单纯性肥胖症患者血甲状腺激素与甲状腺激素受体的改变

应用外周血淋巴细胞甲状腺激素受体(T_3R)测定方法,测定14例单纯性肥胖症和10例正常成人T_3R的最大结合量(B_(max))和解离常数(Kd)以及甲状晾激素水平。结果表明单纯性肥胖症患者血清TT_3、TT_4都在正常值的高限,外周血淋巴细胞T_3R的B_(max)((?)±s)为18.00±2.90fmol/0.5×10~6细胞,较正常成人(28.94±3.60fmol/0.5×10~6细胞)显著降低,而Kd值与正常成人没有显著差异。这为探讨单纯性肥胖症的发病机制和治疗提供了一些依据。     

ACUTE CHANGES IN SERUM THYROTROPHIN IN TREATED ADDISON''S DISEASE

Serum and salivary cortisol, plasma ACTH and serum TSH, free T4, free T3, PRL, LH and FSH were measured before and hourly after the morning steroid replacement therapy of five patients with Addison's disease. In the 4 h after hydrocortisone the levels of TSH fell in all five patients, the levels (mIU/l) decreasing from 6.8 to 3.8; 0.9 to 0.6; 24.3 to 13.2; 28.1 to 7.4 and 17.2 to 11.6. No such change was seen when the procedure was repeated with the morning steroid dose withheld. In two patients, dexamethasone produced similar changes in serum TSH to those observed with hydrocortisone. Steroid therapy had no consistent effect on LH, FSH and PRL levels. Our results show that the time interval between taking medication and withdrawing blood samples should be considered when interpreting TSH levels in treated Addison's disease.     

SYNOVIAL INVOLVEMENT IN HODGKIN'S DISEASE

We report a case of monoarthropathy in a patient with Hodgkin'sdisease, due to invasion of the synovium, with apparently normaljuxta-articular bone.     

男性Graves病患者唾液睾酮及血清性激素水平的变化

本文观察了20例男性Graves病患者抗甲状腺药物治疗前后的唾液睾酮及血清中几种性激素水平的变化,并与年龄、性别相配对的20例健康者进行了比较分析。患者治疗前唾液睾酮水平明显低于正常,治疗后显著上升,与血T_3、T_4的变化呈负相关;治疗前血总睾酮、雌二醇、LH及FSH显著高于正常,治疗2个月后除雌二醇外均随T_3、T_4的下降而下降。本文结果支持唾液睾酮不受SHBG的影响,提示Graves病患者游离睾酮减低。     

SERUM TRIIODOTHYRONINE IN HEALTH AND DISEASE

Using a double antibody radioimmunoassay (RIA) for the measurement of serum triiodothyronine (T₃), the present study was undertaken to define the role of this hormone in normal and abnormal thyroid states. Other tests of thyroid function performed included measurement of serum thyroid stimulating hormone (TSH, euthyroid range <0.2-3.6 μU/ml by RIA) and free thyroxine index (FTI, 4.6-10.0). In forty-six normal subjects (aged 18-40 years) serum T₃ ranged from 75 to 177 with a mean value of 128 ng/100 ml. This differed significantly (P<0.01) from that of the mean T₃ level of nine subjects taking oral contraceptives (174 ng/100 ml). The administration of 200 μg i.v. synthetic thyrotrophin releasing hormone to six normal subjects produced a significant serum T₃ elevation in all with a mean increase at 120 min of 56%. Serum T₃ values in hyperthyroidism were as follows: diffuse goitre (n= 14, mean 600 ng/100 ml, range 290-1150); multinodular goitre (n= 8, mean 283, range 179-440); Solitary nodule (n= 4, mean 258, range 195-305): T₃-toxicosis (n= 2, mean 262). There was no overlap with the normal range. Twenty patients with severe primary hypothyroidism (FTI 0.2-4.3, serum TSH 83-1546 μU/ml) had a mean serum T₃ level of 42 ng/100 ml. Eighteen patients were studied following drug or radioiodine treatment of thyrotoxicosis. All were clinically euthyroid but had elevated serum TSH (6.0-84 μU/ml). Serum T₃ in this group was normal (87-185 ng/100 ml) whereas T₄ was low in eleven. It is concluded that serum T₃ measurements provide a reliable index of thyroid function, facilitate the diagnosis of T₃-toxicosis and correlate with the clinical status during and after treatment of thyrotoxicosis in a more appropriate manner than do T₄ measurements which may be misleading.     

SERUM AND SYNOVIAL FLUID OSTEOCALCIN (BONE GLA PROTEIN) LEVELS IN JOINT DISEASE

Osteocalcin (bone gla protein) is a sensitive marker of boneturnover in metabolic disease. Using a well characterized antiserum(R 102M) we have assayed serum and synovial fluid samples frompatients with osteoarthritis (OA) and rheumatoid arthritis (RA)and related levels to serological and radiological markers ofdisease. There were 21 patients with RA (mean age 58.2 years,15 F) and 33 with OA (mean age 69.2, 28 F). Paired serum andsynovial fluids (SF) were available in 19 RA patients and 30OA patients. Serum osteocalcin levels were related to age-sex-matchednormals and to a small group of elderly disease controls. Serumlevels tended to be lower in RA than controls, but not significantlyso: RA 5.56 (3.67); control 6.09(2.54) ng/ml; expressed as mean(SD) and the mean serum/SF ratio was 0.88 (0.86). The resultswere much more variable in OA (mean serum osteocalcin 6.1 (3.9)).Elevated levels were mainly due to a small number of patientswith a destructive form of OA and were higher than those withnon-destructive OA (10.3 (3.5), n=20, versus 3.83 (1.6), n=W).Patients with non-destructive OA had a lower serum osteocalcinthan age-/sex-matched normals. In this study, synovial fluidlevels were usually less than serum concentrations, but in twoRA and four OA patients the ratio was reversed, suggesting localproduction. Osteocalcin may be an important marker of bone activityin OA. KEY WORDS: Osteocalcin (bone gla protein), Serum, Synovial fluid, Rheumatoid arthritis, Osteoarthritis, Destructive osteoarthritis     

RELATIONSHIP BETWEEN THE CHANGES IN SERUM THYROID HORMONE LEVELS AND PROTEIN STATUS DURING PROLONGED PROTEIN SUPPLEMENTED CALORIC DEPRIVATION

The relationship between the changes in serum thyroid hormone levels and nitrogen economy during caloric deprivation were investigated in ten obese men during a 40 d, 400 kcal protein-supplemented weight-reducing diet. This regimen induced increases in the serum levels of total T4, free T4 and total rT3, and decreases of total T3, while serum TSH remained unchanged. There were progressive decreases in total body weight and urinary losses of total nitrogen and 3-methylhistidine, with the early negative nitrogen balance gradually returning towards basal values during the 40 days. Subjects with the largest weight loss had the most increase in the serum levels of total T4 and free T4 index and the greatest decrease in T3. The magnitude of the increase of the nitrogen balance from its nadir was correlated with the extent of the reduction of T3 and increase of T3 uptake ratio and free T4 levels. The decrease in the urinary excretion of 3-methylhistidine correlated with the increase in free T4 and rT3 levels. Nadir serum transferrin values were directly related to peak rT3 values, and the lowest albumin concentrations occurred in subjects with the highest total T4 and free T4 index values. Further, the maximum changes in the serum thyroid hormone levels preceded those of the nutritional parameters. These relationships suggest that: (1) increases in serum rT3 and free T4 and reductions in T3 concentrations during protein supplemented weight reduction may facilitate conservation of visceral protein and reduce muscle protein turnover; and (2) the variation in the magnitude of these changes may account for the heterogeneity of nitrogen economy.     

SLE血清和尿中细胞因子水平变化与病情活动的相关性

目的：探讨细胞因子在系统性红斑狼疮发病中的作用及与疾病活动的相关。方法：选择住院的４３例ＳＬＥ患者检测治疗前后ＩＬ－１β，可溶性ＩＬ－２Ｒ，ＩＬ－４，ＩＬ－６，ＩＬ－８，肿瘤坏死因子。α－干扰素，抗ＤＮＡ抗体，２４小时尿蛋白，用疾病活动评分判断疾病活动性，对治疗前后细胞因子水平的变化及它们与抗ＤＮＡ抗体，尿蛋白，ＳＬＡＭ和临床表现间的相关性进行分析。     

哮喘患者嗜酸粒细胞阳离子蛋白及其细胞密度的改变

为研究哮喘患者体内嗜酸性粒细胞（ＥＣ）、Ｔ淋巴细胞功能状态及相互关系，对哮喘，急者外周血ＥＣ密度及血清嗜酸细胞阳离子蛋白（ＥＣＰ）、可溶性白介素－２受体（ｓＩＬ－２Ｒ）浓度进行检测。结果表明，哮喘患者外周血低密度ＥＣ增多，血清ＥＣＰ、ｓＩＬ－２Ｒ浓度同时增高且幅度一致。提示ＥＣ的激活与Ｔ淋巴细胞激活有关，两者共同参与哮喘的发病过程。     

CHEMOTHERAPY OF CHILDHOOD HODGKIN'S DISEASE IN UGANDA

In a 5-year period, 24 Ugandan children Summary with Hodgkin's disease were systematically evaluated, staged, and treated uniformly with combination chemotherapy (nitrogen mustard, vincristine, prednisone, procarbazine). All patients (7 stage I-II, 12 stage III, and 5 stage IV) had complete remissions. 5 of 21 adequately treated patients relapsed, with a median remission duration of 12 months, and all responded completly when combination chemotherapy was 89%; 2 patients died, both of causes not attributable to active Hodgkin's disease. The initial remission was sustained in all 7 patients with localised Hodgkin's disease.     

RELATIONSHIP BETWEEN SERUM CARTILAGE OLIGOMERIC MATRIX PROTEIN LEVELS AND DISEASE PROGRESSION IN OSTEOARTHRITIS OF THE KNEE JOINT

The value of serum cartilage oligomeric matrix protein (COMP)as a marker of disease progression was investigated in 81 hospitalout-patients with clinical knee osteoarthritis (OA). Progressingpatients were defined by a decrease of