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Boillot L, Costes F. [A systemic gene therapy for the treatment of cystic fibrosis]. Med Sci (Paris) 2024; 40:467-470. [PMID: 38819285 DOI: 10.1051/medsci/2024047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024] Open
Abstract
Le master I2VB se propose de donner les bases conceptuelles et pratiques des différents aspects de l’infectiologie. Il s’appuie sur une coopération exemplaire entre les équipes de recherche en infectiologie et en immunologie de l’Université de Tours, et celles, entre autres, de l’Unité Infectiologie et Santé Publique (ISP) du Centre INRAE de Tours-Nouzilly, concrétisée par une profonde interaction entre chercheurs et enseignants-chercheurs.
Cette formation aborde aussi bien les aspects fondamentaux et appliqués de l’infectiologie et de l’immunologie allant de l’étude moléculaire des interactions entre le pathogène et son hôte, jusqu’à la conception et la mise sur le marché des produits de la vaccinologie, des biothérapies anti-infectieuses et des anticorps immuno-thérapeutiques.
Le master I2VB (niveau M1) donne lieu aux parcours ICM, I&B et AcT (niveau M2).
L’option Infectiologie Cellulaire et Moléculaire (ICM) (responsables : Françoise Debierre-Grockiego et Martine Braibant) a pour objectifs de :
former des scientifiques dotés d’une culture générale et technique spécialisée dans les biotechnologies, l’infectiologie, les interactions hôte-pathogène et les mécanismes de la réponse immunitaire anti-infectieuse, contribuant à l’avancée des connaissances scientifiques et à ses applications industrielles, demandes sociétales en forte progression.
former des pharmaciens, médecins, vétérinaires, ingénieurs agronomes aux enjeux actuels de l’infectiologie à la fois dans les domaines fondamentaux et appliqués.
L’option Immunité et biomédicaments (I&B) (responsables : Anne di Tommaso et Isabelle Dimier-Poisson) a pour objectifs de :
former des scientifiques dotés d’une culture générale et technique spécialisée dans les biotechnologies, l’infectiologie, la vaccinologie, les biomédicaments et les biothérapies anti-infectieuses contribuant à l’avancée des connaissances scientifiques et à ses applications industrielles, demandes sociétales en forte progression.
former de jeunes scientifiques, pharmaciens, médecins, vétérinaires, ingénieurs agronomes aux enjeux actuels de l’infectiologie et des biomédicaments à la fois dans les domaines fondamentaux et appliqués.
L’option Anticorps thérapeutiques (AcT) (responsables : Laurie Lajoie et Isabelle Dimier-Poisson) a pour objectifs de :
former des scientifiques dotés d’une culture générale et technique spécialisée dans les biotechnologies, l’immunologie, la cancérologie et les biomédicaments dont les anticorps thérapeutiques, contribuant à l’avancée des connaissances scientifiques et à ses application industrielles et juridiques, demandes sociétales en forte progression.
former de jeunes scientifiques, pharmaciens, médecins, vétérinaires, ingénieurs agronomes aux enjeux actuels de l’infectiologie et des biomédicaments à la fois dans les domaines fondamentaux et appliqués.
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Affiliation(s)
- Léa Boillot
- Université de Tours, Master 2 infectiologie, immunité, vaccinologie et biomédicaments, Tours, France
| | - Floriane Costes
- Université de Tours, Master 2 infectiologie, immunité, vaccinologie et biomédicaments, Tours, France
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McDonald CM, Reid EK, Pohl JF, Yuzyuk TK, Padula LM, Vavrina K, Altman K. Cystic fibrosis and fat malabsorption: Pathophysiology of the cystic fibrosis gastrointestinal tract and the impact of highly effective CFTR modulator therapy. Nutr Clin Pract 2024; 39 Suppl 1:S57-S77. [PMID: 38429959 DOI: 10.1002/ncp.11122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/28/2023] [Accepted: 12/28/2023] [Indexed: 03/03/2024] Open
Abstract
Cystic fibrosis (CF) is a progressive, genetic, multi-organ disease affecting the respiratory, digestive, endocrine, and reproductive systems. CF can affect any aspect of the gastrointestinal (GI) tract, including the esophagus, stomach, small intestine, colon, pancreas, liver, and gall bladder. GI pathophysiology associated with CF results from CF membrane conductance regulator (CFTR) dysfunction. The majority of people with CF (pwCF) experience exocrine pancreatic insufficiency resulting in malabsorption of nutrients and malnutrition. Additionally, other factors can cause or worsen fat malabsorption, including the potential for short gut syndrome with a history of meconium ileus, hepatobiliary diseases, and disrupted intraluminal factors, such as inadequate bile salts, abnormal pH, intestinal microbiome changes, and small intestinal bacterial overgrowth. Signs and symptoms associated with fat malabsorption, such as abdominal pain, bloating, malodorous flatus, gastroesophageal reflux, nausea, anorexia, steatorrhea, constipation, and distal intestinal obstruction syndrome, are seen in pwCF despite the use of pancreatic enzyme replacement therapy. Given the association of poor nutrition status with lung function decline and increased mortality, aggressive nutrition support is essential in CF care to optimize growth in children and to achieve and maintain a healthy body mass index in adults. The introduction of highly effective CFTR modulator therapy and other advances in CF care have profoundly changed the course of CF management. However, GI symptoms in some pwCF may persist. The use of current knowledge of the pathophysiology of the CF GI tract as well as appropriate, individualized management of GI symptoms continue to be integral components of care for pwCF.
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Affiliation(s)
| | - Elizabeth K Reid
- Cystic Fibrosis Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - John F Pohl
- Pediatric Gastroenterology, Primary Children's Hospital, Salt Lake City, Utah, USA
| | - Tatiana K Yuzyuk
- Pathology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- ARUP Institute for Clinical & Experimental Pathology, Salt Lake City, Utah, USA
| | - Laura M Padula
- Pediatric Specialty, University Health, San Antonio, Texas, USA
| | - Kay Vavrina
- Pediatric Specialty, University Health, San Antonio, Texas, USA
| | - Kimberly Altman
- Gunnar Esiason Adult Cystic Fibrosis and Lung Center, Columbia University Medical Center, New York, New York, USA
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Katz TE, Wakefield CE, Signorelli C, Day AS, Vernon-Roberts A, Ooi CY. Gastroenterology services for patients with Cystic Fibrosis across Australia and New Zealand: a multi-stakeholder assessment of patients' and professionals' perspectives. Front Pediatr 2023; 11:1322941. [PMID: 38161436 PMCID: PMC10755025 DOI: 10.3389/fped.2023.1322941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Gastrointestinal (GI) symptoms are common in individuals with Cystic Fibrosis (CF). International research has highlighted that GI care for this group of patients is lacking. Gastroenterology services to CF clinics across Australasia are yet to be examined. This study aimed to describe the current service delivery model and identify areas for improvement that may lead to positive patient outcomes. Materials and methods CF clinicians (dietitians, clinical nurse consultants, respiratory consultants), gastroenterologists (GE), and patients or their carers from Australia and New Zealand (NZ) were surveyed online to gather their opinions on CF gastroenterology services provided in their region. Data were analysed using descriptive statistics (frequencies and percentages). Likert scale questions were analysed by grouping responses 1-5 and 6-10, presented alongside the median and interquartile range (IQR). Mann-Whitney U and chi-square tests were used to look at differences between stakeholder groups. Results One hundred and fifty-six health professionals and 172 patients or their carers completed the survey. Results showed that the current GI model of care is predominantly a publicly funded service delivered outside of CF clinic time. GE are largely not integrated into the CF team and report a lack of training opportunities. There is a higher level of dissatisfaction with the current service model in NZ than Australia. Discussion No stakeholder group deemed the current CF gastroenterology service model as adequate, leaving opportunity for transformations in this field. Ideally this study will invigorate the need for promotion and integration of GI services that would ultimately benefit the whole CF community.
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Affiliation(s)
- Tamarah E. Katz
- Department of Nutrition and Dietetics, Sydney Children’s Hospital, Randwick, Sydney, NSW, Australia
| | - Claire E. Wakefield
- Discipline of Paediatrics & Child Health, Randwick Clinical Campus, School of Clinical Medicine, UNSW Medicine & Health, Sydney, NSW, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Sydney, NSW, Australia
| | - Christina Signorelli
- Discipline of Paediatrics & Child Health, Randwick Clinical Campus, School of Clinical Medicine, UNSW Medicine & Health, Sydney, NSW, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Sydney, NSW, Australia
| | - Andrew S. Day
- Discipline of Paediatrics & Child Health, Randwick Clinical Campus, School of Clinical Medicine, UNSW Medicine & Health, Sydney, NSW, Australia
- Department of Gastroenterology, Sydney Children’s Hospital, Randwick, Sydney, NSW, Australia
- Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand
| | | | - Chee Y. Ooi
- Discipline of Paediatrics & Child Health, Randwick Clinical Campus, School of Clinical Medicine, UNSW Medicine & Health, Sydney, NSW, Australia
- Department of Gastroenterology, Sydney Children’s Hospital, Randwick, Sydney, NSW, Australia
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Salari A, Xiu R, Amiri M, Pallenberg ST, Schreiber R, Dittrich AM, Tümmler B, Kunzelmann K, Seidler U. The Anion Channel TMEM16a/Ano1 Modulates CFTR Activity, but Does Not Function as an Apical Anion Channel in Colonic Epithelium from Cystic Fibrosis Patients and Healthy Individuals. Int J Mol Sci 2023; 24:14214. [PMID: 37762516 PMCID: PMC10531629 DOI: 10.3390/ijms241814214] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
Studies in human colonic cell lines and murine intestine suggest the presence of a Ca2+-activated anion channel, presumably TMEM16a. Is there a potential for fluid secretion in patients with severe cystic fibrosis transmembrane conductance regulator (CFTR) mutations by activating this alternative pathway? Two-dimensional nondifferentiated colonoid-myofibroblast cocultures resembling transit amplifying/progenitor (TA/PE) cells, as well as differentiated monolayer (DM) cultures resembling near-surface cells, were established from both healthy controls (HLs) and patients with severe functional defects in the CFTR gene (PwCF). F508del mutant and CFTR knockout (null) mice ileal and colonic mucosa was also studied. HL TA/PE monolayers displayed a robust short-circuit current response (ΔIeq) to UTP (100 µM), forskolin (Fsk, 10 µM) and carbachol (CCH, 100 µM), while ΔIeq was much smaller in differentiated monolayers. The selective TMEM16a inhibitor Ani9 (up to 30 µM) did not alter the response to luminal UTP, significantly decreased Fsk-induced ΔIeq, and significantly increased CCH-induced ΔIeq in HL TA/PE colonoid monolayers. The PwCF TA/PE and the PwCF differentiated monolayers displayed negligible agonist-induced ΔIeq, without a significant effect of Ani9. When TMEM16a was localized in intracellular structures, a staining in the apical membrane was not detected. TMEM16a is highly expressed in human colonoid monolayers resembling transit amplifying cells of the colonic cryptal neck zone, from both HL and PwCF. While it may play a role in modulating agonist-induced CFTR-mediated anion currents, it is not localized in the apical membrane, and it has no function as an apical anion channel in cystic fibrosis (CF) and healthy human colonic epithelium.
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Affiliation(s)
- Azam Salari
- Department of Gastroenterology, Hannover Medical School, 30625 Hannover, Germany; (A.S.); (R.X.); (M.A.)
| | - Renjie Xiu
- Department of Gastroenterology, Hannover Medical School, 30625 Hannover, Germany; (A.S.); (R.X.); (M.A.)
| | - Mahdi Amiri
- Department of Gastroenterology, Hannover Medical School, 30625 Hannover, Germany; (A.S.); (R.X.); (M.A.)
| | - Sophia Theres Pallenberg
- Department of Pediatric Pneumonology, Allergology and Neonatology, Hannover Medical School, 30625 Hannover, Germany (A.-M.D.)
| | - Rainer Schreiber
- Institute of Physiology, University of Regensburg, 93040 Regensburg, Germany; (R.S.); (K.K.)
| | - Anna-Maria Dittrich
- Department of Pediatric Pneumonology, Allergology and Neonatology, Hannover Medical School, 30625 Hannover, Germany (A.-M.D.)
| | - Burkhard Tümmler
- Department of Pediatric Pneumonology, Allergology and Neonatology, Hannover Medical School, 30625 Hannover, Germany (A.-M.D.)
| | - Karl Kunzelmann
- Institute of Physiology, University of Regensburg, 93040 Regensburg, Germany; (R.S.); (K.K.)
| | - Ursula Seidler
- Department of Gastroenterology, Hannover Medical School, 30625 Hannover, Germany; (A.S.); (R.X.); (M.A.)
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Cameron RA, Office D, Matthews J, Rowley M, Abbott J, Simmonds NJ, Whitty JA, Carr SB. Treatment Preference Among People With Cystic Fibrosis: The Importance of Reducing Treatment Burden. Chest 2022; 162:1241-1254. [PMID: 35868349 PMCID: PMC9773229 DOI: 10.1016/j.chest.2022.07.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 05/06/2022] [Accepted: 07/09/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND There is a growing consensus that the perspective of the patient should be considered in the evaluation of novel interventions. RESEARCH QUESTION What treatment outcomes matter to people with cystic fibrosis (CF), and what trade-offs would they make to realize these outcomes? STUDY DESIGN AND METHODS Adults attending a specialist CF center were invited to complete an online discrete choice experiment (DCE). The DCE required participants to evaluate hypothetical CF treatment profiles, defined by impact on lung function, pulmonary exacerbations, abdominal symptoms, life expectancy, quality of life, inhaled medicine usage, and physiotherapy requirement. Choice data were analyzed, using multinomial logit and latent class models. RESULTS One hundred and three people with CF completed the survey (median age, 35 years; range, 18-76 years); 52% were female; mean FEV1 % predicted, 69% [SD, 22%]). On average, an improvement in life expectancy by 10 years or more had the greatest impact on treatment preference, followed by a 15% increase in lung function. However, it was shown that people would trade substantial reductions in these key outcomes to reduce treatment time or burden. Preference profiles were not uniform across the sample: three distinct subgroups were identified, each placing markedly different importance on the relative importance of both life expectancy and lung function compared with other attributes. INTERPRETATION The relative importance of treatment burden to people with CF, compared with life expectancy and lung function, suggests it should be routinely captured in clinical trials as an important secondary outcome measure. When considering the patient perspective, it is important that decision-makers recognize that the values of people with CF are not homogeneous.
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Affiliation(s)
- Rory A Cameron
- Norwich Medical School, University of East Anglia, Norwich, England; National Institute for Health Research, Applied Research Collaboration, East of England, Cambridge, England.
| | - Daniel Office
- Adult Cystic Fibrosis Centre, Royal Brompton Hospital, London, England
| | - Jessie Matthews
- Adult Cystic Fibrosis Centre, Royal Brompton Hospital, London, England
| | | | - Janice Abbott
- School of Psychology, University of Central Lancashire, Preston, England
| | - Nicholas J Simmonds
- Adult Cystic Fibrosis Centre, Royal Brompton Hospital, London, England; National Heart and Lung Institute, Imperial College, London, England
| | - Jennifer A Whitty
- Norwich Medical School, University of East Anglia, Norwich, England; National Institute for Health Research, Applied Research Collaboration, East of England, Cambridge, England; Evidera, London, England
| | - Siobhán B Carr
- National Heart and Lung Institute, Imperial College, London, England; Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, England
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Piotrowski-Daspit AS, Barone C, Lin CY, Deng Y, Wu D, Binns TC, Xu E, Ricciardi AS, Putman R, Garrison A, Nguyen R, Gupta A, Fan R, Glazer PM, Saltzman WM, Egan ME. In vivo correction of cystic fibrosis mediated by PNA nanoparticles. SCIENCE ADVANCES 2022; 8:eabo0522. [PMID: 36197984 PMCID: PMC9534507 DOI: 10.1126/sciadv.abo0522] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 08/18/2022] [Indexed: 05/26/2023]
Abstract
Cystic fibrosis (CF) is caused by mutations in the CF transmembrane conductance regulator (CFTR) gene. We sought to correct the multiple organ dysfunction of the F508del CF-causing mutation using systemic delivery of peptide nucleic acid gene editing technology mediated by biocompatible polymeric nanoparticles. We confirmed phenotypic and genotypic modification in vitro in primary nasal epithelial cells from F508del mice grown at air-liquid interface and in vivo in F508del mice following intravenous delivery. In vivo treatment resulted in a partial gain of CFTR function in epithelia as measured by in situ potential differences and Ussing chamber assays and correction of CFTR in both airway and GI tissues with no off-target effects above background. Our studies demonstrate that systemic gene editing is possible, and more specifically that intravenous delivery of PNA NPs designed to correct CF-causing mutations is a viable option to ameliorate CF in multiple affected organs.
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Affiliation(s)
| | - Christina Barone
- Department of Pediatrics, Yale School of Medicine, New Haven, CT 06520, USA
| | - Chun-Yu Lin
- Department of Biomedical Engineering, Yale University, New Haven, CT 06511, USA
| | - Yanxiang Deng
- Department of Biomedical Engineering, Yale University, New Haven, CT 06511, USA
| | - Douglas Wu
- Department of Biomedical Engineering, Yale University, New Haven, CT 06511, USA
| | - Thomas C. Binns
- Department of Biomedical Engineering, Yale University, New Haven, CT 06511, USA
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT 06520, USA
| | - Emily Xu
- Department of Molecular, Cellular, and Developmental Biology, Yale University, New Haven, CT 06511, USA
| | - Adele S. Ricciardi
- Department of Biomedical Engineering, Yale University, New Haven, CT 06511, USA
| | - Rachael Putman
- Department of Biomedical Engineering, Yale University, New Haven, CT 06511, USA
| | - Alannah Garrison
- Department of Pediatrics, Yale School of Medicine, New Haven, CT 06520, USA
| | - Richard Nguyen
- Department of Pediatrics, Yale School of Medicine, New Haven, CT 06520, USA
| | - Anisha Gupta
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT 06520, USA
| | - Rong Fan
- Department of Biomedical Engineering, Yale University, New Haven, CT 06511, USA
| | - Peter M. Glazer
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT 06520, USA
- Department of Genetics, Yale School of Medicine, New Haven, CT 06520, USA
| | - W. Mark Saltzman
- Department of Biomedical Engineering, Yale University, New Haven, CT 06511, USA
- Department of Chemical and Environmental Engineering, Yale University, New Haven, CT 06511, USA
- Department of Cellular and Molecular Physiology, Yale School of Medicine, New Haven, CT 06520, USA
| | - Marie E. Egan
- Department of Pediatrics, Yale School of Medicine, New Haven, CT 06520, USA
- Department of Cellular and Molecular Physiology, Yale School of Medicine, New Haven, CT 06520, USA
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Han Y, Hu S, Chen B, Huang S, Qin Q, Tou J. Meconium Peritonitis, Intestinal Atresia Combined With Biliary Atresia: A Case Report. Front Pediatr 2022; 10:917116. [PMID: 35722473 PMCID: PMC9201381 DOI: 10.3389/fped.2022.917116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/05/2022] [Indexed: 11/17/2022] Open
Abstract
Meconium peritonitis (MP) combined with intestinal atresia (IA) is a rare neonatal condition, and it is even rarer in combination with biliary atresia (BA). We describe a case of an infant who developed short bowel syndrome after partial intestinal resection due to MP and IA, along with a Santullienterostomy. During continuous enteral and parenteral nutrition, the stool color became paler. BA was identified by elevated direct bilirubin (DBIL), gamma-glutamyltransferase (GGT), serum matrix metalloproteinase-7 (MMP-7), and hepatobiliary ultrasound; then, Kasai portoenterostomy (KPE) was performed promptly. The Roux-en-Y limb was adjusted intraoperatively to preserve the maximum length of the small intestine while closing the enterostomy. After the operation, the infant gradually adapted to enteral nutrition, his bilirubin level returned to normal, and his weight gradually caught up to the normal range. Although rare, BA should be suspected when MP is combined with IA and when the stool becomes paler in color in the enterostomy state.
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Affiliation(s)
- Yijiang Han
- Department of Neonatal Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Shuqi Hu
- Department of Neonatal Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Baohai Chen
- Department of Information Center, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Shoujiang Huang
- Department of Neonatal Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Qi Qin
- Department of Neonatal Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Jinfa Tou
- Department of Neonatal Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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