Insights into tolerance mechanisms of earthworms (Eisenia fetida) in copper-contaminated soils by integrating multi-omics analyses.

Earthworms can resist high levels of soil copper (Cu) contamination and play an essential role in absorbing them effectively. However, the molecular mechanisms underlying Cu tolerance in earthworms are poorly understood. To address this research gap, we studied alterations of Eisenia fetida in antioxidant enzymes, gut microbiota, metabolites, and genes under varying levels of Cu exposure soils (0, 67.58, 168.96, 337.92 mg/kg). Our results revealed a reduction in antioxidant enzyme activities across all treatment groups, indicating an adaptive response to alleviate Cu-induced oxidative stress. Analysis of gut microbiota revealed a significant increase in the abundance of bacteria associated with nutrient uptake and Cu2+ excretion under Cu stress. Furthermore, metabolomic analysis discovered an increase in certain metabolites associated with energy metabolism, such as pyruvic acid, L-malic acid, and fumaric acid, as Cu concentration escalated. These results suggested that enhanced energy supply contributes to the elevated tolerance of E. fetida towards Cu. Additionally, transcriptome analysis not only identified crucial detoxification genes (Hsp70, CTSL, GST, CHAC, and GCLC), but also confirmed the critical role of glutathione metabolism as a key pathway in E. fetida Cu detoxification processes. These findings provide a new perspective on the molecular mechanisms of Cu tolerance in earthworms.

Blended Tea Ameliorates T2DM via Modulation of Gut Microflora.

Increasing evidences suggest that type 2 diabetes mellitus (T2DM) is closely related to gut microflora dysbiosis, which can be improved by dietary intervention. Four natural plant products, including Cyclocarya paliurus, Fu brick tea, Ampelopsis grossedentata, and Lithocarpus litseifolius, were blended to form a blended tea product for obtaining the better flavor. The blended tea was also expected to have excellent pharmacological activity. Therefore, the ameliorative effect of blended tea on T2DM and underlying mechanisms were studied in this study. The results showed that the blended tea extract effectively attenuated the symptoms of glucose and lipid metabolism-related disorders in T2DM mice fed by high-fat and high-sucrose diet. Furthermore, blended tea extract intervention significantly attenuated gut microbiota dysbiosis, the abundance of bacteria such as Bacteroidetes and Firmicutes, which aid in the hydrolysis and utilization of carbohydrates, significantly increased, while the abundance of pathogenic bacteria such as Proteobacteria significantly decreased. Certain core microorganisms involved in energy metabolism, including Ruminococcaceae_UCG-005, Butyricimonas, Roseburia, Oscillibacter, [Eubacterium]_nodatum_group, Muribaculaceae, Prevotellaceae UCG 001, were also found to be improved by blended tea extract. Collectively, our results demonstrated that the blended tea may ameliorate T2DM through modulation of gut microflora. The blended tea may serve as novel functional drink for the treatment of T2DM and dysbiosis of gut microbiota.

Socioeconomic development shows positive links to the conservation efficiency of China's protected area network.

While the protected area (PA) covers >15% of the planet's terrestrial land area and continues to expand, factors determining its effectiveness in conserving endangered species are being debated. We investigated the links between direct anthropogenic pressures, socioeconomic settings, and the coverage of vertebrate taxa by China's PA network, and indicated that high socioeconomic status and low levels of human pressure correlate with high species coverage, with threatened mammals more effectively conserved than reptiles or amphibians. Positive links between conservation outcomes and socioeconomic progress appear linked to local livelihood improvements triggering positive perceptions of local PAs-aided further by ecological compensation and tourism schemes introduced in wealthy areas and reinforced by continued positive conservation outcomes. Socioeconomic development of China's less developed regions might assist regional PA efficiency and achievement of the Kunming-Montreal Global Biodiversity Framework, while also addressing potential shortcomings from an insufficient past focus on socioeconomic impacts for biodiversity conservation.

Pregnancy outcomes and neonatal thyroid function in women with thyroid cancer: a retrospective study.

BACKGROUND: Evidence regarding adverse pregnancy outcomes in patients with thyroid cancer has been conflicting, and the effect of thyroid dysfunction caused by thyroid hormone suppression therapy in terms of neonatal thyroid stimulating hormone (TSH) is unclear. This study aimed to investigate whether thyroid cancer was associated with adverse pregnancy outcomes and had an adverse effect on neonatal thyroid function. METHODS: This was a retrospective study of 212 singleton pregnancies with thyroid cancer and 35,641 controls without thyroid cancer. Data on maternal pregnancy outcomes and neonatal outcomes were analyzed. RESULTS: The median TSH level in the thyroid cancer group was significantly lower than that in the control group (0.87 µIU/mL vs. 1.17 µIU/mL; P < 0.001), while the FT4 level was higher than that in the control group (17.16 pmol/L vs. 16.33 pmol/L; P < 0.001). The percentage of thyroid peroxidase antibodies (TPOAb) positive in the thyroid cancer group was significantly higher than that in the control group (25.0% vs. 11.8%; P < 0.001). Pregnancies with thyroid cancer had a higher risk of late miscarriage (OR 7.166, 95% CI: 1.521, 33.775, P = 0.013), after adjusting maternal TPOAb positive, there was no statistical significance (OR 3.480, 95% CI: 0.423, 28.614, P = 0.246). Pregnancies with thyroid cancer had higher gestational weight gain (GWG) (14.0 kg vs. 13.0 kg, P < 0.001). Although there was no significant difference in the prevalence of gestational diabetes mellitus (GDM) (20.8% vs. 17.4%, P = 0.194), the oral glucose tolerance test (OGTT) showed that fasting plasma glucose and 2-hour value in the thyroid cancer group were higher than those in the control group (P = 0.020 and 0.004, respectively). There was no statistically significant difference in TSH between the thyroid cancer group and the control group, regardless of full-term newborns or preterm newborns. CONCLUSIONS: Thyroid cancer might not have substantial adverse effects on pregnancy outcomes except for excessive GWG. No adverse effect on neonatal TSH was found, but the effect on long-term thyroid function and neuropsychological function in offspring need further study. TRIAL REGISTRATION: Beijing Birth Cohort Study (ChiCTR220058395).

Investigating the Shear Strength of Granitic Gneiss Residual Soil Based on Response Surface Methodology.

The shear strength of granitic gneiss residual soil (GGRS) determines the stability of colluvial landslides in the Huanggang area, China. It depends on several parameters that represent its structure and state as well as their interactions, and therefore requires accurate assessment. For an effective evaluation of shear strength parameters of GGRS based on these factors and their interactions, three parameters, namely, moisture content, bulk density, and fractal dimension of grain size, were selected as influencing factors in this study based on a thorough investigation of the survey data and physical property tests of landslides in the study area. The individual effects and interaction of the factors were then incorporated by implementing a series of direct shear tests employing the response surface methodology (RSM) into the regression model of the shear parameters. The results indicate that the factors affecting shear parameters in the order of greater to lower are bulk density, moisture content, and fractal dimension, and their interactions are insignificant. The proposed model was validated by applying it to soil specimens from other landslide sites with the same parent bedrock, showing the validity of the strength regression model. This study demonstrates that RSM can be applied for parameter estimation of soils and provide reliable performance, and is also significant for conducting landslide investigation, evaluation, and regional risk assessment.

Does China's increasing coupling of 'urban population' and 'urban area' growth indicators reflect a growing social and economic sustainability?

Over the last four decades, China has experienced rapid parallel economic development and urbanization, leading to internal mass -migrations of its people from increasingly marginalized rural areas to urban centers where job opportunities and wealth are now concentrated. We compare the relative temporal growth trends in population-related and land-(i.e., area-) related urbanization systems to evaluate China's urbanization in the context of the 'New-Type' Urbanization Program (2014-2020). Based on coupling coordination models, we observed that the two systems were overall slightly decoupled since spatial urban expansion commonly outgrew urban population growth, but the degree of coordination between the two parameters was increasing. Employing exploratory spatial data analysis, we revealed that a high degree of coupling coordination has spread from Eastern to Western provinces. Urban planning and land policies have contributed to an increasing urban vegetation cover and the control of excessive urban land expansions. While China's urbanization appears to have become increasingly sustainable due to the increasing degree of coupling coordination between its subsystems, ongoing urban expansions require strong oversight to limit the environmental impacts of the country's sprawling mega-cities.

Clinical characteristics and related gene mutations of infants with short-chain acyl-CoA dehydrogenase deficiency by neonatal screening in Beijing.

OBJECTIVE: To investigate the clinical characteristics of infants with short-chain acyl-CoA dehydrogenase deficiency (SCADD) and related gene mutations in Beijing. METHODS: The acylcarnitine levels in the blood samples of 100 603 neonates in Beijing during August 2014 and March 2022 were measured by tandem mass spectrometry (MS/MS). The suspected SCADD neonates were rechecked by MS/MS, urine gas chromatography-mass spectrometry (GC/MS) and next-generation sequencing (NGS) for diagnosis. The clinical, biochemical and gene mutation characteristics of infants with SCADD were analyzed; the growth and intellectual development of these patients were observed regularly. RESULTS: Among 100 603 live births, the elevated C4 concentration or elevated C4/C3 ratio were detected in the initial screening from 196 neonates, and 131 were recalled. Five cases of SCADD were diagnosed with an incidence rate of 4.97/100 000 (1/20 121). There was no significant abnormality in clinical manifestations, however, the blood butyrylcarnitine (C4) level and the ratio of C4 to propionylcarnitine (C3) were raised in all diagnosed cases. Urinary organic acids were analyzed in 4 cases, all of whom had increased ethyl malonate acid levels. Seven mutations were detected in the ACADS gene, all of which were known missense mutations. One patient had homozygous mutation, and the others showed compound heterozygous mutations. No clinical symptoms were observed, and the physical and intellectual development was normal in all patients at a median age of 33 (4-40) months during follow-up. CONCLUSIONS: The incidence rate of SCADD was 1/20 121 in Beijing. Neonates with early diagnosis and without clinical symptoms usually have good prognosis.

Repeatability and Reliability of Home-Based Stool Color Card Screening for Biliary Atresia Based on Results in China and Japan.

Biliary atresia (BA) is the most frequent hepatic cause of death in early childhood. Early referral and timely Kasai portoenterostomy are essential for the improvement of long-term native liver survival rate of BA patients. Screening with stool color card (SCC) has been implemented in Japan since 1994. Recently current digital edition of SCC consisted of seven digitally created images was introduced to China. Our study aimed to evaluate the repeatability and reliability of same edition of SCC used in Beijing, China and Sapporo, Japan. In Beijing from 2013 to 2014, SCCs were distributed to infants' guardians by trained nurses in maternal facilities during information sessions on neonatal screening programs. SCC was used at three checkpoints for each infant after birth for screening. The SCC data were collected from 27,561 infants (92.5%) in Beijing by 42-day health checkup, mobile phone and social network services. In Sapporo from 2012 to 2015, the SCCs with a postcard and guardian instructions were inserted into Maternal and Child Health Handbook and distributed to all pregnant women. The data were collected from a total of 37,478 (94.3%) infants in Sapporo via the postcard during the 1st month infant health checkup. We thus identified two BA patients in Sapporo and two BA patients in Beijing. High rates of sensitivity and specificity in both cities were observed. The frequency distribution of color images on SCC reported in both cities was similar. This study shows excellent repeatability and reliability of the current digital edition of SCC.

Metabolite changes associated with earthworms (Eisenia fetida) graphene exposure revealed by matrix-assisted laser desorption/ionization mass spectrometry imaging.

The increased production and environmental release of graphene nanoparticles has raised concerns about its environmental impact, but the effects of graphene on living organisms at the metabolic level remain unknown. In this study, we used matrix assisted laser desorption/ionization mass spectrometry imaging (MALDI-MSI)-based untargeted metabolomics to investigate the metabolic response of juvenile earthworms (Eisenia fetida) to graphene exposure in soil tests for the first time. Our results reveal that graphene-exposure significantly disturbs earthworm metabolome, and graphene toxicity on earthworm shows non-concentration-dependent effect. Alanine, phenylalanine, proline, glutamate, arginine, histidine, maltose, glucose, malate, succinate, myo-inositol, and spermidine were successfully screened as significantly change compounds in earthworms for the exposure of graphene. The heterogeneous distributions of these metabolites in earthworm were also clearly imaged by MALDI-MSI. Our MSI results fully showed that the metabolite expression levels in juvenile earthworms significantly changed (up-/down-regulation) after exposure to graphene nanoparticles. This work improves our understanding of graphene nanoparticle toxicity to juvenile earthworms and also enables the continued progression of MALDI-MSI-based metabolomics as an emerging, reliable, and rapid ecotoxicological tool for assessing contaminant toxicity.

A Novel Change Detection Method Based on Statistical Distribution Characteristics Using Multi-Temporal PolSAR Data.

Unsupervised change detection approaches, which are relatively straightforward and easy to implement and interpret, and which require no human intervention, are widely used in change detection. Polarimetric synthetic aperture radar (PolSAR), which has an all-weather response capability with increased polarimetric information, is a key tool for change detection. However, for PolSAR data, inadequate evaluation of the difference image (DI) map makes the threshold-based algorithms incompatible with the true distribution model, which causes the change detection results to be ineffective and inaccurate. In this paper, to solve these problems, we focus on the generation of the DI map and the selection of the optimal threshold. An omnibus test statistic is used to generate the DI map from multi-temporal PolSAR images, and an improved Kittler and Illingworth algorithm based on either Weibull or gamma distribution is used to obtain the optimal threshold for generating the change detection map. Multi-temporal PolSAR data obtained by the Radarsat-2 sensor over Wuhan in China are used to verify the efficiency of the proposed method. The experimental results using our approach obtained the best performance in East Lake and Yanxi Lake regions with false alarm rates of 1.59% and 1.80%, total errors of 2.73% and 4.33%, overall accuracy of 97.27% and 95.67%, and Kappa coefficients of 0.6486 and 0.6275, respectively. Our results demonstrated that the proposed method is more suitable than the other compared methods for multi-temporal PolSAR data, and it can obtain both effective and accurate results.

An Unsupervised Change Detection Method Using Time-Series of PolSAR Images from Radarsat-2 and GaoFen-3.

The traditional unsupervised change detection methods based on the pixel level can only detect the changes between two different times with same sensor, and the results are easily affected by speckle noise. In this paper, a novel method is proposed to detect change based on time-series data from different sensors. Firstly, the overall difference image of the time-series PolSAR is calculated by omnibus test statistics, and difference images between any two images in different times are acquired by Rj test statistics. Secondly, the difference images are segmented with a Generalized Statistical Region Merging (GSRM) algorithm which can suppress the effect of speckle noise. Generalized Gaussian Mixture Model (GGMM) is then used to obtain the time-series change detection maps in the final step of the proposed method. To verify the effectiveness of the proposed method, we carried out the experiment of change detection using time-series PolSAR images acquired by Radarsat-2 and Gaofen-3 over the city of Wuhan, in China. Results show that the proposed method can not only detect the time-series change from different sensors, but it can also better suppress the influence of speckle noise and improve the overall accuracy and Kappa coefficient.

Polarimetric Calibration and Quality Assessment of the GF-3 Satellite Images.

The GaoFen-3 (GF-3) satellite is the first fully polarimetric synthetic aperture radar (SAR) satellite designed for civil use in China. The satellite operates in the C-band and has 12 imaging modes for various applications. Three fully polarimetric SAR (PolSAR) imaging modes are provided with a resolution of up to 8 m. Although polarimetric calibration (PolCAL) of the SAR system is periodically undertaken, there is still some residual distortion in the images. In order to assess the polarimetric accuracy of this satellite and improve the image quality, we analyzed the polarimetric distortion errors and performed a PolCAL experiment based on scattering properties and corner reflectors. The experiment indicates that the GF-3 images can meet the satellite's polarimetric accuracy requirements, i.e., a channel imbalance of 0.5 dB in amplitude and ±10 degrees in phase and a crosstalk accuracy of -35 dB. However, some images still contain residual polarimetric distortion. The experiment also shows that the residual errors of the GF-3 standard images can be diminished after further PolCAL, with a channel imbalance of 0.26 dB in amplitude and ±0.2 degrees in phase and a crosstalk accuracy of -42 dB.

Four novel variants identified in the ACADVL gene causing very-long-chain acyl-coenzyme A dehydrogenase deficiency in four unrelated Chinese families.

Background: The biochemical and genetic characteristics of four very-long-chain acyl-coenzyme A dehydrogenase deficiency (VLCADD) patients, clarifying their pathogenic genetic factors and evaluating the application value of genetic diagnosis in the early diagnosis of VLCADD, are reported and discussed in this article. Methods: Patients underwent blood tandem mass spectrometry (MS/MS), urine gas chromatography (GC/MS), and high-throughput sequencing technology. New variants were analyzed for pathogenicity using bioinformatics software. Swiss-PdbViewer software was used to predict the effect of variants on the structure of the very-long-chain acyl-CoA dehydrogenase (VLCAD) protein. Result: A total of four VLCADD patients were diagnosed. They revealed elevated levels of C14, C14:1, C14:2, C14:1/C2, C14:1/C10, and C14:1/C12:1. Two patients were early-onset neonatal cases and died during infancy and the neonatal period, respectively. Seven kinds of variants were detected, including four novel variants. Bioinformatics software revealed that the variants were harmful, and the Swiss-PdbViewer results suggest that variation affects protein conformation. Conclusion: This study identified four novel ACADVL gene variants. These findings contribute to the understanding of the genetic basis and pathogenesis of VLCADD. Meanwhile, the study enriches the genetic mutation spectrum and the correlation between genotypes and phenotypes of VLCADD, indicating that genetic diagnosis plays an essential role in the early diagnosis and treatment of VLCADD.

Neonatal Amino Acids and Acylcarnitines Associated With Maternal Blood Glucose Levels Throughout Pregnancy: Insights From the Beijing Birth Cohort Study.

OBJECTIVE: To determine the association between maternal blood glucose patterns throughout pregnancy and neonatal amino acids and acylcarnitines. RESEARCH DESIGN AND METHODS: We conducted a prospective cohort study involving 11,457 singleton pregnant women without preexisting diabetes from the Beijing Birth Cohort Study, along with their neonates born between July 2021 and October 2022 in Beijing, China. Distinct maternal glucose trajectories were identified using a latent class model based on blood glucose levels across the three trimesters, and their association with neonatal circulating metabolites, including 11 amino acids and 33 acylcarnitines, was examined, adjusting for potential confounding factors. RESULTS: Three distinct groups of maternal glucose trajectories were identified: consistent normoglycemia (n = 8,648), mid-to-late gestational hyperglycemia (n = 2,540), and early-onset hyperglycemia (n = 269). Mid-to-late gestational hyperglycemia was associated with decreased levels of amino acids (alanine, arginine, ornithine, and proline) involved in the arginine and proline metabolism and urea cycle pathway, as well as increased levels of C4DC+C5-OH and decreased level of C6DC and C10:1. Early-onset hyperglycemia was associated with elevated levels of free acylcarnitine and C4DC+C5-OH and a decreased level of C10:1, involved in the fatty acid oxidation pathway. However, these associations were primarily observed in male neonates rather than in female neonates. CONCLUSIONS: Our findings revealed a significant link between maternal glucose trajectories throughout pregnancy and neonatal arginine and proline metabolism, urea cycle pathway, and fatty acid oxidation pathway. These results highlight the importance of maintaining optimal blood glucose levels throughout pregnancy to promote healthy neonatal metabolic outcomes.

Multi-omics analysis reveals copper-induced growth inhibition mechanisms of earthworm (Eisenia fetida).

Exposure to high concentrations of copper can cause toxic effects on the growth and development of organisms, but the relevant toxic mechanisms are far from fully understood. This study investigated the changes of metabolites, genes, and gut microorganisms in earthworms (Eisenia fetida) exposed to 0 (control), 67.58 (low), 168.96 (medium), and 337.92 (high) mg/kg of Cu in soil for 60 days. Differentially expressed genes (DEGs) and differential metabolites (DMs) at the low-, medium-, and high-level Cu exposure groups were identified and introduced into Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. Integrated metabolomic and transcriptomic analysis revealed that amino acid metabolism, lipid metabolism, and carbohydrate metabolism are the major metabolic pathways disturbed by Cu exposure. Furthermore, Cu exposure significantly decreased the diversity of the intestinal bacterial community and affected the relative abundance (increased or decreased) of intestinal colonizing bacteria. This resulted in high energy expenditure, inhibited nutrient absorption and fatty acid synthesis, and weakened antioxidant and detoxification abilities, ultimately inhibiting the growth of E. fetida. These findings offer important clues and evidence for understanding the mechanism of Cu-induced growth and development toxicity in E. fetida and provide further data for risk assessment in terrestrial ecosystems.

Identification of gene mutations in six Chinese patients with maple syrup urine disease.

Background: Maple syrup urine disease (MSUD) is a rare autosomal recessive amino acid metabolic disease. This study is to identify the pathogenic genetic factors of six cases of MUSD and evaluates the application value of high-throughput sequencing technology in the early diagnosis of MUSD. Methods: Clinical examination was carried out for patients and used blood tandem mass spectrometry (MS/MS), urine gas chromatography-mass spectrometry (GC/MS), and the application of high-throughput sequencing technology for detection. Validate candidate mutations by polymerase chain reaction (PCR)-Sanger sequencing technology. Bioinformatics software analyzed the variants' pathogenicity. Using Swiss PDB Viewer software to predict the effect of mutation on the structure of BCKDHA and BCKDHB proteins. Result: A total of six MSUD patients were diagnosed, including four males and two females. Nine variants were found in three genes of six MSUD families by high-throughput sequencing, including four missense mutations: c.659C>T(p.A220V), c.818C>T(p.T273I), c.1134C>G(p.D378E), and c.1006G>A(p.G336S); two non-sense mutations: c.1291C>T(p.R431*) and c.331C>T(p.R111*); three deletion mutations: c.550delT (p.S184Pfs*46), c.718delC (p.P240Lfs*14), and c.795delG (p.N266Tfs*64). Sanger sequencing's results were consistent with the high-throughput sequencing. The bioinformatics software revealed that the mutations were harmful, and the prediction results of Swiss PDB Viewer suggest that variation affects protein conformation. Conclusion: This study identified nine pathogenic variants in the BCKDHA, BCKDHB, and DBT genes in six MSUD families, including two novel pathogenic variants in the BCKDHB gene, which enriched the genetic mutational spectrum of the disease. High-throughput sequencing is essential for the MSUD's differential diagnosis, early treatment, and prenatal diagnosis.

Identification and molecular analysis of 11 cases of the PTS gene variants associated with tetrahydrobiopterin deficiency.

Background: Tetrahydrobiopterin deficiency (BH4D) is a rare autosomal recessive amino acid metabolic disease that belongs to a kind of hyperphenylalaninemia (HPA), and 6-pyruvyltetrahydrotrexate synthase (PTPS) deficiency is the most common type of BH4D. This study investigates the clinical and genetic characteristics of 11 PTPS deficiency cases in the Beijing area, identifies the genetic pathogenic factors, and evaluates the value of high-throughput sequencing in the precise diagnosis of PTPS deficiency. Methods: The Beijing Neonatal Disease Screening Center diagnosed patients with HPA. The study used phenylalanine (Phe) in blood, the ratio of Phe to Thr, urotrexate spectrum analysis, erythrocyte dihydrotrexate reductase (DHPR) activity determination, and high-throughput sequencing as methods. Bioinformatics software analyzed the variants' pathogenicity and used RT-PCR to identify deep intron variants' pathogenicity. Result: Among 635 cases with HPA, 38 cases were diagnosed with BH4D, of which the incidence in HPA was 5.98%. Nine kinds of PTS gene variants were detected, including seven missense variants, one splicing variant, and one deletion variant. The splicing variant c.84-291A>G had three splicing results in vivo: normal length, 79bp pseudoexon insertion, and exon 3 skipping. Bioinformatics and Sanger sequencing were performed to verify the identified variants. Conclusion: High-throughput sequencing is a helpful tool for clinical diagnosis and differential diagnosis of BH4D. This study confirms that c.84-291A>G is the hot spot variant of PTPS deficiency, and it is the first reported variant with a new splicing pattern in vivo. A novel deletion variant c.84_163del (p.Lys29Cysfs∗9) was found to enrich the genetic variant spectrum of the disease.

Clinical characteristics and genetics analysis for the ITD of congenital hypothyroidism.

OBJECTIVES: Iodide transport defect (ITD) is one of the principal causes of congenital hypothyroidism (CH) and its primary molecular mechanism is a mutation of the sodium/iodide symporter (NIS) gene. This study aims to analyse the clinical characteristics and genetic mutations of ITD. METHODS: The participants were a pair of siblings diagnosed with congenital hypothyroidism. Inductively coupled plasma mass spectrometry was used to determine the concentration of salivary iodine and serum iodine and to calculate their ratio. At the same time, next-generation sequencing (NGS) was applied to detect all exons of congenital hypothyroidism-related genes. All suspicious variants were further validated in the patients and their parents by PCR and Sanger sequencing. RESULTS: Both patients were conclusively diagnosed with thyroid iodine transport defect (ITD). NGS identified two variants of the NIS gene in the siblings: c.1021G>A (p.Gly341Arg) with paternal origin and c.1330-2A>C with maternal origin. Both of these variants have not been reported to date. They are predicted to be pathogenic based on these clinical symptoms and comprehensive software analysis. CONCLUSIONS: This is the first reported family study of congenital hypothyroidism with SLC5A5 mutation in China. Next-generation sequencing technology is an effective means of studying the genetics of congenital hypothyroidism. The therapeutic effect of potassium iodide needs to be further evaluated.

Inborn errors of metabolism detectable by tandem mass spectrometry in Beijing.

Background Individual inborn errors of metabolism (IEMs) are rare disorders. Expanded newborn screening for IEMs by tandem mass spectrometry (TMS) is an efficient approach for early diagnosis. Here we provide the newborn screening program for the application of this approach (between July 2014 and March 2019) to the identification of newborns in Beijing at risk of developing a potentially fatal disease. Methods The amino acids and acylcarnitines in dried blood spots were analyzed by TMS. Diagnoses of newborns with elevated metabolites were confirmed by gas chromatography-mass spectrometry, biochemical studies, and genetic analysis. Results Among the healthy newborns, 16 metabolic disorder cases were confirmed, giving a total birth prevalence of 1:3666 live births. Organic acidemia (OA) was the most common (9/16 patients; 56%), and methylmalonic acidemia was the most frequently observed OA (7/9 patients; 89%). Five infants were diagnosed with methylmalonic acidemia with homocystinuria type CblC, two with isolated methylmalonic acidemia, one with propionic acidemia, and one with isovaleric acidemia. Four patients (4/16, 25%) were diagnosed with hyperphenylalaninemia. One suffered with medium-chain acyl CoA dehydrogenase deficiency, one with carnitine uptake deficiency, and one with citrin deficiency. Eleven cases underwent genetic analysis. Seventeen mutations in eight IEM-associated genes were identified in 11 confirmed cases. Symptoms were already present within 2 days after birth in 44% (7/16) cases. The infant with propionic acidemia died at 7 days after birth. The other cases received timely diagnosis and treatment, and most of them grew well. Conclusions The results illustrate challenges encountered in disease management highlighting the importance of newborn screening for inherited metabolic disorders, which is not yet nationally available in our country. Regional newborn screening programs will provide a better estimation of the incidence of IEM.

Whole-exome sequencing as a powerful tool for identifying genetic causes in a patient with POLG-related disorders and phenylketonuria.

OBJECTIVE: This study's aim was to identify the genetic causes in a patient with phenylketonuria and hearing loss, liver disease, developmental and mental retardation, hypotonia, and external ophthalmoplegia. METHODS: Whole-exome sequencing and Sanger sequencing analysis were used to determine the genetic causes of manifestations in a young boy with hearing loss, liver disease, develop-mental and mental retardation, hypotonia, and external ophthalmoplegia. RESULTS: We found that the child harbored polymerase gamma ( POLG) compound heterozygous mutations, c.2617G>A (p.E873K) and c.3550G>A (p.D1184N), and phenylalanine hydroxylase ( PAH) compound heterozygous mutations, c.721C>T (p.R241C) and c.728G>A (p.R243Q). Among them, the POLG p.E873K mutation is a novel mutation and is not present in the Exome Aggregation Consortium database, Genome Aggregation database, and 1000 Genomes database. The two heterozygous mutations were each inherited from both of the child's parents. This finding suggested that the phenotype and the genotype were segregated. CONCLUSION: Using whole-exome sequencing, we not only identified PAH mutations causing phenylketonuria, but also identified the genetic cause of the mitochondrial disease and found a novel POLG mutation. Our findings could be useful in helping future parents obtain healthy embryos through assisted reproductive technology.