甲状腺功能减退症：彩色多普勒超声在亚临床甲状腺功能低下诊断中的应用

35例经临床及实验室检查证实的亚临床甲状腺功能低下（亚甲低）患者进行彩色多普勒血流显像（CDFI）检查。同时检测健康正常组30例及单纯性甲亢组20例作为对照。结果：亚甲低组高频超声图像表现为甲状腺容积增大、光点粗，     

彩色多普勒显像在甲亢鉴别诊断中的应用

检测20例Graves病(GD)甲亢和19例非GD甲亢患者的甲状腺131I吸收率并用彩色多普勒血流显像(CDFI)测定甲状腺上动脉的收缩期最高血流速度(Vmax)和动脉舒张期内径宽度(φ)。GD组Vmax和φ明显高于非GD组。CDFI对GD的鉴别诊断有帮助。     

甲状腺血流速度与血清FT3FT4关系的探讨

1　资料与方法1.1　一般资料　收集本院 2 0 0 0 - 0 1～ 2 0 0 2 - 0 6住院的2 9例甲亢患者 ,其临床表现和实验室检查均符合甲亢的诊断标准[1] 。男 12例 ,女 17例。年龄 2 4～ 6 4岁 ,平均 4 4岁 ,病程 1个月至 10年 ;同期以 2 2例良性甲状腺腺瘤患者(该组患者无临床甲亢或甲减症状 ,血清FT3 、FT4均在正常范围内 ,瘤体直径≤ 2cm)为对照组 (简称甲瘤组 ) ,男 4例 ,女 18例。年龄 18～ 71岁 ,平均 35岁 ,病程 10d至 8年。1.2　方法　应用ALOKO SSD 170 0型彩色多普勒超声血流显像仪检测双侧甲状腺上动脉的收缩期血流速度峰值(PSV ,…     

STA血流与甲状腺功能的关系

甲状腺功能的改变直接影响其腺体的血供。我们试用彩色经颅多普勒超声诊断仪(TCD)测试98例甲状腺上动脉(STA)血流,旨在观察甲状腺功能对STA血流速度的影响,以探讨诊断该类疾病的新方法。     

甲状腺功能低下与亢进的脉冲多普勒诊断

目的：探讨脉冲多普勒对亚临床甲状腺功能低下和甲状腺功能亢进的鉴别诊断价值。方法：应用彩色多普勒和脉冲多普勒技术检查12例亚临床甲状腺功能低下和23例甲状腺功能亢进患者，测量双侧甲状腺上动脉的收缩期最大血流速度、舒张期末最低流速和阻力指数，用统计学方法进行分析。结果：甲状腺功能亢进患者的甲状腺上动脉各项血流动力学指标均高于亚临床甲状腺功能低下者，经t检验，2种疾病各项指标间差异均有显著意义（P＜0．01）。左、右侧甲状腺上动脉收缩期最大血流速度t值分别为3．220，2859；舒张期末最低流速t值为2．806，2．941；阻力指数为4．1923，3．273。 应用脉冲多普勒技术诊断亚临界甲状腺功能低下的准确率为83．33％；诊断甲状腺功能亢进的准确率为91．30％。结论：脉冲多普勒不便能诊断亚临界甲状腺功能低下和甲状腺功能亢进，而且是鉴别此2种疾病的可靠方法。     

甲状腺微小癌的二维超声与彩色多普勒血流显像特征

目的探讨甲状腺微小癌(TMC)的二维超声表现与彩色多普勒血流显像特征。方法选取自贡市富顺县人民医院2013年4月—2017年3月收治并确诊的TMC患者50例为TMC组,另选取本院同期甲状腺良性结节患者50例为良性结节组。患者均采用二维超声和彩色多普勒超声检查,比较两组患者结节回声、钙化情况及甲状腺血流情况等。结果两组患者淋巴结肿大方面比较,差异无统计学意义(P0.05);TMC组患者结节回声、钙化、纵横比、血流丰富指标均大于良性结节组(P0.05)。TMC组患者甲状腺Ⅰ型、Ⅱ型血流占比低于良性结节组,Ⅲ型血流占比高于良性结节组(P0.05)。彩色多普勒超声仪可见,TMC组患者甲状腺结节及淋巴结周围血流非常丰富。结论二维超声及彩色多普勒血流显像特征均可较为准确的诊断TMC,具有较高的临床诊断价值。     

彩色多普勒超声检查在甲状腺恶性肿瘤的诊断价值

目的分析彩色多普勒超声检查在甲状腺恶性肿瘤的诊断价值。 方法研究共纳入38例患者观察对象,均是肇庆市第二人民医院2018年1月至2020年12月收治的经手术病理学检查确诊的甲状腺恶性肿瘤患者,38例患者均接受彩色多普勒超声检查。将手术病理学检查结果作为参照,观察彩色多普勒超声检查的结果。 结果38例患者经彩色多普勒超声检查后,有2例误诊甲状腺结节,6例漏诊,余下30例诊断为甲状腺恶性肿瘤,诊断准确率为78.95%(30/38)。38例患者主要超声表现为低回声结节,内部结构较甲状腺周围正常组织的密度高,血流量丰富,边界欠规整。 结论彩色多普勒超声检查用于甲状腺恶性肿瘤的诊断价值显著,可以为甲状腺恶性肿瘤提供良好的诊断依据,提高诊断准确率。     

甲状腺过氧化物酶抗体球蛋白抗体微粒体抗体在甲状腺自身免疫性疾病中的改变

目的 观察甲状腺过氧化物酶抗体(TPO Ab)、甲状腺球蛋白抗体(TG Ab)和甲状腺微粒体抗体(TM Ab)在自身免疫性甲状腺疾病(AITD)中的改变,探讨TPO Ab在临床诊断和治疗上的作用和意义.方法 收集AITD患者,根据甲状腺功能不同分为甲状腺功能亢进(简称甲亢)组(Graves病、GD,57例)、甲低组(桥本氏甲状腺炎、HT,48例)、亚甲低组(41例)和AITD复诊组(甲状腺功能恢复正常1～6个月,41例).另取一级亲属无GD或HT的健康人群53例为对照组.采用放射免疫分析法检测血清中甲状腺自身抗体(TPO Ab、TG Ab和TM Ab)及甲状腺激素和促甲状腺激素(FT3、FT4,sTSH)水平.结果 甲亢组、甲低组和亚甲低组中TPO Ab阳性率(87.70%、97.20%、100.00%)均明显高于同组内TG Ab阳性率(43.90%、60.42%、48.78%)和TM Ab阳性率(43.90%、79.10%、60.98%);3种甲状腺自身抗体的阳性率和阳性患者的抗体水平均高于相应的对照组.AITD复诊组的TPO Ab阳性患者的抗体水平[(683.04±606.55)kU/L]明显低于甲亢组、甲低组和亚甲低组[(1049.31±941.00)、(106 440.79±272.38)、(5133.01±4449.67)kU/L].结论 TPO Ab在AITD的诊断更具有代表意义,抗体水平为AITD治疗及预后评估提供了重要的依据.     

彩色多普勒在2型糖尿病患者足背动脉早期硬化趋势中的分析

目的探讨彩色多普勒超声检查在2型糖尿病患者足背动脉早期硬化趋势中的临床应用价值。方法选择2012年3月—2013年5月就诊于该院内分泌糖尿病患者,分别对72例2型糖尿病患者与39例非糖尿病患者的足背动脉进行彩色多普勒检查。结果正常对照组、糖尿病组足背动脉收缩期峰值流速分别为(34.89±8.73)、(38.89±14.73)㎝/s,2组间比较差异无统计学意义;两组足背动脉第一正向峰的加速时间与总时间比值(ΔT)分别为(0.39±0.04)、(0.46±0.09),差异有统计学意义(P0.05)。结论彩色多普勒超声对2型糖尿病患者足背动脉早期硬化趋势的诊断有重要的临床意义。     

彩色多普勒超声对亚急性甲状腺炎的诊断价值

目的探讨彩色多普勒超声对亚急性甲状腺炎（SAT）的诊断价值。方法回顾性分析49例临床确诊的SAT患者的彩色多普勒超声检查声像图特征。结果与健康人比较,SAT患者的甲状腺厚度、宽度均显著增加（P〈0.05）;CDFI示病变内血流信号均较丰富;甲状腺动脉最高血流速度（Vmax）明显升高（弥散型与结节型者无显著差异）;阻力指数（RI）无显著差异。超声诊断为SAT 43例,其中弥漫型38例（双侧25例、单侧13例）,结节型5例,诊断正确率为87.8%。结论彩色多普勒超声检查对亚急性甲状腺炎的临床诊断具有重要的临床价值。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.