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Can patients with mild non-neoplastic lesions diagnosed at baseline screening be safely exempt from surveillance: evidence from multicenter community-based cohorts

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Science China Life Sciences 2025年第1期 263-271页

作者： Siyi He Zhiyi Zhang Guohui Song Zhenhai Wang Chunyun Dai Shipeng Yan Kun Jiang Bingbing Song He Li Maomao Cao Dianqin Sun Fan Yang Xinxin Yan Shaoli Zhang Yi Teng Qianru Li Changfa Xia Wanqing Chen Office of Cancer Screening National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical College Department of Gastroenterology Gansu Wuwei Tumor Hospital Cixian Cancer Institute Linzhou Cancer Hospital Center for Disease Control and Prevention of Sheyang County Department of Cancer Prevention and Control Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of MedicineCentral South University Luoshan Center for Disease Control and Prevention Office for Cancer Control and Research Affiliated Cancer Hospital of Harbin Medical University

Surveillance recommendations for gastric cancer（GC） in current guidelines focused on advanced precancerous lesions and were based on precise diagnosis of severity/extent of baseline lesions. We aimed to develop a less endoscopy-related equipment-dependent risk-stratification tool, and assessed whether mild-precursor-lesion patients can be safely exempt from surveillance. In the multicenter communitybased cohort, 75,051 participants receiving baseline endoscopy were enrolled during 2015–2017 and followed-up until 2021. Cumulative incidence rates（CIRs） of GC for precancerous-conditions were calculated by Kaplan-Meier method and compared by Log-rank tests. Mixedeffects Cox regression models were used to detect potential factors for progression towards GC. A risk score was calculated as counts of selected factors. An independent cohort, including 26,586 participants was used for external validation. During a median follow-up of 6.25 years, CIRs of GC were 0.302%, 0.436%, and 4.756% for normal group, non-neoplastic（atrophic gastritis/intestinal metaplasia） and neoplastic lesions（low-grade/high-grade dysplasia）, respectively(Ptrend<0.001). Four predictors, including male, ≥60 years, smoking, and limited vegetable consumption, were selected for risk-stratification. High-risk patients（≥3 risk factors） with non-neoplastic lesions showed higher GC risks（adjusted HR=7.73, 95%CI: 4.29–13.92）, and their four-year CIR reached the one-year CIR of neoplastic lesions. Further categorizing non-neoplastic lesions by histological grade, both patients with moderate-to-severe lesions（aHR=3.07, 95%CI: 1.67–5.64） and high-risk patients with mild lesions（aHR=7.29, 95%CI: 3.58–14.86） showed higher risks. Consistent trends were observed in validation cohort. High-risk mild-precursor-lesion patients should receive surveillance within 3–5 years after baseline screening. Our study provides evidence on supplementing current guideline recommendations.

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Exosomes originating from neural stem cells undergoing necroptosis participate in cellular communication by inducing TSC2 upregulation of recipient cells following spinal cord injury

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Neural Regeneration Research 2025年第11期20卷 3273-3286页

作者： Shiming Li Jianfeng Li Guoliang Chen Tao Lin Penghui Zhang Kuileung Tong Ningning Chen Shaoyu Liu shenzhen Key Laboratory of Bone Tissue Repair and Translational Research Department of Orthopedic SurgeryThe Seventh Affiliated HospitalSun Yat-sen UniversityShenzhenGuangdong ProvinceChina Department of Orthopedic Surgery The First Affiliated Hospital of Jinan UniversityGuangzhouGuangdong ProvinceChina Department of Orthopedics and Traumatology Zhujiang HospitalSouthern Medical UniversityGuangzhouGuangdong ProvinceChina Department of Orthopedic Surgery The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdong ProvinceChina Department of Orthopedic Surgery The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdong ProvinceChina

We previously demonstrated that inhibiting neural stem cells necroptosis enhances functional recovery after spinal cord *** exosomes are recognized as playing a pivotal role in neural stem cells exocrine function,their precise function in spinal cord injury remains *** investigate the role of exosomes generated following neural stem cells necroptosis after spinal cord injury,we conducted singlecell RNA sequencing and validated that neural stem cells originate from ependymal cells and undergo necroptosis in response to spinal cord ***,we established an in vitro necroptosis model using neural stem cells isolated from embryonic mice aged 16-17 days and extracted *** results showed that necroptosis did not significantly impact the fundamental characteristics or number of *** sequencing of exosomes in necroptosis group identified 108 differentially expressed messenger RNAs,104 long non-coding RNAs,720 circular RNAs,and 14 microRNAs compared with the control *** of a competing endogenous RNA network identified the following hub genes:tuberous sclerosis 2(Tsc2),solute carrier family 16 member 3(Slc16a3),and forkhead box protein P1(Foxp1).Notably,a significant elevation in TSC2 expression was observed in spinal cord tissues following spinal cord ***2-positive cells were localized around SRY-box transcription factor 2-positive cells within the injury ***,in vitro analysis revealed increased TSC2 expression in exosomal receptor cells compared with other *** assessment of cellular communication following spinal cord injury showed that Tsc2 was involved in ependymal cellular communication at 1 and 3 days post-injury through the epidermal growth factor and midkine signaling *** addition,Slc16a3 participated in cellular communication in ependymal cells at 7 days post-injury via the vascular endothelial growth factor and macrophage migration inhibitory factor signaling

关键词： cellular communication competing endogenous RNA exosomes Foxp1 necroptosis neural stem cells Slc16a3 spinal cord injury transcriptome sequencing Tsc2

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Clinical benefit of COX-2 inhibitors in the adjuvant chemotherapy of advanced non-small cell lung cancer: A systematic review and metaanalysis

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World Journal of Clinical Cases 2021年第3期9卷 581-601页

作者： Yu-Qiong Xu Xiang Long Ming Han Ming-Qiang Huang Jia-Fa Lu Xue-Dong Sun Wei Han Department of Emergency medicine Shenzhen University General HospitalShenzhen University Clinical Medical AcademyShenzhen 518000Guangdong ProvinceChina Department of Respiratory and Critical Care medicine Peking University Shenzhen HospitalShenzhen 518000Guangdong ProvinceChina

BACKGROUND Lung cancer is a major cause of death among patients,and non-small cell lung cancer(NSCLC)accounts for more than 80%of all lung cancers in many *** To evaluate the clinical benefit(CB)of COX-2 inhibitors in patients with advanced NSCLC using systematic *** We searched the six electronic databases up until December 9,2019 for studies that examined the efficacy and safety of the addition of COX-2 inhibitors to chemotherapy for *** survival(OS),progression free survival(PFS),1-year survival rate(SR),overall response rate(ORR),CB,complete response(CR),partial response(PR),stable disease(SD),and toxicities were measured with more than one outcome as their *** and random effects models were used to calculate risk estimates in a *** publication bias was calculated using Egger’s linear regression *** analysis was performed using R *** The COX-2 inhibitors combined with chemotherapy were not found to be more effective than chemotherapy alone in OS,progression free survival,1-year SR,CB,CR,and ***,there was a difference in overall response rate for patients with advanced *** a subgroup analysis,significantly increased ORR results were found for celecoxib,rofecoxib,first-line treatment,and *** adverse events,the increase in COX-2 inhibitor was positively correlated with the increase in grade 3 and 4 toxicity of leukopenia,thrombocytopenia,and cardiovascular *** COX-2 inhibitor combined with chemotherapy increased the total effective rate of advanced NSCLC with the possible increased risk of blood toxicity and cardiovascular events and had no effect on survival index.

关键词： Non-small cell lung cancer COX-2 Survival Progression free survival Systematic review Randomized controlled trials

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Antibiotic usage in Chinese children: a point prevalence survey

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World Journal of Pediatrics 2018年第4期14卷 335-343页

作者： Jiao-Sheng Zhang Gang Liu Wen-Shuang Zhang Hai-Yan Shi Gen Lu Chang-An Zhao Chang-Chong Li Yan-Qi Li Ya-Nan Shao Dai-Yin Tian Ming-Jie Ding Chun-Yan Li Li-Juan Luo Xiao-Yan Dong Ping Jin Ping Wang Chun-Mei Zhu Chuan-Qing Wang Yue-Jie Zheng Ji-Kui Deng Mike Sharland Ying-Fen Hsia Kun-Ling Shen Yong-Hong Yang Department of Infectious diseases Shenzhen Children’s HospitalShenzhenChina Department of Inf ectious diseases Beijing Children’s Hospital Affi liated to Capit al Medical UniversityBeijingChina Department ofR espiratory medicine Tianjin Children’s HospitalTianjinChina Department of Pharmacology Shandong Provincial Qianfoshan HospitalShandong UniversityJinanChina Department ofR espiratory medicine Guangzhou Women and Children’s Medical CenterGuangzhouChina Emergency Department Guangdong Maternal and Child Health Care HospitalGuangzhouChina Department ofP ediatric Respiratory medicine The Second Affi liated Hospital&Yuying Children’s Hospital of W enzhou Medical UniversityWenzhouChina Department ofR espiratory medicine Xi’an Children’s HospitalXi’anChina Department ofR espiratory medicine Children’s HospitalZhejiang University School of MedicineHangzhouChina Department ofR espiratory medicine Children’s Hospital of Chongqing Medical UniversityChongqingChina Department ofR espiratory medicine Jinan Children’s HospitalJinanChina Department ofR espiratory medicine The First Hospital of Jilin UniversityChangchunChina Department of Infectious diseases Shanghai Children’s Medical CenterShanghai Jiaotong University School of MedicineShanghaiChina Department ofR espiratory medicine Shanghai Children’s HospitalShanghaiChina Pediatric Intensive Care Unit Bao’an Maternity and Child Health HospitalShenzhenChina Neonatal Department Beijing Obstetrics and Gynecology HospitalCapital Medical UniversityBeijingChina Department ofR espiratory medicine Children’s Hospital Attached to The Capital Institute of P ediatricsBeijingChina Infection-control Department Fudan University Pediatric HospitalShanghaiChina Department ofR espiratory medicine Shenzhen Children’s HospitalShenzhenChina Pediatric Infectious Diseases Research Group St George’sUniversity of LondonLondonUK Department ofR espiratory medicine Beijing Children’s Hospital Affi liated to Capit al Medical UniversityBeijingChina Beiji

Background Children as a population have high antimicrobial prescribing rates which may lead to high resistance of bacteria according to data from some single-center surveys of antibiotic prescribing rates in China. The acquirement of baseline data of antibiotic prescribing is the basis of developing intervention strategies on inappropriate antimicrobial prescriptions. Few studies show clearly the pattern and detailed information on classes of antibiotics and distribution of indications of antibiotic prescriptions in children in China. This study aims to assess the antibiotic prescribing patterns among children and neonates hospitalized in 18 hospitals in China. Methods A 24-hour point prevalence survey on antimicrobial prescribing was conducted in hospitalized neonates and chil-dren in China from December 1st, 2016 to February 28th, 2017. Information on the antibiotic use of patients under 18 years of age who were administered one or more on-going antibiotics in the selected wards over a 24-hour period was collected. These data were submitted to the GARPEC (Global Antimicrobial Resistance, Prescribing and Efficacy in Children and Neonates) web-based application ( https ://pidrg -datab ***/redca p/ ). For statistical analysis, Microsoft Excel 2007 and SPSS 22.0 were used. Results The antibiotic data were collected in 35 wards in 18 hospitals from 9 provinces. In total, 67.76% (975/1439) of the patients (n = 1439) were given at least one antibiotic, including 58.1% (173/298) of neonates (n = 298) and 70.3% (802/1141) of children (n = 1141). In neonates, the three most frequently prescribed antibiotics were third-generation cephalosporins (41.7%), penicillins plus enzyme inhibitor (23.8%), and carbapenems (11.2%). In children, the three most frequently pre-scribed antibiotics were third-generation cephalosporins (35.5%), macrolides (23.2%), and penicillins plus enzyme inhibi-tors (15.9%). The most common indication for antibiotics was proven or probable bac

关键词： Antibiotic Children China Neonate Prescription

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Colorectal cancer burden,trends and risk factors in China:A review and comparison with the United States

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Chinese Journal of Cancer Research 2022年第5期34卷 483-495页

作者： Qianru Li Hongliang Wu Maomao Cao He Li Siyi He Fan Yang Xinxin Yan Shaoli Zhang Yi Teng Changfa Xia Ji Peng Wanqing Chen Office of Cancer Screening National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and ImplementBeijing 100021China Department of Anesthesiology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Cancer Prevention and Control Shenzhen Center for Chronic Disease ControlShenzhen 518020China

Objective:China and the United States(the U.S.)have the heaviest colorectal cancer(CRC)burden with considerable variations in temporal *** study aims to analyze the temporal patterns of CRC burden and its risk factors in China and the *** the past three ***:Data were extracted from the Global Burden of Disease(GBD)Study in 2019,including cases,deaths,disability-adjusted life-years(DALYs),age-standardized rate(ASR),and summary exposure value(SEV)of CRC in China and the *** 1990 and *** average percentage changes(AAPCs)of CRC burden were calculated using the Joinpoint regression *** mortality in CRC attributable to potential risk factors was characterized by countries,gender,and age ***:In 2019,there were 607,900 and 227,241 CRC cases,and 261,777 and 84,026 CRC deaths in China and the U.S.,*** age-standardized incidence rate(ASIR)was 30.55 per 100,000 in China and 41.86 per100,000 in the U.S.,and the age-standardized mortality rate(ASMR)was 13.86 per 100,000 in China and 14.77 per100,000 in the *** incidence,mortality,and DALY rate in the *** downward trends in the past three decades(AAPC=-0.47,-1.06,and-0.88,respectively),while upward trends were observed in China(AAPC=3.11,1.05,and 0.91,respectively).Among the cause of CRC,the leading risk factor contributing to CRC death was low milk in China and smoking in the U.S.,***:From 1990 to 2019,the burden of CRC in China increased dramatically,particularly for males and middle-aged and elderly *** management of the major risk factors associated with the high burden of CRC should be enhanced.

关键词： Colorectal cancer burden trends China the U.S

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Early detection of multiple endocrine neoplasia type 1: A case report

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World Journal of Gastroenterology 2024年第26期30卷 3247-3252页

作者： Jie-Hao Yuan Su Luo Ding-Guo Zhang Li-Sheng Wang Department of Gastroenterology Shenzhen People’s Hospital(The Second Clinical Medical CollegeJinan University)Shenzhen 518020Guangdong ProvinceChina

BACKGROUND Multiple endocrine neoplasias(MENs)are a group of hereditary diseases invol-ving multiple endocrine glands,and their prevalence is *** type 1(MEN1)has diverse clinical manifestations,mainly involving the parathyroid glands,gastrointestinal tract,pancreas and pituitary gland,making it easy to miss the clinical *** SUMMARY We present the case of a patient in whom MEN1 was detected early.A middle-aged male with recurrent abdominal pain and diarrhea was admitted to the *** tests at admission revealed hypercalcemia and hypophosphatemia,and emission computed tomography of the parathyroid glands revealed a hy-perfunctioning parathyroid *** findings suggested a duodenal bulge and *** endoscopy revealed a hypoechoic lesion in the duodenal *** blood tests revealed elevated levels of serum *** was performed,and pathological analysis of the surgical specimens revealed a parathyroid adenoma after parathyroidectomy and a neuroendocrine tumor after duodenal *** time from onset to the definitive diagnosis of MEN1 was only approximately 1 *** For patients who present with gastrointestinal symptoms accompanied by hyper-calcemia and hypophosphatemia,clinicians need to be alert to the possibility of MEN1.

关键词： Multiple endocrine neoplasia type 1 Gastrointestinal symptoms Hypercal-cemia Early detection Case report

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Liver transplantation for late-onset ornithine transcarbamylase deficiency:A case report

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World Journal of Clinical Cases 2022年第18期10卷 6156-6162页

作者： Xiao-Hui Fu Yu-Hui Hu Jian-Xiang Liao Li Chen Zhan-Qi Hu Jia-Lun Wen Shu-Li Chen Department of Inherited Metabolic Disorders The Affiliated Hospital of China Medical University and Shenzhen Children’s HospitalShenzhen 518038Guangdong ProvinceChina Department of Neurology The Affiliated Hospital of China Medical University and Shenzhen Children’s HospitalShenzhen 518038Guangdong ProvinceChina

BACKGROUND Ornithine transcarbamylase deficiency(OTCD)is an X-linked inherited disorder and characterized by marked elevation of blood *** goal of treatment is to minimize the neurological damage caused by *** can be cured by liver transplantation(LT).Post-transplant patients can discontinue anti-hyperammonemia agents and consume a regular diet without the risk of developing *** neurological damage caused by hyperammonemia is almost *** SUMMARY An 11.7-year-old boy presented with headache,vomiting,and altered *** patient was diagnosed with late-onset *** nitrogen scavenging treatment and a protein-free diet,ammonia levels were reduced to normal on the third day of ***,the patient remained in a moderate *** discussion,LT was *** LT,the patient’s blood ammonia and biochemical indicators stabilized in the normal range,he regained consciousness,and his nervous system function significantly *** months after LT,blood amino acids and urine organic acids were normal,and brain magnetic resonance imaging showed a decrease in subcortical *** LT can significantly improve partial neurological impairment caused by late-onset OTCD hyperammonemic encephalopathy,and LT can be actively considered when early drug therapy is ineffective.

关键词： Ornithine transcarbamylase deficiency Urea cycle disorder Hyperammonemic encephalopathy Liver transplantation Case report

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Bone marrow edema in a postpartum female following ankle sprain: a case report

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World Journal of Emergency medicine 2024年第4期15卷 325-327页

作者： Peng Zhang Junjie Zhang Peng Chen Jianjing Lin Jiang Guo Weixuan Liu Zhiwen Luo Qing Wang Xintao Zhang Department of Sports medicine Peking University Shenzhen HospitalShenzhen 518000China Department of Sports medicine Huashan HospitalFudan UniversityShanghai 200040China Department of Orthopaedics Kunshan Hospital of Traditional Chinese MedicineKunshan 215300China

Bone marrow edema(BME)is characterized by an accumulation of interstitial fluid within the bone marrow,the cancellous,hematopoietic compartment within bones.[1]BME is divided into two principal categories:idiopathic or primary BME,with an unknown etiology,and secondary BME,which occurs as a result of an identifiable underlying pathology.[2]Although the prevalence of BME is not limited to specific demographic parameters,it shows a predilection for males or individuals assigned male at birth,predominantly aged between the ages of 30 and 60 years,especially in cases of bone marrow edema syndrome(BMES),a rare idiopathic variant.[3]The etiological spectrum of BME is diverse,including oncological entities(such as acute myeloid leukemia and osteosarcoma),degenerative diseases(such as osteoarthritis),infectious processes(osteomyelitis),ischemic conditions(avascular necrosis),metabolic dysfunctions(osteoporosis),inflammatory disorders(rheumatoid arthritis),and traumatic injuries(such as stress fractures).[1,2]Clinically,BME primarily manifests as localized pain,often accompanied by joint effusion and warmth near the affected *** protocols typically include physical examination,serological assays,bone marrow biopsies,dual-energy X-ray absorptiometry(DEXA)scans,magnetic resonance imaging(MRI),and ultrasonography,with computed tomography(CT)scans and radiographs being less effective.

关键词： edema injuries female

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Unmanned aerial vehicle based intelligent triage system in mass-casualty incidents using 5G and artificial intelligence

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World Journal of Emergency medicine 2023年第4期14卷 273-279页

作者： Jiafa Lu Xin Wang Linghao Chen Xuedong Sun Rui Li Wanjing Zhong Yajing Fu Le Yang Weixiang Liu Wei Han Emergency Department of shenzhen University General Hospital Shenzhen 518055China shenzhen Institute of Advanced Technology Chinese Academy of SciencesShenzhen 518055China School of Biomedical Engineering Health Science CenterShenzhen UniversityShenzhen 518060China Tianjin University Tianjin 300072China

BACKGROUND:Rapid on-site triage is critical after mass-casualty incidents(MCIs)and other mass injury *** aerial vehicles(UAVs)have been used in MCIs to search and rescue wounded individuals,but they mainly depend on the UAV operator’s *** used UAVs and artificial intelligence(AI)to provide a new technique for the triage of MCIs and more efficient solutions for emergency ***:This was a preliminary experimental *** developed an intelligent triage system based on two AI algorithms,namely OpenPose and *** were recruited to simulate the MCI scene and triage,combined with UAV and Fifth Generation(5G)Mobile Communication Technology real-time transmission technique,to achieve triage in the simulated MCI ***:Seven postures were designed and recognized to achieve brief but meaningful triage in *** volunteers participated in the MCI simulation *** results of simulation scenarios showed that the proposed method was feasible in tasks of triage for ***:The proposed technique may provide an alternative technique for the triage of MCIs and is an innovative method in emergency rescue.

关键词： Mass-casualty incidents Emergency medical service Unmanned aerial vehicle Fifth Generation Mobile Communication Technology Artificial intelligence

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New tight junction protein 2 variant causing progressive familial intrahepatic cholestasis type 4 in adults: A case report

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World Journal of Gastroenterology 2020年第5期26卷 550-561页

作者： Chun-Shan Wei Naja Becher Jenny Blechingberg Friis Peter Ott Ida Vogel Henning Grønbæk Department of Clinical medicine-Department of Hepatology and Gastroenterology Aarhus University HospitalAarhus N DK-8200Denmark Department of Hepatology Shenzhen Traditional Chinese Medicine HospitalThe Fourth Clinical Medical College of Guangzhou University of Chinese MedicineShenzhen 518033Guangdong ProvinceChina Department of Clinical Genetics Aarhus University HospitalAarhus N DK-8200Denmark

BACKGROUND Progressive familial intrahepatic cholestasis(PFIC)encompasses a group of autosomal recessive disorders with high morbidity and *** in the gene encoding tight junction protein-2(TJP2)have been linked to PFIC type 4(PFIC4),which predominantly presents in ***,there are only limited data from adults with TJP2-related *** report a family with an autosomal recessive disorder with a novel variant in the TJP2 gene in adults with very variable expression of *** SUMMARY The index patient presented at 19 years old with liver cirrhosis and variceal bleeding and was treated with endoscopic banding and *** 2018,he developed primary liver cancer that was treated with radiofrequency ablation followed by liver transplantation in *** testing revealed a novel homozygous TJP2 variant causing PFIC4(TJP2([NM_004817.3]:c.[3334C>T];[3334C>T])).The consanguineous family consists of the father and mother(both heterozygous)and their 12 children,of which five carry the variant in a homozygous state;however,these five siblings have highly variable expression of *** homozygous brothers had cirrhosis and portal hypertension at diagnosis at the ages of 19 and *** other homozygous brothers,age 23 and 19,and the homozygous sister,age 21,have elevated liver enzymes but presently no cirrhosis,which may suggest an age-dependent *** addition,five sisters had severe and mild intrahepatic cholestasis of pregnancy and carry the TJP2 variant in a homozygous and heterozygous state,*** This novel TJP2 variant is associated with PFIC4 causing severe liver disease with cirrhosis and primary liver cancer in adolescents/adults.

关键词： Progressive familial intrahepatic cholestasis Tight junction protein 2 Genetic variants Liver cirrhosis Liver cancer Case report

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