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Objective To study the effects of preterm birth, infection, pathological jaundice and asphyxia on neonatal thyroid function. Methods From April 2012 to April 2014,neonates within 7 days after birth admitted to the neonatal department of our hospital were recruited. The neonates with one or more of the 4 aforementioned conditions were assigned to the observation group; the full-term newborns without any diseases to the control group. 2 ml of venous blood from each patient was collected 5-7 days after birth to determine the levels of serum free iodine thyroid original glycine ( FT3 ) , free thyroxine ( FT4 ) and thyroid stimulating hormone ( TSH ) . The thyroid function of newborns in the observation group were re-examined after recovery, and compared among different groups and conditions. Results A total of 220 newborns were recruited in the observation group and 34 in the control group. FT3 in the observation group was significantly lower than the control group ( P＜0. 05 ) . As for FT4 and TSH, no statistically significant differences existed between the two groups ( p＞0. 05 ) . FT3 and FT4 in neonates with severe infection were significantly lower than mild infection ( P＜0. 05 ) . FT3 in the preterm group with gestational age ( GA ) ≤32 weeks was significantly lower than GA＞32 weeks, and FT3 in the jaundice group, serum bilirubin level ≥ 342 mol/L group significantly lower than ＜342 mol/L group (P＜0. 05) . In the observation group, the re-examined FT3 concentration was significantly higher (P＜0. 05) than the result tested 5-7 days after birth while FT4 and TSH didn′t show significant differences. And no significant differences existed between the observation group and the control group in re-examined thyroid functions ( P＞0. 05 ) . The multivariate analysis showed that GA, pathological jaundice, infection and asphyxia were associated with FT3 concentration 5-7 days after birth (P＜0. 05), while the delivery method and gender not (P＞0. 05). Conclusions The main effect of preterm birth, infection, pathological jaundice and asphyxia on thyroid function was to decrease FT3 temporarily. Severe infection might decrease FT4 temporarily. However, the thyroid function would return to normal with recovery.
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Objective To study the clinical effect of microsurgical treatment of craniopharyngioma by modified pterional approach.Methods Forty-one patients were carried out a retrospective case study with craniopharyngioma who underwent microsurgieal treatment via modified pterional approach at our department.Preoperative preparation mainly included hormone replacement therapy and prevention of epilepsy.The modified pterional approach was adopted.The patients' clinical indications were monitored postoperatively such as consciousness, blood pressure, in and out quantity of water, urine specific gravity, electrolytes, CT and MRI, and prompt prevention and treatment of the complications including diabetes insipidus and disorder of electrolytes were carried out after the surgery.Meanwhile, measures were taken to prevent postoperative epilepsy and low level of hormone.Results Thrrty-three patients had total craniopharyngioma resection, 5 had subtotal craniopharyngioma resection and 3 had partial craniopharyngioma resection, and all of them survived from the surgery.2 to 19 months postoperative follow-up showed that 32 patients could normally live,study and work, while 9 patients had to be assisted for normal lives.There was a recurrence of the tumor in 3 patients out of 8 patients that had subtotal and partial craniopharyngioma resection within 12 months postoperatively.Conclusion Adopting modified pterional approach plus efficient and effective perioperative management can reduce the damage rate of hypothalamus and improve the total resection rate of the craniopharyngioma, and achieve good results of the treatment.
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<p><b>OBJECTIVE</b>To study the severe acute respiratory syndrome (SARS)-associated coronavirus genotype and its characteristics.</p><p><b>METHODS</b>A SARS-associated coronavirus isolate named ZJ01 was obtained from throat swab samples taken from a patient in Hangzhou, Zhejing province. The complete genome sequence of ZJ01 consisted of 29,715 bp (GenBank accession: AY297028, version: gi: 30910859). Seventeen SARS-associated coronavirus genome sequences in GenBank were compared to analyze the common sequence variations and the probability of co-occurrence of multiple polymorphisms or mutations. Phylogenetic analysis of those sequences was done.</p><p><b>RESULTS</b>By bioinformatics processing and analysis, the 5 loci nucleotides at ZJ01 genome were found being T, T, G, T and T, respectively. Compared with other SARS-associated coronavirus genomes in the GenBank database, an A/G mutation was detected besides the other 4 mutation loci (C:G:C:C/T:T:T:T) involved in this genetic signature. Therefore a new definition was put forward according to the 5 mutation loci. SARS-associated coronavirus strains would be grouped into two genotypes (C:G:A:C:C/T:T:G:T:T), and abbreviated as SARS coronavirus C genotype and T genotype. On the basis of this new definition, the ZJ01 isolate belongs to SARS-associated coronavirus T genotype, first discovered and reported in mainland China. Phylogenetic analysis of the spike protein gene fragments of these SARS-associated coronavirus strains showed that the GZ01 isolate was phylogenetically distinct from other isolates, and compared with groups F1 and F2 of the T genotype, the isolates of BJ01 and CUHK-W1 were more closely related to the GZ01 isolate. It was interesting to find that two (A/G and C/T) of the five mutation loci occurred in the spike protein gene, which caused changes of Asp to Gly and Thr to Ile in the protein, respectively.</p><p><b>CONCLUSION</b>Attention should be paid to whether these genotype and mutation patterns are related to the virus's biological activities,epidemic characteristics and host clinical symptoms.</p>