1.Effect of Runmu Dihuang Decoction on Perimenopausal Dry Eye in Rats with Liver-kidney Yin Deficiency Syndrome Based on SIRT3/HIF-1α/NF-κB Signaling Pathway
Sainan TIAN ; Wei MA ; Yao CHEN ; Yu CAO ; Guicheng LIU ; Pei LIU ; Junxian LEI ; Qinghua PENG ; Jun PENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):201-210
ObjectiveTo investigate the mechanisms of Runmu Dihuang decoction (RMDHD) in treating perimenopausal dry eye with liver-kidney Yin deficiency syndrome based on the silent information regulator 3 (SIRT3)/hypoxia-inducible factor-1α (HIF-1α)/nuclear factor-κB (NF-κB) signaling pathway. MethodsSixty female Sprague-Dawley rats were randomly divided into six groups (n=10 per group): Sham operation group, model group, sodium hyaluronate eye drop group, and low-, medium-, and high-dose RMDHD groups (5.625, 11.25, 22.50 g·kg-1). Except for the sham operation group, all rats underwent bilateral ovariectomy and were administered 0.1% benzalkonium chloride eye drops combined with long-term chronic irritation to establish a perimenopausal dry eye model with liver-kidney Yin deficiency syndrome. Drug administration began in the 11th week after modeling and continued for 21 days. General conditions, screen-grip test scores, tear secretion volume, tear film breakup time (TFBUT), and corneal fluorescein staining were recorded. Serum levels of reactive oxygen species (ROS), follicle-stimulating hormone (FSH), estradiol (E2), and progesterone (PROG) were measured by enzyme-linked immunosorbent assay (ELISA). Pathological changes in the lacrimal glands, corneas, and uteri were observed using hematoxylin-eosin (HE) staining. Protein expression levels of SIRT3, HIF-1α, phosphorylated NF-κB p65 (p-NF-κB p65), and total NF-κB p65 in the lacrimal glands were detected by Western blot. The expression of inflammatory cytokines interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in the lacrimal glands was assessed by immunohistochemistry (IHC). ResultsAfter model establishment, no significant differences were observed among the groups except the sham operation group. Compared with the sham operation group, the other groups exhibited slowed movement, dull responses, increased irritability, reduced body weight, elevated rectal temperature, decreased screen-grip test scores, reduced tear secretion, and significantly shortened TFBUT (P<0.05). After treatment, compared with the model group, the sodium hyaluronate eye drop group and all RMDHD groups showed improved general conditions, significantly increased tear secretion (P<0.05), prolonged TFBUT (P<0.05), and elevated screen-grip test scores (P<0.05). Serum ROS and FSH levels were significantly decreased, while E2 and PROG levels were significantly increased (P<0.05). Pathological damage to the cornea, lacrimal glands, and uterus was ameliorated. In addition, protein expression levels of SIRT3 and HIF-1α in the lacrimal glands were significantly upregulated (P<0.05), whereas the expression of p-NF-κB p65, IL-1β, and TNF-α was significantly downregulated (P<0.05). ConclusionRMDHD increases tear secretion and TFBUT, improves lacrimal gland and corneal injury, and alleviates dry eye symptoms in a perimenopausal dry eye rat model with liver-kidney Yin deficiency syndrome. The underlying mechanism may be related to regulation of the SIRT3/HIF-1α/NF-κB signaling pathway, inhibition of oxidative stress and inflammatory responses, and reduction of ocular surface tissue damage.
2.Interventional effect and mechanism of Bifidobacterium in chronic liver disease
Liyi PAN ; Yueqiao CHEN ; Yu CHEN ; Yuyun HUANG ; Hao PEI ; Fenglan WU ; Lyuping YE ; Na WANG
Journal of Clinical Hepatology 2026;42(2):464-471
Compared with traditional therapies for chronic liver disease (CLD), Bifidobacterium has the characteristics of multi-target intervention, high biosafety, and good host compatibility and provides new strategies for intervention of CLD progression in terms of microecological regulation. Various studies have shown that Bifidobacterium regulates liver homeostasis and exerts a therapeutic effect on CLD by regulating intestinal flora, maintaining antioxidation, promoting energy consumption, alleviating inflammation, improving glycolipid metabolism, and exerting an antitumor effect. This article systematically reviews the studies on Bifidobacterium in the treatment of CLD in China and globally, explores their different mechanisms, and elaborates on the interaction between related signaling pathways (such as the nuclear factor erythroid 2-related factor 2 signaling pathway and the adenosine monophosphate-activated protein kinase signaling pathway) and the liver, in order to provide a basis for probiotic intervention in liver pathology, as well as new ideas for the comprehensive treatment of CLD.
3.Hypermethylation of UQCRC1 is involved in cognitive impairment after neonatal sevoflurane exposure
Yan LIU ; Yanjuan CHEN ; Min ZHANG ; Zonghong LONG ; Yu LI ; Jie PEI ; Qiuyue WANG ; Hong LI
Journal of Army Medical University 2025;47(8):775-783
Objective To investigate whether aberrant DNA methylation of ubiquinol-cytochrome C reductase core protein 1(UQCRC1)is related to cognitive impairment caused by neonatal sevoflurane exposure.Methods A total of 94 SPF C57 mice of either sex,aged 6 d,and weighing 4~6 g,were randomly divided into 7 groups:control group(Con,n=6),sevoflurane-6 and-24 h exposure groups(Sev-6 and-24 h,n=6),control+DMSO group(Con+DMSO,n=19),control+5-aza-2'-deoxycytidine(5-AZA,methylation inhibitor)group(Con+5-AZA,n=19),sevoflurane+DMSO group(Sev+DMSO group,n=19),and sevoflurane+5-AZA group(Sev+5-AZA group,n=19).From 6 to 8 d after birth,the mice of the Sev-6 and-24 h exposure groups were exposed to 3%sevoflurane daily(with 97%oxygen,2 L/min,2 h per day),while those from the Con groups were given exposure of 100%oxygen(2 L/min,2 h per day).For the mice of the 5-AZA and DMSO groups,1 mg/kg of 5-AZA or an equal volume of DMSO was injected intraperitoneally 30 min before daily exposure.In 6 and 24 h after the last exposure to sevoflurane,6 mice from the Con,Sev-6 h,and Sev-24 h groups were euthanized for biochemical analysis,and in 24 h post-exposure,6 mice from the Con+DMSO,Con+5-AZA,Sev+DMSO,and Sev+5-AZA groups were randomly selected for biochemical analysis,while another 3 mice from above each group were also randomly selected for morphological analysis.The remaining 10 mice in these groups underwent behavioral testing(open field test,novel object test,and Y-maze test)at 30~33 d after birth to assess cognitive function,and were euthanized in 24 h after the final behavioral test.RT-qPCR and Western blotting were used to detect the hippocampal expression of UQCRC1,DNA methyltransferases(Dnmts),and methyl CpG binding protein 2(Mecp2)at mRNA and protein levels,respectively.Immunofluorescence assay was employed to observe the distribution and expression of UQCRC1 in the hippocampus.Bisulfite sequencing PCR(BSP)was applied to measure the methylation in the UQCRC1 promoter region.Results Compared with the Con group,the mRNA and protein levels of UQCRC1 were down-regulated(P<0.05),and the mRNA level of Dnmts was up-regulated(P<0.05)in both the Sev-6 h and Sev-24 h exposure groups,while the methylation level in the UQCRC1 promoter region was enhanced in the Sev-24 h exposure group(P<0.05).Additionally,the Sev+5-AZA group had obviously increased mRNA and protein levels of UQCRC1(P<0.05),and notable improvement in cognitive impairment(P<0.05)when compared with the Sev+DMSO group.Conclusion Hypermethylation of UQCRC1 promoter region and thus down-regulating its mRNA and protein expression might be the main mechanism by which repeated neonatal sevoflurane exposure induces cognitive impairment later in life.
4.Visualization and Analysis of Sweat Pore Features in Latent Fingerprints Using Core-Shell Structured Composite Nanofibrous Membrane
Shi-Yue MA ; Ya-Li PEI ; Hong-Yu CHEN ; Xin DU ; Yan-Feng ZHANG ; Rong-Liang MA ; Mei-Qin ZHANG
Chinese Journal of Analytical Chemistry 2025;53(8):1269-1278
Introducing fingerprint level 3 features(especially sweat pores)in fingerprint recognition can significantly improve the value of fingerprints.However,conventional fingerprint visualization methods suffer from issues such as poor stability and reproducibility,insufficient resolution,and feature masking in detecting level 3 features.Electrospun membrane has unique advantages in latent fingerprint(LFP)detection due to its excellent adsorption performance and high specific surface area,and thus its application potential in LFP visualization urgently need to be explored.A novel pore visualization method based on core-shell structured PAN-Flu/PVP composite nanofibrous membrane was proposed in this work.Specifically,the PAN-Flu/PVP composite nanofibrous membrane was prepared via coaxial electrospinning technology,with polyacrylonitrile(PAN)loaded with fluorescein(Flu)as the core and polyvinylpyrrolidone(PVP)as the shell.The experimental results showed that the prepared PAN Flu/PVP composite nanofibrous membrane had a porous structure and excellent adsorption performance.Based on the water solubility of the outer shell PVP and the water induced fluorescence enhancement effect of the core Flu,high-resolution visualization of sweat pores could be achieved within 2 s.The optimization experiment showed that the best quality of sweat latent fingerprints was obtained when the Flu content was 4 mg/mL,the spinning time was 1 h,and the sweating time was 2 min.Through repeated fingerprinting and live fingerprint comparison experiment,the strong stability and high reproducibility of the as-produced membrane in displaying fingerprint sweat pores were finally verified.In summary,the development method could quickly,stably and accurately extract the spatial distribution and activity level of fingerprint sweat pores,which was of great significance for improving the utilization and value of fingerprints.
5.Optimization of extraction process for Shenxiong Huanglian Jiedu Granules based on AHP-CRITIC hybrid weighting method, grey correlation analysis, and BP-ANN.
Zi-An LI ; De-Wen LIU ; Xin-Jian LI ; Bing-Yu WU ; Qun LAN ; Meng-Jia GUO ; Jia-Hui SUN ; Nan-Yang LIU ; Hui PEI ; Hao LI ; Hong YI ; Jin-Yu WANG ; Liang-Mian CHEN
China Journal of Chinese Materia Medica 2025;50(10):2674-2683
By employing the analytic hierarchy process(AHP), the CRITIC method(a weight determination method based on indicator correlations), and the AHP-CRITIC hybrid weighting method, the weight coefficients of evaluation indicators were determined, followed by a comprehensive score comparison. The grey correlation analysis was then performed to analyze the results calculated using the hybrid weighting method. Subsequently, a backpropagation-artificial neural network(BP-ANN) model was constructed to predict the extraction process parameters and optimize the extraction process for Shenxiong Huanglian Jiedu Granules(SHJG). In the extraction process, an L_9(3~4) orthogonal experiment was designed to optimize three factors at three levels, including extraction frequency, water addition amount, and extraction time. The evaluation indicators included geniposide, berberine, ginsenoside Rg_1 + Re, ginsenoside Rb_1, ferulic acid, and extract yield. Finally, the optimal extraction results obtained by the orthogonal experiment, grey correlation analysis, and BP-ANN method were compared, and validation experiments were conducted. The results showed that the optimal extraction process involved two rounds of aqueous extraction, each lasting one hour; the first extraction used ten times the amount of added water, while the second extraction used eight times the amount. In the validation experiments, the average content of each indicator component was higher than the average content obtained in the orthogonal experiment, with a higher comprehensive score. The optimized extraction process parameters were reliable and stable, making them suitable for subsequent preparation process research.
Drugs, Chinese Herbal/analysis*
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Neural Networks, Computer
6.Tetrahydropalmatine acts on α7nAChR to regulate inflammation and polarization of BV2 microglia.
Yan-Jun WANG ; Guo-Liang DAI ; Pei-Yao CHEN ; Hua-Xi HANG ; Xin-Fang BIAN ; Yu-Jie CHEN ; Wen-Zheng JU
China Journal of Chinese Materia Medica 2025;50(11):3117-3126
Based on the α7 nicotinic acetylcholine receptor(α7nAChR), this study examined how tetrahydropalmatine(THP) affected BV2 microglia exposed to lipopolysaccharide(LPS), aiming to clarify the possible mechanism underlying the anti-depression effect of THP from the perspectives of preventing inflammation and regulating polarization. First, after molecular docking and determination of the content of Corydalis saxicola Bunting total alkaloids, THP was initially identified as a possible anti-depression component. The BV2 microglia model of inflammation was established with LPS. BV2 microglia were allocated into a normal group, a model group, low-and high-dose(20 and 40 μmol·L~(-1), respectively) THP groups, and a THP(20 μmol·L~(-1))+α7nAChR-specific antagonist MLA(1 μmol·L~(-1)) group. The CCK-8 assay was used to screen the safe concentration of THP. A light microscope was used to examine the morphology of the cells. Western blot and immunofluorescence were used to determine the expression of α7nAChR. qRT-PCR was performed to determine the mRNA levels of inducible nitric oxide synthase(iNOS), cluster of differentiation 86(CD86), suppressor of cytokine signaling 3(SOCS3), arginase-1(Arg-1), cluster of differentiation 206(CD206), tumor necrosis factor(TNF)-α, interleukin(IL)-6, and IL-1β. Enzyme-linked immunosorbent assay(ELISA) was employed to measure the levels of TNF-α, IL-6, and IL-1β in the cell supernatant. The experimental results showed that THP at concentrations of 40 μmol·L~(-1) and below had no effect on BV2 microglia. THP improved the morphology of BV2 microglia, significantly up-regulated the protein level of α7nAChR, significantly down-regulated the mRNA levels of iNOS, CD86, SOCS3, TNF-α, IL-6, and IL-1β, significantly up-regulated the mRNA levels of Arg-1 and CD206, and dramatically lowered the levels of TNF-α, IL-6, and IL-1β in the cell supernatant. However, the antagonist MLA abolished the above-mentioned ameliorative effects of THP on LPS-treated BV2 microglia. As demonstrated by the aforementioned findings, THP protected LPS-treated BV2 microglia by regulating the M1/M2 polarization and preventing inflammation, which might be connected to the regulation of α7nAChR on BV2 microglia.
Berberine Alkaloids/chemistry*
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alpha7 Nicotinic Acetylcholine Receptor/chemistry*
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Microglia/metabolism*
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Mice
;
Animals
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Cell Line
;
Corydalis/chemistry*
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Humans
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Molecular Docking Simulation
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Inflammation/drug therapy*
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Nitric Oxide Synthase Type II/immunology*
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Tumor Necrosis Factor-alpha/immunology*
7.Antidepressant effects of Ziziphi Spinosae Semen extract on depressive-like behaviors in sleep deprivation rats based on integrated serum metabolomics and gut microbiota.
Liang-Lei SONG ; Ya-Yu SUN ; Ze-Jia NIU ; Jia-Ying LIU ; Xiang-Ping PEI ; Yan YAN ; Chen-Hui DU
China Journal of Chinese Materia Medica 2025;50(16):4510-4524
Based on serum metabolomics and gut microbiota technology, this study explores the effects and mechanisms of the water extract of Ziziphi Spinosae Semen(SZRW) and the petroleum ether extract of Ziziphi Spinosae Semen(SZRO) in improving depressive-like behaviors induced by sleep deprivation. A modified multi-platform water environment method was employed to establish a rat model of sleep deprivation. Depressive-like behaviors in rats were assessed through the sucrose preference test and forced swim test. The expression of barrier proteins, such as Occludin, in the colon was determined by immunofluorescence. UPLC-Q-Orbitrap MS was utilized to analyze the serum metabolic profiles of sleep-deprived rats, screen for differential metabolites, and analyze metabolic pathways. The diversity of the gut microbiota was detected using 16S rRNA gene sequencing. Spearman correlation coefficient analysis was conducted to assess the correlation between differential metabolites and gut microbiota. The results indicated that SZRO significantly increased the sucrose preference index and decreased the immobility time in the forced swim test in rats. A total of 34 differential metabolites were identified through serum metabolomics. SZRW and SZRO shared five metabolic pathways, including phenylalanine metabolism. SZRW uniquely featured taurine and hypotaurine metabolism, while SZRO uniquely featured linoleic acid metabolism and tyrosine metabolism. Correlation analysis revealed that SZRW could upregulate the abundance of Bilophila, promoting the production of indole-3-propionic acid and subsequently upregulating the expression levels of intestinal tight junction proteins such as ZO-1, Occludin, and Claudin-1. SZRO could indirectly influence metabolic pathways such as arginine metabolism and linoleic acid metabolism by upregulating the abundance of gut microbiota such as Coprococcus and Eubacterium species. Both SZRW and SZRO can regulate endogenous metabolism, including amino acids, energy, and lipids, alter the gut microbiota microecology, and improve depressive-like behaviors. SZRO demonstrated superior effects in regulating metabolic pathways and gut microbiota structure compared to SZRW. The findings of this study provide a scientific basis for elucidating the pharmacodynamic material basis of Ziziphi Spinosae Semen.
Animals
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Rats
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Gastrointestinal Microbiome/drug effects*
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Male
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Metabolomics
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Drugs, Chinese Herbal/administration & dosage*
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Depression/blood*
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Rats, Sprague-Dawley
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Sleep Deprivation/complications*
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Ziziphus/chemistry*
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Antidepressive Agents/administration & dosage*
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Behavior, Animal/drug effects*
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Humans
8.Accurate Machine Learning-based Monitoring of Anesthesia Depth with EEG Recording.
Zhiyi TU ; Yuehan ZHANG ; Xueyang LV ; Yanyan WANG ; Tingting ZHANG ; Juan WANG ; Xinren YU ; Pei CHEN ; Suocheng PANG ; Shengtian LI ; Xiongjie YU ; Xuan ZHAO
Neuroscience Bulletin 2025;41(3):449-460
General anesthesia, pivotal for surgical procedures, requires precise depth monitoring to mitigate risks ranging from intraoperative awareness to postoperative cognitive impairments. Traditional assessment methods, relying on physiological indicators or behavioral responses, fall short of accurately capturing the nuanced states of unconsciousness. This study introduces a machine learning-based approach to decode anesthesia depth, leveraging EEG data across different anesthesia states induced by propofol and esketamine in rats. Our findings demonstrate the model's robust predictive accuracy, underscored by a novel intra-subject dataset partitioning and a 5-fold cross-validation method. The research diverges from conventional monitoring by utilizing anesthetic infusion rates as objective indicators of anesthesia states, highlighting distinct EEG patterns and enhancing prediction accuracy. Moreover, the model's ability to generalize across individuals suggests its potential for broad clinical application, distinguishing between anesthetic agents and their depths. Despite relying on rat EEG data, which poses questions about real-world applicability, our approach marks a significant advance in anesthesia monitoring.
Animals
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Machine Learning
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Electroencephalography/methods*
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Ketamine/administration & dosage*
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Rats
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Male
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Propofol/administration & dosage*
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Rats, Sprague-Dawley
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Anesthesia, General/methods*
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Brain/physiology*
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Intraoperative Neurophysiological Monitoring/methods*
9.Glutamine signaling specifically activates c-Myc and Mcl-1 to facilitate cancer cell proliferation and survival.
Meng WANG ; Fu-Shen GUO ; Dai-Sen HOU ; Hui-Lu ZHANG ; Xiang-Tian CHEN ; Yan-Xin SHEN ; Zi-Fan GUO ; Zhi-Fang ZHENG ; Yu-Peng HU ; Pei-Zhun DU ; Chen-Ji WANG ; Yan LIN ; Yi-Yuan YUAN ; Shi-Min ZHAO ; Wei XU
Protein & Cell 2025;16(11):968-984
Glutamine provides carbon and nitrogen to support the proliferation of cancer cells. However, the precise reason why cancer cells are particularly dependent on glutamine remains unclear. In this study, we report that glutamine modulates the tumor suppressor F-box and WD repeat domain-containing 7 (FBW7) to promote cancer cell proliferation and survival. Specifically, lysine 604 (K604) in the sixth of the 7 substrate-recruiting WD repeats of FBW7 undergoes glutaminylation (Gln-K604) by glutaminyl tRNA synthetase. Gln-K604 inhibits SCFFBW7-mediated degradation of c-Myc and Mcl-1, enhances glutamine utilization, and stimulates nucleotide and DNA biosynthesis through the activation of c-Myc. Additionally, Gln-K604 promotes resistance to apoptosis by activating Mcl-1. In contrast, SIRT1 deglutaminylates Gln-K604, thereby reversing its effects. Cancer cells lacking Gln-K604 exhibit overexpression of c-Myc and Mcl-1 and display resistance to chemotherapy-induced apoptosis. Silencing both c-MYC and MCL-1 in these cells sensitizes them to chemotherapy. These findings indicate that the glutamine-mediated signal via Gln-K604 is a key driver of cancer progression and suggest potential strategies for targeted cancer therapies based on varying Gln-K604 status.
Glutamine/metabolism*
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Myeloid Cell Leukemia Sequence 1 Protein/genetics*
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Humans
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Proto-Oncogene Proteins c-myc/genetics*
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Cell Proliferation
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Signal Transduction
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Neoplasms/pathology*
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F-Box-WD Repeat-Containing Protein 7/genetics*
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Cell Survival
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Cell Line, Tumor
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Apoptosis
10.Outcomes of identifying enlarged vestibular aqueduct (Mondini malformation) related gene mutation in Mongolian people
Jargalkhuu E ; Tserendulam B ; Maralgoo J ; Zaya M ; Enkhtuya B ; Ulzii B ; Ynjinlhkam E ; Chuluun-Erdene Ts ; Chen-Chi Wu ; Cheng-Yu Tsai ; Yin-Hung Lin ; Yi-Hsin Lin ; Yen-Hui Chan ; Chuan-Jen Hsu ; Wei-Chung Hsu ; Pei-Lung Chen
Mongolian Journal of Health Sciences 2025;87(3):8-15
Background:
Hearing loss (HL) is one of the most common sensory disorders,
affecting over 5-8% of the world's population. Approximately half of HL cases are
attributed to genetic factors. In hereditary deafness, about 75-80% is inherited
through autosomal recessive inheritance, and common pathogenic genes include
GJB2 and SLC26A4. Pathogenic variants in the SLC26A4gene are the leading
cause of hereditary hearing loss in humans, second only to the GJB2 gene. Variants in the SLC26A4gene cause hearing loss, which can be non-syndromic autosomal recessive deafness (DFNB4, OMIM #600791) associated with enlarged
vestibular aqueduct (EVA) or Pendred syndrome (Pendred, OMIM #605646).
DFNB4 is characterized by sensorineural hearing loss combined with EVA or less
common cochlear malformation defect. Pendred syndrome is characterized by bilateral sensorineural hearing loss with EVA and an iodine defect that can lead to
thyroid goiter. Currently, it is known that EVA is associated with variants in the
SLC26A4 gene and is a penetrant feature of SLC26A4-related HL. Predominant
mutations in these genes differ significantly across populations. For instance, predominant SLC26A4 mutations differ among populations, including p.T416P and
c.1001G>A in Caucasians, p.H723R in Japanese and Koreans, and c.919-2A>G
in Han Taiwanese and Han Chinese. On the other hand, there has been no study
of hearing loss related to SLC26A4 gene variants among Mongolians, which is the
basis of our research.
Aim:
We aimed to identify the characteristics of the SLC26A4 gene variants in
Mongolian people with Enlarged vestibular aqueduct and Mondini malformation.
Materials and Methods:
In 2022-2024, We included 13 people with hearing loss
and enlarged vestibular aqueduct, incomplete cochlea (1.5 turns of the cochlea
with cystic apex- incomplete partition type II- Mondini malformation) were examined by CT scan of the temporal bone in our study. WES (Whole exome sequencing) analysis was performed in the Genetics genetic-laboratory of the National
Taiwan University Hospital.
Results:
Genetic analysis revealed 26 confirmed pathogenic variants of bi-allelic
SLC26A4 gene of 8 different types in 13 cases, and c.919-2A>G variant was dominant with 46% (12/26) in allele frequency, and c.2027T>A (p.L676Q) variant 19%
(5/26), c.1318A>T(p.K440X) variant 11% (3/26), c.1229C>T (p.T410M) variant 8%
(2/26) ) , c.716T>A (p.V239D), c.281C>T (p.T94I), c.1546dupC, and c.1975G>C
(p.V659L) variants were each 4% (1/26)- revealed. Two male children, 11 years
old (SLC26A4: c.919-2A>G) and 7 years old (SLC26A4: c.919-2A>G:, SLC26A4:
c.2027T>A (p.L676Q))had history of born normal hearing and progressive hearing
loss.
Conclusions
1. 26 variants of bi-allelic SLC26A4 gene mutation were detected
in Mongolian people with EVA and Mondini malformation, and c.919-2A>G was
the most dominant allele variant, and rare variants such as c.1546dupC, c.716T>A
(p.V239D) were detected.
2. Our study shows that whole-exome sequencing (WES) can identify gene
mutations that are not detected by polymerase chain reaction (PCR) or NGS analysis.

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