1.Protective Effect of Huayu Jiedu Prescription Against PC12 Cell Damage Induced by Combination of NETs and OGD
Wuchaonan LIU ; Ruiyu HUANG ; Qianru ZENG ; Mengge ZHANG ; Yunhao YI ; Tao GAO ; Dingxiang LI ; Yihui DENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(21):120-130
ObjectiveTo investigate the protective effect of Huayu Jiedu prescription against PC12 cell damage induced by a combination of neutrophil extracellular traps (NETs) and oxygen-glucose deprivation (OGD). MethodsFirst, dimethyl sulfoxide (DMSO) was used to induce the differentiation of the human promyelocytic leukemia cell line (HL-60) into neutrophil-like cells (dHL-60), and cell differentiation was assessed through Giemsa staining and flow cytometry. Next, phorbol myristate (PMA) was used to induce the formation of NETs in dHL-60 cells. The formation of NETs was assessed via SYTOX Green staining, and NETs were extracted by low-speed centrifugation. Finally, the NETs prepared through the conditioned medium were combined with OGD to induce a high-differentiation PC12 neuronal cell damage model through the co-culture method. This model was treated with the Huayu Jiedu prescription-containing serum. Cells were randomly allocated into a normal control group, a model (NETs + OGD) group, a traditional Chinese medicine (NETs + OGD + 5% Huayu Jiedu prescription-containing serum) group, and a NETosis inhibitor (100 mg·L-1 DNase I + NETs + OGD) group. The cell counting kit-8 (CCK-8) assay was used to evaluate cell viability and screen the optimal intervention concentrations of NETs and Huayu Jiedu Formula-containing serum, as well as the optimal intervention time for OGD. Enzyme-linked immunosorbent assay (ELISA) was adopted to measure the levels of myeloperoxidase-DNA complexes (MPO-DNA), citrullinated histone H3 (CitH3), and neutrophil elastase (NE). Western blot was employed to quantify the protein levels of CitH3 and cleaved Caspase-3. Terminal-deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay (TUNEL) staining and flow cytometry were employed to assess neuronal apoptosis. ResultsCompared with those in the normal control group, cells in the model group successfully differentiated into dHL60 cells after DMSO induction. Wright-Giemsa staining revealed that the cells in the model group had disappeared nucleoli, distinct reniform and lobulated changes of nuclei, highly condensed chromatin, and the cytoplasm containing pale purple fine granules. Flow cytometry showed that the mean fluorescence intensity (MFI) of CD11b in the model group was enhanced (P<0.01). Compared with those in the normal control group, dHL60 cells in the model group successfully generated NETs after PMA induction. SYTOX Green staining revealed loss of cell membrane integrity, with chromatin released from the cytoplasm to form abundant extracellular, cloud-like fibrillar structures, and a marked increase in fluorescence intensity (P<0.01). Through the CCK-8 assay for assessing the viability of highly differentiated PC12 cells, the optimal concentration for NETs was determined as 1 000 ng·L-1, the optimal concentration of Huayu Jiedu formula-containing serum as 5%, and the optimal duration for OGD as 2 h. Compared with the normal control group, the model group showed elevated levels of MPO-DNA, CitH3, and NE (P<0.01) and upregulated protein levels of CitH3 and cleaved Caspase-3 (P<0.01). Furthermore, TUNEL staining revealed an increased proportion of apoptotic cells (P<0.01) and flow cytometry showed an increased apoptosis rate (P<0.01) in the model group. Compared with the model group, the Huayu Jiedu formula-containing serum group and the NETosis inhibitor group exhibited declined levels of MPO-DNA, CitH3, and NE (P<0.05,P<0.01) and downregulated protein levels of CitH3 and cleaved Caspase-3 (P<0.01). In addition, TUNEL staining showed a decrease in the proportion of apoptotic cells (P<0.01), and flow cytometry revealed a decrease in the apoptosis rate (P<0.01). ConclusionHuayu Jiedu prescription may exert a protective effect against ischemic neuronal damage by inhibiting NET formation or alleviating NET-induced neurotoxicity
2.Protective Effect of Huayu Jiedu Prescription Against PC12 Cell Damage Induced by Combination of NETs and OGD
Wuchaonan LIU ; Ruiyu HUANG ; Qianru ZENG ; Mengge ZHANG ; Yunhao YI ; Tao GAO ; Dingxiang LI ; Yihui DENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(21):120-130
ObjectiveTo investigate the protective effect of Huayu Jiedu prescription against PC12 cell damage induced by a combination of neutrophil extracellular traps (NETs) and oxygen-glucose deprivation (OGD). MethodsFirst, dimethyl sulfoxide (DMSO) was used to induce the differentiation of the human promyelocytic leukemia cell line (HL-60) into neutrophil-like cells (dHL-60), and cell differentiation was assessed through Giemsa staining and flow cytometry. Next, phorbol myristate (PMA) was used to induce the formation of NETs in dHL-60 cells. The formation of NETs was assessed via SYTOX Green staining, and NETs were extracted by low-speed centrifugation. Finally, the NETs prepared through the conditioned medium were combined with OGD to induce a high-differentiation PC12 neuronal cell damage model through the co-culture method. This model was treated with the Huayu Jiedu prescription-containing serum. Cells were randomly allocated into a normal control group, a model (NETs + OGD) group, a traditional Chinese medicine (NETs + OGD + 5% Huayu Jiedu prescription-containing serum) group, and a NETosis inhibitor (100 mg·L-1 DNase I + NETs + OGD) group. The cell counting kit-8 (CCK-8) assay was used to evaluate cell viability and screen the optimal intervention concentrations of NETs and Huayu Jiedu Formula-containing serum, as well as the optimal intervention time for OGD. Enzyme-linked immunosorbent assay (ELISA) was adopted to measure the levels of myeloperoxidase-DNA complexes (MPO-DNA), citrullinated histone H3 (CitH3), and neutrophil elastase (NE). Western blot was employed to quantify the protein levels of CitH3 and cleaved Caspase-3. Terminal-deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay (TUNEL) staining and flow cytometry were employed to assess neuronal apoptosis. ResultsCompared with those in the normal control group, cells in the model group successfully differentiated into dHL60 cells after DMSO induction. Wright-Giemsa staining revealed that the cells in the model group had disappeared nucleoli, distinct reniform and lobulated changes of nuclei, highly condensed chromatin, and the cytoplasm containing pale purple fine granules. Flow cytometry showed that the mean fluorescence intensity (MFI) of CD11b in the model group was enhanced (P<0.01). Compared with those in the normal control group, dHL60 cells in the model group successfully generated NETs after PMA induction. SYTOX Green staining revealed loss of cell membrane integrity, with chromatin released from the cytoplasm to form abundant extracellular, cloud-like fibrillar structures, and a marked increase in fluorescence intensity (P<0.01). Through the CCK-8 assay for assessing the viability of highly differentiated PC12 cells, the optimal concentration for NETs was determined as 1 000 ng·L-1, the optimal concentration of Huayu Jiedu formula-containing serum as 5%, and the optimal duration for OGD as 2 h. Compared with the normal control group, the model group showed elevated levels of MPO-DNA, CitH3, and NE (P<0.01) and upregulated protein levels of CitH3 and cleaved Caspase-3 (P<0.01). Furthermore, TUNEL staining revealed an increased proportion of apoptotic cells (P<0.01) and flow cytometry showed an increased apoptosis rate (P<0.01) in the model group. Compared with the model group, the Huayu Jiedu formula-containing serum group and the NETosis inhibitor group exhibited declined levels of MPO-DNA, CitH3, and NE (P<0.05,P<0.01) and downregulated protein levels of CitH3 and cleaved Caspase-3 (P<0.01). In addition, TUNEL staining showed a decrease in the proportion of apoptotic cells (P<0.01), and flow cytometry revealed a decrease in the apoptosis rate (P<0.01). ConclusionHuayu Jiedu prescription may exert a protective effect against ischemic neuronal damage by inhibiting NET formation or alleviating NET-induced neurotoxicity
3.Effect and Mechanism of Wulingsan Decoction in Protecting Blood Brain Barrier and Ameliorating Cerebral Edema after Intracerebral Hemorrhage in Mice
Damei TAO ; Huihong LI ; Xiaoqing ZHENG ; Yunfei DENG ; Wei WEI ; Xiehua XUE
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(4):1-9
ObjectiveTo study the effect of Wulingsan on cerebral edema after intracerebral hemorrhage (ICH) in mice and explore the treatment mechanism. MethodsThe mouse model of ICH was established by injection of collagenase into the caudate nucleus. Mice were randomly assigned into the following groups: sham, ICH, intervention before modeling with low-dose and high-dose (3.69, 11.07 g·kg-1, respectively) Wulingsan, and intervention after modeling with high-dose Wulingsan. The modified neurological severity score (mNSS) was recorded, and the small animal MRI T2 sequential scanning was performed to measure the volume of cerebral hemorrhage after the modeling of ICH in each group. The Y-maze test, open field test, and Morris water maze test were conducted to evaluate the neurological behaviors of mice in each group. Hematoxylin-eosin staining was employed to observe the pathological changes in the brain tissue. Immunohistochemistry was employed to observe the expression of aquaporin 4 (AQP4), neuronal nuclei (NeuN), and glial fibrillary acidic protein (GFAP) in the brain tissue. Western blot was employed to determine the protein levels of AQP4, Claudin-5, and zonula occludens-1 (ZO-1) in the hematoma area. ResultsCompared with the sham group, the ICH group showed increases in the mNSS, the cerebral hemorrhage volume, and the escape latency in the Morris water maze test (P<0.01), decreases in the times of touching the platform and times of entering the quadrant where the platform was located in the Morris water maze test, and reductions in the spontaneous alternation rate in the Y-maze test and the ratio of distance of center travel to total travel distance in the open field test (P<0.01). Moreover, pathological changes such as cell disarrangement, cell space enlargement, and cell swelling were observed in the ICH group. Immunohistochemistry results showed that the ICH group had higher proportions of AQP4- and GFAP-positive cells and lower proportion of NeuN-positive cells than the sham group (P<0.01). Compared with the sham group, the ICH group showed an up-regulated protein level of AQP4 and down-regulated protein levels of Claudin-5 and ZO-1 (P<0.01). Compared with the ICH group, the intervention with Wulingsan decreased the mNSS, the volume of cerebral hemorrhage, and the escape latency in the Morris water maze test (P<0.05, P<0.01), while increasing the times of touching the platform and times of entering the quadrant where the platform was located in the Morris water maze test, the spontaneous alternation rate in the Y-maze test, and the ratio of distance of center travel to total travel distance in the open field test (P<0.05, P<0.01). Furthermore, the intervention with Wulingsan alleviated the pathological changes in the brain tissue after ICH, decreased the proportion of AQP4- and GFAP-positive cells (P<0.01), increased the proportion of NeuN-positive cells (P<0.01), down-regulated the protein level of AQP4 (P<0.01), and up-regulated the protein levels of Claudin-5 and ZO-1 (P<0.01). ConclusionThe intervention with Wulingsan could reduce the neural function score and the cerebral hemorrhage volume, up-regulate the expression of Claudin-5 and ZO-1, and down-regulate the expression of AQP4 to ameliorate the neurological function defect and cerebral edema after ICH, thereby protecting the brain.
4.Literature research on acupoint prescriptions for acupuncture and moxibustion in the prevention of aerospace depression syndrome
Kaiyuan DENG ; Yawen TAO ; Yingdong WANG ; Yidan XU ; Qiang XI ; Jiwen QIU ; Xinju LI ; Ruonan LIANG ; Yi YU ; Hao LIU ; Peng ZHOU ; Mingxing ZHANG ; Yi GUO
Space Medicine & Medical Engineering 2025;36(4):305-311
Under the influence of long-term space flights and the confined space environment,it is very easy to induce space depression syndrome,mainly manifested as decreased emotional stability,sleep disorders,mental fatigue,etc.,which seriously affect the living conditions and working abilities of astronauts.The current treatment methods mainly focus on psychological support and drug intervention.Acupuncture has a good effect in treating depression.Therefore,starting from the TCM pathogenesis and modern medical pathogenesis of aerospace depression syndrome,we conducted literature retrieval from databases such as the Chinese Medical Classic,China National Knowledge Infrastructure(CNKI),Wanfang,VIP,PubMed,and Web of science.For the included literature,we adopted the stratified evidence scoring method and combined the TCM mechanism and modern medical mechanism of the effect of acupuncture.A prescription for acupuncture points was constructed to provide a basis for selecting acupuncture points for the prevention of aerospace depression syndrome through acupuncture.
5.GJB4 Gene Expression in Relation to Clinical and Pathological Features of Pancreatic Cancer Patients
Runlin FENG ; Zongqi DENG ; Mengyao WU ; Yunna WANG ; Yu WANG ; Guilan LIU ; Yanping TAO
Journal of Kunming Medical University 2025;46(1):78-86
Objective To investigate the expression of GJB4 gene in pancreatic cancer tissue and its correlation with clinicopathology.Methods The expression levels of GJB4 mRNA in pancreatic cancer and adjacent cancer tissues were analyzed using bioinformatics to analyze the Cancer Genome Atlas(TCGA)and Genotype-Tissue Expression(GTEx)RNA sequencing datasets.A total of 120 pancreatic cancer samples and 40 adjacent cancer samples from the Pathology Department of The Second Affiliated Hospital of Kunming Medical University from January 2019 to December 2023 were collected and sorted.Immunohistochemistry staining method was used to detect the expression difference of GJB4 protein between the two groups.RT-qPCR method was used to detect the expression levels of GJB4 in four pancreatic cancer cell lines.Univariate and multivariate Cox regression and Kaplan-Meier curves were used to analyze the clinical pathological data of GJB4 and pancreatic cancer patients.DAVID functional annotation bioinformatics and GSEA enrichment analysis were used to explore the relevant pathways of GJB4 in pancreatic cancer.Results The expression level of GJB4 mRNA in pancreatic cancer was higher than that in adjacent tissues,and the high expression of GJB4 was significantly associated with poor prognosis of patients(P<0.05).Immunohistochemical analysis showed that GJB4 protein was brown-yellow granular in pancreatic cancer tissues,mainly expressed in cytoplasm and cell membrane,and GJB4 protein expression was up-regulated in pancreatic cancer(P<0.05).The RT-qPCR test results showed that out of 4 pancreatic cancer cell lines,3 of them had upregulated expression(P<0.05).COX regression analysis showed that GJB4 gene was an independent risk factor in the prognosis of pancreatic cancer patients.The results of GO enrichment analysis showed that GJB4 was related to the transmembrane transport,ion channel,signal release and membrane potential regulation of pancreatic cancer.GSEA analysis showed that GJB4 was enriched in the Wnt/β-catenin signaling pathway.Conclusion In pancreatic cancer,the high expression level of GJB4 is closely related to the clinicopathological features of the patients,which may predict the poor prognosis of the patients.GJB4 may be involved in regulating the Wnt/β-catenin signaling pathway of pancreatic cancer,and is expected to be one of the potential biomarkers of pancreatic cancer prognosis.
6.The Impact of Emotional Release Technique Combined with the PERMA Model Intervention on the Fear of Disease Progression in Patients after Liver Cancer Surgery
Jing GUO ; Ying ZHANG ; Fengxia YANG ; Yan ZHOU ; Tao FENG ; Xiaofeng DENG
Journal of Kunming Medical University 2025;46(4):163-169
Objective To explore the effects of Emotional Freedom Techniques combined with PERMA model intervention on fear of disease progression and quality of life in postoperative liver cancer patients.Methods A total of 58 liver cancer patients admitted from September 2023 to February 2024 were randomly divided into the experimental group(n=29)and the control group(n=29)using a random number table method.The experimental group received Emotional Freedom Techniques combined with PERMA-based positive psychological intervention,while the control group received the holistic nursing and routine psychological guidance.Both groups underwent the continuous intervention for 8 weeks.Outcomes were assessed using the Fear of Progression Questionnaire-Short Form(FoP-Q-SF),Distress Thermometer(DT),Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),Cancer Fatigue Scale(CFS),Athens Insomnia Scale(AIS)and Index of Well-Being(IWB).Results After the intervention,the experimental group showed the significantly lower scores than those in the control group in FoP-Q-SF(24.97±2.34/34.10±8.46),DT(2.24±0.95/2.93±1.33),SAS(49.55±1.35/58.55±4.60),SDS(51.86±1.58/61.79±4.00),CFS(4.03±0.94/5.10±1.18),and AIS(2.45±1.12/4.07±0.96)(all P<0.05),while the IWB score(10.56±1.74/7.39±2.05)was significantly higher than that in the control group(P<0.05).Conclusion The combination of Emotional Freedom Techniques and PERMA model intervention can effectively alleviate the disease-related fears,improve the negative emotions,reduce the physical symptoms and enhance the subjective well-being in postoperative liver cancer patients,and it has a significant clinical application value.
7.A review on the screening methods for the discovery of natural antimicrobial peptides
Bin YANG ; Hongyan YANG ; Jianlong LIANG ; Jiarou CHEN ; Chunhua WANG ; Yuanyuan WANG ; Jincai WANG ; Wenhui LUO ; Tao DENG ; Jialiang GUO
Journal of Pharmaceutical Analysis 2025;15(1):81-96
Natural antimicrobial peptides(AMPs)are promising candidates for the development of a new gener-ation of antimicrobials to combat antibiotic-resistant pathogens.They have found extensive applications in the fields of medicine,food,and agriculture.However,efficiently screening AMPs from natural sources poses several challenges,including low efficiency and high antibiotic resistance.This review focuses on the action mechanisms of AMPs,both through membrane and non-membrane routes.We thoroughly examine various highly efficient AMP screening methods,including whole-bacterial adsorption binding,cell membrane chromatography(CMC),phospholipid membrane chromatography binding,membrane-mediated capillary electrophoresis(CE),colorimetric assays,thin layer chromatography(TLC),fluorescence-based screening,genetic sequencing-based analysis,computational mining of AMP data-bases,and virtual screening methods.Additionally,we discuss potential developmental applications for enhancing the efficiency of AMP discovery.This review provides a comprehensive framework for identifying AMPs within complex natural product systems.
8.Exploring the correlation between motor function and cognitive function, emotion and sleep in the Chinese community older adults
Yueying LIU ; Xinxin MA ; Yu DU ; Jingjing DUAN ; Jianhong XIAO ; Jian LIN ; Xiongang HUANG ; Chao LIU ; Binbin WANG ; Wujun CHEN ; Ting DENG ; Tao CHEN ; Wen SU
Chinese Journal of Geriatrics 2025;44(1):60-67
Objective:To apply the Timed Up and Go Test(TUGT)to investigate the correlation between motor function, emotional state, cognitive function, and sleep quality among elderly individuals in the Chinese community.Methods:A cross-sectional study was conducted, involving 739 subjects aged 60 to 90 years, who were randomly recruited from December 2021 to August 2023 across Beijing, Tianjin, Zhejiang, Guangdong, and Hainan Provinces in China.Basic demographic information was collected, and the TUGT was utilized to assess motor function.Based on the TUGT time(t), the subjects were divided into three groups: normal motor function group, mild motor abnormality group, and significant motor abnormality group.Cognitive function was evaluated using the Chinese Revised Mini-Mental State Examination(MMSE), while the Patient Health Questionnaire Depression Scale(PHQ-9)was employed to measure the degree of depression.Additionally, the Epworth Sleepiness Scale(ESS)was used to assess excessive daytime sleepiness.The correlation between subjects' motor function and their cognitive abilities, mood, and sleep was subsequently analyzed.Results:Systolic blood pressure, heart rate, PHQ-9, MMSE, and ESS scores were identified as significant factors influencing TUGT time.Specifically, TUGT time was positively correlated with PHQ-9 and ESS scores, while exhibiting negative correlations with systolic blood pressure, heart rate, and MMSE scores.Additionally, TUGT time was negatively correlated with the MMSE subcomponents of orientation, immediate memory, and verbal ability.All observed differences were statistically significant(all P<0.05).Logistic regression analysis indicated that an increase in the PHQ-9 score was associated with an odds ratio( OR)of 1.099(95% CI: 1.045-1.155, P<0.001)(mild motor abnormality group)and 1.150(95% CI: 1.066-1.242, P<0.001)(Significant motor abnormality group).Additionally, a reduction in the MMSE score was observed, with an OR of 0.939(95% CI: 0.886-0.995, P<0.001)(mild motor abnormality group)and 0.793(95% CI: 0.729-0.862, P<0.001)(Significant motor abnormality group).Furthermore, an increase in the ESS score was noted, with ORs of 1.139(95% CI: 1.094-1.186, P<0.001)(mild motor abnormality group)and 1.203(95% CI: 1.132-1.279, P<0.001)(Significant motor abnormality group).These findings suggest that these variables are independently related to decreased motor function. Conclusions:Depression, cognitive impairment, and excessive daytime sleepiness are independent risk factors for motor dysfunction among elderly individuals in community settings.The Timed Up and Go Test TUGT can be utilized for the early screening of motor function decline in this population.
9.Efficacy of Percutaneous Sacroiliac Screws Combined With Retrograde Pubic Ramus Screws in the Treatment of Unstable Pelvic Fractures
Wei CUI ; Yuliang SUN ; Jing LIU ; Tao GU ; Huagang SHI ; Xuangeng DENG
Chinese Journal of Minimally Invasive Surgery 2025;25(4):210-215
Objective To explore the safety and efficacy of percutaneous sacroiliac screw combined with retrograde pubic ramus screws in the treatment of unstable pelvic fractures.Methods A retrospective analysis was made on clinical data of 32 cases of unstable pelvic fractures treated with percutaneous sacroiliac screws combined with retrograde pubic ramus screws from August 2021 to November 2023.The channel screws were inserted under the guidance of C-arm fluoroscopy.Results A total of 75 channel screws were inserted,including 36 sacroiliac screws and 39 retrograde pubic ramus screws.Each sacroiliac screw underwent fluoroscopy for(32.2±4.6)times,and each pubic ramus screw for(40.3±11.7)times.The operation time was(154.2±43.8)min,and the intraoperative blood loss was(30.5±8.7)ml.There were no iatrogenic vascular or nerve injuries.One case of pubic ramus screw infection occurred after surgery,and a debridement was performed to remove internal fixation.All the fractures had bone union,and the healing time was(13.2±3.7)weeks.The quality of fracture reduction(Matta criteria)was excellent in 27 cases,good in 3 cases,and fair in 2 cases,with an excellent and good rate of 93.8%(30/32).CT images showed the penetration of 73 screws at level 0,1 screw at level 1,and 1 at level 2.All the 32 cases were followed up for 6-42 months(mean,16.3±6.1 months).According to the Majeed functional scoring criteria,28 cases were excellent,3 cases were good,and 1 case was fair,with an excellent and good rate of 96.9%(31/32).Conclusion Percutaneous sacroiliac screws combined with retrograde pubic ramus screws in the treatment of unstable pelvic fractures is easy to operate and safe,and has satisfactory therapeutic effects.
10.Clinical and molecular genetic analysis of nine patients with neonatal Dubin-Johnson syndrome
Tao XU ; Dan LI ; Li GUO ; Mei DENG ; Weixia LIN ; Yuanzong SONG
Chinese Journal of Hepatology 2025;33(5):481-488
Objective:Dubin-Johnson syndrome (DJS) is a hereditary liver disease caused by biallelic pathogenic variants in the ABCC2 gene. As a rare disease, the ABCC2 genotype and clinical phenotype characteristics of DJS patients still need to be summarized in depth. Methods:Nine cases diagnosed with DJS and treated in the Department of Pediatrics of the First Affiliated Hospital of Jinan University were collected as the study subjects. Clinical and laboratory data, general information, symptoms, signs, pathological changes, treatment, and prognostic conditions were systematically analyzed. Targeted high-throughput sequencing was used to detect hereditary diseases. The positive results for the family lineage were verified by Sanger sequencing. The pathogenicity of the novel ABCC2 variants was evaluated according to the American College of Medical Genetics and Genomics guidelines and standards. One-way analysis of variance or Kruskal-Wallis test was used to compare the statistical differences between multiple groups of data. Results:Among the nine DJS cases, seven and two were males, and females. All of them had the initial symptom of jaundice (100%), with a median age of onset of 5 (2,15) days. During the course of the disease, seven (7/9) and two (2/9) cases had hepatomegaly and splenomegaly. All of the patients exhibited direct hyperbilirubinemia, concurrently with elevated total bile acids (TBA) and γ-glutamyl transferase (GGT). Serum transaminases (4/9) and alkaline phosphatase levels (3/9) were elevated in some patients. A total of twelve types of ABCC2 variants were detected in nine cases, of which c.2362_2363del (p.Leu788ValfsTer13), c.364C>T (p.Gln122Ter), c.338T>C (p.Leu113Pro) and c.419T>A (p.Ile140Lys) were novel pathogenic/likely pathogenic variants. Jaundice disappeared and alleviated in five cases (5/9) and four cases (4/9), while hepatomegaly improved in five cases (5/9) at the last follow-up at 7.79 (7.0,15.25) months following treatment with drugs such as liver protectives, choleretics, and jaundice-reducing agents. Among them, three cases (3/9) had a normal restored liver size. All patients had varying degrees of improvement in bilirubin, TBA, GGT, and ALP levels. Conclusions:The onset of high GGT cholestatic jaundice is the main clinical manifestation in patients with neonatal DJS. The genetic analysis results showed four novel types of variants, which expanded the ABCC2 gene variation spectrum, providing novel molecular markers for confirming a diagnosis of DJS. The patient's clinical manifestations and laboratory abnormalities improved or disappeared after internal medicine treatment, suggesting that DJS may be a type of genetic disease with a favorable long-term prognosis.

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