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1.
J Pediatr Endocrinol Metab ; 32(4): 375-382, 2019 Apr 24.
Article in English | MEDLINE | ID: mdl-30849045

ABSTRACT

Background Cystinosis is a rare autosomal-recessive disorder caused by a defective transport of cystine across the lysosomal membrane. Previous studies have mapped cystinosis to the CTNS gene which is located on chromosome 17p13, and various CTNS mutations have been identified to correlate them with this disease. Methods We analyzed six patients from five unrelated families who were diagnosed with cystinosis in our hospital. We described the diagnostic procedures for all the patients and proposed alternative therapies for cystinosis patients instead of using cysteamine, an orphan drug which was commercially unavailable in China. Moreover, genetic analysis of all patients' samples was carried out to identify novel CTNS gene mutations. Results and conclusions The patients in this study were followed up from 1 to more than 10 years to monitor their growth and development, which indicated that the alternative therapies we used were helpful to ameliorate the complications of the cystinosis patients without cysteamine. Furthermore, by sequencing the patients' genome, we identified novel mutations in the CTNS gene including: c.477C > G (p.S159R), c.274C > T (p.Q92X) and c.680A > T (p.E227V); these mutations were only observed in cystinosis patients and had never been reported in any other populations, suggesting they might be specific to Chinese cystinosis patients.


Subject(s)
Amino Acid Transport Systems, Neutral/genetics , Cystinosis/diagnosis , Genetics, Population , Mutation , Adolescent , Child , Child, Preschool , China/epidemiology , Cystinosis/drug therapy , Cystinosis/epidemiology , Cystinosis/genetics , Female , Follow-Up Studies , Human Growth Hormone/administration & dosage , Humans , Infant , Male , Pedigree , Prognosis
2.
J Nerv Ment Dis ; 205(6): 480-486, 2017 06.
Article in English | MEDLINE | ID: mdl-28141630

ABSTRACT

The underlying mechanism of modified electroconvulsive therapy (MECT) treatment for drug-resistant and catatonic schizophrenia remains unclear. Here, we aim to investigate whether MECT exerts its antipsychotic effects through elevating N-acetylaspartate (NAA) concentration measured by proton magnetic resonance spectroscopy (H-MRS). Multiple-voxel H-MRS was acquired in the bilateral prefrontal cortex (PFC) and thalamus to obtain measures of neurochemistry in 32 MECT, 34 atypical antipsychotic-treated schizophrenic patients, and 34 healthy controls. We found that both MECT and atypical antipsychotic treatments showed significant antipsychotic efficacy. MECT and atypical antipsychotic treatments reversed the reduced NAA/creatine ratio (NAA/Cr) in the left PFC and left thalamus in schizophrenic patients compared with healthy controls. Furthermore, the NAA/Cr ratio after treatments was significant higher in the MECT group, but not in the medication group. Our findings demonstrate that eight times of MECT elevated the relative NAA concentration to display neuroprotective effect, which may be the underlying mechanism of rapid antipsychotic efficacy.


Subject(s)
Aspartic Acid/analogs & derivatives , Electroconvulsive Therapy/methods , Neuroprotection/physiology , Outcome Assessment, Health Care , Prefrontal Cortex/metabolism , Schizophrenia/metabolism , Schizophrenia/therapy , Thalamus/metabolism , Adult , Aspartic Acid/metabolism , Creatine/metabolism , Female , Humans , Male , Prefrontal Cortex/diagnostic imaging , Proton Magnetic Resonance Spectroscopy , Schizophrenia/diagnostic imaging , Thalamus/diagnostic imaging , Young Adult
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