karyotype analysis, and 3 cases were detected with abnormal karyotypes, with a detection rate of 8% (3/38). A total of 49 fetuses with isolated CCA underwent CMA (or CNV-seq) detection, and 6 cases of pathogenic CNV were detected, the detection rate was 12% (6/49). Among them, the karyotype analysis results were abnormal, and the detection rate of further CMA detection was 1/1. The karyotype results were normal, and the detection rate of further CMA (or CNV-seq) detection was 14% (3/21). The detection rate of CMA as the first-line detection technique was 7% (2/27). A total of 25 fetuses with isolated CCA with negative results of karyotyping and/or CMA were tested by WES, and 9 cases (36%, 9/25) were detected with pathogenic genes. The gradient genetic diagnosis of chromosomal karyotyping, CMA and WES resulted in a definite genetic diagnosis of 26% (17/65) of isolated CCA fetuses.Conclusions:Prenatal genetic diagnosis of isolated CCA fetuses is of great clinical significance. The detection rate of CMA is higher than that of traditional karyotyping. CMA detection could be used as a first-line detection technique for fetuses with isolated CCA. WES could increase the pathogenicity detection rate of fetuses with isolated CCA when karyotype analysis and/or CMA test results are negative.

Value of chromosomal microarray analysis for fetuses with duodenal obstruction / 中华医学遗传学杂志

OBJECTIVE@#To assess the value of chromosomal microarray analysis (CMA) for fetal duodenal obstruction (DO).@*METHODS@#Fifty-one fetuses with DO identified by prenatal ultrasound were divided into DO only group and DO with other anomaly group. CMA was carried out on amniotic fluid or umbilical blood samples, and the outcome of pregnancy of all cases were followed up.@*RESULTS@#Eight fetuses (15.7%) were found with genomic abnormalities, which included 3 chromosomal aneuploidies and 5 copy number variations (CNVs), including one 17q12 microduplication syndrome, one 13q21.33q31.1 microdeletion, one 13q21.32q22.3 deletion, one 13q21.2q31.1 deletion and one 1q43q44 duplication. EDNRB from 13q and HNF1B from 17q12 are candidate genes for fetal DO. No significant difference was found in the detection rate of pathogenic CNVs between the DO only and DO with other anomaly groups (9.5% vs.11.1%, P> 0.05). There were 39 live borns, 1 stillbirth, and 11 artificial abortions (8 with abnormal CMA results).@*CONCLUSION@#There is a correlation between fetal DO and abnormal copy number of the genome, for which prenatal diagnosis is necessary. CMA not only can detect microdeletions/microduplications, but also identify pathogenic genes, which can facilitate prenatal diagnosis, genetic counseling and prognosis for the fetus.

Analysis of families with fetal congenital abnormalities but negative prenatal diagnosis by whole exome sequencing / 中华妇产科杂志

Objective:To evaluate the value of whole exome sequencing (WES) in prenatal clinical application.Methods:A total of 1 152 cases of congenital abnormal [including structural malformation, nuchal translucency (NT) thickening and intrauterine growth restriction] with traditional prenatal diagnosis [including G-band karyotype analysis and chromosome microarray analysis (CMA)] negative were analyzed. The congenital abnormal fetuses were divided into retrospective group and prospective group according to the time of WES detection, that is whether the pregnancy termination or not. According to the specific location of fetal malformation and their family history, the cohort was divided into subgroups. The clinical prognosis of all fetuses were followed up, and the effect of WES test results on pregnancy decision-making and clinical intervention were analyzed. According to the follow-up results, the data of fetuses with new phenotypes in the third trimester or after birth were re-analyzed.Results:Among 1 152 families who received WES, 5 families were excluded because of nonbiological parents. Among the remaining 1 147 families, 152 fetuses obtained positive diagnosis (13.3%,152/1 147), including 74 fetuses in the retrospective group (16.1%,74/460) and 78 fetuses in the prospective group (11.4%,78/687). In fetuses with negative CMA and G-band karyotype analysis results but new phenotypes in the third trimester or after birth, the positive rate by WES data re-analysis was 4.9% (8/163). A total of 34 (21.3%, 34/160) fetuses were directly affected by the corresponding positive molecular diagnosis. Among 68 cases of live births with diagnostic variation grade 4, 29 cases (42.7%, 29/68) received appropriate medical intervention through rapid review of WES results.Conclusions:WES could increase the detection rate of abnormal fetuses with negative G-banding karyotype analysis and CMA by 13.3%. Prenatal WES could guide pregnancy decision-making and early clinical intervention. It might be an effective strategy to pay attention to the special follow-up of the third trimester and postnatal fetus and to re-analyze the WES data.

Protection Mechanism of Addition and Subtraction Therapy of Danshenyin Combined with Wendantang for Myocardial Ischemia in Patients with Stable Angina / 中国实验方剂学杂志

Objective:To observe the efficacy of addition and subtraction therapy of Danshenyin combined with Wendantang in the treatment to stable angina pectoris （SAP） with stagnation of phlegm and blood stasis， and to explore its protection mechanism for myocardial ischemia. Method:One hundred and thirty-two patients were randomly divided into control group and observation group equally. Finished the 63 cases study both in control group and observation group after dropout， loss of follow-up and withdrawal. Patients in control group and observation group got antianginal drugs and the treatment of drug therapy to control the risk factors. All patients were treated with anti-angina drugs and risk factors control drugs. Patients in control group got Danlou Tablets by oral administration， 5 tablets/time， 3 times/day. Patients in observation group got dispensing decoction pieces of Danshenyin and Wendantang 1 dose/day. The treatment continued for 3 months in both groups. Scores of angina attack were graded every week. Before and after treatment， electrocardiogram treadmill exercise test was made to evaluate myocardial ischemia of coronary heart disease， and scores of phlegm stasis block syndrome and Seattle Angina questionnaire （SAQ） were graded for TCM symptoms and quality of life. Levels of hemorheology index， interleukin-6 （IL-6）， tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>）， intercellular adhesion molecule-1 （ICAM-1）， Cystatin C （CysC）， homocysteine （Hcy）， ischemic modified albumin （IMA） and macrophage migration inhibitory factor were detected. In addition， safety was evaluated. Result:After treatment， scores of times， duration， degree of angina pectoris， nitroglycerin dosage of angina pectoris and nitroglycerin dosage in the observation group were lower than those in the control group （<italic>P</italic><0.01）. Total exercise time， duration of ST depression for 1.0 mm， occurrence time of stable angina pectoris， metabolic equivalent and scores of Duke in the observation group were more than those in the control group （<italic>P</italic><0.01）. Score of stagnation of phlegm and blood stasis in the observation group was lower than that in the control group （<italic>P</italic><0.01）， while score of SAQ was higher than that in the control group （<italic>P</italic><0.01）. Levels of IL-6， TNF-<italic>α</italic>， ICAM-1， CysC， IMA， Hcy， MIF， whole blood viscosity （low cut， high cut）， whole blood reducing viscosity， plasma viscosity， platelet aggregation rate and fibrinogen （FIB） in the observation group were lower than those in the control group （<italic>P</italic><0.01）. Effect of angina pectoris in observation group was superior to that in control group （<italic>Z</italic>=2.091， <italic>P</italic><0.01）. No adverse reactions related to Danshenyin combined with Wendantang were found. Conclusion:Addition and subtraction therapy of Danshenyin combined with Wendantang based on the routine western medicine treatment can control the attack of angina pectoris， relieve the symptoms of phlegm and stasis block syndrome， and improve the quality of life for patients with SAP， showing superior clinical efficacy and safety. In addition， it can improve the hemorheology of patients， inhibit the inflammatory reaction， reduce the stenosis or obstruction of lumen in order to improve the degree of myocardial ischemia.

Application of whole exome sequencing technology in fetuses with congenital structural abnormalities / 中华医学遗传学杂志

OBJECTIVE@#To investigate the application value of whole exome sequencing technology in fetuses with congenital structural abnormalities.@*METHODS@#The chromosomal abnormalities of 1147 families were analyzed. According to the follow-up results, the data of fetuses with new phenotypes in late pregnancy or after birth were reanalyzed. Subgroups were divided according to the organs involved and whether single malformation or not. The gene regulatory network map was drawn by using string database and Cytoscape software. Fisher exact probability method was used to compare the difference of the diagnostic rate of pathogenic genes among the groups.@*RESULTS@#A total of 160 fetal cases received positive molecular diagnosed, involving 178 variant sites of 125 pathogenic genes, including 8 cases (4.9%, 8/163) by data reanalysis, and the overall positive diagnosis rate was 13.9%. Diagnostic rate was highest in the group of skeletal malformation (31.5%, 39/124) and lowest in that with thoracic malformation (0, 0/32). The gene clusters of fetal edema and intrauterine growth restriction were independent, and were not associated with the major structural malformations. The probability of each parent carrying the same recessive gene variant was 0.03 (39/1146) and 0.08 (4/53) with positive family history.@*CONCLUSION@#For fetuses with congenital structural abnormalities that are negative for conventional genetic tests, 13.9% of phenotypic associated pathogenic/likely pathogenic genetic variants can be detected by whole exome sequencing technology. Its application value for prenatal diagnosis varies in fetus with different organs involved. Reanalysis of sequencing data for cases with new phenotypes in late pregnancy or after birth can further improve the molecular diagnosis rate. Further investigations are needed to explore the related genetic mechanisms.

Application of chromosome microarray analysis in congenital heart disease in infants and young children / 中华实用儿科临床杂志

Objective:To explore the application value of whole genome and high resolution chromosome microarray analysis (CMA) in genetically etiological diagnosis of infants and young children with congenital heart disease (CHD).Methods:The clinical data of 130 infants and young children with CHD who were hospitalized and received CMA test at the Department of Pediatrics, Guangzhou Women and Children′s Medical Center, Guangzhou Medical University from January 2016 to December 2018 were retrospectively analyzed.The whole genome CMA test was carried out as per the standard operating procedure of American Affymetrix CytoScan HD platform.The results were analyzed by using chromosome analysis suite (ChAS) software and related bioinformatics.CHD patients were divided into the isolated CHD group and the syndromic CHD group according to whether they had extracardial abnormalities.According to the CHD phenotype features of these 2 groups obtained by anatomical results, patients were divided into the simple CHD group and the complex CHD group.Results:Among 130 CHD infants and young children receiving CMA, there were 60 clinically significant copy number variations (CNVs) detected by CMA in 53 patients, with a diagnostic rate of 40.8%(53/130 cases). The pathogenic CNVs of 32 patients (24.6%) were less than 10 7 bp.There were 29 cases (54.7%) of genetic syndromes related to chromosomal microdeletion or microduplication.22q11.2 microdeletion syndrome, Williams-Beuren syndrome and Wolf-Hirschhorn syndrome were the most common syndromes.The detection rates of pathogenic CNVs between the isolated CHD group [42.8% (30/70 cases)] and the syndromic CHD group [38.3% (23/60 cases)] was not statistically significantly different ( P=0.60). The detection rates of pathogenic CNVs between the simple CHD group [34.4% (20/58 cases)] and the complex CHD group [45.8% (33/72 cases)] was not statistically significantly different ( P=0.19). By genotypic and phenotypic analysis, genes such as SUZ12, DGCR6, YWHAE, CRKL, LZTR1, DLG1, ADAP2 and TBX6 were identified as potential candidate pathogenic genes of CHD. Conclusions:CMA has important application value in CHD in infants and young children.It is recommended that CMA should be used as the first-line genetic detection technology for CHD infants and children.CHD patients of various types should be tested by CMA.

Application of chromosomal microarray analysis in 815 fetuses with increased nuchal translucency during early pregnancy / 中华医学遗传学杂志

OBJECTIVE@#To explore genetic etiology and prognosis for fetuses with increased nuchal translucency (NT).@*METHODS@#A total of 815 fetuses with increased NT (≥ 3.0 mm) were included. The fetuses were grouped by NT thickness and divided into 3.0-3.4 mm, 3.5-4.4 mm, 4.5-5.4 mm, 5.5- 6.4 mm and ≥ 6.5 mm groups. Based on the presence of additional abnormalities, the samples were divided into increased NT alone group and increased NT and other anomalies group. Chromosomal microarray analysis (CMA) was applied as a first-line test to detect pathogenic copy number variations (CNVs). The outcome of the pregnancies was followed up.@*RESULTS@#One hundred seventy-eight (21.8%) fetuses were found to harbor pathogenic CNVs, which included 138 (77.5%) with chromosomal aneuploidies, 14 (7.9%) with microdeletion/microduplication syndromes, and 26 (14.6%) harboring non-syndromic pathogenic CNVs. A significant difference was found in the detection rate of pathogenic CNVs between groups with different NT thickness. The detection rate of pathogenic CNVs also significantly differed between groups with regard to other structural abnormalities or the overall adverse pregnancy outcome.@*CONCLUSION@#CMA can be used as a first-line test for fetuses with increased NT during early pregnancy, with the overall detection rate of pathogenic CNVs being as high as 21.8%. Our results confirmed that NT thickness is correlated with other structural abnormalities and adverse pregnancy outcome, especially for those with NT ≥ 4.5 mm. At the same time, fetuses with other structural abnormalities are at an increased risk for adverse pregnancy outcome.

Surveillance of soil-borne nematodiasis in Danyang City from 2012 to 2018 / 中国血吸虫病防治杂志

Objective To monitor the epidemic status of human soil-borne nematodiasis in Danyang City, so as to provide scientific evidence for formulating control measures. Methods The soil-borne nematode infections were tested using a modified Kato-Katz technique among residents aged more than 3 years living in Danyang City from 2012 to 2018, and the Enterobius vermicularis eggs were detected using the transparent adhesive tape anal swab method among children at ages of 3 to 12 years. Results A total of 13 540 residents were monitored for soil-borne nematode infections from 2012 to 2018, and the prevalence of human soil-borne nematode infections was 0.45%. The prevalence of Ascaris lumbricoides, Trichuris trichura and Enterobius vermicularis infections was 0.32%, 0.12% and 0.01%, respectively, and a single parasite infection was predominant. There were significant differences in the prevalence of soil-borne nematode (χ2 = 42.610, P < 0.05), A. lumbricoides (χ2 = 26.276, P < 0.05) and T. trichura (χ2 = 20.692, P < 0.05). The prevalence of human soil-borne nematode infections was 0.45% in males and 0.47% in females, and lower prevalence was found in local residents than in floating population (0.28% vs. 0.66%; χ2 = 10.561, P < 0.05). The highest infection was found in subjects at ages of 31 to 40 years (0.59%), followed by in subjects at ages of 41 to 50 years (0.56%), and the lowest infection was seen in children at ages of 3 to 5 years (0.27%). In addition, the prevalence of human soilborne nematode infections varied significantly in occupation (χ2 = 75.692, P < 0.05), with the highest infection seen in boatmen. Among the 5 078 children monitored, the prevalence of E. vermicularis infection was 0.37%, and the prevalence of E. vermicularis infection varied significantly in year (χ2= 15.466, P < 0.05). Conclusion The human soil-borne nematode infection is at a low level in Danyang City; however, the surveillance of soil-borne nematodiasis remains to be intensified in children living in rural areas and immigrant populations.

Surveillance of soil-borne nematodiasis in Danyang City from 2012 to 2018 / 中国血吸虫病防治杂志

Objective To monitor the epidemic status of human soil-borne nematodiasis in Danyang City, so as to provide scientific evidence for formulating control measures. Methods The soil-borne nematode infections were tested using a modified Kato-Katz technique among residents aged more than 3 years living in Danyang City from 2012 to 2018, and the Enterobius vermicularis eggs were detected using the transparent adhesive tape anal swab method among children at ages of 3 to 12 years. Results A total of 13 540 residents were monitored for soil-borne nematode infections from 2012 to 2018, and the prevalence of human soil-borne nematode infections was 0.45%. The prevalence of Ascaris lumbricoides, Trichuris trichura and Enterobius vermicularis infections was 0.32%, 0.12% and 0.01%, respectively, and a single parasite infection was predominant. There were significant differences in the prevalence of soil-borne nematode (χ2 = 42.610, P < 0.05), A. lumbricoides (χ2 = 26.276, P < 0.05) and T. trichura (χ2 = 20.692, P < 0.05). The prevalence of human soil-borne nematode infections was 0.45% in males and 0.47% in females, and lower prevalence was found in local residents than in floating population (0.28% vs. 0.66%; χ2 = 10.561, P < 0.05). The highest infection was found in subjects at ages of 31 to 40 years (0.59%), followed by in subjects at ages of 41 to 50 years (0.56%), and the lowest infection was seen in children at ages of 3 to 5 years (0.27%). In addition, the prevalence of human soilborne nematode infections varied significantly in occupation (χ2 = 75.692, P < 0.05), with the highest infection seen in boatmen. Among the 5 078 children monitored, the prevalence of E. vermicularis infection was 0.37%, and the prevalence of E. vermicularis infection varied significantly in year (χ2= 15.466, P < 0.05). Conclusion The human soil-borne nematode infection is at a low level in Danyang City; however, the surveillance of soil-borne nematodiasis remains to be intensified in children living in rural areas and immigrant populations.

Establishment and validation of hsa_circ_0004123 absolute quantitative PCR method / 解放军医学杂志

Objective To establish an absolute reverse transcription fluorescence quantitative PCR method (RT-qPCR) that can accurately quantify the circRNA hsa_circ_0004123, and verify the copy number of hsa_circ_0004123 in the leukemia cell line. Methods Total RNA was extracted from HMy2.CIR cell line, and reverse transcribed to cDNA. Using cDNA as template, a 236 bp characteristic segment containing the back-spliced junction of hsa_circ_0004123 transcript was cloned and inserted into the pGM-T vector, and then the recombinant plasmid was sequenced. Regarding the gradient diluted recombinant plasmid as standard substance, the standard curve of hsa_circ_0004123 was established by SYBR fluorescent staining RT-qPCR, and then the copy number of hsa_circ_0004123 in leukemia cell lines (HMy2.CIR, Jurkat, Raji, K562) were verified. Results The absolute RT-qPCR method was established that can accurately quantify the copy number of hsa_circ_0004123 with wide linear range (9.63×103–9.63×109) copies/μl, high sensitivity (4528±516) copies/μl, intra-batch coefficient of variation (CV) of 0.30%-1.86%, inter-batch CV of 1.40%-2.30%, and a single peak dissolution curve. The copy number of hsa_circ_0004123 in leukemia cell lines HMy2.CIR, Jurkat, Raji and K562 was detected respectively. The expression of hsa_circ_0004123 was significantly different (P<0.001) in the 4 kinds of leukemia cell lines. Conclusion The absolute RT-qPCR method used to detect the copy number of hsa_circ_0004123 has a wide linear range, high sensitivity and specificity, and good repeatability, and lays a technical foundation for accurate quantification of hsa_circ_0004123 in leukemia.

Vascular endothelial function and hemorheological indexes in patients with POAG and its risk factors / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the changes of vascular endothelial function and hemorheological indexes in patients with primary open angle glaucoma(POAG)and to analyze the risk factors of POAG. <p>METHODS: A total of 86 cases of POAG patients were selected as the research object(observation group), and they were divided into mild group(<i>n</i>=27), moderate group(<i>n</i>=29)and severe group(<i>n</i>=30)according to the visual field defect, another 30 cases normal healthy volunteers were selected as the control group. The levels of vascular endothelial function and blood hemorheology between the groups were compared, and to analysis the risk factors of the disease. <p>RESULTS: The results of single factor analysis showed that there was no significant difference in the sex ratio, average age, history of alcoholism and cardiovascular disease between the control group and the observation group(<i>P</i>>0.05); the smoking history, hypertension history, diabetes history, and family history were statistically significant(<i>P</i><0.05). The level of NO in the observation group was significantly lower than that in the control group, and the level of the severe group was significantly lower than that in the moderate group, which was significantly lower than that of the mild group, and the difference was statistically significant(<i>P</i><0.05). Compared with the control group, the levels of endothelin-1(ET-1), plasma viscosity(PV), hematocrit(HCT)and fibrinogen(FIB)in the observation group were significantly increased, and the ET-1 and HCT levels in the severe group were significantly higher than those in the moderate group, which were significantly higher than those in the mild group(<i>P</i><0.05); and the levels of PV and FIB in the severe group were significantly higher than those in the mild group, the difference was statistically significant(<i>P</i><0.05). Logistic regression analysis showed that smoking history, hypertension history, diabetes history, family history, ET-1, PV, HCT and FIB were risk factors for primary glaucoma, and NO was a protective factor(<i>P</i><0.05). <p>CONCLUSION: There are endothelial dysfunction and hemorrheology abnormality in patients with POAG. Smoking history, hypertension history, diabetes history, family history are related to the occurrence of POAG.

Analysis of 26 fetuses with congenital anomalies of the kidney and urinary tract by whole exome sequencing / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic etiology of fetuses with congenital anomalies of the kidney and urinary tract (CAKUT) by whole exome sequencing (WES).@*METHODS@#WES was performed on DNA extracted from cord blood samples of 26 fetuses with unexplained CAKUT with/without other structural anomalies. In the first 19 cases, sequencing was performed on fetal DNA only, and the turnaround time was 11-12 weeks. For the remaining 7 cases, the fetus and its parents were sequenced simultaneously, and the turnaround time was 8-9 weeks.@*RESULTS@#Of the 26 cases, pathogenic variants were identified in 4 (15.4%) cases, which respectively involved UMOD, NEK8, HNF1B, and BBS2 genes, and likely pathogenic variants were identified in 2 (7.7%) cases, which respectively involved HSPD1 and GRIN2B genes. Two of the 4 cases had other anomalies in addition to CAKUT. Thus, the detection rate was only 2/19 (10.5%) for isolated CAKUT and 4/7 (57.1%) for CAKUT with additional anomalies.@*CONCLUSION@#The application of WES as a prenatal diagnostic approach for CAKUT fetuses with or without other anomalies allowed early and accurate diagnosis and improved their clinical management.

A Case Discussion of Individualized Administration of Warfarin by Maximum a Posteriori Bayesian Estima-tion Method / 中国药师

Objective:To explore the role played by clinical pharmacists in the formulation and pharmaceutical care of individual-ized administration of warfarin. Methods:Clinical pharmacists adopted maximum a posteriori Bayesian method to formulate the dosage regimen of patients treated with warfarin and monitored the implementation process. The increase of INR was timely identified on ac-count of drug interactions to avoid bleeding events,as well as the decrease of INR caused by patients' medication mistakes to avoid re-currence of thrombosis. Results:The maximum a posterior Bayesian estimation method could be used to estimate and guide clinical medication,which showed great reference value for individualized drug regimen. Conclusion:Clinical pharmacists should formulate in-dividualized administration plan according to genetic testing results and choose optimal treatment for patients. Moreover,the implemen-tation of dosage regimen should be monitored during the whole progress,so as to timely find INR abnormal fluctuations due to disease interactions,drug interactions,poor treatment compliance and so on,and consequently improve anticoagulant effect and reduce adverse reactions such as bleeding and thrombosis etc.

Quantification and Genotyping of Trace Samples / 法医学杂志

Objective To introduce real-time polymerase chain reaction (real-time PCR) into the initial sample screening, to improve the effectiveness of traditional trace sample extraction method.Methods Serial diluted 9947A was quantified using a Rotor-Gene Q real-time RT-PCR, and the genotype was determined with AmpF?STRTMIdentifilerTMPlus PCR kit.Thus a quantitative threshold model was built to obtain complete STR typing from the trace samples.In addition, 903 trace samples were used to verify the reliability.Results When the samples quality concentration was＞0.03 ng/μL, the effective STR typing could be directly obtained;when the concentration was＞0.01 and≤0.03 ng/μL, the effective STR typing could be directly obtained by optimizing the PCR thermal cycle parameters (30 cycles);and when the concentration was≤0.01 ng/μL, no effective map could be obtained even if PCR was optimized.Conclusion The real-time PCR quantitative threshold model is effective for the screening of trace samples.

Application of chromosome microarray analysis in 489 children with developmental delay/intellectual disability / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the value of chromosome microarray analysis (CMA) for identifying the etiology of developmental delay/intellectual disability (DD/ID).</p><p><b>METHODS</b>A total of 489 children referred for DD/ID with or without other abnormalities were recruited. All patients showed a normal karyotype. DNA was extracted and hybridized with Affymetrix CytoScan 750K array by following the manufacturer's protocol. The data was analyzed with CHAS v2.0 software.</p><p><b>RESULTS</b>The children were classified as with isolated DD/ID (n=358), DD/ID with epilepsy (n=49), and DD/ID with other structural anomalies (n=82). Pathogenic copy number variants (CNVs) were identified in 126 cases (25.8%), which included 89 (24.9%, 89/358) of whose with isolated DD/ID, 13 (26.5%, 13/49) of those with DD/ID and epilepsy, and 24 (29.3%, 24/82) of whose with DD/ID and other structural anomalies [P=0.064 (24.9% vs. 26.5%), P=0.679 (24.9% vs. 29.3%), and P=0.113 (26.5% vs. 29.3%), respectively]. Among the 126 cases, 79 were identified as microdeletion/microduplication syndromes, which included 15q24 microdeletion syndrome, Xq28 microduplication syndrome, and Lowe syndrome. Forty-seven cases had de novo pathogenic CNVs. ABAT, PMM2, FTSJ1, DYNC1H1 and SETBP1 were considered as candidate genes for DD/ID.</p><p><b>CONCLUSION</b>CMA is an effective method for identifying the etiology of DD/ID and is capable of identifying microdeletion/microduplication syndromes as well as de novo pathogenic CNVs which may be missed by conventional karyotyping. Based on the results, candidate genes for DD/ID may be identified.</p>

Application of chromosome microarray analysis for the delineation of pathogenesis for fetal ventriculomegaly / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the value of genome-wide high-resolution chromosomal microarray analysis (CMA) for the delineation of pathogenesis for fetal ventriculomegaly diagnosed by ultrasound or magnetic resonance imaging (MRI).</p><p><b>METHODS</b>Three hundred and forty-one cases of fetal ventriculomegaly were collected. The samples were grouped based on the extent of lateral ventricular dilatation, presence of additional features, site of occurrence, and the maternal age. All samples were subjected to karyotyping analysis. For those with a normal karyotype, DNA was extracted and hybridized with an Affymetrix CytoScan HD array. All cases were followed up.</p><p><b>RESULTS</b>Among the 341 fetuses, 21 (6.2%) were detected with an abnormal karyotype. For the 320 cases with a normal karyotype, 179 (55.9%) have accepted CMA analysis. Potentially pathogenic CNVs were identified in 12 (6.7%) of the 179 cases, whose sizes ranged from 198 kb to 8.71 Mb. These included a 1q21.3q23.1 deletion, a 2q37.3 deletion, a 3p14.1p13 deletion, a 6q25.3 deletion, a 8q11.23 duplication, a 10q21.1 deletion, a 15q11.2 deletion and a 16p13.11p12.3 duplication, a 22q13.33 duplication, a 22q11.21 duplication and a Xp21.1 duplication (Duchenne muscular dystrophy). Pathogenic CNVs were detected respectively in 7.5% and 3.1% of those with mild and severe ventriculomegaly (P=0.615), in 6.1% and 7.4% of those with isolated and non-isolated ventriculomegaly (P=0.732), in 5.6% and 7.9% of those with unilateral and bilateral ventriculomegaly (P=0.511), and in 6.7% of both elderly and non-elderly groups (P=1.000).</p><p><b>CONCLUSION</b>The detection rate for abnormal karyotypes among fetuses with ventriculomegaly was 6.2%. CMA can increase the detection rate by approximately 6.7%. There was no significant correlation between ventriculomegaly and presence of pathogenic CNVs. In clinical practice, fetuses with ventriculomegaly and a normal karyotype should be considered for CMA analysis.</p>

Application of chromosomal microarray analysis for fetuses with ventricular septal defects / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To explore the genetic etiology of fetuses with ventricular septal defects (VSD) using chromosomal microarray analysis (CMA).</p><p><b>METHODS</b>A total of 248 fetuses were divided into isolated VSD group, VSD with other cardiac and/or great vessels malformation group, VSD with extra-cardiac anomalies group (including malformation and sonographic soft markers), and VSD with both cardiac and extra-cardiac anomalies group. Standard karyotyping was carried out for all fetuses, and CMA was performed for 6 fetuses with an abnormal karyotype and a proportion of fetuses with a normal karyotype. All cases were followed up, and neonates were followed up until 1 year of age.</p><p><b>RESULTS</b>Chromosomal abnormalities were identified in 60 (24.2%) of the 248 fetuses. For 6 of the fetuses subjected to further CMA analysis, the origin of abnormal chromosomes were clarified, among which 2 have overlapped with the critical region of Wolf-Hirschhorn syndrome. Candidate genes for VSD included WHSC1, LBX1, LDB3 and BBS10. For 143 fetuses with a normal karyotype, CMA has identified pathogenic copy number variations (CNVs) in 11 cases (7.7%). These included 9 well-known microdeletion or microduplication syndromes, including 22q11.2 microdeletion, 17p11.2 microdeletion (Smith-Magenis syndrome), 17p13.3 microdeletion (Miller-Dieker syndrome), 1p36 microdeletion, 1q21.1 microduplication and 4q deletion. Candidate genes for VSD included TBX1, LZTR1, FAT1, AKAP10, SKI, PRDM26, GJA5, ERCC4 and YWHAE. For 48.7% of the fetuses with benign CNVs, spontaneously closure has occurred within the first year of life.</p><p><b>CONCLUSION</b>CMA may increase the detection rate of submicroscopic imbalances by 7.7%. No significant correlation between different groups of VSD and the pathogenic CNVs was observed. Whole-genome CMA should be recommended to the fetuses with VSD but a normal karyotype. Nearly half of VSDs with benign CNVs may close spontaneously within the first year of life.</p>

Application of chromosome microarray analysis for patients with skeletal anomalies and a normal karyotype / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze patients with skeletal anomalies (SA) but a normal karyotype using chromosome microarray analysis (CMA).</p><p><b>METHODS</b>From June 2012 to May 2015, 43 children found to have skeletal anomalies with or without other abnormalities were subjected to karyotyping analysis. For those with a normal karyotype, DNA was extracted and hybridized with Affymetrix CytoScan 750 kb arrays following the manufacturer's protocol. The results were analyzed with CHAS v2.0 software.</p><p><b>RESULTS</b>Two patients (4.65%) were detected with an abnormal karyotype. The remaining 41 patients with a normal karyotype were classified into 3 groups: isolated SA (n=17), SA with mental retardation (n=6), and SA with other structural anomalies (n=18). Clinically significant copy number variations (CNVs) were found in 21.95% (9/41) of the cases, which included 17.65% (3/17) with isolated SA, 33.33% (2/6) with SA and mental retardation, and 22.22% (4/18) of SA with other structural deformities.</p><p><b>CONCLUSION</b>Whole-genome CMA can detect clinically significant CNVs which may not be found by conventional karyotyping analysis and increase the detection rate by approximately 21.95%. It may be recommended for patients with SA but a normal karyotype.</p>