促甲状腺激素在胰岛素抵抗发生中的作用

流行病学研究发现,血清促甲状腺激素(TSH)水平与胰岛素抵抗呈正相关。然而,血清TSH水平与胰岛素抵抗之间存在相关性的机制目前尚不清楚。促甲状腺激素受体(TSHR)不仅存在于甲状腺滤泡细胞表面,在前脂肪细胞和脂肪细胞表面同样检测到TSHR的表达。血清TSH可以直接与脂肪细胞表面的TSHR结合,发挥甲状腺以外的效应。血清TSH是否刺激脂肪细胞分泌炎性因子,进而参与胰岛素抵抗的发生,尚有待研究。     

甲状腺乳头状癌中促甲状腺激素受体与钠碘转运体mRNA的表达

目的钠碘转运体(Na+/I-symporter,NIS)是介导甲状腺细胞摄取碘的重要载体,其表达、定位与促甲状腺激素(thyroid stimulating hormone,TSH)关系密切。文中主要研究甲状腺乳头状癌(papillary thyroid carcinomas,PTC)及癌旁组织中TSH受体(TSH receptor,TSHR)与NIS基因的表达。方法实时荧光定量PCR法测定36例PTC及癌旁组织,20例正常组织中TSHR mRNA及NIS mRNA的表达水平。结果 PTC及癌旁组织中TSHR mRNA表达水平明显低于正常组织,P<0.05;NIS mRNA表达水平在PTC组织中显著下降,P<0.05。结论 PTC组织中TSHR与NIS mRNA基因表达水平呈现同步下降趋势,可能与TSH-TSHR信号通路的调控有关。     

胰岛素样生长因子Ⅰ受体抑制剂通过改变甲状腺相关眼病中成纤维细胞的免疫表型发挥治疗作用

甲状腺相关眼病（TAO）是Graves病（GD）的一种难治性并发症。刺激性促甲状腺素受体（TSAb）可以与GD眼眶成纤维细胞（GD-OF）表达的TSH受体（TSHR）/胰岛素样生长因子Ⅰ受体（IGF-IR）复合体结合,促进TAO的发生发展。IGF-IR是TSHR启动细胞信号传导所必须的成分,teprotumumab作为...     

促甲状腺素受体在亚临床甲状腺功能减退小鼠心室肌的表达及意义

【摘要】 目的 探讨促甲状腺素受体（TSHR）在亚临床甲状腺功能减退（SCH）小鼠心室肌的表达及意义。方法 30只BALB/c小鼠随机分为对照组及实验组,每组15只。实验组小鼠构造亚临床甲状腺功能减退动物模型,对照组小鼠饮用正常水,腹腔注射等量生理盐水。比较两组小鼠超声心动图检测结果,血清TT3、TT4、TSH水平。免疫组织化学染色法检测各组小鼠心室肌组织中TSHR的表达情况。结果 两组超声心动图检测结果显示,实验组E/E’值高于对照组（P＜001）。两组TT3水平比较差异无统计学意义(P＞005);实验组血清TT4水平明显低于对照组,血清TSH水平明显高于对照组（P＜001）。免疫组织化学染色结果显示,实验组心室肌组织中TSHR表达明显高于对照组。结论〓当发生亚临床甲状腺功能减退时,心室肌组织TSHR表达上调,与高浓度的TSH结合后可能通过某种机制影响心脏舒缩功能。     

抑制血浆TSH水平的药物及其临床意义

促甲状腺激素（thyrotropin,TSH）为腺垂体分泌的一种激素,TSH与促甲状腺激素受体（thyroid stimulating hormonere．ceptor,TSHR）是人体内参与甲状腺功能调控的2种重要蛋白分子。TSHR主要存在于甲状腺滤泡细胞膜上,生理情况下,其与TSH结合后介导TSH调节甲状腺滤泡细胞的正常生长和功能,     

甲亢患者血清IGF-1、BGP和DPD水平与骨密度相关分析

目的探讨甲状腺功能亢进(简称甲亢)患者血清胰岛素样生长因子-1(IGF-1)、骨钙素(BGP)、尿脱氧吡啶啉(DPD)与骨密度(BMD)的关系.方法放免法测定血清IGF-1、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、BGP水平,酶免法测定尿DPD水平;应用双能X线骨密度仪测定腰椎2～4、股骨上端BMD值.结果甲亢患者血清IGF-1、BGP、DPD水平高于正常对照组,骨密度低于对照组,FT4与IGF-1呈正相关,TSH与IGF-1呈负相关.结论甲状腺激素促进成骨细胞产生IGF-1,IGF-1促进成骨细胞复制和自分泌方式合成骨基质,甲亢为高转换型骨质疏松,以骨吸收大于骨形成为特点.     

三碘甲腺原氨酸对大鼠成骨细胞表达碱性磷酸酶、骨钙素的影响

目的探讨三碘甲腺原氨酸(T_3)对大鼠成骨细胞表达碱性磷酸酶(ALP)、骨钙素(OC)的影响。方法采用骨组织块法原代分离培养新生SD大鼠颅骨成骨细胞,然后配置含不同浓度(10~(-9)、10~(-8)、10~(-7) mol/L)T_3的培养基,与大鼠成骨细胞共培养4 d,采用比色法测定细胞ALP,采用放射免疫法测定成骨细胞OC表达变化。结果T_3可促进大鼠成骨表达ALP,随T_3浓度的增高,成骨细胞表达ALP活性增强(F=17.60,P=0.039);10~(-8)、10~(-7) mol/L T_3促进成骨细胞表达OC(F=19.25,P=0.032)。结论 T_3可以刺激成骨细胞表达ALP、OC。     

miR-25/TWIST1调控通路在成骨细胞矿化中的作用研究

目的探究miR-25在成骨细胞分化过程中的作用及其作用机制。方法β-甘油磷酸(β-glycerophosphate,β-GP)和抗坏血酸(aseorbic acid)诱导成骨细胞矿化,茜素红(Alizarin Red S)染色实验观察成骨细胞的矿化情况。生物信息学运算预测miR-25的靶基因。实时定量PCR法检测miR-25以及其他相关基因的表达。过表达实验和抑制实验用于研究miR-25在成骨细胞分化中的作用及其与靶基因之间的相互关系。荧光素酶报告基因实验验证miR-25与其靶基因之间的结合。结果 miR-25的表达随成骨分化过程而逐渐升高。过表达miR125通过转录后调控其靶基因TWIST1的表达来促进成骨分化。作为调控成骨细胞分化的的转录因子,扭曲基础螺旋—环—螺旋蛋白1(TWIST1)是miR-25的靶基因。结论 miR-125通过作用于靶基因TWIST1在成骨细胞的分化中发挥了重要的调控作用,表明调控miR-25的表达,可能成为骨代谢疾病新的治疗靶点。     

2型糖尿病与促甲状腺激素及骨代谢关系的研究进展

糖尿病及甲状腺疾病是内分泌最常见的代谢性疾病,2型糖尿病是糖尿病最常见的类型。2型糖尿病患病率逐渐增加,已成为威胁人类健康的慢性代谢性疾病,其合并甲状腺功能异常表现不一,临床中主要以亚临床甲状腺功能减退或甲状腺功能减退较常见。2型糖尿病可通过多因素作用直接或间接影响促甲状腺激素(TSH)水平,使TSH降低或升高。TSH经骨组织上的TSH受体介导调节骨代谢,一定程度的TSH改变使成骨细胞与破骨细胞活性改变,甚至导致骨代谢失衡,TSH降低对骨代谢不利,TSH一定程度升高对骨有保护作用。     

促甲状腺激素受体特异性单克隆抗体K1-70TM治疗Graves病及Graves眼病的Ⅰ期临床研究

Graves病是一种自身免疫性甲状腺疾病, Graves病患者体内存在甲状腺刺激性抗体(TSAb), TSAb能够模拟促甲状腺激素(TSH)的作用与TSH受体(TSHR)相结合而引发甲状腺功能亢进。浸润性Graves眼病是Graves病患者的一种难治性并发症, TSAb能够与眼眶成纤维细胞及眼眶脂肪细胞表面的TSHR相结合而促进其增殖分化与堆积, 推动Graves眼病的发生与进展。人单克隆TSHR自身抗体K1-70?能够以高亲和力特异性结合TSHR, 阻止TSAb与TSHR结合, 从而阻断TSAb的刺激作用。K1-70?作为一种特异性结合并阻断TSHR的单克隆抗体, 在治疗Graves病和Graves眼病领域有着非常好的应用前景, 但该药物用于人体的安全性和有效性仍有待大规模临床研究进行证实。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.