桥本氏甲状腺炎58例手术治疗分析

目的：总结桥本氏甲状腺炎手术治疗的意义。方法：回顾性分析我院手术治疗的58例桥本氏甲状腺炎患者的临床资料。结果：58例桥本氏甲状腺炎患者合并甲状腺乳头状癌7例,占同期桥本氏甲状腺炎患者12.1%。结论：桥本氏甲状腺炎的误诊率较高,桥本氏甲状腺炎合并甲状腺癌的发病率较高。     

桥本氏甲状腺炎的超声背向散射积分与病理对照

目的探讨背向散射积分(IBS值)在桥本氏甲状腺炎检测中的应用价值。方法在常规的甲状腺超声检查基础上,测量44例桥本氏甲状腺炎患者及60例正常人的甲状腺实质的IBS值,并进行同期甲状腺穿刺病理检查进行对比分析。结果桥本氏甲状腺炎患者回声普遍偏低、不均匀,IBS值明显低于正常人(P<0.001),甲状腺明显大于正常人(P<0.01~P<0.001);病理检查显示以淋巴细胞浸润为主。结论桥本氏甲状腺炎患者的IBS值有特征性变化,对临床治疗可提供更多的信息,有诊断价值。     

桥本氏甲状腺炎合并结节样病变超声诊断与病理结果分析

目的:探讨桥本氏甲状腺炎合并结节样病变不同病理结果的超声特征,以提高诊断准确率.方法:回顾性分析经病理确诊的70例桥本氏甲状腺炎合并结节样病变的不同病理结果的超声声像图表现,总结桥本氏甲状腺炎背景下良恶性结节的鉴别要点及不同病理结节的声像图特征.结果:良性结节(结甲、腺瘤、结节型桥本氏甲状腺炎)50例,恶性结节20例(甲状腺乳头状癌19例,其中2例漏诊,淋巴瘤1例).结论:常规超声联合弹性成像在桥本氏甲状腺炎背景下的结节样病变的良恶性的鉴别上具有较高的临床价值.     

许芝银"麻附温治"桥本氏甲状腺炎功效探析

桥本氏甲状腺炎是一种自身免疫性甲状腺疾病,西医无特效的治疗办法;中医认为,桥本病起情志艰涩,首犯肝气,中生痰瘀,日久迁延则成脾肾阳虚,当以"温"治.许芝银教授认为,麻黄、附子药组共奏温阳散寒、通络破滞之功,引药入症,强温散、化痰瘀,对降低血清抗体水平,改善脾肾阳虚型桥本氏甲状腺炎的临床症状效果显著.     

彩色多普勒超声诊断桥本氏甲状腺炎38例分析

桥本氏甲状腺炎（Hashimoto＇s thyroiditis,HT）又称慢性淋巴细胞性甲状腺炎,是一种自身免疫性疾病。超声表现复杂多样,本文总结2007—01—2009—07超声诊断后,经手术或针吸细胞学病理证实的38例桥本氏甲状腺炎的声像表现报告如下。     

桥本氏甲状腺炎的声像图表现与分析

桥本氏甲状腺炎的声像图表现与分析江苏省南通市第一人民医院孔祥军，严勇兵，刘文客桥本氏甲状腺炎临床多表现为甲状腺肿块，质硬．易与甲状腺癌混淆。我们收集经超声检查和手术病理证实的桥本氏甲状腺炎２０例，现将其声像图表现分析报告如下。２０例均为女性，年龄３７...     

针吸细胞学在桥本氏甲状腺炎诊断中的应用

目的 :探讨针吸细胞学对桥本氏甲状腺炎的诊断意义。方法 :回顾 1990～ 1997年间临床疑桥本氏甲状腺炎行针吸细胞学穿刺 (FNA)病例 36 5例 ,随访其治疗及病情转归情况。结果 :针吸细胞学诊断桥本氏甲状腺炎的准确度为 89.9%。结论 :FNA诊断桥本氏甲状腺炎安全、可靠 ,值得临床应用     

桥本氏甲状腺炎合并甲状腺癌34例临床分析

桥本氏甲状腺炎（Hashimoto＇s thyroiditis，HT）又称慢性淋巴细胞性甲状腺炎，是一种自身免疫性疾病，近年来发病呈上升趋势。HT的临床表现较复杂，上世纪50年代Lindsay首先报道了桥本氏甲状腺炎合并甲状腺癌（TC），此后报道逐渐增多，但对其发病机理及诊疗争议颇多。作对1984年8月至2004年8月在两家医院治疗经术后病理证实的34例HT合并TC患进行分析，探讨诊断及治疗方法。     

桥本氏甲状腺炎超声诊断分析

目的 总结桥本氏甲状腺炎的超声声像图表现,评价超声显像技术对桥本氏甲状腺炎的诊断价值,目的在于提高超声显像技术对桥本氏甲状腺炎的诊断准确率.方法 回顾性分析65例经穿刺针吸活检或手术切取病理活检确诊为桥本氏甲状腺炎患者的超声声像图表现.结果 桥本氏甲状腺炎超声声像图表现为腺体弥漫性肿大,峡部明显增厚,甲状腺实质回声减低、增粗,分布不均呈网格状,部分可伴有单个或多个低回声结节;彩色多普勒(CD-FI)显示甲状腺内部血流信号丰富,部分无明显改变;脉冲多普勒(PW)显示甲状腺上动脉(STA)血流速度峰值(Vmax)增快,阻力指数(RI)无明显改变.结论 桥本氏甲状腺炎的超声声像图改变具有较强的特征性,超声显像技术对该疾病的诊断意义较大,可以作为诊断该疾病的重要依据.     

结节性甲状腺肿合并桥本氏甲状腺炎的诊断和治疗

目的：总结分析结节性甲状腺肿（下称结甲）合并桥本氏甲状腺炎的诊断治疗以及手术效果。方法：回顾性研究1982年-2001年结甲合桥本氏甲状腺炎29例，对其诊断治疗及术后疗效进行分析。结果：全部病例均行手术治疗并经病理证实，术前诊断率为41.4％。根据不同术前诊断采取了不同手术方法。术后甲状腺功能减退（下称甲减）发生率为15.4％，甲状腺结节复发率为13.8％。结论：应重视结甲合并桥本氏甲状腺炎的诊断，甲状腺细针穿刺及术中冰冻切片有助于明确诊断。手术治疗是可行的，正确采取手术方法和切除范围能够有效防止术后甲减和结节复发。     

杨文明从“本虚—痰瘀致呆”论治阿尔茨海默病

阿尔茨海默病(Alzheimer disease,AD)是一种退行性疾病,可影响老年人健康及其生活质量。《医宗必读》首次明确指出"肾为先天之本,脾为后天之本",基于此,杨文明教授提出"脾肾两虚"为AD的病机基础;根据多年的临证经验提出"痰瘀交结"是本病的病机关键,治疗以补肾健脾、豁痰化瘀为原则,创制智脑胶囊,并通过大量实验揭示其作用机制,同时通过临床研究验证其有效。     

论糖尿病性骨质疏松症与虚、痰、瘀相关

糖尿病性骨质疏松症(diabetic osteoporosis,DOP)是糖尿病的一种并发症,主要表现为骨量降低、骨微结构破坏、脆性增加和骨折风险增加。作者通过文献研究,探讨糖尿病性骨质疏松症发生的病因病机,认为基本病因为肺津受损,脾肾肝亏虚,加上痰湿、血瘀等病理因素,总属本虚标实之证,治疗上,重视补益脾肾,同时配合疏肝、祛痰、化瘀、润燥等治法,为临床实践提供指导。     

陈其华从“肾虚血瘀”论治少弱精症经验

该文介绍陈其华教授从"肾虚血瘀"论治少弱精症的经验。陈师认为,"脾肾不足,湿热痰瘀阻滞"作为该病的核心病机,认为该病病位在肾,与心、脾、肝三脏密切相关,病理因素多以"血瘀"为主,多以肾虚立论,从血瘀立法。陈师论治少弱精症重视整体及局部辩证,整体审察,四诊合参,治疗上强调"通"法应用,扶正祛邪与个性化辨治,用药坚持量小力专,在"补益先后天之本"的基础上兼治湿热、痰浊、血瘀等病症,注重日常调护,强调身心同治,每获良效,另举验案供同道参考。     

黄柳向从虚、痰、湿、热、瘀、毒治疗胃食管反流病经验

黄柳向教授根据多年临床经验,认为胃食管反流病的病理特点是以脾胃虚弱为本,以痰、湿、热、瘀、毒为标。故临证时从虚、痰、湿、热、瘀、毒多角度论治,切中病机,达到标本同治、改善症状的目的。论文旨在介绍黄柳向教授对胃食管反流病病因病机的认识,总结黄教授的治疗经验。     

从“肝-脾-肺-肾”探讨肉芽肿性乳腺炎的中医辨治

肉芽肿性乳腺炎的发生发展与肝、脾、肺、肾功能失调密切相关,病机在于诸脏功能失调,引起气血津液虚滞,生成痰、瘀二邪阻滞乳络,发为本病。该病发展过程复杂,疾病迁延难愈,治疗上应标本同治,祛痰、除瘀的同时辨析脏腑发病的内在原因,予以补肾、益肺、疏肝、调脾,从根源出发调理脏腑,抵御外邪,防治肉芽肿性乳腺炎。     

国医大师徐经世从肝论治甲状腺功能亢进症四法

甲状腺功能亢进症是临床多发疾病,西医治疗因其各种不良反应,限制了其临床应用。此病中医多从瘿病论治,医家多从气、痰、火、瘀方面论治。国医大师徐经世先生临证60余载,对瘿病的诊治有着丰富的经验和独特的见解。徐师认为,此病治疗当首辨病位,甲状腺乃肝经循行所系,其病多责之于肝,故临床治疗多从肝入手,并结合母病及子、木土相克之五行理论,兼治脾心。其次当辨虚实,结合病程新久,实证分气滞、痰凝、肝火和血瘀之不同;虚证当辨肝阴亏虚、心阴不足和脾虚失运之别。总结出行气化痰消瘿法、清肝泻火散结法、理气活血化痰法和滋阴养肝宁心法治疗瘿病,验之临床,疗效卓著。     

Demystifying autoimmune thyroid disease. Which disorders require treatment?

The term "autoimmune thyroid disease" encompasses all of the autoimmune thyroid conditions, including Hashimoto's thyroiditis, Graves' disease, most cases of silent thyroiditis, and postpartum thyroiditis. Extrathyroidal manifestations (e.g., ophthalmopathy, dermopathy) can occur in Graves' disease and, less commonly, Hashimoto's thyroiditis. Spontaneous hypothyroidism is common in patients with Hashimoto's thyroiditis, and when it develops, life-long therapy with levothyroxine is needed. In the United States, most adult patients with Graves' disease are initially or eventually treated with radioiodine thyroid ablation. For transient thyroiditis involving hypothyroidism or hyperthyroidism, short-term or symptomatic therapy is adequate.     

Autoimmune thyroid disease: immunological, pathological, and clinical aspects

Autoimmune thyroiditis, most notably Hashimoto's thyroiditis, appears to be increasing in prevalence and is now more easily detected by sensitive laboratory tests and more invasive procedures such as fine needle aspiration. During the last decade, marked progress has been made in the understanding of these diseases. There is a greater awareness of the interaction between the humoral and cell-mediated arms of the immune system in autoimmune thyroiditis. Recent studies implicate a subpopulation of suppressor T lymphocytes which have an antigen-specific defect, resulting in their suboptimal interaction with the helper T lymphocytes and subsequent autoimmune manifestations. There is some evidence that thyroid epithelial cells which inappropriately express HLA-DR may enhance presentation of thyroid antigens to the immune system, possibly significant in the initiation or enhancement of the autoimmune response. The presence of various antithyroid autoantibodies allows the use of laboratory assays to confirm the clinical diagnosis and predict the results of treatment. There appears to be predisposing genetic factors in the development of autoimmune thyroiditis, with some geographical and racial differences. Environmental factors, most notably dietary intake of iodine, have also been implicated in the pathogenesis of Hashimoto's thyroiditis. Several animal models have been developed addressing such issues. Ongoing studies in the areas of postpartum thyroiditis and childhood thyroiditis are helpful in clarifying their relationship with Hashimoto's thyroiditis. Graves' disease and postpartum thyroiditis are being investigated as possible causes of postpartum depression. The association of Hashimoto's thyroiditis and carcinoma of the thyroid gland is still controversial, but its relationship with malignant lymphoma is now well accepted. Thus, although the pathogenesis of autoimmune thyroiditis remains elusive, there has been significant refinement of the clinical diagnosis, and immunological abnormalities of specific intrathyroidal lymphocytes have been identified. Hopefully, these new areas of knowledge will assist in the treatment of these diseases and in the prevention of the development of malignant lymphomas of the thyroid gland.     

刘云益气化痰祛瘀法治疗慢性阻塞性肺疾病稳定期经验

慢性阻塞性肺疾病是呼吸科常见病,导师刘云教授总结多年临证经验,认为慢性阻塞性肺疾病稳定期以久病气虚为主,痰瘀阻肺贯穿于慢性阻塞性肺疾病始终,根据这一病机,实践中坚持以补虚泻实、标本同治为原则,从虚、痰瘀论治,运用益气化痰祛瘀法治疗本病,可以改善患者临床肺系症状,从根本上减少急性发作次数,取得满意效果。该文旨在为慢性阻塞性肺疾病稳定期提供更有效的中医治疗方法。     

Autoantibody against Na+/I- symporter (NaIS)]

Na+/I- symporter (NaIS) cDNA was first cloned in 1996. Endo et al. reported that autoantibody against NaIS was found in 84% sera from patients with Graves' disease and 12% sera from patients with Hashimoto's thyroiditis. These IgGs, purified from sera from patients with Hashimoto's thyroiditis, caused 14 to 62% inhibition of iodide uptake. Furthermore, Ajjan et al. reported that 30.7% sera from patients with Graves' disease inhibited 7 to 44% of iodide uptake. In addition, Morris et al. suggested that NaIS represents an important autoantigen in autoimmune thyroid disease. In conclusion, it is suggested that the incidence of the antibodies against NaIS is higher in Graves' disease than Hashimoto's thyroiditis, and these antibodies inhibit iodide uptake.