放射配基结合抑制分析监测抗β受体抗体应答

通过正交试验改良放射配基(~(125)I-心得静)结合抑制分析(RBIA),所得的最佳实验条件为孵育温度30℃,缓冲液pH7.4,加血清预孵育40min,加~(125)I-PIN孵育20min;用于监测猪心肌细胞膜免疫BALB/c小鼠的抗β受体抗体应答,其血清中抗体对~(125)I-PIN结合β受体的抑制呈浓度依赖性,且为非竞争性抑制。同时还讨论了RBIA对于测定病人体内循环抗β受体自身抗体的临床应用价值。     

Fluorine-18 fluorodeoxyglucose dual-head positron emission tomography in the detection of recurrent differentiated thyroid cancer: preliminary results

In the follow-up of patients with thyroid cancer, it may be very difficult to identify the site of recurrence in the presence of persistently elevated or rising thyroglobulin (Tg) levels and negative iodine-131 whole-body scintigraphy (WBS). The aim of this study was to assess the feasibility of employing fluorine-18 fluorodeoxyglucose and a dual-head positron emission tomography (PET) camera to detect recurrent thyroid cancer in patients with elevated Tg levels and negative ¹³¹I WBS. Eleven patients suspect of having recurrent thyroid cancer (five males, six females; mean age 47 years; range 26–73 years) were studied with both ¹³¹I WBS and FDG using a dual-head PET camera. The suspicion that these patients had recurrent thyroid cancer was based on elevated Tg levels. Thyroid stimulating hormone (TSH) and Tg levels as well as antibodies to Tg were measured 3 weeks after the withdrawal of tri-iodothyronine. In patients in whom pathological uptake was seen on the PET images but who had no signs of recurrent thyroid cancer on WBS, ultrasonography and/or computed tomography or magnetic resonance imaging was performed followed by fine-needle aspiration cytology. The mean Tg and TSH levels after discontinuation of l-thyroxine were 156 ng/ml (range 4–815 ng/ml) and 84 mU/l (range 43–159 mU/l), respectively. None of the patients had antibodies to thyroglobulin. In seven out of ten patients with negative ¹³¹I WBS, FDG PET showed focally increased uptake in the head and neck region. In one patient, the site of increased uptake on the PET images corresponded with the site of increased ¹³¹I uptake. Malignancies with a diameter less than 1 cm (n=3) were not depicted by either CT or US. It is concluded that detection of recurrent thyroid cancer by means of FDG dual-head PET is feasible in patients with elevated Tg concentrations and negative ¹³¹I WBS. The results justify a prolongation of the study. Received 1 May and in revised form 11 June 1999     

Successful therapy of pemphigus vulgaris with immunoadsorption using the TheraSorb™ adsorber

Pemphigus vulgaris (PV) is caused by autoantibodies to desmogleins. Standard immunosuppressive therapy may be limited by concomitant diseases or ineffective.In these cases, removal of circulating antibodies by immunoadsorption can induce remission. An 87‐year‐old woman with PV and considerable co‐morbidities suffered from extensive mucous membrane erosions and bouts of skin blistering refractory to treatment with methotrexate,as well as mycopheno‐late mofetil and corticosteroids even when combined with plasmapheresis and intravenous immunoglobulin. Adjuvant immunoadsorption therapy with the TheraSorb? columns‐first weekly, than monthly‐induced a complete remission, as well as a parallel decrease in PV antibody titers. Continued therapy for 18 months kept the patient in remission but for one infection‐related relapse, and remission has been stable over two further years on low‐dose methotrex‐ate monotherapy. This case confirms the clinical efficacy of immunoad‐sorption in PV and adds another type of adsorber column to the armamentarium, which is useful to the dermatologist who has to cooperate with local lipid apheresis or dialysis units.     

TRs突变及其下游通路与肿瘤相关研究进展

信号通路是肿瘤发生、发展、预防及治疗的重要研究领域，现已公认Ras和P13K等是肿瘤发生发展的重要信号通路，甲状腺激素（TH）及其受体（TRs）可以影响这些通路起到抑制癌细胞生长和转移的作用，并逐渐成为研究的热点。近年研究发现甲状腺激素／受体影响B—catenin降解的机制，成为影响肿瘤发生发展的重要通路之一。而肿瘤普遍存在TRs突变现象，TRs突变严重影响了甲状腺激素／受体调解下游通路的功能，并成为激活下游癌基因的诱因。甲状腺激素／受体介导的B—catenin降解机制，不仅丰富了它们在抑制肿瘤发生发展中的作用机制，并进一步为突变受体对下游癌基因的持续激活提供了强有力的理论依据，最终会指导临床，将会为肿窟预防和分子靶基因治疗提供新的理论依据。     

趋化因子CXCL14在甲状腺乳头状癌中的表达水平及其临床意义

目的  探讨趋化因子CXCL14在甲状腺乳头状癌中的表达及其与临床病理的关系。方法  采用免疫组织化学方法、蛋白印迹法（Western blot）检测120例甲状腺乳头状癌、40例结节性甲状腺肿及40例正常甲状腺组织中CXCL14的表达水平，并分析其与甲状腺乳头状癌的临床病理特征的关系。结果  免疫组织化学结果表明，甲状腺乳头状癌组织中CXCL14蛋白阳性率（20.83%）较结节性甲状腺肿（85.00%）、正常甲状腺组织（75.00%）明显降低，差异有统计学意义（P <0.05）。Western blot结果表明，CXCL14蛋白在甲状腺乳头状癌组织中的表达量为（0.823±0.143），明显低于结节性甲状腺肿组织（1.211±0.012）和正常甲状腺组织（1.219±0.004），差异有统计学意义（P <0.05）。CXCL14蛋白的表达与甲状腺乳头状癌的包膜浸润、淋巴结转移、肿瘤临床分期及肿瘤分化有关（P <0.05）。CXCL14高表达组的甲状腺乳头状癌患者的生存率明显高于CXCL14低表达组（P <0.05）。结论  CXCL14蛋白的表达可能成为判断甲状腺乳头状癌恶化程度及预后的指标。

     

Effect of Ginseng Injection on Congestive Heart Failure and Thyroid Hormones

Ｃｏｎｇｅｓｔｉｖｅｈｅａｒｔｆａｉｌｕｒｅ（ＣＨＦ）ｉｓａｃｏｍ ｍｏｎｒｅｓｕｌｔｏｆｖａｒｉｏｕｓｋｉｎｄｓｏｆｌａｔｅａｎｇｉｏｃａｒ ｄｉｏｐａｔｈｙａｎｄａｌｗａｙｓｌｅａｄｓｔｏｓｅｒｉｅｓｏｆｃｈａｎｇｅｓｉｎｎｅｒｖｅ ｅｎｄｏｃｒｉｎｅｓｙｓｔｅｍ．Ｉｎｒｅｃｅｎｔｙｅａｒｓ，ｗｅｈａｖｅｄｉｓｃｏｖｅｒｅｄｔｈａｔＣＨＦｐａｔｉｅｎｔｓａｒｅｇｅｎｅｒａｌｌｙｃｏｎｃｏｍｉｔａｎｔｗｉｔｈｏｂｖｉｏｕｓａｂｎｏｒｍａｌｉｔｙｏｆｔｈｙ ｒｏｉｄｈｏｒｍｏｎｅｓ，ｗｈｉｃｈｉｓｏ…     

超声引导激光消融治疗甲状腺乳头状癌的价值

目的 探讨超声引导激光消融对甲状腺乳头状癌局部复发的治疗效果。方法 收集2014 年12 月- 2016 年9 月上海市嘉定区安亭医院接受超声引导激光消融治疗的局部复发性甲状腺乳头状癌患者47 例。比 较患者治疗前后并发症的发生率及血清甲状腺球蛋白水平，并随访患者治疗后1、3、6、12 个月结节大小、 回声及血流。结果 ①患者出现术后恶心呕吐的发生率为19.15%，声音嘶哑发生率为21.28%，呛咳发生率为 8.51%，颈静脉血栓发生率为6.38%。②激光消融治疗后12 个月结节体积和直径低于治疗后1 个月，在治疗后 12 个月中呈逐渐缩小趋势，差异有统计学意义（P <0.05）。消融治疗在随访治疗后12 个月的结节回声消失和 血流信号消失的比率低于治疗后1 个月，差异有统计学意义（P <0.05）。③患者治疗后的血清甲状腺球蛋白 水平低于治疗前，治疗后1、3、6、12 个月之间比较，患者的血清甲状腺球蛋白水平呈逐渐下降趋势，差异有 统计学意义（P <0.05）。结论 超声引导激光消融具有安全性高、预后好、创伤小、恢复速度快的优点，可有 效治疗甲状腺乳头状癌局部复发，因此可作为甲状腺乳头状癌局部复发患者手术方式的一种选择。     

甲状腺癌组织c-erbB-2/neu蛋白表达及其临床意义

目的：探讨甲状腺癌中c-erbB-2蛋白（p185）的表达与临床预后因素的相关性及意义。方法：运用免疫组化SP法检测45例甲状腺癌石蜡标本中，p185的表达并与临床预后因素进行相关分析。结果：45例患者中p185蛋白的阳性表达率为71．1％（32／45）。其中乳头状癌的p185为71．0％（22／31）；滤泡癌及髓样癌的p185阳性表达分别为2／4和2／4；未分化癌的p185阳性表达分别为5／6。p185表达与甲状腺癌的组织学类型之间存在明显相关性；与性别及年龄无相关；在有淋巴结转移及有复发、远处转移或死亡的患者中，p185的表达呈明显增强趋势，与无复发组相比较差异有统计学意义，P〈0．05。结论：在甲状腺癌中，p185存在着不同程度的表达，在一定程度上反映了甲状腺癌的组织学分化程度、淋巴结转移和复发倾向；p185的强阳性表达暗示着淋巴结转移概率的增加，将对甲状腺癌的手术方式选择有指导意义；p185的阳性表达可作为判断甲状腺癌预后的临床病理指标。     

Secretion of GAWK, a Presumed Product of Chromogranin B Processing, by a Human Medullary Thyroid Carcinoma Cell Line: Effect of Phorbol Ester, Forskolin and Calcium-lonophore

GAWK was isolated from human pituitary glands and presumed to be a processing product of human Chromogranin B. In the present studies, we investigated effects of phorbol ester (TPA), forskolin and Ca²⁺-ionophore (A23187) on GAWK secretion using a human medullary thyroid carcinoma-derived cell line (TT-cell). A dose-responsive stimulation of GAWK-like immunoreactivity (LI) secretion was found in the presence of TPA as well as forskolin. A23187 caused an increase of GAWK-LI secretion and addition of TPA together with A23187 revealed an additive effect on the GAWK-LI secretion. These findings indicate that GAWK-LI is a secretory peptide in the TT-cells and suggest that A and C kinase, and possibly Ca²⁺-calmodulin transduction systems are involved in the GAWK-LI secretion by the TT-cells. TT-cells may provide a good model for the investigation of regulation of Chromogranin secretion.