急性脑卒中患者甲状腺激素变化的初步探讨

目的 :探讨急性脑卒中患者血中促甲状腺激素 (TSH)、三碘甲状腺原氨酸 (T3 )、甲状腺素 (T4)、游离三碘甲状腺原氨酸(FT3 )、游离甲状腺素 (FT4)的变化。方法 :采用放免法 (RIA)测定 63例同期住院急性脑卒中患者血中TSH、T3 、T4、FT3 、FT4水平 ,并与健康者进行对比分析。结果 :急性脑卒中对TSH、T3 、T4、FT4有明显影响。结论 :急性脑卒中时下丘脑 -垂体 -甲状腺轴功能明显受累 ,可能是机体自我保护机制之一。     

抗精神病药物治疗精神分裂症的甲状腺功能改变与疗效的相关性分析

目的　探索抗精神病药治疗之初的甲状腺功能改变与治疗 4周末疗效的相关性。方法　给 2 3例精神分裂症病人服维思通 (3 6± 0 8)mg/d ,16例精神分裂症病人服氯氮平 (32 8± 6 1)mg/d。在服药治疗的第 4周晨检测T3 、T4和TSH ;服用药 0天和 4周末各测评一次BPRS。结果　①在氯氮平组 ,T4与 4周末焦虑因子分改善呈正相关性 (r =0 7117,P <0 0 1)。②在维思通组 ,T4水平与 4周末缺乏活力因子分改善呈正相关性 (r =0 4 15 4 ,P <0 0 5 )。结论　①氯氮平基础剂量 (10 0mg/d)时的T4升高可能预示用氯氮平治疗量到 4周时焦虑症状明显改善。②维思通基础剂量 (1mg/d)时的T4升高可能预示用维思通治疗量到 4周末时缺乏活力明显改善     

甲状腺功能水平与抑郁症的相关性探索

目的探索甲状腺功能与抑郁症之间的相关性。方法应用酶联免疫吸附法法测定38例抑郁症患者和性别匹配的38名正常对照的总三碘甲腺原氨酸（TT3）,总甲状腺素（TT4）,促甲状腺激素（TSH）的水平,汉密尔顿抑郁量表（HAMD-17）项评定抑郁的严重程度,汉密尔顿焦虑量表（HAMA）评定患者的焦虑严重程度,社会功能大体评定量表（GAF）评估患者的社会功能状况。结果抑郁症患者的平均TT3水平为（1.03±0.58）ng/mL,平均TT4水平为（8.20±2.53）ug/dL,平均TSH水平为（2.75±1.77）uIU/mL,健康对照组的平均TT3水平为（0.69±0.30）ng/mL,平均TT4水平为（7.10±1.25）ug/dL,平均TSH水平为（3.44±2.20）uIU/mL,两组间TT3,TT4水平具有统计学差异,TSH的组间差异未达到统计学显著水平。女性抑郁症患者的平均TT3水平为（1.14±0.69）ng/mL,平均TT4水平为（9.00±2.94）ug/dL,健康对照组的平均TT3水平为（0.60±0.21）ng/mL,平均TT4水平为（6.92±0.88）ug/dL,组间TT3、TT4水平具有统计学差异。男性抑郁症组,TSH水平与躯体性焦虑呈正相关（r=0.582,P=0.014）,与GAF总分呈负相关（r=-0.555,P=0.021）。结论抑郁症患者甲状腺功能存在一定变化,这种变化以女性患者明显,甲状腺激素水平与抑郁症患者的一些症状存在相关性。     

急性脑卒中患者甲状腺激素变化的初步探讨

目的：探讨急性脑卒中患者血中促甲状腺激素（TSH）、三碘甲状腺原氨酸（T3）、甲状腺素（T4）、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）的变化。方法：采用放免法（RIA）测定63例同期住院急性脑卒中患者血中TSH、T3、T4、FT3、FT4水平，并与健康者进行对比分析。结果：急性脑卒中对TSH、T3、T4、FT4有明显影响。结论：急性脑卒中时下丘脑－垂体－甲状腺轴功能明显受累，可能是机体自我保护机制之一。     

氯氮平对血清甲状腺素和血糖、血脂水平的影响

目的 探讨氯氮平对精神分裂症患者糖、脂代谢与血清甲状腺素水平的影响.方法 对60例接受氯氮平治疗的住院精神分裂症患者分别在治疗前和治疗8周末检测血糖（FPG）、胆固醇（TC）和甘油三脂（TG）及甲状腺相关激素水平.并对以上检测指标做统计分析.结果 氯氮平治疗8周后血清T4水平显著下降（P＜0.01）,TSH水平显著升高（P＜0.01）;血糖、甘油三脂显著升高（P＜0.01）;治疗8周末血糖分别与血清FT3、FT4、T3及T4水平呈显著负相关;甘油三脂与TSH水平呈显著正相关.结论 氯氮平导致糖、脂代谢紊乱和甲状腺功能改变,而糖、脂代谢紊乱与其血清甲状腺素水平变化有-定的相关性.     

动脉粥样硬化性脑梗死患者FT4,FT3,TSH水平与血管狭窄程度的相关性研究

目的 分析动脉粥样硬化性脑梗死患者游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)、促甲状腺激素(TSH)水平与血管狭窄程度的相关性。方法 选取2018年6月-2019年6月本院收治的动脉粥样硬化性脑梗死患者80例作为动脉粥样硬化性脑梗死组,同期选取非动脉粥样硬化性脑梗死患者80例作为非动脉粥样硬化性脑梗死组,同期选取于本院行健康体检的健康志愿者80例作为健康对照组,测定FT4,FT3,TSH水平,分析FT4,FT3,TSH水平与有无斑块、血管狭窄程度的关系及三者相关性。结果 动脉粥样硬化性脑梗死组血清FT4,TSH水平高于健康对照组、非动脉粥样硬化性脑梗死组,FT3水平低于健康对照组、非动脉粥样硬化性脑梗死组(P<0.05); 非动脉粥样硬化性脑梗死组与健康对照组FT4,FT3,TSH水平比较无明显差异(P>0.05)。有斑块组血清FT4,TSH水平高于无斑块组,FT3水平低于无斑块组(P<0.05); 不稳定性斑块组血清FT4,TSH水平高于稳定性斑块组,FT3水平低于稳定性斑块组(P<0.05)。中度狭窄组、重度狭窄组血清FT4,TSH水平高于轻度狭窄组,FT3水平低于轻度狭窄组(P<0.05); 重度狭窄组血清FT4,TSH水平高于中度狭窄组,FT3水平低于中度狭窄组(P<0.05)。血清FT4与FT3水平呈负相关(r=-0.279,P=0.012),血清FT4与TSH水平呈正相关(r=0.439,P=0.001),血清FT3与TSH水平呈负相关(r=-0.291,P=0.009)。结论 FT4,TSH在动脉粥样硬化性脑梗死中高表达,FT3在动脉粥样硬化性脑梗死中低表达,且与患者有无斑块、血管狭窄程度相关,有斑块、血管越狭窄,则表达越增加。     

甲状腺激素与抑郁症发病的相关性分析

目的探究甲状腺激素水平和抑郁症之间的关系。方法从我院2017年12月～2018年12月选取60例抑郁症患者,同时同期选取60位健康者,将抑郁症患者作为观察组,健康者作为对照组,对比两组的促甲状腺激素(TSH)水平、四碘甲状腺原氨酸(FT4)、三碘甲状腺原氨酸(FT3)。对HAMD评定各因子进行Person相关分析。结果观察组和对照组的TSH没有明显差异(P0.05),观察组的FT3、FT4明显低于对照组(P0.05)。观察组不同年龄的FT3均比对照组低(P0.05)。观察组不同病程患者的FT3,均明显比对照组低(P0.05),病程为12～24个月、24～60个月的患者,FT4明显比对照组低(P0.05)。患者的TSH和HAMD总分、病程呈现正相关。患者的病程与阻滞因子呈现负相关,与FT3正相关。结论抑郁症患者与正常人在甲状腺功能方面存在差异,甲状腺激素可能参与抑郁症的发病。     

血清甲状腺素水平变化在中枢神经系统感染患儿疾病评价中的临床意义

目的探讨中枢神经系统感染患儿血清甲状腺素水平(尤其是FT3、FT4及TSH变化异常)的变化及其意义。方法采用临床对照研究的方法,分别对化脓性脑膜炎组(化脑组)、病毒性脑炎组(病脑组)及对照组患儿于入院48h内、2周后、出院前用DxI-800全自动化学发光分析仪、BeckmaIl-Coulter公司提供的甲状腺素试剂盒检测血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺激素(FT4)、促甲状腺激素(TSH)。结果中枢神经系统感染患儿甲状腺素水平异常率约50%,其中重度脑炎异常程度最显著,异常率高达61%,与轻度病例组之间差异有统计学意义(P<0.05),化脑组与病脑组之间无明显差异(P>0.05),经治疗后各组异常病例患儿血清甲状腺素水平皆有不同程度恢复,遗留后遗症患儿血清甲状腺素水平明显低于对照组,经治疗后血清FT3、FT4、TSH水平虽皆明显升高,但至出院前仍未达到到正常水平,和对照组相比在治疗前、治疗2周后、出院前差异皆具有明显统计学意义(均为P<0.05)。结论甲状腺素水平变化与中枢神经系统感染患儿病情程度存在密切关系,其异常程度与日后遗留后遗症之间有密切相关性,可敏感反应疾病的预后,并有助判断脑损伤的程度及评估患儿预后。     

氯氮平和利培酮对首发精神分裂症患者糖代谢影响的研究

目的　探讨氯氮平和利培酮对首发精神分裂症患者糖代谢的影响。方法　 6 8例首发精神分裂症患者随机分为两组 ,分别给予氯氮平治疗 ( 34例 ,氯氮平组 )和利培酮治疗 ( 34例 ,利培酮组 )。两组患者治疗前和治疗后第 4周末做糖耐量试验 ,测定空腹胰岛素、C肽、甘油三酯、胆固醇、瘦素 ,并测量身高、体重 ,计算体重指数 [BMI,体重 (kg) /身高 (m2 ) ]。共观察 4周。结果　治疗第 4周末 ,氯氮平组餐后 1h、2h的血糖值 [分别为 ( 8 6± 1 8)mmol/L和 ( 6 7± 1 1)mmol/L]比治疗前 [分别为( 7 4± 2 2 )mmol/L和 ( 5 8± 1 4 )mmol/L]明显升高 (P <0 0 5 ,P <0 0 1) ,而利培酮组无明显变化。治疗后氯氮平组 ( 2 0 % ,7例 )患者糖耐量减低的发生率高于利培酮组 ( 3% ,1例 ) ,差异有显著性 ( χ2 =3 972 ,P <0 0 5 )。结论　氯氮平对首发精神分裂症患者餐后血糖值的影响大于利培酮     

甲状腺激素水平与卒中后疲劳的相关性研究

目的探讨甲状腺激素水平与卒中后疲劳(PSF)的关系。方法纳入2019-03—12在河北工程大学附属医院住院的脑卒中患者151例,依据疲劳严重程度量表(FSS)将患者分为PSF组(n=78)和非PSF组(n=73)。比较2组患者入院后第2天、第10天、1个月和3个月的甲状腺激素水平变化情况,并分析激素水平改变与PSF的关系。结果 PSF组和非PSF组各时间节点的甲状腺激素水平均有显著差异,其中PSF组促甲状腺素(TSH)和游离甲状腺素(FT4)水平均高于非PSF组,而游离三碘甲状腺原氨酸(FT3)水平均低于非PSF组,差异有统计学意义(P0.05)。随着治疗时间的增加,患者疲劳症状改善且伴随FSS分值的减少,TSH和FT4水平也出现下降趋势,而FT3水平呈上升趋势。Pearson相关分析显示,TSH和FT4水平与FSS值呈正相关(r=0.712,P0.01;r=0.529,P0.05),FT3与FSS值呈负相关(r=-0.573,P0.05)。结论甲状腺激素水平变化与PSF有相关性,且监测甲状腺激素水平变化对预估PSF的发生、发展及预后有一定的临床价值。     

CD62L Treg cells with superior immunosuppressive properties accumulate within the CNS during remissions of EAE

The role of regulatory T cell populations within the CNS in the regulation of CNS-autoimmunity is controversial. We show that during recovery from relapsing remitting experimental autoimmune encephalomyelitis, regulatory T cells accumulate within the CNS that express high levels of CD62L. These CD62L^high Treg cells express increased amounts of CTLA-4, ICOS and TGF-β and are more potent than CD62L^low Treg cells in suppressing proliferation and inducing apoptosis in effector T cells. CD62L^high Treg cells thus represent a population of Treg cells that display superior immunosuppressive properties and accumulate in the CNS during recovery from CNS-autoimmunity.     

5-羟色胺2A受体基因T102C多态性与抑郁症患者大脑灰质密度的相关性

目的 探讨5-羟色胺2A受体(5-HT2A)基因T102C多态性与抑郁症患者大脑灰质密度的相关性.方法 以1.5T超导型磁共振仪对57例抑郁症患者及37名性别、年龄、受教育年限与患者组无差异的正常对照进行脑部的三维磁共振扫描,同时检测受试者的5-HT2A受体基因T102C多态性.采用基于像素的形态学分析方法分析被试的脑...     

1．5T MRI对立体定向功能神经外科靶点定位影响的研究

目的 1.5T MRI对立体定向颅内靶点定位的精确性的影响.方法 分别对17例尸脑采用MRI扫描和断层切割摄影后三维重建方法,确定丘脑重心坐标值,对比研究两种显像模式下三维丘脑重心坐标值的差异.结果 尸脑MR扫描三维重建丘脑重心平均坐标值(X,Y,Z) 分别为(9.01±0.23)mm、(-7.16±0.19)mm和(6.94±0.15)mm.断层切割摄影丘脑三维重建的重心坐标值(X,Y,Z)分别为(9.42±0.17)mm、(-7.22±0.14)mm和(7.27±0.12)mm.两者相比较,重建的丘脑重心在X轴和Z轴的方向上差异显著(P＜0.05),在Y轴的方向上无明显差异(P＞0.05).在不考虑空间方向性变化的情况下,两者确定的丘脑重心位置相距(0.56±0.11)mm.结论 1.5T MRI影像确定的靶点与实际解剖位置有一定程度的差异.     

Peripheral blood regulatory T cell measurements correlate with serum vitamin D levels in patients with multiple sclerosis

Vitamin D has been associated with a decreased risk of multiple sclerosis (MS). In this study, serum 1, 25-dihydroxyvitamin D (1, 25-(OH)2 vitD) and 25-hydroxyvitamin D (25-OH vitD), regulatory T cell percentages and naïve and memory T helper cell subsets were measured in 26 patients with multiple sclerosis, 21 who were not on treatment with disease modifying therapy. These studies showed an inverse correlation between 25-OH vitD levels and Treg cell percentages and a direct correlation between Treg cell percentages and 1, 25-(OH)2 vitD:25-OH vitD ratios. In addition, 25-OH vitD levels correlated directly and 1, 25-(OH)2 vitD:25-OH vitD ratios correlated inversely with CXCR3+ naïve T helper cell percentages and CXCR3+naïve:CXCR3+ memory T helper cell ratios. All together, these data demonstrate that vitamin D measurements can reflect measures of immune status among patients with MS.     

Clinical application of high and ultra high-field MRI

The 21st century ushered in the century of human beings. The previous era characterized by the chase after super technology has been replaced by a new era which focuses on the meaning of human existence and quality of life. Clinical practice has accordingly also undergone rapid change. Amongst the many competing technologies, clearly magnetic resonance technology, especially ultra high-field magnetic resonance imaging, plays a major role in defining current clinical practice. Elimination of all invasive aspects from diagnostic imaging, including intravenous infusion or use of ionizing radiation, is one of the final goals of the new generation of clinical imaging. This goal is especially worthwhile when one consider the welfare of children. Technological MRI advancements are steadily bridging the gap towards this goal. With T2 reversed and three-dimensional anisotropy (3DAC) contrast imaging on a 3.0T system, the anatomical resolution of routine clinical images has reached a level of resolution equivalent to general pathology. Realistic imaging microscopy application is also on the horizon with the establishment of clinical 7.0T systems. Individual brain activation maps can now be readily obtained under clinical settings thanks to high-field functional MRI (fMRI). Nevertheless, because active self-organizing processes of cortical functionalities are under active development in the pediatric population, fMRI has only limited, if any, clinical usage in children. Similarly, whereas connectivity analysis in the individual patient using diffusion tensor imaging (DTI) has little clinical usage in the pediatric population, DTI can be successfully applied to multiple subject analysis for exploring unknown connectivity abnormalities in this age group. Magnetic resonance spectroscopy (MRS) and its pictorial display (spectroscopic imaging) is now finding more and more clinical applications across the age spectrum of patients.     

Abnormalities of T-lymphocyte subsets in epileptic patients

This study concerns the distribution of T-cell subsets as determined by specific monoclonal antibodies in 50 individuals with complex partial seizures (31) and primary generalized tonic-clonic seizures (19), and in 30 healthy controls. The epileptic group had significantly fewer circulating T4 "helper" lymphocytes and significantly greater number of T8 "suppressor" lymphocytes than the controls. The T4/T8 ratio was consistently significantly lower in the epileptic group. There was no relation between lymphocyte subsets or T4/T8 ratio and antiepileptic medication. The results suggest a derangement of cell-mediated immunity in individuals with epilepsy.     

Thyroid hormones and TSH, prolactin and LH responses to repeated TRH and LRH injections in depressed patients.

Twelve patients with unipolar depressive disorders received 600 microgram of synthetic TRH or LRH, in a random order, for 3 days each. Placebo injections were given as two 3-day courses prior to and between the active treatments. Serum TSH, prolactin (Prl) and LH were measured by radioimmunoassays prior to the experiment as well as immediately before and 20 min after each injection. Serum T4 and T3 were determined by radioimmunoassays before the treatments and 24 h after the first two TRH injections. Serum T4 level in depressed patients did not differ from controls. Serum T3 level in depressed patients was significantly below, and the reverse T3 level was slightly above the normal mean. However, the latter difference was not statistically significant due to the large variation of rT3 levels among the depressed patients. The TSH responses did not differ from that of controls after the first injection but the responses after the second injection were lower than in a control study. The Prl responses to TRH were sub-normal in seven out of eight patients. Blunted LH responses to LRH were seen in three patients.