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Objectives To summarize screening and therapeutic effects of congenital hypothyroidism (CH) in Zhongshan. Methods The thyroid stimulating hormone (TSH) concentration in dried heel blood samples on iflter paper was detected using time-resolved fluorescence immunoassay. The cases of positive screening tests were called back for further examination of venous blood TSH concentration using chemiluminescence method. Fifty-four children with permanent CH treated routinely for 2 years (CH group) and 120 age-gender matched health children (control group) were recruited. The physical development (height, body weight) was monitored. The neurodevelopment and temperament type were tested using Pediatric Nneuropsychological Development Assessment and Children's Temperament Scale respectively at 6 and 24 months after birth. Results Two hundred eight-five thousand two hundred forty-two neonates were screened. One hundred and forty cases were confirmed and the incidence rate was 1/2037. There was no statistical difference in length-for-age z score (LAZ) and weight-for-age z score (WAZ) between CH and control group (P>0.05). The neurodevelopment in CH group was normal, but gross motor development was worse than that in control group (P<0.05). The temperament type and distribution had statistical difference between CH and control group (P<0.05). The percentage of the dififcult type and central dififcult type was increased in CH group as compared to control group, especially in the activity, adaptability, reaction intensity and perseverance (P<0.05). Conclusions The physical and neurodevelopment are nearly normal in patients with CH after early supplementation, but the psychological behavior problems need to be focused on in the process of intervention.
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Objective To explore the clinical signiifcance of combined detection of thyroid stimulating hormone (TSH) and free thyroxin (FT4) in dried blood spots in screening for congenital hypothyroidism (CH) in neonates. Methods The TSH and FT4 levels in dried blood spot were measured by time-resolved lfuorescence immunity in live born neonates from June to December 2013. If the screening was positive, the blood was drawn and the serum TSH and FT4 were measured and compared with the results from dried blood spots. Results In a total of 31 199 neonates screened, 12 cases were diagnosed with CH and the prevalence rate of CH was 1/2 600;4 cases were hyperthyropinemia and no pituitary CH was detected. There was no signiifcant difference between TSH or FT4 levels in dried blood spot and those in serum in neonates diagnosed with CH (P>0.05). Conclusions Combined detection of TSH and FT4 in dried blood spot can be used for neonatal screening of CH. It can be applied for early distinguishing CH from hyperthyropinemia, and also helpful for early diagnosis and treatment of central CH.
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ObjectiveTo investigate the correlation of dysphagia and malnutrition of patients with acute stroke and to establish intervention countermeasures.MethodsThe Swallow Water Test was performed by professional rehabilitation nurses in 100 cases of acute stroke patients without food and water within 24 hours after admission and two weeks later to confirm the existence of dysphagia.Rehabilitation exercises of swallow function were performed pertinently.At the same time,we evaluate the state of nutrition of these patients and followed up for two weeks,and to determine the state of malnutrition.ResultsThere was 23.0%(23/100) acute stroke patients didn't pass the initial Swallow Water Test,19 patients (82.5%) with dysphagia could swallow normally before discharge,13% patients needed indwelling nasal-gastric tube.The rate of malnutrition in dysphagia group (34.8%) was higher than patients without dysphagia (11.7%),the difference was statistically significant (P<0.05).In addition,the activity ability of daily living was poorer,the disability degree was higher and the average day of hospitalization was longer in dysphagia group in the fourth week.ConclusionsTo estimate the dysphagia timely in acute stroke patients can make the medical staff think highly of this status to formulate the scientific project of nutrition and provide the scientific rehabilitation exercises to the patients.It can decrease the incidence rate of malnutrition,complications and the disability degree of the acute stroke patients and to promote early rehabilitation.
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Objective:To study the effect of airway IL-4RA gene transfer on asthma-associated expression of STAT6 in the mice of allergic asthma.Methods:Forty BALB/c mice were randomly divided into four groups:blank control,asthma model,asthma model administered by pLNC-laz,and asthma model administered by glucocorticoid and pLNC-IL-4RA.The ten mice in each groups were sensitized by i.p.injection of 10 ?g of OVA emulsified in 40 mg of aluminum hydroxide in a total volume of 200 ?l on the days of 1st,7th and 14th.On the 15th day,the mice were challenged via airways with OVA for 7 days,20 min a day,blank control were sensitized by i.p.injection of 200 ?l pH=7.4 PBS on days 7 and 14.Asthma model was administered by pLNC-laz or pLNC-IL-4RA for 3 days beginning at the 12th day.The mice of the group with glucocorticoid was administered with glucocorticoid on the 15th day for 7 days.24 hours after the last challenge,the mice were sacrificed by bloodletting.Serum OVA-specific IgE and blood Eosinophils were measured.The lungs were fixed by immersion in 10% formalin.Expression of STAT6 was identified by immunohistochemistry.Results:It was shown that pLNC-IL-4RA was integrated to the genomic DNA of pneumonic tissues.Retrovirus-mediated delivery of IL-4RA to airways of the asthma mice weakened airway eosinophilia triggered by either IL-13 or IL-4.Furthermore,IL-4RA delivered by retrovirus was expressed in airways of the mice with allergen sensitization,resulting in significiant reduction of expressing level of asthma-associated STAT6 in the experimental mice of allergic asthma.Conclusion:Retrovirus mediated delivery of IL-4RA to airways reduces expression of STAT6 in pneumonic tissues of asthmatic mice.Thus,the gene theraphy can be a potential therapeutic option to treat and control chronic airway inflammation and asthmatic symptoms.