OBJECTIVE: To explore the clinical features and genetic etiology of two Chinese patients with Cowden syndrome (CS). METHODS: Two patients diagnosed with multiple gastrointestinal polyps by gastroenteroscopy at Henan Provincial People's Hospital in September and November 2023 were selected as the study subjects. Clinical data of the patients were collected. Whole exome sequence (WES) was carried out. Candidate variants were verified by Sanger sequencing. This study was approved by the Medical Ethics Committee of the Hospital (Ethics No.: 2018-03-01). RESULTS: The patients were diagnosed with multiple gastrointestinal polyps in addition with polypoid changes of the gallbladder. Genetic testing revealed that patient 1 has harbored a heterozygous c.738dupG (p.Leu247Valfs*6) variant of the PTEN gene, which was unreported previously. Patient 2 has harbored a heterozygous c.469G>T (p.Glu157Ter) variant of the PTEN gene, which was known to be pathogenic. None of their family members was found to harbor the above variants. Based on the guidelines from the American College of Medical Genetics and Genomics, both variants were rated as pathogenic (PVS1+PM2_Supporting+PP3+PP4). Bioinformatic analysis suggested that both variants can significantly affect the tertiary structure of the PTEN protein. CONCLUSION The heterozygous variants of the PTEN gene probably underlay the CS in both patients. Discovery of the novel variant has enriched the mutational spectrum of the PTEN gene.
Adult ; Female ; Humans ; Male ; China ; Hamartoma Syndrome, Multiple/genetics* ; Mutation ; Pedigree ; PTEN Phosphohydrolase/chemistry* ; East Asian People/genetics*

Background/Aims: The incidence and prevalence of inflammatory bowel disease (IBD) is rising in Asia recently. The study aimed to obtain a comprehensive understanding of the current status of drug therapy and monitoring for IBD in Asia. Methods: A questionnaire investigation on drug therapy and monitoring for IBD was conducted right before the 6th Annual Meeting of Asian Organization for Crohn’s & Colitis. Questionnaires were provided to Asian physicians to fill out via emails between March and May 2018. Results: In total, responses of 166 physicians from 129 medical centers were included for analysis. Among the surveyed regions, the most average number of IBD specialist gastroenterologists and nurses was 4.8 per center in Taiwan and 2.5 per center in Mainland China, respectively. 5-Aminosalicylic acid/sulfasalazine (99.4%) was the most preferred first-line choice for mild-moderate ulcerative colitis (UC), meanwhile corticosteroid (83.7%) was widely applied for severe UC. The first-line medication for Crohn’s disease (CD) markedly varied as corticosteroid (68.1%) was the most favored in Mainland China, Japan, and South Korea, followed by infliximab (52.4%) and azathioprine (47.0%). Step-up strategy was preferred in mild-moderate UC (96.4%), while 51.8% of the physicians selected top-down treatment for CD. Only 25.9% and 17.5% of the physicians could test blood concentration of infliximab and antibody to infliximab in their hospitals, respectively. Conclusions The current status of drug therapy and monitoring for IBD in Asia possesses commonalities as well as differences. Asian recommendations, IBD specialist teams and practice of therapeutic drug monitoring are required to improve IBD management in Asia.

Background:Enteroids are considered to be the best tool for studies on intestinal epithelium in vitro and have a widely application prospects,however,there are no associated reports in China. Aims:To establish and optimize the culture technique for enteroids and provide a fantastic platform for the basic research of small intestinal epithelial cells in China. Methods:L-WRN cells were cultured routinely and the conditioned medium with different concentrations of fetal bovine serum(FBS)was collected. Six to eight weeks old C57BL/ 6 mice were sacrificed and 15 cm small intestine from the terminal ileum was removed and cut longitudinally. Crypts were digested with EDTA and then collected and embedded in Matrigel? Matrix;after polymerization of Matrigel? Matrix,L-WRN conditioned medium at different concentration gradient was added. The budding ratio and length of buds were measured dynamically under microscope. The enteroids were re-embedded for subculture when certain length of buds was reached. Results:Compared with L-WRN conditioned medium containing 20% FBS,the conditioned medium containing 10% FBS was more favorable for enteroids culture in vitro. When conditioned medium accounted for 10% ,15% ,20% ,25% or 30% of the mixed medium,they all promoted the growth of enteroids and the 15% one seemed to yield better result. Conclusions:An enteroids culture technique was successfully established for the first time in China. When the L-WRN conditioned medium containing 10% FBS accounts for 15% of the mixed medium,it might promote budding better than the others.