1.A case of primary microcephaly associated with compound heterozygous variants of WDR62 gene.
Lihua YU ; Xingwang WANG ; Ling LIU ; Yukun ZENG ; Yiming QI ; Yanlin HUANG ; Hongke DING
Chinese Journal of Medical Genetics 2025;42(2):175-179
OBJECTIVE:
To explore the genetic basis for a girl with primary microcephaly and growth retardation.
METHODS:
A girl who was admitted to Guangdong Maternal and Child Health Care Hospital in was selected as the study subject. Peripheral blood samples were collected from the child and her parents. Trio whole exome sequencing was carried out, and candidate variants were verified by Sanger sequencing and bioinformatic analysis. This study was approved by the Medical Ethnics Committee of Guangdong Maternal and Child Health Care Hospital (Ethics No. 202201278).
RESULTS:
DNA sequencing revealed that the child has harbored compound heterozygous variants of the WDR62 gene, including a frameshifting c.2963delC (p.Pro988Argfs*80) variant in exon 24 which was inherited from the unaffected father, and a nonsense c.3163G>T (p.Glu1055*) variant in exon 26, which was inherited from her unaffected mother. Both variants were predicted to affect the reading frame of the WDR62 gene.
CONCLUSION
Based on the clinical manifestations, results of genetic testing and pedigree analysis, the compound heterozygous variants were predicted to underlay the pathogenesis of microcephaly and growth retardation in this child. Above discovery has expanded the mutational spectrum for WDR62-associated Primary microcephaly type 2, and facilitated genetic counseling for the family.
Female
;
Humans
;
Cell Cycle Proteins
;
Heterozygote
;
Microcephaly/genetics*
;
Mutation
;
Nerve Tissue Proteins/genetics*
;
Pedigree
2.Clinical phenotypic and genetic analysis of three children with Paroxysmal kinesigenic dyskinesia and Self-limited familial infantile epilepsy caused by PRRT2 gene mutation.
Dandan SONG ; Xiaoyi PENG ; Yao WANG ; Aojie CAI ; Sapana TAMANG ; Huaili WANG ; Zhihong ZHUO
Chinese Journal of Medical Genetics 2025;42(3):292-299
OBJECTIVE:
To investigate the clinical phenotypic and genetic characteristics of three children with Paroxysmal kinesigenic dyskinesia (PKD) and Self-limited familial infantile epilepsy (SeLIE) caused by PRRT2 gene mutation.
METHODS:
Three children with PKD and SeLIE caused by PRRT2 gene mutation (children 1-3) who were treated in the First Affiliated Hospital of Zhengzhou University from November 2022 to August 2023 were selected as the research subjects. A retrospective study was conducted to collect the clinical and family history data of the three children. 2 mL of peripheral venous blood from children 1-3 and parents of children 1-2 were collected (parents of children refused to undergo genetic testing and no blood samples were collected), genomic DNA was extracted, whole exome sequencing (WES) was performed, and Sanger sequencing method was used for verification. According to the Classification Standards and Guidelines for Genetic Variants formulated by the American Society of Medical Genetics and Genomics (ACMG) (hereinafter referred to as the "ACMG Guidelines"), the pathogenicity of the variant loci detected in three children was rated, and the detrimental loci of the variant loci were analyzed by multiple bioinformatics software. This study has been approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University (Ethics No. 2024-KY-0881-002).
RESULTS:
The clinical data and genetic test results of the three children in this study are as follows. Child 1: female, age of onset of 4 months and 10 days, with seizures, manifested as sudden cessation of movements, staring in both eyes, cyanosis of the lips, paleness, and stiffness and shaking of limbs. The results of genetic testing showed that child 1 had maternal PRRT2 gene c.583_584dup (p.P196Afs*34) frameshift variant, which was rated as a pathogenic variant (PVS1 PM2_Supporting PP4) according to ACMG guidelines. According to the clinical manifestations and genetic test results of child 1, he was diagnosed with SeLIE and took oral sodium valproate [0.5 mL/(kg.d)], and was still taking medication at the follow-up of 2 years old, and did not have seizures again after 5 months of age. Child 2: male, age of onset of 10 years old, manifested as dystonia after sudden movement. The results of genetic testing showed that child 2 had PRRT2 gene mutations: paternal c.649dupC (p.R217Pfs*8) frameshift variant and maternal c.445C>A (p.Q149K) mutation. Among them, c.649dupC was a reported pathogenic variant, and according to ACMG guidelines, c.445C>A variant was rated as a variant of unknown clinical significance (PM2_Supporting), with a high probability of benignness. According to the clinical manifestations and genetic test results of the child 2, he was diagnosed with PKD, and was followed up with oral oxcarbazepine 9 mg/(kg.d) until 12 years and 2 months, and was still on the drug, and there was no recurrence of the seizure of the form of dyskinesia after taking the drug. Child 3: male, age of onset of 11 years old, manifested by dystonia after sudden exercise. The results of genetic testing showed that child 3 had a missense variant of PRRT2 gene c.904G>C (p.D302H), and his parents refused genetic testing, and the source of the mutation was unknown, and the variant was rated as a variant of unknown clinical significance (PM2_Supporting+PP3_Moderate+PP4) according to ACMG guidelines. According to the clinical manifestations and genetic test results of child 3, he was diagnosed with PKD, and was treated with oral oxcarbazepine 10 mg/(kg.d) for 1 year and then discontinued on his own, and was followed up at the age of 17, and there was no recurrence of the seizure of the form of movement disorder after taking the drug.
CONCLUSION
One case of SeLIE and two cases of PKD caused by PRRT2 gene mutations responded well to anti-seizure drugs. In this study, four variant loci of PRRT2 gene were found: c.583_584dup, c.904G>C, c.649dupC, c.445C>A, among which c.583_584dup were new variants, enriching the variant spectrum of PRRT2 gene.
Humans
;
Male
;
Nerve Tissue Proteins/genetics*
;
Female
;
Membrane Proteins/genetics*
;
Mutation
;
Child, Preschool
;
Infant
;
Phenotype
;
Dystonia/genetics*
;
Retrospective Studies
;
Child
3.Clinical and genetic analysis of four patients with Phelan-McDermid syndrome due to variants of SHANK gene.
Liangqiong DENG ; Xuan ZENG ; Linyan LIAO ; Xiaobo XIONG ; Aiwen LI ; Yan MEI ; Liujuan ZHANG ; Dejian YUAN
Chinese Journal of Medical Genetics 2025;42(5):563-567
OBJECTIVE:
To explore the clinical phenotype and genetic characteristics of four patients with Phelan-McDermid syndrome (PMS) due to variants of SHANK3 gene.
METHODS:
Four patients diagnosed with PMS at Guangzhou Women and Children's Medical Center Liuzhou Hospital from January 2020 to January 2025 were selected as the study subjects. Clinical data of the patients were collected. Peripheral venous blood samples were collected from each patient for the extraction of genomic DNA, followed by whole-exome sequencing (WES) and validation by Sanger sequencing. Pathogenicity of candidate variants was rated based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), and multiple bioinformatic tools were used to assess the pathogenic effects of the variants. The study was approved by the Ethics Committee of the Hospital (Ethics No. 2025-007).
RESULTS:
All four patients had exhibited language delay and intellectual disability (IQ 35 ~ 65). Some also presented with autism spectrum disorder and schizophrenia, albeit with significant phenotypic heterogeneity. All patients were found to harbor deletions of 22q13.33 region, ranging from 55.46 Kb to 112.64 Kb, primarily involving the SHANK3 gene.
CONCLUSION
PMS is typically caused by deletions or mutations of the SHANK3 gene. The clinical manifestations are diverse, with developmental delay and intellectual disability being the most common. Accurate diagnosis requires integration of genetic testing and standardized clinical assessment. Genetic screening for suspected patients and at-risk pregnant women is recommended to facilitate their genetic counseling.
Child
;
Humans
;
Chromosome Deletion
;
Chromosome Disorders/genetics*
;
Chromosomes, Human, Pair 22/genetics*
;
Exome Sequencing
;
Nerve Tissue Proteins/genetics*
;
Phenotype
4.Clinical and genetic analysis of a patient with unilateral Pigmented paravenous retinochoroidal atrophy and Retinitis pigmentosa in the contralateral eye related to CRB1 gene variant.
Yongping TANG ; Hanshi HUANG ; Xiaoyan LIN ; Zailong CHI
Chinese Journal of Medical Genetics 2025;42(5):621-627
OBJECTIVE:
To explore the clinical phenotype, genotype and genetic characteristics for a patient with unilateral Pigmented paravenous retinochoroidal atrophy (PPRCA) and Retinitis pigmentosa (RP) in the contralateral eye.
METHODS:
A PPRCA pedigree which had presented at the Department of Medical Genetics of the Eye Hospital of Wenzhou Medical University in August 2021 was selected as the study subject. Clinical data of the family members were collected. The proband underwent wide-field fundus photography, wide-field autofluorescence, full-field electroretinogram (ff-ERG), visual field testing, optical coherence tomography (OCT), and fundus angiography (FFA and ICGA). Blood samples were collected from the proband and family members (parents and two sisters), and buccal mucosal cells were collected from the proband's daughter, and genomic DNA was extracted for each family member. Whole exome sequencing (WES) was performed on the proband. Candidate variants were verified using Sanger sequencing and pathogenicity analysis. This study was approved by the Medical Ethics Committee of the Eye Hospital of Wenzhou Medical University (Ethics No. 2019-134).
RESULTS:
Wide-angle fundus photography and autofluorescence showed that the right eye was consistent with PPRCA and the left eye with RP. OCT showed that the outer layer of the fovea was intact in the right eye, while disorganized outer segment was found in the fovea of the left eye, and outer segment atrophies outside the fovea were found in both eyes. The amplitudes of ff-ERG decreased significantly in both eyes, and the amplitudes in right eye were slightly higher than those of the left eye. Visual field showed a paracentral arcuate scotoma in the right eye and severe centripetal contraction in the left eye. FFA showed hyperfluorescence in the retinal vein distribution area caused by atrophy of retinal pigment epithelium of the right eye and hypofluorescence related to bone spicule pigmentation, in addition with mottled hypofluorescence of choroid in the left eye. ICGA showed mild paravenous retinochroidal atrophy of the right eye and diffuse choroid capillaries atrophy in the middle and peripheral area of the left eye. WES revealed that the proband had a heterozygous c.2234C>T (p.Thr745Met) variant of the CRB1 gene. Sanger sequencing confirmed that the proband and family members except the father of the proband carried the same CRB1 gene variant. Based on the criteria and guidelines for the classification of genetic variation and related consensus from the American College of Medical Genetics and Genomics (ACMG), this variant was classified as pathogenic (PM3_VeryStrong+PM1+PM2_Supporting +PP3).
CONCLUSION
The heterozygous c.2234C>T (p.Thr745Met) variant of the CRB1 gene may underlay the unilateral PPRCA with contralateral eye RP in this proband. Above findings have enriched the mutational spectrum of the CRB1 gene.
Humans
;
Electroretinography
;
Exome Sequencing
;
Eye Proteins/genetics*
;
Membrane Proteins/genetics*
;
Mutation
;
Nerve Tissue Proteins/genetics*
;
Pedigree
;
Phenotype
;
Retinitis Pigmentosa/genetics*
;
Tomography, Optical Coherence
;
Retinal Degeneration
;
Eye Diseases, Hereditary
5.Analysis of clinical manifestations and genetic variants among 11 Chinese pedigrees affected with Leber congenital amaurosis.
Zhouxian BAI ; Jingzhi SHAO ; Xiangdong KONG
Chinese Journal of Medical Genetics 2025;42(6):660-666
OBJECTIVE:
To retrospectively analyze 11 Chinese pedigrees affected with Leber congenital amaurosis (LCA) and summarize the clinical manifestations and genetic characteristics of patients.
METHODS:
Eleven Chinese pedigrees with probands diagnosed with LCA at the First Affiliated Hospital of Zhengzhou University from January 2020 to December 2023 were selected as the study subjects. Clinical phenotypic data of the probands were collected. Peripheral blood samples of patients and their family members were collected for the extraction of genomic DNA and whole exome sequencing. Candidate variants were validated by Sanger sequencing, qPCR assay and search of relevant databases and bioinformatic analysis. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), a diagnosis was made based on the patient's clinical phenotype, family history, and results of genetic testing. Prenatal diagnosis was provided for relevant families upon their subsequent pregnancies. This study has been approved by the Medical Ethnic Committee of the Hospital (Ethics No.: KS-2018-KY-36).
RESULTS:
Pedigrees 1 to 9 showed clinical features consistent with LCA and were diagnosed through genetic testing. Pedigrees 10 and 11, whilst suspected for having LCA, only had heterozygous variants detected. In total 11 novel variants were detected, including c.385C>T (p.Gln129*), c.42A>C (p.Lys14Asn) and c.1018dupA (p.Thr340Asnfs*67) of the AIPL1 gene, c.1196_1200delAAAAT (p.Asn400Thrfs*31) and exon 6-12 deletion of the SPATA7 gene, c.251A>T (p.Gln84Leu), c.875_892dupGTGCCTGGAA (p.Ser292_Gln297dup) and c.444delC (p.Ser150Glnfs*37) of the CRX gene, c.1368C>A (p.Cys456*) and c.2512A>T (p.Lys838*) of the CRB1 gene and c.3221delC (p.Pro1074Leufs*5) of the RPGRIP1 gene.
CONCLUSION
The phenotypic and genetic heterogeneity of LCA has posed substantial difficulty for clinical diagnosis and subtyping of the disease. Our retrospective analysis has identified novel pathogenic variants and multiple subtypes of LCA. The discovery of novel pathogenic variants and phenotypic characterization of LCA subtypes may enhance the understanding of disease etiology and clinical heterogeneity, and provide a basis for diagnosis, treatment, and genetic counseling.
Adult
;
Child
;
Child, Preschool
;
Female
;
Humans
;
Male
;
China
;
Eye Proteins/genetics*
;
Genetic Testing
;
Genetic Variation
;
Leber Congenital Amaurosis/diagnosis*
;
Membrane Proteins/genetics*
;
Mutation
;
Nerve Tissue Proteins/genetics*
;
Pedigree
;
Phenotype
;
Retrospective Studies
;
East Asian People/genetics*
;
Adaptor Proteins, Signal Transducing
6.Analysis of clinical phenotypes and genotypic characteristics in children with epilepsy.
Yanli JIANG ; Lulu YAN ; Bin FU ; Dongli CAI ; Min XIE ; Xinhua SHAO ; Changshui CHEN ; Shanshan WU ; Haibo LI
Chinese Journal of Medical Genetics 2025;42(9):1045-1052
OBJECTIVE:
To investigate the clinical phenotypes and genetic variant characteristics in children with epilepsy.
METHODS:
A total of 91 children with epilepsy admitted to the Women's and Children's Hospital Affiliated to Ningbo University from July 2021 to October 2022 were selected as the study subjects. Peripheral blood samples were collected from the children for whole exome sequencing. Candidate genetic variants were validated by Sanger sequencing and copy number variation sequencing (CNV-seq). The clinical phenotypes and treatment outcomes of the children with epilepsy were followed up, and an analysis of the relationship between genotype and phenotype was conducted. This study was approved by the Women's and Children's Hospital Affiliated to Ningbo University (Ethics No.: EC2020-048).
RESULTS:
Among the 91 children with epilepsy, 21 cases (23.08%, 21/91) were found to carry pathogenic or likely pathogenic variants. Of these, 18 cases had involved single base variant or insertional deletion, while 3 cases involved copy number variations. The gene with the highest detection rate was PRRT2 (38.10%, 8/21). Among the children with genetic variants, 47.62% (10/21) had onset during infancy, with 8 diagnosed with Benign familial infantile epilepsy (BFIE), 8 with Developmental epileptic encephalopathy (DEE), and 3 with Epileptic encephalopathy (EE). One case of Dravet syndrome (DS) and one case of Infantile spasms (IS) were also noted. The clinical manifestations of children were diverse and primarily included generalized tonic-clonic seizures and focal seizures. Among them, 52.38% (11/21) had exhibited cluster seizures, 23.81% (5/21) showed fever sensitivity, and 14.29% (3/21) experienced status epilepticus. After pharmacological treatment, 42.86% (9/21) of children had achieved complete seizure control, while 61.90% (13/21) had intellectual disability and 19.05% (4/21) had co-morbid autism spectrum disorder.
CONCLUSION
Pathogenic or likely pathogenic variants were identified in 23.08% of the pediatric epilepsy cases, with the PRRT2 gene being the most frequently involved. Among children carrying genetic variants, 47.62% had seizure onset during infancy. Genetic factors are an important cause of epilepsy, and early genetic testing may facilitate precise diagnosis, treatment, and prognostic evaluation.
Humans
;
Female
;
Male
;
Epilepsy/genetics*
;
Child, Preschool
;
Child
;
Phenotype
;
Genotype
;
DNA Copy Number Variations/genetics*
;
Infant
;
Membrane Proteins/genetics*
;
Nerve Tissue Proteins/genetics*
;
Adolescent
;
Exome Sequencing
7.The Medial Prefrontal Cortex-Basolateral Amygdala Circuit Mediates Anxiety in Shank3 InsG3680 Knock-in Mice.
Jiabin FENG ; Xiaojun WANG ; Meidie PAN ; Chen-Xi LI ; Zhe ZHANG ; Meng SUN ; Tailin LIAO ; Ziyi WANG ; Jianhong LUO ; Lei SHI ; Yu-Jing CHEN ; Hai-Feng LI ; Junyu XU
Neuroscience Bulletin 2025;41(1):77-92
Anxiety disorder is a major symptom of autism spectrum disorder (ASD) with a comorbidity rate of ~40%. However, the neural mechanisms of the emergence of anxiety in ASD remain unclear. In our study, we found that hyperactivity of basolateral amygdala (BLA) pyramidal neurons (PNs) in Shank3 InsG3680 knock-in (InsG3680+/+) mice is involved in the development of anxiety. Electrophysiological results also showed increased excitatory input and decreased inhibitory input in BLA PNs. Chemogenetic inhibition of the excitability of PNs in the BLA rescued the anxiety phenotype of InsG3680+/+ mice. Further study found that the diminished control of the BLA by medial prefrontal cortex (mPFC) and optogenetic activation of the mPFC-BLA pathway also had a rescue effect, which increased the feedforward inhibition of the BLA. Taken together, our results suggest that hyperactivity of the BLA and alteration of the mPFC-BLA circuitry are involved in anxiety in InsG3680+/+ mice.
Animals
;
Prefrontal Cortex/metabolism*
;
Basolateral Nuclear Complex/metabolism*
;
Mice
;
Anxiety/metabolism*
;
Nerve Tissue Proteins/genetics*
;
Male
;
Gene Knock-In Techniques
;
Pyramidal Cells/physiology*
;
Mice, Transgenic
;
Neural Pathways/physiopathology*
;
Mice, Inbred C57BL
;
Microfilament Proteins
8.Reprogramming miR-146b-snphb Signaling Activates Axonal Mitochondrial Transport in the Zebrafish M-cell and Facilitates Axon Regeneration After Injury.
Xin-Liang WANG ; Zong-Yi WANG ; Xing-Han CHEN ; Yuan CAI ; Bing HU
Neuroscience Bulletin 2025;41(4):633-648
Acute mitochondrial damage and the energy crisis following axonal injury highlight mitochondrial transport as an important target for axonal regeneration. Syntaphilin (Snph), known for its potent mitochondrial anchoring action, has emerged as a significant inhibitor of both mitochondrial transport and axonal regeneration. Therefore, investigating the molecular mechanisms that influence the expression levels of the snph gene can provide a viable strategy to regulate mitochondrial trafficking and enhance axonal regeneration. Here, we reveal the inhibitory effect of microRNA-146b (miR-146b) on the expression of the homologous zebrafish gene syntaphilin b (snphb). Through CRISPR/Cas9 and single-cell electroporation, we elucidated the positive regulatory effect of the miR-146b-snphb axis on Mauthner cell (M-cell) axon regeneration at the global and single-cell levels. Through escape response tests, we show that miR-146b-snphb signaling positively regulates functional recovery after M-cell axon injury. In addition, continuous dynamic imaging in vivo showed that reprogramming miR-146b significantly promotes axonal mitochondrial trafficking in the pre-injury and early stages of regeneration. Our study reveals an intrinsic axonal regeneration regulatory axis that promotes axonal regeneration by reprogramming mitochondrial transport and anchoring. This regulation involves noncoding RNA, and mitochondria-associated genes may provide a potential opportunity for the repair of central nervous system injury.
Animals
;
Zebrafish
;
MicroRNAs/genetics*
;
Nerve Regeneration/physiology*
;
Mitochondria/metabolism*
;
Zebrafish Proteins/genetics*
;
Axons/metabolism*
;
Signal Transduction/physiology*
;
Axonal Transport/physiology*
;
Nerve Tissue Proteins/genetics*
9.Deciphering the Role of Shank3 in Dendritic Morphology and Synaptic Function Across Postnatal Developmental Stages in the Shank3B KO Mouse.
Jing YANG ; Guaiguai MA ; Xiaohui DU ; Jinyi XIE ; Mengmeng WANG ; Wenting WANG ; Baolin GUO ; Shengxi WU
Neuroscience Bulletin 2025;41(4):583-599
Autism Spectrum Disorder (ASD) is marked by early-onset neurodevelopmental anomalies, yet the temporal dynamics of genetic contributions to these processes remain insufficiently understood. This study aimed to elucidate the role of the Shank3 gene, known to be associated with monogenic causes of autism, in early developmental processes to inform the timing and mechanisms for potential interventions for ASD. Utilizing the Shank3B knockout (KO) mouse model, we examined Shank3 expression and its impact on neuronal maturation through Golgi staining for dendritic morphology and electrophysiological recordings to measure synaptic function in the anterior cingulate cortex (ACC) across different postnatal stages. Our longitudinal analysis revealed that, while Shank3B KO mice displayed normal neuronal morphology at one week postnatal, significant impairments in dendritic growth and synaptic activity emerged by two to three weeks. These findings highlight the critical developmental window during which Shank3 is essential for neuronal and synaptic maturation in the ACC.
Animals
;
Nerve Tissue Proteins/metabolism*
;
Mice, Knockout
;
Dendrites/metabolism*
;
Mice
;
Synapses/metabolism*
;
Gyrus Cinguli/metabolism*
;
Male
;
Mice, Inbred C57BL
;
Autism Spectrum Disorder/genetics*
;
Microfilament Proteins
10.SOX11-mediated CBLN2 Upregulation Contributes to Neuropathic Pain through NF-κB-Driven Neuroinflammation in Dorsal Root Ganglia of Mice.
Ling-Jie MA ; Tian WANG ; Ting XIE ; Lin-Peng ZHU ; Zuo-Hao YAO ; Meng-Na LI ; Bao-Tong YUAN ; Xiao-Bo WU ; Yong-Jing GAO ; Yi-Bin QIN
Neuroscience Bulletin 2025;41(12):2201-2217
Neuropathic pain, a debilitating condition caused by dysfunction of the somatosensory nervous system, remains difficult to treat due to limited understanding of its molecular mechanisms. Bioinformatics analysis identified cerebellin 2 (CBLN2) as highly enriched in human and murine proprioceptive and nociceptive neurons. We found that CBLN2 expression is persistently upregulated in dorsal root ganglia (DRG) following spinal nerve ligation (SNL) in mice. In addition, transcription factor SOX11 binds to 12 cis-regulatory elements within the Cbln2 promoter to enhance its transcription. SNL also induced SOX11 upregulation, with SOX11 and CBLN2 co-localized in nociceptive neurons. The siRNA-mediated knockdown of Sox11 or Cbln2 attenuated SNL-induced mechanical allodynia and thermal hyperalgesia. High-throughput sequencing of DRG following intrathecal injection of CBLN2 revealed widespread gene expression changes, including upregulation of numerous NF-κB downstream targets. Consistently, CBLN2 activated NF-κB signaling, and inhibition with pyrrolidine dithiocarbamate reduced CBLN2-induced pain hypersensitivity, proinflammatory cytokines and chemokines production, and neuronal hyperexcitability. Together, these findings identified the SOX11/CBLN2/NF-κB axis as a critical mediator of neuropathic pain and a promising target for therapeutic intervention.
Animals
;
Neuralgia/metabolism*
;
Ganglia, Spinal/metabolism*
;
Up-Regulation
;
Mice
;
NF-kappa B/metabolism*
;
SOXC Transcription Factors/genetics*
;
Male
;
Neuroinflammatory Diseases/metabolism*
;
Mice, Inbred C57BL
;
Nerve Tissue Proteins/genetics*
;
Hyperalgesia/metabolism*
;
Signal Transduction
;
Spinal Nerves

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