Objective To determine the reference intervals for thyroid function tests during the second half of pregnancy (20-40 gestational weeks),and to assess the relationship between thyroid peroxidase antibody (TPOAb) levels and the incidence of gestational thyroid diseases.Methods Levels of thyroid stimulating hormone (TSH),free thyroxine (FT4),TPOAb and urinary iodine excretion were determined in 4 729 pregnant women,who received prenatal health care at First Affiliated Hospital of Nanjing Medical University from July 2011 to August 2013.Among these women,2 568 were selected using the recommendations of the American National Academy of Clinical Biochemistry,and were divided into five groups according to their gestational age:≥ 20 to ＜24 weeks (682 cases),≥ 24 to ＜28 weeks (1 322 cases),≥ 28 to ＜32 weeks (178 cases),≥ 32 to ＜36 weeks (185 cases) and ≥ 36 to ≤ 40 weeks (201 cases).Reference intervals of thyroid function tests in the second half of pregnancy were calculated.The reference values of thyroid functions in different gestational weeks were compared,and the reference intervals of thyroid functions in the second half of pregnancy were determined.The effects of maternal age and positive TPOAb on gestational thyroid diseases were analyzed.A non-parametric test,analysis of variance or Chi-square test was used for statistical analysis.Results (1) Reference intervals for maternal thyroid function in the second half of pregnancy in our hospital were established [TSH:0.65-5.27 mU/L and FT4:8.74-14.84 pmol/L].(2) The percentage of thyroid diseases was higher using the non-pregnancy reference intervals (TSH:0.27-4.20 mU/L and FT4:12.00-22.00 pmol/L) than using the pregnancy reference intervals [64.0％ (3 025/4 729) vs 16.1％ (763/4 729),x2=47.465,P ＜ 0.01],which manifested as a higher rate of clinical hypothyroidism and simple hypothyroxinemia [5.4％ (255/4 729) vs 0.4％ (20/4 729),x2=14.321;54.1％ (2 560/4 729) vs 9.1％ (429/4 729),x2=47.108;both P＜0.01] and a lower rate of subclinical and clinical hyperthyroidism [1.2％ (58/4 729) vs 3.3％ (155/4 729),x2=6.650;0.3％ (13/4 729) vs 0.6％ (27/4 729),x2=2.062;both P＜0.05].(3) The incidence of clinical hypothyroidism and simple hypothyroxinemia in pregnant women aged ＞30 years was higher than in those aged ≤ 30 years [0.7％ (10/1 377) vs 0.3％ (10/3 352),x2=4.257;11.7％ (161/1 377) vs 8.0％ (268/3 352),x2=16.102;both P＜0.05].The incidence of clinical hypothyroidism and clinical hyperthyroidism in TPOAb positive women was higher than that in TPOAb negative women [2.7％ (9/335) vs 0.3％ (11/4 394),x2=44.009;3.9％ (13/335) vs 1.2％ (52/4 394),x2=16.784;both P＜0.01].Conclusions The established pregnancy-specific reference ranges of thyroid function tests can reduce the missed diagnosis and misdiagnosis of gestational thyroid diseases.Maternal age ＞30 years and positive TPOAb may increase the risk ofgestational thyroid diseases.

Multiple sequence alignment is one of the basic techniques in bioinformatics, and it plays a vital role in structure modeling, functional site prediction, and phylogenetic analysis. In this paper, we review the methodologies and recent advances in the multiple protein sequence alignment, e.g., speeding up the calculation of distances among sequences and employing the iterative refinement and consistency-based scoring function, with emphasis on the use of additional sequence and structural information for improving alignment quality.
Algorithms ; Proteins ; chemistry ; Sequence Alignment ; methods ; Sequence Analysis, Protein ; methods

Objective To investigate the clinical value of myocardial enzymes and umbilical artery blood gas analysis in the diagnosis and treatment of neonatal asphyxia (HIE).Methods Eighty-seven neonates with HIE and 94 healthy neonates(control group) were selected and compared.The myocardial enzymes [aspartate aminotransferase (AST),creatine phosphokinase(CK),creatine phosphokinase isoenzyme (CK-MB),hydroxybutyrate dehydrogenase (HB-DH),lactate dehydrogenase (LDH)] and umbilical artery blood gas analysis [pH,alkali residue (BE),arterial oxygen pressure(PaO2),arterial carbon dioxide partial pressure (PaCO2)] of the two groups were detected and compared.Results The levels of AST,CK,CK-MB,HB-DH and LDH in the observation group were (123.54 ±36.57) U/L,(1 786.83 ± 542.37) U/L,(584.63 ± 164.54) U/L,(652.31 ± 187.38) U/L,(956.38 ± 257.64) U/L,respectively,which were significantly higher than those in the control group [(65.38 ± 20.34) U/L,(675.48 ± 240.32) U/L,(48.61 ± 12.15) U/L,(248.36 ± 51.69) U/L,(581.36 ± 102.67) U/L] (t =13.35,17.75,31.50,20.10,13.04,all P ＜0.05).The pH,BE,PaO2,PaCO2 of the observation group were (7.02 ±0.13),(9.56 ± 1.74) mmol/L,(3.26 ± 0.26) kPa,(6.88 ± 1.24) kPa,respectively,which of the control group were (7.20 ± 0.16),(8.96 ± 1.52) mmol/L,(3.21 ±0.33) kPa,(6.58 ± 1.84) kPa,respectively.the pH value in the observation group was significantly lower than that in the control group (t =8.27,P ＜ 0.05).The BE,PaO2 and PaCO2 between the two groups had no statistically significant differences (all P ＞ 0.05).In the observation group,the levels of AST,CK,CK-MB,HB-DH and LDH of the neonates with ideal prognosis were (59.68 ±-13.52) U/L,(542.36 ± 103.65) U/L,(49.37 ± 14.25) U/L,(275.36 ± 64.51) U/L,(567.35 ± 115.24) U/L,respectively,which were significantly lower than those of the neonates with poor prognosis [(81.32 ± 36.24) U/L,(1 265.38 ± 362.74) U/L,(168.35 ±50.01)U/L,(602.31 ± 205.34)U/L,(853.64 ± 212.54)U/L],and the pH value of the observation group with ideal prognosis was significantly higher than that of the neonates with poor prognosis [(7.19 ± 0.21) vs.(7.01 ±0.18)],the differences were statistically significant (t =14.67,14.42,17.22,11.14,7.14,2.91,all P ＜ 0.05).Conclusion The myocardial enzymes and umbilical artery blood gas analysis can be used in the early diagnosis of HIE and evaluation of the prognosis,and it has high clinical value.