沈阳地区新生儿先天性甲低筛查促甲状腺素切值研究

目的：建立沈阳地区新生儿先天性甲状腺功能减低症（CH）促甲状腺素（TSH）筛查切值。方法：新生儿出生72h后采集足跟血，滴于规定滤纸上，采用时间分辨荧光免疫分析方法（DELFIA），测定新生儿足跟血TSH含量。结果：测定新生儿足跟血TSH共计41907例，确定沈阳地区新生儿TSH切值为9．0tμIU／ml。结论：新生儿TSH筛查切值的确立为沈阳地区今后的新生儿CH筛查提供了依据。     

高频及彩色多普勒超声对甲状腺肿瘤的诊断价值

目的探讨应用高频及彩色多普勒超声对甲状腺肿瘤的诊断价值。方法应用彩色多普勒超声诊断仪,对128例甲状腺肿瘤患者进行超声检查,对术后经病理诊断的甲状腺肿瘤进行分析。结果经手术病理证实良性肿瘤超声诊断符合率（81/87）为93.1%,恶性肿瘤超声诊断符合率（34/41）为82.8%。结论应用高频及彩色多普勒超声能清晰显示甲状腺肿瘤的形态、大小、数目、内部回声及彩色血流情况,对甲状腺肿瘤的诊断有较高的临床应用价值,有助于对甲状腺良恶性肿瘤的鉴别诊断。     

Paradoxical vocal cord movement in newborn and congenital idiopathic vocal cord paralysis: two of a kind?

The second most common cause of stridor reported in the newborn is bilateral vocal cord paralysis (BVCP) and one-third of the cases have been categorized as idiopathic. During the last year four children with stridor since birth were referred to our department for examination. Videotaped flexible laryngoscopy, carried out with the patient awake or under general anaesthesia with a spontanous respiration, revealed instead of abduction of the vocal cords during inspiration, rather an active adductory movement. Consequently instead of BVCP, we made the diagnosis paradoxical vocal cord movement (PVCM). One of the twins required a tracheostomy, the three other patients have been observed without the need of further treatment. No previous publications have described PVCM in newborn. However, our observations and video recordings clearly show that the stridor in our four patients is due to PVCM. This is possibly the same condition as earlier reported as congenital, idiopathic BVCP where incoordinated vocal cord movement or dyskinesia has been a part of the laryngoscopic findings. The mechanism behind PVCM in this age group or site of lesion is unclear.     

Lymphocytes in peripheral blood and thyroid tissue in children with Graves’ disease

Background  This study was undertaken to analyze subsets of lymphocytes in peripheral blood in the early phase and in the thyroid tissue in the late phase of Graves’ disease (GD) in children. Methods  The study included 30 children with GD and 30 healthy children. Monoclonal antibodies were used to define peripheral blood lymphocyte subsets and they were analyzed using the flow cytometer Ortho Diagnostic System. After thyroidectomy, T cells were detected by CD3, CD4, CD8 antibodies, B cells by CD79α antibodies, and the antigen presenting dendritic cells (APCs) by CD1α antibodies (DakoCytomation) in the thyroid tissue. Results  Before the treatment, an increased percentage of CD4+ T helper cells and B cells and decreased CD8+ T suppressor/cytotoxic cells were observed in peripheral blood in all the GD children. The number of lymphocytes and dendritic cells in the thyroid tissue increased in the children with GD in comparison to the control group, especially T cells subsets CD4+ and CD8+ and CD79α+ B cells. The percentage of T cells in the thyroid tissue was lower and that of B cells was higher than in peripheral blood. In their structure, thyrocytes can have components similar to α-chains connected with β-microglobulins, which were characteristic for APCs. Conclusions  The primary defect of immunoregulation in children with GD is probably dependent on a large number and the activity of T helper cells and on a small number and hypofunction of T suppressor cells. The amount of lymphocytes decreased proportionally to the duration of methimazole treatment. The thyrocytes probably can present antigens.     

二维及频谱多普勒诊断甲状腺肿瘤的应用价值

目的:应用二维及频谱多普勒检测甲状腺肿瘤血管,并进行分析,探讨其在甲状腺肿瘤诊断和鉴别诊断中的价值,更好地为临床服务。方法:入选35例甲状腺良性肿瘤(结甲21例,腺瘤14例)和21例甲状腺癌患者术前均行二维及频谱多普勒检查,包括最高流速(Vmax),阻力指数(RI)。对良恶性肿瘤的二维图像特征及血流动力学参数差异进行分析。结果:甲状腺良恶性肿瘤的二维图像特征及血流动力学参数(Vmax、RI)存在极显著差异(P<0.01)。结论:二维及频谱多普勒对鉴别甲状腺良恶性肿瘤具有重要意义。     

甲状腺乳头状癌组织中VEGF-C及VEGFR3的表达及意义

目的观察VEGF-C和VEGFR3在甲状腺乳头状癌组织中的表达,研究二者表达的相关性,探讨甲状腺乳头状癌细胞淋巴管转移机理。方法用免疫组化方法检测VEGF-C和VEGFR3在人甲状腺乳头状癌、甲状腺腺瘤中的表达情况,并进行比较和分析。结果在甲状腺乳头状癌、甲状腺腺瘤组织中均见到VEGF-C和VEGFR3阳性表达,但在甲状腺乳头状癌组织VEGF-C和VEG-FR3的表达率和表达强度均高于甲状腺腺瘤,且VEGF-C和VEGFR3在甲状腺乳头状癌中的表达呈正相关。结论VEGF-C和VEGFR3在甲状腺乳头状癌细胞中高表达,并且可能与此肿瘤的淋巴管转移相关。     

甲状腺癌75例临床治疗分析

目的总结75例甲状腺癌临床诊治经验。方法回顾性分析75例甲状腺癌的临床资料。结果经病理诊断甲状腺癌75例,术前误诊32例,误诊率为42.9%。其中2次手术28例,占37.6%,根据病理结果采取不同的手术方式,行多功能联合根治术49例,占65.3%,术后床旁行气管切开4例,术后出血5例,乳糜瘘1例,单侧喉返神经损伤6例,因切口皮瓣坏死致瘢痕挛缩7例,手术死亡1例。结论术前注重病史、体格检查及B超诊断,术中快速冰冻切片,可减少误诊率。再次手术的手术方式,均应根据病理类型及临床分期决定,术中仔细操作,术后密切观察,可减少并发症的发生。     

维持性血液透析患者血清甲状腺激素与血脂代谢的相关性

目的探讨维持性血液透析(MHD)患者血清甲状腺激素的变化以及对MHD患者血脂代谢的影响。方法MHD组患者30例和正常对照组30例监测血清TT3、TT4、FT3、FT4、S-TSH,以及测定患者的血浆TP、ALB、TG、HDL、LDL、Scr和BUN。临床观察患者的身高、体重,计算BM I。分析血清甲状腺激素和血脂代谢的相关性。结果MHD患者血清甲状腺激素显著低于对照组(P<0.01),TP、ALB显著低于对照组(P<0.05,P<0.01);血浆TG、LDL显著高于对照组(P<0.05,P<0.05),HDL显著低于对照组(P<0.01)。结论血清甲状腺激素水平降低与肾功能损害程度密切相关,与MHD患者血脂代谢紊乱有一定的关系。因此,MHD患者血清甲状腺激素水平降低是MHD患者脂质代谢紊乱的重要因素之一。     

Toxicity of phorbol esters for human epithelial cells expressing a mutant ras Oncogene

Phorbol esters and related compounds provide a promising source of potential anticancer agents. The mechanism of their toxicity, however, is unclear, and interpretation has been complicated by the conflicting responses exhibited by different transformed cell lines. Previously we showed that in primary thyroid follicular cells, expression of mutant p21^ras conferred a striking sensitivity to the toxic effects of phorbol esters. We have now extended this work using a thyroid cell line with an inducible mutant ras gene to exclude the possibility that this result was a trivial consequence of the marked growth stimulation induced in these cells by mutant p21^ras. Furthermore, by assessing the action of a panel of phorbol esters and a potential chemotherapeutic agent, bryostatin, we demonstrated that this phenomenon was only a function of biologically active phorbol esters. These results provide a molecular rationale for the development of phorbol ester analogues as chemotherapeutic agents.