1.Study on the effect and mechanism of Xinyang Tablet on myocardial ferroptosis in mice with chronic heart failure
Jinhua KANG ; Pengpeng LIANG ; Xiaoxiong ZHOU ; Ao LIU ; Zhongqi YANG ; Hongyan WU
Journal of Beijing University of Traditional Chinese Medicine 2025;48(4):516-528
Objective:
Exploring the effect and mechanism of Xinyang Tablet on reduction of ferroptosis in myocardial cells from mice with chronic heart failure.
Methods:
Sixty C57BL/6J mice were randomly assigned to the sham, model, Xinyang Tablet low-dose (0.34 g/kg), Xinyang Tablet medium-dose (0.68 g/kg), Xinyang Tablet high-dose (1.36 g/kg), and perindopril (0.607 mg/kg) groups using a random number table method (10 mice in each group). Except for the sham group, all other groups underwent aortic arch constriction surgery to construct a chronic heart failure model. On the third day after completion of the modeling, each treatment group was administered the corresponding medication by gavage, while the sham and model groups were administered equal volumes of water by gavage once a day for eight consecutive weeks. After treatment, cardiac ultrasound was used to detect the structure and function of the mouse heart. Hematoxylin and eosin staining was used to detect pathological changes in mouse heart tissue. Masson staining was used to detect the proportion of fibrotic area of mouse heart tissue. Realtime fluorescence PCR was used to detect the mRNA expression of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), collagen 3α (Col3α), and myosin heavy chain 7 (MYH7) in mouse myocardial tissue. Transmission electron microscope was used to detect the ultrastructure of myocardial cell mitochondria. Reactive oxygen species (ROS) staining was used to detect the mean fluorescence intensity of ROS in myocardial tissue. Micro-determination was used to detect superoxide dismutase (SOD) activity in myocardial tissue. An immunofluorescence assay was used to detect the mean fluorescence intensity of phosphorylated histone deacetylase 2 (p-HDAC2) in myocardial cell. Western blotting was used to detect the protein expression of nuclear factor-erythroid 2-related factor 2 (Nrf2), p-HDAC2, nicotinamide adenine dinucleotide phosphate oxidase 1 (NOX1), glutathione peroxidase 4 (GPX4), and cystine glutamate reverse transporter (xCT) in mouse myocardial tissue.
Results:
Compared to the sham group, the model group showed a decrease in left ventricular ejection fraction (LVEF), left ventricular fraction shortening (LVFS), an increase in left ventricular end-systolic diameter(LVESD) and left ventricular end-diastolic diameter (LVEDD), an increase in the proportion of cardiac fibrosis area, an increase in relative expression levels of ANP, BNP, Col3α, and MYH7 mRNA, an increase in ROS mean fluorescence intensity, a decrease in SOD activity, an increase in mean fluorescence intensity of p-HDAC2, an increase in relative expression levels of p-HDAC2 and NOX1 proteins, and a decrease in relative expression levels of Nrf2, GPX4, and xCT proteins (P<0.05). Myocardial fibrosis lesions are obvious, with disordered mitochondrial arrangement, decreased volume and shrinkage, increased membrane density, and reduced mitochondrial cristae. Compared to the model group, the LVEF and LVFS of mice in each dose group of Xinyang Tablet and the perindopril group increased, LVESD and LVEDD decreased, the proportion of fibrotic area of heart tissue decreased, the relative expression levels of ANP, BNP, Col3α, MYH7 mRNA decreased, ROS mean fluorescence intensity decreased, SOD activity increased, mean fluorescence intensity of p-HDAC2 decreased, relative expression levels of p-HDAC2 and NOX1 proteins decreased, and relative expression levels of Nrf2 and xCT proteins increased (P<0.05). Myocardial fibrosis was reduced, the mitochondrial arrangement was more regular, the mitochondria enlarged, the membrane density was reduced, and mitochondrial cristae increased. Compared to the model group, the relative expression level of the GPX4 protein in myocardial tissue increased in the Xinyang Tablet medium-, high-dose, and the perindopril groups (P<0.05).
Conclusion
Xinyang Tablet can improve ferroptosis and ventricular remodeling in mice with chronic heart failure by regulating the HDAC2-mediated Nrf2 antioxidant pathway.
2.Feiyanning Inhibits Invasion and Metastasis of Non-small Cell Lung Cancer by Regulating EMT via TGF-β1/Smad Signaling Pathway
Xiaojie FU ; Jia YANG ; Kaile LIU ; Wenjie WANG ; Zhenye XU ; Zhongqi WANG ; Haibin DENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):110-120
ObjectiveTo explore the mechanism of the anti-cancer compound formula Feiyanning in inhibiting epithelial-mesenchymal transition (EMT) and invasion and metastasis of non-small cell lung cancer (NSCLC). MethodsCell proliferation and activity were assessed using the cell counting kit-8(CCK-8) assay to evaluate the effect of Feiyanning on the proliferation of A549 and H1299 cells. Wound healing and Transwell assays were conducted to examine Feiyanning's impact on the metastasis of A549 and H1299 cells. The effects of Feiyanning on EMT and the transforming growth factor-β1 (TGF-β1)/Smad signaling pathway proteins in A549 and H1299 cells were detected by Western blot. Exogenous TGF-β1 was used to induce EMT in A549 and H1299 cells. The effects of Feiyanning on TGF-β1-induced NSCLC cell metastasis, EMT, and the TGF-β1/Smad pathway proteins were assessed by wound healing assay, Transwell assay, and Western blot. In vivo, an A549 lung metastasis model was established via tail vein injection in nude mice. A total of 28 SPF male nude mice were randomly divided into four groups: Model (NC) group, Feiyanning low-dose (FYN1) group, Feiyanning high-dose (FYN2) group, and the positive control group (TGF-β receptor kinase inhibitor SB431542 group). The corresponding interventions were performed. After 40 days, the mice were euthanized, and lung metastases were analyzed. The expression of E-cadherin, N-cadherin, p-Smad2, and p-Smad3 in each group was detected by immunohistochemistry (IHC). ResultsAfter Feiyanning intervention, compared to the blank group, Feiyanning inhibited the proliferation of A549 and H1299 cells in a concentration-dependent manner (P<0.01). The metastasis ability of Feiyanning-treated cells was significantly decreased compared to the blank group (P<0.01). The expression of EMT marker proteins N-cadherin and zinc finger transcription factors (Zeb1, Snail, Slug) was significantly reduced in the Feiyanning groups compared to the blank group (P<0.05, P<0.01). The expression of p-Smad2/3, Smad2/3, TβRI, and TβRⅡ, key proteins in the TGF-β1/Smad signaling pathway, was also significantly decreased (P<0.01). In the TGF-β1-induced EMT model, compared to the TGF-β1 group, the cell metastasis ability in the Feiyanning groups was reduced (P<0.01), and the expression levels of N-cadherin, Zeb1, Snail, and Slug were significantly lower (P<0.01). The expression levels of p-Smad2/3, Smad2/3, TβRI, and TβRⅡ were also significantly reduced (P<0.01). In vivo results showed that compared to the model group, the number of lung metastases in the FYN1, FYN2, and SB431542 groups was reduced (P<0.01), and the range of cell infiltration was narrowed. Immunohistochemical results showed that compared to the model group, the expression of E-cadherin in the FYN1, FYN2, and SB431542 groups was increased (P<0.01), the expression of N-cadherin decreased (P<0.05, P<0.01), and the expression of p-Smad2 and p-Smad3, key proteins of the TGF-β1/Smad pathway, was reduced (P<0.01). ConclusionFeiyanning inhibits the invasion and metastasis of NSCLC cells and EMT. The mechanism is related to the inhibition of TGF-β1/Smad signaling pathway.
3.Feiyanning Inhibits Invasion and Metastasis of Non-small Cell Lung Cancer by Regulating EMT via TGF-β1/Smad Signaling Pathway
Xiaojie FU ; Jia YANG ; Kaile LIU ; Wenjie WANG ; Zhenye XU ; Zhongqi WANG ; Haibin DENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):110-120
ObjectiveTo explore the mechanism of the anti-cancer compound formula Feiyanning in inhibiting epithelial-mesenchymal transition (EMT) and invasion and metastasis of non-small cell lung cancer (NSCLC). MethodsCell proliferation and activity were assessed using the cell counting kit-8(CCK-8) assay to evaluate the effect of Feiyanning on the proliferation of A549 and H1299 cells. Wound healing and Transwell assays were conducted to examine Feiyanning's impact on the metastasis of A549 and H1299 cells. The effects of Feiyanning on EMT and the transforming growth factor-β1 (TGF-β1)/Smad signaling pathway proteins in A549 and H1299 cells were detected by Western blot. Exogenous TGF-β1 was used to induce EMT in A549 and H1299 cells. The effects of Feiyanning on TGF-β1-induced NSCLC cell metastasis, EMT, and the TGF-β1/Smad pathway proteins were assessed by wound healing assay, Transwell assay, and Western blot. In vivo, an A549 lung metastasis model was established via tail vein injection in nude mice. A total of 28 SPF male nude mice were randomly divided into four groups: Model (NC) group, Feiyanning low-dose (FYN1) group, Feiyanning high-dose (FYN2) group, and the positive control group (TGF-β receptor kinase inhibitor SB431542 group). The corresponding interventions were performed. After 40 days, the mice were euthanized, and lung metastases were analyzed. The expression of E-cadherin, N-cadherin, p-Smad2, and p-Smad3 in each group was detected by immunohistochemistry (IHC). ResultsAfter Feiyanning intervention, compared to the blank group, Feiyanning inhibited the proliferation of A549 and H1299 cells in a concentration-dependent manner (P<0.01). The metastasis ability of Feiyanning-treated cells was significantly decreased compared to the blank group (P<0.01). The expression of EMT marker proteins N-cadherin and zinc finger transcription factors (Zeb1, Snail, Slug) was significantly reduced in the Feiyanning groups compared to the blank group (P<0.05, P<0.01). The expression of p-Smad2/3, Smad2/3, TβRI, and TβRⅡ, key proteins in the TGF-β1/Smad signaling pathway, was also significantly decreased (P<0.01). In the TGF-β1-induced EMT model, compared to the TGF-β1 group, the cell metastasis ability in the Feiyanning groups was reduced (P<0.01), and the expression levels of N-cadherin, Zeb1, Snail, and Slug were significantly lower (P<0.01). The expression levels of p-Smad2/3, Smad2/3, TβRI, and TβRⅡ were also significantly reduced (P<0.01). In vivo results showed that compared to the model group, the number of lung metastases in the FYN1, FYN2, and SB431542 groups was reduced (P<0.01), and the range of cell infiltration was narrowed. Immunohistochemical results showed that compared to the model group, the expression of E-cadherin in the FYN1, FYN2, and SB431542 groups was increased (P<0.01), the expression of N-cadherin decreased (P<0.05, P<0.01), and the expression of p-Smad2 and p-Smad3, key proteins of the TGF-β1/Smad pathway, was reduced (P<0.01). ConclusionFeiyanning inhibits the invasion and metastasis of NSCLC cells and EMT. The mechanism is related to the inhibition of TGF-β1/Smad signaling pathway.
4.Kangliu Zengxiao Jiandu Prescription in Enhancing Cisplatin Chemotherapy for Lung Cancer:A Network Pharmacology and Experimental Study
Wenjie WANG ; Xin LIU ; Jia YANG ; Xiaojie FU ; Xinhong WU ; Yuejiao CAI ; Zhenye XU ; Zhongqi WANG ; Haibin DENG
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(8):38-45
Objective To explore the mechanism of Kangliu Zengxiao Jiandu Prescription(KLJD)in enhancing the efficacy of cisplatin chemotherapy in non-small cell lung cancer(NSCLC)through network pharmacology and in vivo/in vitro experiments.Methods Components of KLJD were screened via the TCMSP database to identify active components and potential targets.Lung cancer-related genes were obtained from the GeneCards and OMIM databases.GO and KEGG pathway enrichment analysis was performed on drug-disease intersection targets using the Metascape database;molecular docking was performed between core target proteins and main active components.A Lewis lung cancer mouse model was established,and intervened with KLJD and cisplatin.Organ indexes and tumor inhibition rate were counted,and Western blot and RT-PCR were used to detect the expressions of key pathway target proteins and mRNA;A549 and H1299 cells were intervened with KLJD,and Western blot was used to detect key target protein expressions.Results Network pharmacology identified 74 active components and 20 key targets of KLJD,primarily involved in biological processes such as cell proliferation and inflammatory response,and pathways in cancer and PI3K/AKT signaling pathway;molecular docking revealed stable binding between EGFR and major compounds.Animal experiments demonstrated that,compared with the model group,the KLJD group showed significantly higher tumor inhibition rate(P<0.01)and downregulation of EGFR,AKT and PI3K protein and mRNA expression in tumor tissues(P<0.05).Compared with the cisplatin group,the combination group exhibited significantly enhanced tumor inhibition rate(P<0.01),elevated thymic and splenic indices(P<0.01),and decreased EGFR,PI3K and AKT protein and mRNA expressions(P<0.01).Cell experiments showed that KLJD concentration-dependently inhibited A549 and H1299 cell proliferation(IC50:14.72 mg/mL and 14.68 mg/mL,respectively).Combined with cisplatin,KLJD synergistically down-regulated EGFR PI3K and AKT protein expressions(P<0.01).Conclusion KLJD effectively enhances cisplatin's chemotherapeutic efficacy in NSCLC by inhibiting the EGFR/PI3K/AKT pathway while improving immune organ function.Its mechanism likely involves multi-target regulation,including suppression of tumor proliferation,promotion of apoptosis,and modulation of the immune microenvironment.
5.Study on Distribution Law of TCM Syndrome Elements in Obesity with Metabolic Associated Fatty Liver Disease
Zhaoyi CHEN ; Jinkun WANG ; Jun ZHOU ; Shengxian LI ; Minting LUO ; Zhongqi YUAN ; Lu LIU ; Qiuyu XIA ; Bin LI
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(12):154-159
Objective To explore the characteristics of TCM syndromes in patients with obesity with metabolic associated fatty liver disease(MAFLD).Methods TCM Symptom Collection Form was developed to collect the clinical symptoms of obesity patients who attended the Department of Acupuncture and Moxibustion of Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,from July to December of 2024.Factor analysis and clustering analysis were used to explore the distribution law of different syndrome elements and TCM syndromes.Results A total of 309 obese patients(221 with MAFLD)were included,with 20 symptoms with a frequency of≥5%.Factor analysis suggested that there was a significant difference between the two groups in the pathogenic syndrome elements of qi stagnation,yin deficiency,qi deficiency,hyperactivity of yang,yang deficiency,dampness,dynamic wind,and the locus of disease syndrome elements of the spleen and the heart spirit(P<0.05).Clustering analysis showed that the syndrome types of patients with MAFLD were mainly the syndrome of liver and stomach stagnation and heat,the syndrome of spleen deficiency and stomach heat,and the syndrome of spleen and kidney deficiency;the syndrome types of patients without MAFLD were mainly spleen-stomach qi stagnation,gastrointestinal excess-heat,spleen-deficiency-dampness obstruction,and spleen-kidney deficiency.Conclusion Patients of obesity with MAFLD are more likely to have the co-existence of the pathogenesis of damp-heat obstruction and spleen-kidney deficiency.
6.Rifampicin-resistant tuberculosis prevention and control in Jiangsu Province from 2013 to 2023
Hui DING ; Quanji YU ; Xiaoyan DING ; Yan SHAO ; Peng LU ; Zhongqi LI ; Limei ZHU ; Qiao LIU
Chinese Journal of Epidemiology 2025;46(4):655-661
Objective:To investigate the trends in detection, treatment, and outcomes of rifampicin-resistant tuberculosis (TB) in Jiangsu Province from 2013 to 2023, assess the effectiveness of control policies and measures for drug-resistant TB, and provide evidence for better control of drug-resistant TB.Methods:Data and indicators related to the screening, diagnosis, treatment, and outcomes of rifampicin-resistant TB in Jiangsu Province from 2013 to 2023 were obtained from the Tuberculosis Management Information System. The Joinpoint regression method was employed to analyze the trends over this period, and annual percent change (APC) and average annual percent change (AAPC) were calculated. A comparative analysis was also conducted to evaluate the changes before and after implementing relevant policies and measures.Results:From 2013 to 2023, the number of registered rifampicin-resistant TB patients in Jiangsu Province showed a consistent upward trend (APC=AAPC=1.45%, P=0.035). The screening rates for drug resistance among new TB patients in high-risk groups and the proportion of molecular biological testing for drug resistance all exhibited increasing trends, with a notable turning point occurring in 2018. The trend of the treatment enrollment rate for rifampicin-resistant TB patients experienced a significant shift in 2020, showing a marked increase from 2013 to 2020 (APC=12.91%, P=0.008). The treatment success rate of rifampicin-resistant TB patients also showed a significant upward trend after a turning point in 2020 (APC=9.94%, P=0.004). Conclusion:From 2013 to 2023, significant progress was seen in preventing and treating rifampicin-resistant TB in Jiangsu Province, with relevant policies and measures proving to be highly effective.
7.Involvement of sympathetic nerve in the regulation of disuse atrophy of skeletal muscles: a preliminary study
Dongliang CHENG ; Mingming ZHANG ; Jiang LIU ; Junmin SHEN ; Zhongqi WANG ; Xinyu SUN ; Duanyang WANG ; Feifan CHANG ; Haobo ZHANG ; Pincong FU ; Ming CHEN ; Yi LI ; Pengbin YIN ; Licheng ZHANG ; Peifu TANG
Chinese Journal of Orthopaedic Trauma 2025;27(3):242-249
Objective:To investigate the changes in sympathetic nerve activity after lower limb immobilization and the role of sympathetic nerve in regulating disuse atrophy of skeletal muscles.Methods:The experiment was divided into the following 3 parts: ① Twelve 8-week-old male C57 mice were randomly divided into a blank control group and a hind limb fixation group ( n=6). The blank control group received no intervention while the hind limb fixation group received splint fixation of the hind limbs for 2 weeks before the musculoskeletal multi-dimensional characterization was completed at the behavioral, pathological and molecular levels. ② Thirty-six 8-week-old male C57 mice were selected and randomly divided into a control group and 5 hind limb fixation groups (for 1, 3, 5, 7 and 14 days) ( n=6). The control group was fed normally until 14 days without any intervention while the 5 hind limb fixation groups were sampled after fixation for 1, 3, 5, 7 and 14 days, respectively. The level of norepinephrine in the serum and the expression level of tyrosine hydroxylase (TH), a marker of sympathetic nerve activity in the paraventricular nucleus of hypothalamus (PVN), were detected to observe the plasticity of sympathetic nerve activity. ③ Eighteen 8-week-old male C57 mice were selected and randomly divided into a blank control group, a hind limb fixation group and a hind limb fixation plus medication group ( n=6). The blank control group received no intervention while the 2 fixation groups were injected with phosphate buffer (PBS) and propranolol hydrochloride solution for 2 consecutive weeks, respectively. The parameters related to the skeletal muscles were compared between the 3 groups. Results:① Compared with the control group, the mass and function of skeletal muscles in the hind limb fixation group were statistically significantly decreased ( P<0.05). ② The levels of serum norepinephrine [(3.27±1.03) ng/mL, (9.21±1.05) ng/mL, (6.36±0.88) ng/mL, (3.84±1.00) ng/mL, and (3.91±0.75) ng/mL] and the PVN TH levels (42.00%±5.38%, 61.67%±5.57%, 55.82%±3.11%, 50.90%±2.53%, and 39.17%±9.07%) in the 5 hind limb fixation groups (for 1, 3, 5, 7 and 14 days) were significantly higher than those in the control group [(1.81±0.72)] ng/mL and 23.33%±5.50%] ( P<0.05). ③ The wet weight of the gastrocnemius muscle [(93.50±4.32) mg] and the cross-section area of the tibial anterior muscle [(1,180.00±95.09) μm 2] in the hind limb fixation plus medication group were increased significantly compared with those in the hind limb fixation group [(80.83±9.99) mg and (907.80±121.00) μm 2] ( P<0.05). Conclusions:Overactivation of the sympathetic nervous system occurs in the mice model of skeletal muscle disuse atrophy after hind limb fixation. Inhibition of sympathetic nerve activity may reduce the severity of skeletal muscle atrophy at the lower limbs.
8.Clinical features and genetic analysis of horizontal gaze palsy with progressive scoliosis caused by ROBO3 gene variation in two families
Ting LIU ; Fei WANG ; Yuebing LU ; Zhongqi FANG ; Ping LI ; Shijie DONG ; Dayong BAI
Chinese Journal of Experimental Ophthalmology 2025;43(7):611-617
Objective:To observe and analyze the ocular clinical features and pathogenic genes of horizontal gaze palsy with progressive scoliosis (HGPPS).Methods:A pedigree study was conducted.Two families with HGPPS diagnosed by ophthalmology examination at Henan Children's Hospital from November 2023 to April 2024 were included, with 3 people from two generations in each family.Medical history and family history of the subjects were inquired.Vision acuity, diopter, anterior segment, intraocular pressure, wide-angle laser scanning ophthalmoscopy, optical coherence tomography, visual evoked potential (VEP), electroretinogram (ERG), ocular B-ultrasound, full spine AP+ lateral view, orbit+ skull+ cervical spine+ thoracic spine+ lumbosacral spine MRI plain scan were performed on the subjects.Whole genomic DNA was extracted from 2 ml of peripheral venous blood collected from the subjects, and gene sequencing was performed using whole exome sequencing (WES) technology.Suspicious pathogenic variant loci were verified by Sanger sequencing, and the pathogenicity of gene variant loci was analyzed according to the ACMG standards and guidelines for the interpretation of sequence variants.This study followed the Declaration of Helsinki.The study protocol was reviewed and approved by the Ethics Committee of Henan Children's Hospital (No.2024-KY-0024).All subjects and guardians signed informed consent forms and were informed of relevant matters before genetic testing.Results:The proband from family 1 was male, 3 years and 2 months old.At the age of 6 months, he was found to have head tilted to the left with a right scoliosis of the spine centered on T11-12 and no obvious abnormalities on VEP and ERG examinations.The proband from family 2 was male, 3 years and 4 months old, with a left scoliosis of the spine centered on T12.Both probands developed horizontal fixation paralysis, unable to rotate eye outward, slightly limited inward rotation, left eye hypertropia, mild horizontal nystagmus, normal vertical eye movement, backward development of major movements, and normal vision, anterior segment and fundus.MRI examination showed that the medulla oblongata was butterfly shaped, and a brainstem fissure could be seen in the center of the medulla oblongata.The genetic testing showed that the proband from family 1 had compound heterozygous variations c. 1054delC/p.Gln352Serfs *90 (M1) in exon 7 and c. 1219G>T/p.Gly407Cys (M2) in exon 8 of ROBO3 gene.The father of the proband carried M1 and the mother of the proband carried M2.The proband from family 2 had compound heterozygous variations c. 1888C>T/p.R630X (M3) in exon 12 and c. 2684C>A/p.A895E (M4) in exon 17 of ROBO3 gene.M1 and M3 were possible pathogenic, and M2 and M4 were of unknown clinical significance, and prediction software predicted M2 and M4 were harmful variations. Conclusions:The main clinical features of two HGPPS pedigree are horizontal fixation paralysis and progressive scoliosis, accompanied by nystagmus and strabismus.MRI shows brainstem fissure in the central medullary area.Four variants are novel variants, which increases the variation spectrum of ROBO3 gene.
9.Clinical features and genetic analysis of horizontal gaze palsy with progressive scoliosis caused by ROBO3 gene variation in two families
Ting LIU ; Fei WANG ; Yuebing LU ; Zhongqi FANG ; Ping LI ; Shijie DONG ; Dayong BAI
Chinese Journal of Experimental Ophthalmology 2025;43(7):611-617
Objective:To observe and analyze the ocular clinical features and pathogenic genes of horizontal gaze palsy with progressive scoliosis (HGPPS).Methods:A pedigree study was conducted.Two families with HGPPS diagnosed by ophthalmology examination at Henan Children's Hospital from November 2023 to April 2024 were included, with 3 people from two generations in each family.Medical history and family history of the subjects were inquired.Vision acuity, diopter, anterior segment, intraocular pressure, wide-angle laser scanning ophthalmoscopy, optical coherence tomography, visual evoked potential (VEP), electroretinogram (ERG), ocular B-ultrasound, full spine AP+ lateral view, orbit+ skull+ cervical spine+ thoracic spine+ lumbosacral spine MRI plain scan were performed on the subjects.Whole genomic DNA was extracted from 2 ml of peripheral venous blood collected from the subjects, and gene sequencing was performed using whole exome sequencing (WES) technology.Suspicious pathogenic variant loci were verified by Sanger sequencing, and the pathogenicity of gene variant loci was analyzed according to the ACMG standards and guidelines for the interpretation of sequence variants.This study followed the Declaration of Helsinki.The study protocol was reviewed and approved by the Ethics Committee of Henan Children's Hospital (No.2024-KY-0024).All subjects and guardians signed informed consent forms and were informed of relevant matters before genetic testing.Results:The proband from family 1 was male, 3 years and 2 months old.At the age of 6 months, he was found to have head tilted to the left with a right scoliosis of the spine centered on T11-12 and no obvious abnormalities on VEP and ERG examinations.The proband from family 2 was male, 3 years and 4 months old, with a left scoliosis of the spine centered on T12.Both probands developed horizontal fixation paralysis, unable to rotate eye outward, slightly limited inward rotation, left eye hypertropia, mild horizontal nystagmus, normal vertical eye movement, backward development of major movements, and normal vision, anterior segment and fundus.MRI examination showed that the medulla oblongata was butterfly shaped, and a brainstem fissure could be seen in the center of the medulla oblongata.The genetic testing showed that the proband from family 1 had compound heterozygous variations c. 1054delC/p.Gln352Serfs *90 (M1) in exon 7 and c. 1219G>T/p.Gly407Cys (M2) in exon 8 of ROBO3 gene.The father of the proband carried M1 and the mother of the proband carried M2.The proband from family 2 had compound heterozygous variations c. 1888C>T/p.R630X (M3) in exon 12 and c. 2684C>A/p.A895E (M4) in exon 17 of ROBO3 gene.M1 and M3 were possible pathogenic, and M2 and M4 were of unknown clinical significance, and prediction software predicted M2 and M4 were harmful variations. Conclusions:The main clinical features of two HGPPS pedigree are horizontal fixation paralysis and progressive scoliosis, accompanied by nystagmus and strabismus.MRI shows brainstem fissure in the central medullary area.Four variants are novel variants, which increases the variation spectrum of ROBO3 gene.
10.Rifampicin-resistant tuberculosis prevention and control in Jiangsu Province from 2013 to 2023
Hui DING ; Quanji YU ; Xiaoyan DING ; Yan SHAO ; Peng LU ; Zhongqi LI ; Limei ZHU ; Qiao LIU
Chinese Journal of Epidemiology 2025;46(4):655-661
Objective:To investigate the trends in detection, treatment, and outcomes of rifampicin-resistant tuberculosis (TB) in Jiangsu Province from 2013 to 2023, assess the effectiveness of control policies and measures for drug-resistant TB, and provide evidence for better control of drug-resistant TB.Methods:Data and indicators related to the screening, diagnosis, treatment, and outcomes of rifampicin-resistant TB in Jiangsu Province from 2013 to 2023 were obtained from the Tuberculosis Management Information System. The Joinpoint regression method was employed to analyze the trends over this period, and annual percent change (APC) and average annual percent change (AAPC) were calculated. A comparative analysis was also conducted to evaluate the changes before and after implementing relevant policies and measures.Results:From 2013 to 2023, the number of registered rifampicin-resistant TB patients in Jiangsu Province showed a consistent upward trend (APC=AAPC=1.45%, P=0.035). The screening rates for drug resistance among new TB patients in high-risk groups and the proportion of molecular biological testing for drug resistance all exhibited increasing trends, with a notable turning point occurring in 2018. The trend of the treatment enrollment rate for rifampicin-resistant TB patients experienced a significant shift in 2020, showing a marked increase from 2013 to 2020 (APC=12.91%, P=0.008). The treatment success rate of rifampicin-resistant TB patients also showed a significant upward trend after a turning point in 2020 (APC=9.94%, P=0.004). Conclusion:From 2013 to 2023, significant progress was seen in preventing and treating rifampicin-resistant TB in Jiangsu Province, with relevant policies and measures proving to be highly effective.


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