A sensitive immunoradiometric assay for serum thyroid stimulating hormone: a replacement for the thyrotrophin releasing hormone test?

The value as a thyroid function test of a new, rapid, and highly sensitive immunoradiometric assay for thyroid stimulating hormone (TSH) was assessed in 188 consecutive new patients with suspected hyperthyroidism. The diagnosis was made on clinical grounds and on the basis of serum total triiodothyronine and thyroxine concentrations and the response of TSH to thyrotrophin releasing hormone (TRH) as measured by radioimmunoassay. In all except one patient the basal TSH concentration by immunoradiometric assay predicted the response of TSH by radioimmunoassay to TRH, an undetectable value being recorded in patients with a subnormal response and a measurable value in those with a normal test result. This clear relation was not observed for basal TSH concentrations as measured by radioimmunoassay. In a series of 39 hospital inpatients with acute or chronic non-thyroidal illness, of whom 11 had low concentrations of total thyroxine or triiodothyronine, or both, basal TSH concentrations were detectable by both radioimmunoassay and immunoradiometric assay in all cases and were associated with normal responses to TRH. The immunoradiometric assay for TSH, which is commercially available, may therefore obviate the need for the more time consuming TRH test and simplify the approach to thyroid function testing in patients with suspected hyperthyroidism.     

左旋甲状腺素治疗亚临床甲减的疗效及对血脂的影响研究

目的探讨左旋甲状腺素治疗亚临床甲减的疗效及对血脂的影响。方法选取2016年1月~2017年1月在我院住院治疗的亚临床甲减患者60例,所有患者根据治疗方法不同随机分为观察组和对照组,每组各30例,对照组根据患者主诉,如乏力、怕冷、浮肿、便秘等进行对症治疗;观察组予以左旋甲状腺素钠1μg/(kg·d)口服治疗,连续治疗3个月。治疗后比较两组的甲状腺激素及血脂各项指标、临床疗效。结果治疗后,观察组、对照组患者的FT3、FT4水平较治疗前明显降低,TSH水平较治疗明显提高,且观察组较对照组变化更显著(P0.05),观察组、对照组的TC、TG及LDL-C水平较治疗前显著降低,而HDL-C水平显著升高,且观察组患者的TC、TG、HDL-C及LDL-C水平较对照组改善更显著(P0.05),两组患者治疗后的总有效率分别为96.7%、70.0%,观察组的总有效率明显高于对照组(P0.05)。结论左旋甲状腺素治疗亚临床甲减疗效确切,能显著降低血脂水平。     

黄连素对L-甲状腺素诱发大鼠心肌肥厚的保护作用

目的　研究黄连素对 L-甲状腺素 (L- Thy)诱发大鼠发生心肌肥厚的保护作用。方法　 SD大鼠腹腔注射 (ip) L-甲状腺素 0 .5 mg/(kg· d)× 10 d,造成心肌肥厚模型 ,同时用黄连素 30 mg/(kg· d)× 10 d灌胃 ,观察大鼠的心肌肥厚指数 ,心肌细胞膜 Na+ - K+ - ATP酶和肌浆网 Ca2 + - ATP酶活力 ,心肌 NO含量 ,心肌钙调神经磷酸酶 (Ca N)活力的变化。结果　与正常对照组相比 ,心肌肥厚组心肌肥厚指数、Ca N活力明显升高 (P<0 .0 1) ,而心肌NO含量、Na+ - K+ - ATP酶活力和 Ca2 + - ATP酶活力均显著降低 (P<0 .0 1)。黄连素治疗组心肌肥厚指数 ,Ca N活力显著低于肥厚组 (P<0 .0 1) ,心肌 NO含量、Na+ - K+ - ATP酶活力和 Ca2 + - ATP酶活力则显著高于肥厚组 (P<0 .0 1)。结论　黄连素对 L-甲状腺素诱导的大鼠心肌肥厚具有保护作用。     

促性腺激素释放激素激动剂延长给药间隔治疗子宫腺肌病和子宫内膜异位症的疗行

目的 探讨促性腺激素释放激素激动剂(GnRH-a)延长给药间隔周期治疗子宫腺肌病、子宫内膜异位症(内异症)的疗效.方法 子宫腺肌病、内异症患者共60例,随机分成两组(n=30).按药方传统给药方法,每4周肌肉注射曲普瑞林3.75 mg,共6次,疗程均为24周,设为对照组;以延长给药间隔周期的新方案作为研究组,每6周肌肉注射曲普瑞林3.75 mg,共4次,疗程亦为24周,但总用药量减少两次.观察治疗前后痛经程度、子宫体积、血清性激素水平的变化.结果 治疗结束时,两组痛经缓解率均为100%;研究组与对照组子宫体积平均缩小分别为37.6%与39.2%.两组患者药物治疗前后黄体生成素(LH)、卵泡刺激素(FSH)及雌二醇(E2)水平 ,均明显降低(P＜0.001),E2降至绝经期水平,分别为(65.6±8.7)pmol/L和(60.0±6.3)pmol/L;用药前,第1次用药后及治疗后12周、24周,研究组与对照组相比,差异均无统计学意义(P＞0.05).结论 应用GnRH-a延长给药间隔的新方案治疗子宫腺肌病、内异症,同样能达到与传统方案相同的疗效,即低雌激素状态的抑制效应,但治疗费用显著降低.     

促性腺激素释放激素激动剂延长给药间隔治疗子宫腺肌病和子宫内膜异位症的疗效

目的探讨促性腺激素释放激素激动剂(GnRH-a)延长给药间隔周期治疗子宫腺肌病、子宫内膜异位症(内异症)的疗效。方法子宫腺肌病、内异症患者共60例,随机分成两组(n=30)。按药方传统给药方法,每4周肌肉注射曲普瑞林3.75mg,共6次,疗程均为24周,设为对照组;以延长给药间隔周期的新方案作为研究组,每6周肌肉注射曲普瑞林3.75mg,共4次,疗程亦为24周,但总用药量减少两次。观察治疗前后痛经程度、子宫体积、血清性激素水平的变化。结果治疗结束时,两组痛经缓解率均为100%;研究组与对照组子宫体积平均缩小分别为37.6%与39.2%。两组患者药物治疗前后黄体生成素(LH)、卵泡刺激素(FSH)及雌二醇(E2)水平均明显降低(P<0.001),E2降至绝经期水平,分别为(65.6±8.7)pmol/L和(60.0±6.3)pmol/L;用药前,第1次用药后及治疗后12周、24周,研究组与对照组相比,差异均无统计学意义(P>0.05)。结论应用GnRH-a延长给药间隔的新方案治疗子宫腺肌病、内异症,同样能达到与传统方案相同的疗效,即低雌激素状态的抑制效应,但治疗费用显著降低。     

免疫增强透射比浊法测定超敏C-反应蛋白的方法学评价

目的 :对免疫增强透射比浊法在全自动生化分析仪上测定超敏C 反应蛋白 (Hs CRP)的方法进行评价。方法 :检测该方法的分析范围、最低检测限、精密度、抗干扰能力及参考范围。结果 :免疫增强透射比浊法测定Hs CRP的分析范围为 0 .12 5～ 12 .5mg/L ,最低检测限为 0 .115mg/L ,批内、批间精度分别为 0 .89%和0 .90 %;本实验室Hs CRP的参考范围为 0 .2 0～ 2 .6 0mg/L。结论 :免疫增强的透射比浊法在全自动生化分析仪上测定Hs CRP的方法具有敏感性高、稳定性好、方便快速的优点 ,适宜于在临床推广应用。     

甲状腺素片对药物治疗Graves病复发率的临床研究

目的 :研究抗甲状腺药物合并甲状腺素片是否对Graves病复发率的影响。方法 :对 2 3 8例患者在他巴唑治疗至甲状腺功能正常后随机分单独他巴唑治疗组和他巴唑合并甲状腺素片治疗组。并监测患者的甲状腺功能、TRAb、TGAb、TPOAb。结果 :合并使用甲状腺素片治疗组较单独使用他巴唑组TRAb水平及Graves病的复发率低 ,且其复发时间也有所推迟。结论 :抗甲状腺药合并甲状腺素片治疗有助于减少或推迟Graves病复发的作用。     

免疫增强透射比浊法测定超敏C-反应蛋白的方法学评价

目的：对免疫增强透射比浊法在全自动生化分析仪上测定超敏C-反应蛋白(Hs-CRP)的方法进行评价。方法：检测该方法的分析范围、最低检测限、精密度、抗干扰能力及参考范围。结果：免疫增强透射比浊法测定Hs-CRP的分析范围为0．125～12．5mg／L，最低检测限为0.115mg／L，批内、批间精度分别为0．89％和0．90％；本实验室Hs-CRP的参考范围为0．20～2．60mg／L。结论：免疫增强的透射比浊法在全自动生化分析仪上测定Hs-CRP的方法具有敏感性高、稳定性好、方便快速的优点，适宜于在临床推广应用。     

尿毒症患者甲状腺激素水平的研究

目的 研究尿毒症患者甲状腺激素水平,以指导其治疗.方法 将尿毒症患者分为血液透析组和非透析组,采用放射免疫法测定血液中甲状腺激素水平,并与正常对照组相比较.结果 尿毒症患者的T3、T4均显著低于正常对照组(P<0.01),而TSH差异无统计学意义(P>0.05);尿毒症病人中血液透析组血液中甲状腺激素水平减低少于非透析组(P<0.01),而TSH差异无统计学意义.结论 尿毒症患者易发生甲状腺功能减退,血液透析治疗能减少其发生.     

重组生长激素释放激素GHRH的纯化及活性测定

目的 用基因工程的方法在大肠杆菌中诱导表达重组生长激素释放激素(GHRH),检测其生物学活性。方法 将重组表达质粒pET-28a /L-ansB-GHRH,转化大肠杆菌BL21(DE3),IPTG诱导融合蛋白表达。经裂解细胞、洗涤、乙醇沉淀、酸水解、SP-Sephadex C-25和Sephadex G25柱层析等方法纯化GHRH。用人生长激素放免试剂盒检测GHRH多肽的活性。结果 SDS-PAGE分析显示重组表达质粒在大肠杆菌中成功地表达了融合蛋白,它以不溶性的包涵体形式存在,占菌体总蛋白的30%左右。经抽提、酸水解、层析等方法表明纯化倍数达147倍,多肽收率为0.68%。通过电喷雾质谱测得多肽的相对分子质量为5235.25,与理论计算值相吻合。多肽的纯度经SDS-PAGE测定为单一峰。GHRH三组刺激实验组与空白对照组相比之间差异显著(P<0.01),且随着剂量增加,差异明显增加。结论 体外重组GHRH多肽具有较高的生物学活性。     

高通量血液透析对甲状旁腺素的影响

目的探讨高透量血液透析（HFHD）对甲状旁腺素（PTH）的影响。方法选择30例维持性血液透析患者,先后接受血液透析（HD）和高通量血液透析两种透析方式,HD选用费森尤斯F6透析器,超率系数为5.5ml/（h.mmHg）,聚砜膜,表面积为1.3m×1.3m,HFHD选用德国费森尤斯F60透析器,超率系数为40ml/（h·mm-Hg）,聚砜膜,表面积为1.3m×1.3m。分别于单次透析前、后测定患者血清尿素氮（BUN）、肌酐（Cr）、钙（Ca）、磷（P）、甲状旁腺素（PTH）和瘦素（Leptin）水平,计算单次透析前、后溶质下降率,并对两种透析方式溶质的下降率进行比较。结果HD和HFHD治疗后血BUN、Cr的下降率差异无统计学意义（P〉0.05）。HFHD治疗后血P、PTH和Leptin的下降率明显高于HD（P〈0.05）。结论HFHD能降低血PTH浓度。     

重组生长激素释放激素GHRH的纯化及活性测定

OBJECTIVE: To express recombinant growth hormone-releasing hormone (GHRH) peptide in E.coli by genetic engineering and examine its biological activity. METHOD: GHRH peptide was purified to homogeneity by means of cell lysis, washing, ethanol precipitation, acid hydrolysis, SP-Sephadex C25 and Sephadex G-25 column chromatographies. RESULT: SDS-PAGE showed that the recombinant plasmid pET-28a /L-ansB-GHRH in E.coli BL21(DE3) expressed the fusion protein under the induction with IPTG. The fusion protein was expressed in the form of inclusion body, accounting for 30% of the total bacterial protein. After the purification procedures, the peptide was purified about 147-fold with a peptide yield of 0.68%. The molecular mass of the peptide was 5 235 Da as determined by electrospray ionization (ESI) mass spectrum, in agreement with the predicted value, and SDS-PAGE presented a single peak in assessment of the purity. Experiment showed that there were significant differences in the growth hormone released by the peptide between the dose groups and the blank control group, and the differences tended to be more obvious with the increase of the doses. CONCLUSION: The recombinant GHRH peptide possesses good biological activities.     

Normal thyrotrophin response to intravenous thyrotrophin releasing hormone administration: the best index of optimal L-thyroxine therapy in primary hypothyroidism

Normalization of basal thyrotrophin (TSH) level is used as the endpoint in L-thyroxine (L-T4) therapy of primary hypothyroidism. However, several reports have questioned the reliability of this index because of seasonal variation of TSH. Therefore, we studied 85 consecutive patients with primary hypothyroidism over a period of 3.5 y. In these patients, TSH response (delta TSH) to intravenous thyrotrophin releasing hormone (TRH) administration was examined when basal TSH was normalized with L-T4 therapy. Eight patients showed a blunted response (delta TSH less than 5 microU), whereas 27 patients demonstrated an exaggerated response (delta TSH greater than 25 microU). Thus, 42% of patients were apparently on inappropriate L-T4 dosage. These abnormal TSH responses normalized on adjusting the L-T4 dosage alone; prolonged therapy with the same dose failed to normalize TSH responses. Minor seasonal variations of basal TSH were observed in 30% of patients. However, TSH response to TRH remained normal. Hence, no adjustment of L-thyroxine dose was required. This study, therefore, demonstrates that normalization of TSH response to TRH administration rather than basal TSH may be the best index of adequate L-thyroxine therapy in primary hypothyroidism.     

不耐高温手术器械两种灭菌方法的效果比较

目的探讨不耐高温手术器械寿命的灭菌方法。方法对过氧化氢等离子低温灭菌法和戊二醛气体熏蒸灭菌箱消毒不耐高温手术器械进行比较。结果两种灭菌方法均达到灭菌要求;过氧化氢等离子低温灭菌法比戊二醛气体熏蒸灭菌箱灭菌法省时155min;灭菌相关器械损耗率分别为戊二醛气体熏蒸灭菌箱0．18％,过氧化氢等离子低温灭菌法为0,差异有统计学意义（P〈0．01）;灭菌剂毒性反应发生率分别为戊二醛气体熏蒸灭菌箱灭菌法3．24％,过氧化氢等离子低温灭菌法为0,差异有统计学意义（P〈0．05）。结论使用过氧化氢等离子低温灭菌器消毒不耐高温手术器械,灭菌周期短,质量可靠,对器械损伤小,对人和环境无害,是不耐高温手术器械首选的灭菌方法。     

Parathyroid carcinoma: location of pelvic metastases by parathyroid hormone assay

A metastasis from a functioning parathyroid carcinoma was located by PTH radioimmunoassay and selective venous catheterization. The site of the metastasis, verified at autopsy, was in the right side of the pelvis. This is the most distant reported location for metastatic parathyroid carcinoma. The patient's plasma immunoreactive PTH rose more than twofold in response to induced hypocalcemia. This suggests that relative hypocalcemia, induced therapeutically in such patients, may result in a higher chronic level of PTH secretion.     

鸭乙型肝炎病毒感染特异细胞介导免疫检测方法的建立

目的：建立简便、特异的鸭乙型肝炎病毒（DHBV）感染特异细胞介导免疫（CMI）检测方法。方法：分别从DHBV强阳性的血清和肝组织中纯化DHBsAg、DHBcAg,Bradford法定量后，用于急性DHBV感染重庆麻鸭CMI的检测。结果：急性感染后10d鸭外周血单个核细胞（PBMC）快速出现对DHBsAg、DHBcAg的不同程度增殖反应，5周内下降至正常水平。7份刺激细胞上清DuIFN-γ检测结果为阳性，OD540nm读数介于0．062－0．108之间，细胞因子的表达水平与PBMC增殖反应强度呈现较好的相关性。结论：DHBV感染重庆麻鸭CMI检测方法的建立，为了解感染鸭特异免疫应答状态提供了重要参考。