The Effect of Acute and Chronic Exercise on Thyroid Hormones in Obesity

Abstract Thyroid hormones were measured before, during and after acute exercise (60 min) or physical training (3 months) in obese women. Thyroid stimulating hormone concentration increased during acute work and decreased immediately after. No changes were seen during the two following days. An increase was seen after ten days as well as after three months of physical training. Thyroxine concentrations showed no changes. 3,5,3′-Triiodothyronine decreased slightly immediately after acute exercise, and after three months of physical training, 3,3′,5′-triiodothyronine (reverse triiodothyronine) increased slowly during and after acute exercise. A negative correlation was found between changes in fasting insulin and thyroxine and a positive correlation between changes in blood pressure and triiodothyronine after training. Lack of agreement in previous reports is probably due to methodological differences such as methods more or less susceptible to fatty acid interference, and thyroid hormones changing differently during acute work and before and after physical training. The duration of the study may also be of importance, even 3 months possibly being too short for attaining equilibrium in thyroid homeostasis.     

甲状腺手术205例分析

对205例甲状腺手术进行分析,其发病情况与资料报道基本相符。各种并发症的发生率未超过1%,无手术死亡,术后无甲状腺危象发生,与60年代以前相比已大为降低。     

双侧声带麻痹及固定的治疗：附12例报告

文中总结了１２例双侧声带麻痹或固定的治疗。气道通畅型２例，行病因治疗。气道阻塞型１０例，８例作了气管切开术，声带外移术３例，２例呼吸发音功能恢复较好，１例失败者行一侧声带切除＋喉扩张术。另外２例行Ｔ型管扩张术，均顺利拔管。药物治疗共５例。并讨论各种手术治疗现状。     

长链非编码RNA lnc-CCDC33-1:1在甲状腺乳头状癌中的表达及临床意义

目的：检测lnc-CCDC33-1:1在甲状腺乳头状癌（PTC）中的表达,并分析其临床意义。方法：选取2021年11月至2022年3月杭州市萧山区第一人民医院收治的120例PTC患者,收集120例PTC组织及30例癌旁正常甲状腺组织。采用qRT-PCR检测lnc-CCDC33-1:1在PTC组织及癌旁组织中的表达。分析本地队列和TCGA队列中lnc-CCDC33-1:1表达水平与PTC患者临床病理因素的相关性。采用受试者工作特征（ROC）曲线评价lnc-CCDC33-1:1对PTC的诊断价值。结果：与癌旁正常甲状腺组织比,lnc-CCDC33-1:1在PTC组织中表达明显升高（P ＜0.001）。ROC曲线显示曲线下面积为0.803（95%CI =0.736～0.869,P ＜0.001）。本地队列显示lnc-CCDC33-1:1 表达与PTC肿瘤大小（P =0.048）、腺外侵犯（P =0.019）、T分期（P =0.011）和淋巴结转移（P =0.009）相关,TCGA组数据显示lnc-CCDC33-1:1表达水平与PTC腺外侵犯（P =0.036）和淋巴结转移（P ＜0.001）相关。结论：lnc-CCDC33-1:1在PTC中表达异常升高,与PTC高危特征相关,可能是潜在的诊断标志物和治疗靶点。     

声触诊组织成像量化技术联合C-TIRADS与K-TIRADS对甲状腺结节的诊断效能比较

目的探讨声触诊组织成像量化(VTIQ)技术联合中国超声甲状腺影像报告系统(C-TIRADS)和韩国甲状腺影像分级系统(K-TIRADS)对甲状腺结节良恶性的诊断效能。 方法回顾性选择160例甲状腺结节患者,按病理结果分为良性组和恶性组。所有患者均经常规超声检查、VTIQ检查,根据C-TIRADS、K-TIRADS分级标准进行分级。ROC曲线分析C-TIRADS、K-TIRADS单独诊断或联合VTIQ对甲状腺结节良恶性的诊断效能。 结果两种系统单独应用时,K-TIRADS灵敏度低于C-TIRADS,但K-TIRADS特异性更高。与C-TIRADS、K-TIRADS比较,K-TIRADS和C-TIRADS联合VTIQ对甲状腺结节的诊断效能均有所增加,C-TIRADS联合VTIQ后特异度和灵敏度高于K-TIRADS联合VTIQ(P＜0.05)。 结论C-TIRADS或K-TIRADS联合VTIQ对甲状腺结节良恶性的诊断效能高于单独诊断,C-TIRADS联合VTIQ更有利于甲状腺良恶性判断。     

C-TIRADS及BRAFV600E基因检测对细针穿刺细胞学难以定性的甲状腺结节的诊断价值

目的 探讨中国版甲状腺影像数据与报告系统（C-TIRADS）、BRAFV600E 基因检测及二者联合对细针穿刺细胞学难以定性的甲状腺结节的诊断价值。方法 纳入我院2020年1月—2021年4月的甲状腺手术患者53例行回顾性分析,术前完成超声、细针穿刺抽吸及BRAFV600E基因检测,选取细针穿刺细胞学难以定性的患者作为研究对象,53例患者共62个结节。以手术病理结果作为金标准,比较C-TIRADS、BRAFV600E基因检测及二者联合诊断对甲状腺结节的诊断效能。结果 C-TIRADS诊断甲状腺癌的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为92.50%、50.00%、77.08%、78.57%、77.42%。BRAFV600E基因诊断甲状腺癌的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为55.00%、100.00%、100.00%、55.00%、70.97%。C-TIRADS联合BRAFV600E基因诊断甲状腺癌的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为95.00%、50.00%、77.55%、84.62%、79.03%。C-TIRADS及联合诊断对甲状腺癌诊断的敏感性高于BRAFV600E基因检测（P<0.001）,BRAFV600E基因检测特异性及阳性预测值高于C-TIRADS及联合诊断（P<0.05）。C-TIRADS、BRAFV600E基因检测及联合诊断对甲状腺癌诊断的阴性预测值和准确性差异无统计学意义（P>0.05）。结论 C-TIRADS及BRAFV600E基因检测对于细胞学难以定性的甲状腺结节均有良好的诊断效能,术前联合应用可以更好地评估甲状腺结节     

血清Tg、TgAb对甲状腺癌根治术联合131I治疗后随访期间复发/转移的评估价值

目的 研究血清甲状腺球蛋白（Tg）、甲状腺球蛋白抗体（TgAb）对甲状腺癌根治术联合¹³¹I治疗后随访期间复发/转移的评估价值。方法 回顾性分析2018年6月—2020年6月中国贵航集团三〇二医院收治的106例分化型甲状腺癌患者的临床资料,患者均接受甲状腺癌根治术治疗,术后均采用¹³¹I进行清除残留的甲状腺组织（清甲）治疗。随访24个月,将患者分为复发转移组（21例）和未复发转移组（85例）。比较两组临床资料、¹³¹I治疗情况及血清促甲状腺激素（TSH）、Tg、TgAb。绘制受试者工作特征（ROC）曲线分析血清Tg、TgAb检测对甲状腺癌根治术联合¹³¹I治疗后复发/转移的预测价值。采取非条件一般Logistic回归模型进行多因素分析。结果 与未复发转移组比较,复发转移组原位肿瘤T₄分期、手术方式为腺叶切除或近全切、残余甲状腺质量≥1 g、手术至¹³¹I治疗时间> 3个月、24 h摄¹³¹I率≤ 20%患者的占比均较高（P <0.05）;复发转移组血清Tg和TgAb水平均较高（P <0.05）;ROC曲线分析结果显示：血清Tg预测甲状腺癌根治术联合¹³¹I治疗后复发或转移的最佳截断值为1.674 μg/L,AUC为0.803（95% CI：0.721,0.884）,敏感性为81.1%（95% CI：0.724,0.898）,特异性为63.8%（95% CI：0.585,0.691）;血清TgAb预测的最佳截断值为44.19 3 IU/mL,AUC为0.911（95% CI：0.859,0.963）,敏感性为89.2%（95% CI：0.813,0.971）,特异性为72.5%（95% CI：0.674,0.774）。非条件Logistic一般回归分析结果显示：原位肿瘤T₄分期［O^R=2.916（95% CI：1.325,6.417）］、腺叶切除或近全切［O^R=3.243（95% CI：2.174,4.838）］、残余甲状腺质量≥ 10 g［O^R=1.835（95% CI：1.514,2.224）］、手术至¹³¹I治疗时间> 3个月［O^R=1.962（95% CI：1.371,2.808）］、24 h摄¹³¹I率≤ 20%［O^R=2.638（95% CI：1.219,5.709）］、血清Tg ≥ 1.674 μg/L［O^R=2.503（95% CI：1.430,4.360）］、血清TgAb≥ 44.193 IU/mL［O^R=2.944（95% CI：2.016,4.299）］可能是甲状腺癌根治术联合¹³¹I治疗后复发或转移的危险因素（P <0.05）;风险因素预测模型预测甲状腺癌根治术联合¹³¹I治疗后复发/转移的ROC曲线下面积为0.961（95% CI：0.935,0.987）,标准误为0.010,临界值为73.162,敏感性为91.9%（95% CI：0.863,0.957）,特异性为88.2%（95% CI：0.845,0.922）。结论 甲状腺癌根治术联合¹³¹I治疗后出现复发/转移的患者血清Tg、TgAb水平明显升高,Tg、TgAb对预测复发/转移具有较好的价值,联合其他危险因素建立风险因素预测模型可进一步提高预测价值。     

Galectin-3 does not reliably distinguish benign from malignant thyroid neoplasms

AIMS: To determine whether galectin-3 is a sensitive indicator of thyroid malignancy. It has been suggested as a potential marker for differentiating thyroid carcinoma from benign or non-neoplastic lesions in preoperative fine-needle aspirates (FNAs). METHODS: Galectin-3 protein expression was assessed by immunohistochemistry in formalin-fixed thyroid tissues from 124 patients with histological diagnoses of papillary carcinoma (n = 38), follicular carcinoma (n = 19), follicular adenoma (n = 32) and dominant nodules of multinodular goitre (n = 35). Expression of galectin-3 was also assessed by Western blotting in 24 fresh thyroid tissues. RESULTS: Galectin-3 expression was observed in the majority of carcinomas (papillary 92%; follicular 74%). However, a large proportion of follicular adenomas (72%) and multinodular goitres (57%) also expressed galectin-3. In addition, galectin-3 expression was observed in epithelial cells of normal thyroid tissue and Hashimoto's thyroiditis. Galectin-3 immunopositivity was significantly greater in papillary carcinomas than in dominant nodules or follicular adenomas (P < 0.0001, P = 0.0005, respectively). However, galectin-3 expression was no greater in follicular carcinomas than in follicular adenomas (P = 0.8735). Western blotting analysis confirmed both the specificity of the antiserum and expression of galectin-3 in multinodular goitres, follicular adenomas/carcinomas and papillary carcinomas. CONCLUSION: The data demonstrate that galectin-3 is not a reliable immunohistochemical marker to distinguish benign from malignant thyroid follicular lesions.     

全喉切除术中保留甲状软骨膜对手术进程和术后恢复影响的探讨

目的：探讨保留甲状软骨膜对全喉切除手术进程和病人术后恢复情况的影响。方法：在甲状软骨膜下游离甲状软骨并切断其上角。不结扎和切断舌骨下肌群和喉上动脉。保留之甲状软骨膜用以加强修复咽壁黏膜。结果：本组病例较经典全喉切除术手术时间缩短30min以上。手术中出血在100ml以下。患者术后第2d下床活动，第4d开始进食流质。手术创口均一期愈合。结论：全喉切除术中保留甲状软骨膜可有效地简化手术步骤，减少创伤和出血。利用甲状软骨膜加强咽壁黏膜缝合口，进一步减少了咽漏的发生.     

Levothyroxine treatment in thyroid peroxidase antibody-positive women undergoing assisted reproduction technologies: a prospective study

BACKGROUND: Infertile women positive for thyroid antibodies suffer from a poor pregnancy/delivery outcome, although conflicting data have been published. Our objective was to investigate if levothyroxine (LT4) exerts any effect on pregnancy and/or delivery rates in thyroid peroxidase antibody (TPOAb)-positive (+) women undergoing assisted reproductive technologies. METHODS: Patients undergoing treatment were screened for TPOAb, thyroid-stimulating hormone (TSH) and free thyroxine (FT4). A total of 72 (15%) out of the 484 euthyroid women selected were TPOAb (+). These 72 patients were randomly divided into two groups: group A (n = 36) underwent LT4 treatment, group B (n = 36) placebo. Group C consisted of 412 women (85%) who were TPOAb negative (-). All patients received controlled ovarian stimulation. The endpoints of treatment were pregnancy rate, miscarriage rate and delivery rate. RESULTS: No differences in pregnancy rate were observed between the three groups. Miscarriage rate was higher in TPOAb (+) in comparison to TPOAb (-) [relative risk: 2.01 (95% CI = 1.13-3.56), P = 0.028]. CONCLUSIONS: The pregnancy rate is not affected either by presence of TPOAb or treatment with LT4. However, TPOAb (+) women show a poorer delivery rate compared to TPOAb (-). LT4 treatment in TPOAb (+) does not affect the delivery rate.