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1

Sanger Sequencing Validation of Splice-Acceptor Mutations

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To validate true positive of the mutation, Sanger sequencing was performed. Primers flanking the candidate loci were designed based on the reference genomic sequences of Human Genome from GenBank in NCBI and synthesized by Invitrogen, Shanghai, China. PCR amplification was carried out in ABI 9700 Thermal Cycler. PCR products were directly sequenced on ABI PRISM 3730 automated sequencer (Applied Biosystems, Foster City, CA, USA). Sequence data comparisons and analysis were performed by DNASTAR SeqMan (DNASTAR, Madison, Wisconsin, USA).
The heterozygous novel splice-acceptor site mutations identified through targeted next generation sequencing were verified through Sanger sequencing using the primers: F1 5′-TTTACCAGTGAGGGACGGGC-3′, R1 5′-GTTTGTCTGGCTCCGGTAAGTA-3′. The reference sequence NM_000038 of APC was used.
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2

Sanger Sequencing for Variant Validation

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To validate true positive of the mutation, Sanger sequencing was performed. Primers flanking the candidate loci were designed based on the reference genomic sequences of Human Genome from GenBank in NCBI and synthesized by Invitrogen, Shanghai, China. PCR amplification was carried out in ABI 9700 Thermal Cycler. PCR products were directly sequenced on ABI PRISM 3730 automated sequencer (Applied Biosystems, Foster City, CA, USA). Sequence data comparisons and analysis were performed by DNASTAR SeqMan (DNASTAR, Madison, Wisconsin, USA).
These two heterozygous novel nonsense mutations identified through targeted next generation sequencing were verified through Sanger sequencing using the primers: F1 5’-TTTACCAGTGAGGGACGGGC-3’, R1 5’-GTTTGTCTGGCTCCGGTAAGTA-3’. The reference sequence NM_001297 of CNGB1 was used.
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3

Phylogenetic analysis of hepatitis E virus

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The sequences obtained were analysed in the program DNAStar SeqMan in the DNAStar program package version 10.1.2 (DNA Star Inc, Madison, WI). The sequences were aligned with the corresponding region of 347 sequences representing HEV3 obtained from GenBank, and one moose HEV strain (Lin, Norder, Uhlhorn, Belak, & Widen, 2014) to root the tree. Phylogenetic analysis was carried out with the phylip package version 3.65 (Felsenstein, 1996). Evolutionary distances were calculated using the F84 algorithm in the DNADIST program with a transition/transversion ratio of 4.29. Boot strap analysis was performed on 1,000 replicas with the Seqboot program of the phylip package. Phylogenetic trees were constructed using the unweight pair‐group method using arithmetic averages (UPGMA) and the neighbour‐joining method in the NEIGHBOR program of the phylip package. The trees were visualized using the program treeview, version 1.6.6. All sequences obtained in the study are deposited in GenBank with accession numbers MK582523‐MK582474.
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4

Phylogenetic Analysis of Hepatitis E Virus

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The sequences obtained were analyzed with DNAStar SeqMan, package version 10.1.2 (DNA Star Inc., Madison, WI, USA). The sequences were aligned with the corresponding region of 347 sequences representing HEV3 and HEV4 obtained from GenBank. Phylogenetic analysis was carried out with the PHYLIP package version 3.65 [36 (link)]. Evolutionary distances were calculated using the F84 algorithm in the DNADIST program in the PHYLIP package with a transition-to-transversion ratio of 4.29. Phylogenetic trees were constructed using the unweight pair-group method using arithmetic averages (UPGMA) and the neighbor-joining method in the NEIGHBOR program of the PHYLIP package. The trees were visualized using the program Tree View, version 1.6.6. All sequences obtained in the study are deposited in GenBank with accession numbers KX757852–KX757878.
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5

Sanger Sequencing for Mutation Validation

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To validate true positive of the mutation, Sanger sequencing was performed. Primers flanking the candidate loci (Forward primer 5’-CCGCCCCAGGACAAGTAAAT-3’, Reverse primer 5’-GGAGGAGCTGTTGAAGCCAT-3’) were designed based on the reference genomic sequences of Human Genome from GenBank in NCBI and synthesized by Invitrogen, Shanghai, China. PCR amplification was carried out in ABI 9700 Thermal Cycler. PCR products were directly sequenced on ABI PRISM 3730 automated sequencer (Applied Biosystems, Foster City, CA, USA). Sequence data comparisons and analysis were performed by DNASTAR SeqMan (DNASTAR, Madison, Wisconsin, USA).
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6

Sanger Sequencing Validation of Splice-Acceptor Mutations

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To validate true positive of the mutation, Sanger sequencing was performed. Primers flanking the candidate loci were designed based on the reference genomic sequences of Human Genome from GenBank in NCBI and synthesized by Invitrogen, Shanghai, China. PCR amplification was carried out in ABI 9700 Thermal Cycler. PCR products were directly sequenced on ABI PRISM 3730 automated sequencer (Applied Biosystems, Foster City, CA, USA). Sequence data comparisons and analysis were performed by DNASTAR SeqMan (DNASTAR, Madison, Wisconsin, USA).
The heterozygous novel splice-acceptor site mutations identified through targeted next generation sequencing were verified through Sanger sequencing using the primers: F1 5′-TTTACCAGTGAGGGACGGGC-3′, R1 5′-GTTTGTCTGGCTCCGGTAAGTA-3′. The reference sequence NM_000038 of APC was used.
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7

Validating Mutation Through Sanger Sequencing

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To validate putative mutations, Sanger sequencing was performed. Primers flanking the candidate loci were designed based on the reference genomic sequences of the Human Genome from GenBank in NCBI and synthesized by Invitrogen, Shanghai, China. PCR amplification was carried out in an ABI 9700 Thermal Cycler. PCR products were directly sequenced on an ABI PRISM 3730 automated sequencer (Applied Biosystems, Foster City, CA). Sequence data comparisons and analysis were performed by DNASTAR SeqMan (DNASTAR, Madison, Wisconsin).
These novel mutations identified through whole exome sequencing was verified through Sanger sequencing using the following primers: F1 5′‐GACCAAGATGCTTCAGACGG‐3′, R1 5′‐GCAATTGGCCAGATTAGGA‐3′; F2 5′‐GTTCAGCAACGTCGCCAG‐3′, R2 5′‐GTTAACGGTCATCAGCGGG‐3′; F3 5′‐GTACACCGGATCGAAGGCTG‐3′, R3 5′‐GTACGCTTTGACGTCGG‐3′. The reference sequence NM_004006 of DMD was used.
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8

Sanger Sequencing for Mutation Validation

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To validate true positive of the mutation, Sanger sequencing was performed. Primers flanking the candidate loci were designed based on the reference genomic sequences of Human Genome from GenBank (GenBank Accession: NM_000267.3) in NCBI and synthesized by Invitrogen, Shanghai, China. PCR amplification was carried out in ABI 9700 Thermal Cycler. PCR products were directly sequenced on ABI PRISM 3730 automated sequencer (Applied Biosystems, Foster City, CA, USA). Sequence data comparisons and analysis were performed by DNASTAR SeqMan (DNASTAR, Madison, Wisconsin, USA).
The details of primer sequence are given in Table 2.
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9

Sanger Sequencing Validation of WES Variants

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Sanger sequencing was performed for the proband as well as for her parents to validate the identi ed variants in WES. Primer pairs were designed for the candidate loci on the basis of reference genomic sequences of the Human Genome from GenBank in NCBI. Primers were synthesized (Invitrogen, Shanghai, China) and polymerase chain reaction (PCR) has been done by using an ABI 9700 Thermal Cycler. Then, PCR products were directly sequenced by an ABI PRISM 3730 automated sequencer (Applied Biosystems, Foster City, CA, USA). Sequencing data analysis was performed by DNASTAR SeqMan (DNASTAR, Madison, Wisconsin, USA).
Sanger sequencing validated the identi ed heterozygous variants by WES by using the following primers:
F1 5'-GCGCGGATCTCAGCATGCGCGG-3', R1 5'-GGGGTCTCCGCGGCTCCCCGG-3'; F1 5'-GGCGCTAGGGTCGAAGGCGGCG-3', R1 5'-GGTCTCGGTAGGCGCGTACTGG-3' The reference sequence NM_000456 of SUOX gene was used.
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10

Validating novel RAG1 variant by Sanger

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To validate the identified variants by WES, we performed Sanger sequencing. Designing primer pairs for the candidate loci have been done based on the reference genomic sequences of the Human Genome from GenBank in NCBI. Primer pairs were synthesized by Invitrogen, Shanghai, China. Polymerase chain reaction (PCR) was performed with an ABI 9700 Thermal Cycler. Next, directly sequenced the PCR products by an ABI PRISM 3730 automated sequencer (Applied Biosystems, Foster City, CA, USA). Analysis of sequencing data has been done by DNASTAR SeqMan (DNASTAR, Madison, Wisconsin, USA).
WES identified the novel homozygous variant, which was validated by Sanger sequencing using the following primers: F1 5′-GGCGCGGGGGTCTCGCGGCG-3′ , R1 5′-GGCGGCGAATTCTATAGCG-3′ . The reference sequence NM_000448.2 of RAG1 was used.
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