OBJECTIVE To investigate the bactericidal effect of levulinic acid-sodium dodecyl sulfate(LVA-SDS)on the strains of Mycobacterium abscessus,Mycobacterium chelonae and Mycobacterium fortuitum,and to provide a new method for the prevention of common pathogenic rapidly growing non-tuberculous mycobacteria(NTM)dis-ease.METHODS The minimum inhibitory concentration(MIC)and minimal bactericidal concentration(MBC)of LVA-SDS were detected by microculture method and suspension quantitative bactericidal test,respectively.Using 1000 mg/L chlorine-containing disinfectant(sodium hypochlorite)as the control,the killing effect of LVA-SDS at different times and concentrations on M.abscessus,M.chelonae and M.fortuitum were detected.RESULTS The MIC values of LVA-SDS against M.abscessus,M.chelonae and M.fortuitum were 0.0625%LVA+0.00625%SDS,0.03125%LVA+0.003125%SDS and 0.125%LVA+0.0125%SDS,respectively.The MBC values were 0.25%LVA+0.025%SDS,0.25%LVA+0.025%SDS,and 1%LVA+0.1%SDS,repectively.Within a cer-tain range,with the increase in LVA-SDS concentration and the extension of time(1-30 min),the bactericidal effect on M.abscessus,M.chelonae and M.fortuitum gradually enhanced.The killing rates of the 18%LVA+1.8%SDS for 5 minutes and the 6%LVA+0.6%SDS for 20 minutes to M.abscessus reached 100.00%;the kill-ing rates of the 18%LVA+1.8%SDS for 10 minutes and the 10%LVA+1%SDS for 25 minutes to M.chelo-nae reached 100.00%;while the killing rates of the 18%LVA+1.8%SDS for 5 minutes and the 6%LVA+0.6%SDS for 30 minutes to M.fortuitum reached 100.00%.Compared with 1000 mg/L chlorine-containing disin-fectant(sodium hypochlorite),LVA-SDS has equivalent bactericidal effects against M.abscessus and M.chelo-nae,and a better bactericidal effect against M.fortuitum.CONCLUSION LVA-SDS has a good bactericidal effect on M.abscessus,M.chelonae and M.fortuitum,and may be used in the disinfection of NTM in the future.

Objective:To investigate the clinical characteristics and prognosis of fetuses with HNF1B gene variants. Methods:Fifty-two fetuses with HNF1B gene variants diagnosed by chromosomal copy number variation sequencing and/or whole exome sequencing at the First Affiliated Hospital of Zhengzhou University from January 2018 to June 2024 were retrospectively enrolled in this study, including 47 cases of 17q12 microdeletion and five cases of HNF1B point mutations. Prenatal ultrasound features, pregnancy outcomes, and postnatal manifestations were summarized and analyzed using descriptive statistics. Results:The prenatal ultrasound features of the 52 fetuses included enhanced renal parenchymal echo in 43 cases (82.7%), renal cysts in 15 cases (28.8%), enlarged kidney volume in 14 cases (26.9%), and pyelectasis in 13 cases (25.0%). Parental verification was completed for 35 cases, with 71.4% (25/35) being de novo mutations and 28.6% (10/35) inherited from either parent. Apart from eight cases with unknown pregnancy outcome (six cases were lost to follow-up, two cases refused to be followed up), the other 44 cases were successfully followed up, among which 68.2% (30/44) terminated the pregnancies and 31.8% (14/44) continued, resulting in live births. Prenatal ultrasound indicated renal abnormalities in all 14 live births, while postnatal follow-up showed seven cases with normal kidneys, one with reduced bilateral renal cysts, one with alleviated bilateral pyelectasis, four with unimproved renal structural abnormalities, and one who did not undergo a re-examination. Conclusion:The rate of renal abnormalities diagnosed by prenatal ultrasound in fetuses with HNF1B gene variants is high, and most of the pregnancies are terminated, although the renal sturctural abnormalities may improve after birth.

Objective:To investigate the clinical characteristics and genetic etiology of fetal Dandy-Walker spectrum (DWS) anomalies.Methods:This retrospective cohort study analyzed 28 fetuses with ultrasonographically confirmed DWS (ten classic Dandy-Walker malformations and 18 Dandy-Walker variants) at the First Affiliated Hospital, Zhengzhou University from January 2019 to June 2024. All cases underwent systematic ultrasonographic evaluation. Genetic analyses included chromosomal karyotyping alone ( n=4) or combined with copy number variation sequencing (CNV-seq) ( n=10). Descriptive statistics and Chi-square tests (or Fisher's exact test) with Bonferroni correction were applied. Results:(1) Among 28 fetuses, seven (25.0%) had isolated DWS and 21 (75.0%) non-isolated DWS. Central nervous system anomalies were most common (53.6%, 15/28). (2) Karyotyping identified abnormalities in four cases (4/14), including two triploidies, one case of mosaicism for a derivative chromosome der(1;10), and one 17p deletion. CNV-seq detected anomalies in six cases (25.0%, 6/24), four of which were missed by karyotyping: 3q23 deletion (encompassing ZIC1/ ZIC4), 13q11 duplication, and other critical variants. (3) Combined testing yielded a higher detection rate (28.6%, 8/28) than karyotyping alone (4/14, χ2=4.62, P=0.032) or CNV-seq alone (25.0%, 6/24, χ2=4.83, P=0.028) ( P=0.048 and 0.044 after Bonferroni correction). Conclusions:DWS demonstrates significant genetic heterogeneity, primarily involving chromosomal numerical anomalies (e.g., triploidy) and copy number variations (e.g., 3q23 deletion). Combined karyotyping and CNV-seq improves detection rates of genetic abnormalities.

OBJECTIVE To investigate the bactericidal effect of levulinic acid-sodium dodecyl sulfate(LVA-SDS)on the strains of Mycobacterium abscessus,Mycobacterium chelonae and Mycobacterium fortuitum,and to provide a new method for the prevention of common pathogenic rapidly growing non-tuberculous mycobacteria(NTM)dis-ease.METHODS The minimum inhibitory concentration(MIC)and minimal bactericidal concentration(MBC)of LVA-SDS were detected by microculture method and suspension quantitative bactericidal test,respectively.Using 1000 mg/L chlorine-containing disinfectant(sodium hypochlorite)as the control,the killing effect of LVA-SDS at different times and concentrations on M.abscessus,M.chelonae and M.fortuitum were detected.RESULTS The MIC values of LVA-SDS against M.abscessus,M.chelonae and M.fortuitum were 0.0625%LVA+0.00625%SDS,0.03125%LVA+0.003125%SDS and 0.125%LVA+0.0125%SDS,respectively.The MBC values were 0.25%LVA+0.025%SDS,0.25%LVA+0.025%SDS,and 1%LVA+0.1%SDS,repectively.Within a cer-tain range,with the increase in LVA-SDS concentration and the extension of time(1-30 min),the bactericidal effect on M.abscessus,M.chelonae and M.fortuitum gradually enhanced.The killing rates of the 18%LVA+1.8%SDS for 5 minutes and the 6%LVA+0.6%SDS for 20 minutes to M.abscessus reached 100.00%;the kill-ing rates of the 18%LVA+1.8%SDS for 10 minutes and the 10%LVA+1%SDS for 25 minutes to M.chelo-nae reached 100.00%;while the killing rates of the 18%LVA+1.8%SDS for 5 minutes and the 6%LVA+0.6%SDS for 30 minutes to M.fortuitum reached 100.00%.Compared with 1000 mg/L chlorine-containing disin-fectant(sodium hypochlorite),LVA-SDS has equivalent bactericidal effects against M.abscessus and M.chelo-nae,and a better bactericidal effect against M.fortuitum.CONCLUSION LVA-SDS has a good bactericidal effect on M.abscessus,M.chelonae and M.fortuitum,and may be used in the disinfection of NTM in the future.

Objective:To investigate the clinical characteristics and prognosis of fetuses with HNF1B gene variants. Methods:Fifty-two fetuses with HNF1B gene variants diagnosed by chromosomal copy number variation sequencing and/or whole exome sequencing at the First Affiliated Hospital of Zhengzhou University from January 2018 to June 2024 were retrospectively enrolled in this study, including 47 cases of 17q12 microdeletion and five cases of HNF1B point mutations. Prenatal ultrasound features, pregnancy outcomes, and postnatal manifestations were summarized and analyzed using descriptive statistics. Results:The prenatal ultrasound features of the 52 fetuses included enhanced renal parenchymal echo in 43 cases (82.7%), renal cysts in 15 cases (28.8%), enlarged kidney volume in 14 cases (26.9%), and pyelectasis in 13 cases (25.0%). Parental verification was completed for 35 cases, with 71.4% (25/35) being de novo mutations and 28.6% (10/35) inherited from either parent. Apart from eight cases with unknown pregnancy outcome (six cases were lost to follow-up, two cases refused to be followed up), the other 44 cases were successfully followed up, among which 68.2% (30/44) terminated the pregnancies and 31.8% (14/44) continued, resulting in live births. Prenatal ultrasound indicated renal abnormalities in all 14 live births, while postnatal follow-up showed seven cases with normal kidneys, one with reduced bilateral renal cysts, one with alleviated bilateral pyelectasis, four with unimproved renal structural abnormalities, and one who did not undergo a re-examination. Conclusion:The rate of renal abnormalities diagnosed by prenatal ultrasound in fetuses with HNF1B gene variants is high, and most of the pregnancies are terminated, although the renal sturctural abnormalities may improve after birth.

Objective:To investigate the clinical characteristics and genetic etiology of fetal Dandy-Walker spectrum (DWS) anomalies.Methods:This retrospective cohort study analyzed 28 fetuses with ultrasonographically confirmed DWS (ten classic Dandy-Walker malformations and 18 Dandy-Walker variants) at the First Affiliated Hospital, Zhengzhou University from January 2019 to June 2024. All cases underwent systematic ultrasonographic evaluation. Genetic analyses included chromosomal karyotyping alone ( n=4) or combined with copy number variation sequencing (CNV-seq) ( n=10). Descriptive statistics and Chi-square tests (or Fisher's exact test) with Bonferroni correction were applied. Results:(1) Among 28 fetuses, seven (25.0%) had isolated DWS and 21 (75.0%) non-isolated DWS. Central nervous system anomalies were most common (53.6%, 15/28). (2) Karyotyping identified abnormalities in four cases (4/14), including two triploidies, one case of mosaicism for a derivative chromosome der(1;10), and one 17p deletion. CNV-seq detected anomalies in six cases (25.0%, 6/24), four of which were missed by karyotyping: 3q23 deletion (encompassing ZIC1/ ZIC4), 13q11 duplication, and other critical variants. (3) Combined testing yielded a higher detection rate (28.6%, 8/28) than karyotyping alone (4/14, χ2=4.62, P=0.032) or CNV-seq alone (25.0%, 6/24, χ2=4.83, P=0.028) ( P=0.048 and 0.044 after Bonferroni correction). Conclusions:DWS demonstrates significant genetic heterogeneity, primarily involving chromosomal numerical anomalies (e.g., triploidy) and copy number variations (e.g., 3q23 deletion). Combined karyotyping and CNV-seq improves detection rates of genetic abnormalities.

Objective:To investigate the current status of knowledge, attitude and practice regarding perioperative lung rehabilitation for lung cancer among nurses of Thoracic Surgery Department, and explore its influencing factors, so as to provide a basis for promoting clinical lung rehabilitation training.Methods:This study was a cross-sectional survey. From May to August 2022, 513 nurses of Thoracic Surgery Department from 10 ClassⅢ hospitals in Henan Province were selected as survey subjects using convenience sampling. Nurses were surveyed using a self-designed Thoracic Surgery Nurses' Perioperative Lung Rehabilitation Knowledge, Attitude, and Practice Questionnaire for Lung Cancer. Multiple linear regression was used to analyze the influencing factors of nurses' knowledge, attitude, and practice. A total of 485 valid questionnaires were collected, with an effective response rate of 94.54% (485/513) .Results:The total score, knowledge dimension score, attitude dimension score, and practice dimension score of knowledge, attitude, and practice of perioperative lung rehabilitation for lung cancer among 485 nurses of Thoracic Surgery Department was (186.25±33.55), (76.36±16.44), (43.27±6.39), and (66.62±15.71), respectively. The results of multiple linear regression analysis showed that the influencing factors of the total score of knowledge, attitude, and practice of perioperative lung rehabilitation for lung cancer among nurses of Thoracic Surgery Department were their post, whether they understood the content of lung rehabilitation, the times they participated in lung rehabilitation training, and whether they implemented lung rehabilitation for patients ( P<0.05) . Conclusions:Thoracic Surgery Department nurses have a positive attitude in perioperative lung rehabilitation for lung cancer, but their knowledge and behavior urgently need to be improved. Nursing managers should actively carry out perioperative lung rehabilitation training, encourage Thoracic Surgery Department nurses to update their self-knowledge system, strengthen their lung rehabilitation execution ability, and further promote the development of lung rehabilitation related work.

Objective:To evaluate the safety and efficacy of daratumumab in the treatment of multiple myeloma (MM).Methods:The clinical data of 19 MM patients treated with daratumumab alone or in combination with chemotherapy regimens from June 2021 to December 2021 in the Affiliated Hospital of Jining Medical College were retrospectively analyzed, of which 2 patients received daratumumab alone, 6 cases received daratumumab combined with lenalidomide+dexamethasone (DRD) regimen, 1 case received daratumumab combined with liposomal doxorubicin+dexamethasone (DVD) regimen, 2 case received daratumumab combined with dexamethasone+cyclophosphamide+etoposide+cisplatin (DECP) regimen, 3 cases received daratumumab combined with isazomib+dexamethasone (ID) regimen, 2 cases received daratumumab combined with bortezomib+dexamethasone (BD) regimen, and 3 cases received daratumumab combined with dexamethasone (DD) regimen. The efficacy and incidence of adverse effects were analyzed.Results:Among the 19 patients, 8 had complete remission (CR), 1 had very good partial remission (VGPR), 5 had partial remission (PR), 1 had stable disease (SD), and 4 had progressive disease (PD). The overall response rate (ORR) was 73.7% (14/19). The median progression-free survival (PFS) time was 10.42 months (95% CI 8.04-12.79 months) and the median overall survival (OS) time was 52.06 months (95% CI 37.85-66.27 months). The main adverse reactions during treatment were grade 3 neutropenia in 3 cases, grade 3 lymphopenia in 3 cases, grade 2 anemia in 5 cases, grade 2 nausea and vomiting in 7 cases, and infusion-related adverse reactions in 7 cases. Conclusions:Daratumumab-based chemotherapy regimens for the treatment of MM patients can achieve great efficacy with good safety and tolerability.

OBJECTIVE: To explore the genetic etiology in four patients with hyperbilirubinemia, and discuss the correlation between clinical characteristics and molecular basis. METHODS: The data of clinical manifestation and auxiliary examinations were collected. Genomic DNA of the four patients was extracted and analyzed by next-generation sequencing using the panel including genes involved in hereditary metabolic liver diseases. Suspected variants were verified by Sanger sequencing. RESULTS: All of the four patients were males with normal liver enzymes. It was revealed that all the patients had heterozygous variants, among which c.3011C>T, c.2443C>T and c.2556del were the variants which have not been reported previously. CONCLUSION All of the patients were diagnosed as Dubin-Johnson syndrome (DJS) caused by ABCC2 gene variants. The novel variants add to the spectrum of genetic variants of the disease. Because of the favorite prognosis, precise diagnosis can greatly reduce the psychological pressure of patients and avoid excessive treatments. At the same time, it could provide pertinent genetic counseling for the families.
DNA ; Female ; Heterozygote ; Humans ; Jaundice, Chronic Idiopathic/genetics* ; Male ; Multidrug Resistance-Associated Protein 2 ; Multidrug Resistance-Associated Proteins/genetics* ; Phenotype

Objective:To investigate the efficacy and safety of ixazomib-based therapy for multiple myeloma.Methods:The data of 32 patients with multiple myeloma treated with isazomib-based regimen in the Affiliated Hospital of Jining Medical University from December 2020 to December 2021 were retrospectively analyzed. Among 32 patients, 17 cases were relapsed/refractory, and the remaining 15 cases had initial treatment. The treatment regimens included ID (isazomib + dexamethasone), IRD (isazomib + lenalidomide + dexamethasone) and ICD (isazomib + cyclophosphamide + dexamethasone). The short-term curative effect and adverse reactions of relapsed/refractory patients and patients at initial onset were analyzed.Results:The overall response rate (ORR) of relapsed/refractory patients was 52.9% (9/17), of which 6 cases achieved complete remission (CR), 2 cases achieved very good partial remission (VGPR) and 1 case achieved partial remission (PR). The ORR of refractory patients receiving bortezomib therapy was 40.0% (4/10). The ORR of patients at initial onset who could be evaluated the curative effect was 100.0% (14/14), including 9 cases of CR, 2 cases of VGPR and 3 cases of PR. After treatment, 2 patients (6.2%) had grade Ⅲ-Ⅳ adverse events (1 case of herpes zoster and 1 case of thrombocytopenia), and none of the patients had grade Ⅲ-Ⅳ peripheral neuropathy.Conclusion:Isazomib is effective and safe in the treatment of initially treated and relapsed/refractory multiple myeloma.