甲状腺腺瘤和腺瘤性甲状腺肿腺叶切除后甲状腺素的补充

目的：探讨甲状腺腺瘤和腺癌性甲状腺肿一侧甲状腺腺叶切除术后补充甲状腺素的临床意义。方法；将接受一侧甲状腺腺叶切除术的40例甲状腺腺瘤或腺癌性甲状腺肿患者随机分为两组：A组术后口眼甲状腺片，B组术后不服甲状腺片，比较术前及术后3～6个月血清TT3、TT4及TSH值和超声波检查保留侧甲状腺大小。结果：A组手术前后TT3、TT4、TSH值及保留侧甲状腺大小无明显变化，B组术后3～6个月TT3、TT4较术前下降，TSH较术前上升，保留侧甲状腺较术前增大。术后的各项数据两组比较，均有显著性差异。结论：甲状腺腺瘤和腺癌性甲状腺肿一侧腺叶切除术后保留侧甲状腺腺叶有增生，而术后补充甲状腺素可改变这一现象从而预防甲状腺癌的发生。     

TOWARDS SUSTAINABLE ELIMINATION OF IODINE DEFICIENCY DISORDERS: A CASE STUDY OF SELECTED VILLAGES IN THE ENDEMIC SOUTHERN HIGHLANDS, TANZANIA

A study was conducted to evaluate the impact and achievements of the government-supported program to eliminate iodine deficiency disorders in selected villages in the Southern Highlands, Tanzania. Results showed that most of the respondents in the surveyed households (92.9%, n = 496) had a clear knowledge of iodine deficiency disorders. More than 99% of the surveyed households were using iodized salt and only a small proportion (0.4%) was using noniodized salt. The majority of the surveyed households (66%, n = 440), retail and wholesale shops had good salt handling practices that minimized iodine losses. The median urinary iodine concentrations were 166 µg/g for boys, 171 µg/L for girls, and 169 µg/L for reproductive-age women. Goiter prevalence among school-age children was Grade one (7%, n = 583), Grade two (0.5%, n = 583) and Grade zero (93%, n = 583). It was concluded that significant achievements have been made in controlling iodine deficiency disorders in the surveyed district. The government should continue the current efforts to ensure sustainability.     

彩色多普勒超声在诊断结节性甲状腺肿的应用价值

目的:探讨高频超声声像图和彩色多普勒血流图对结节性甲状腺肿的诊断价值.方法:对31例甲状腺肿的结节进行仔细观察,评价二维图象和彩色多普勒血流图的表现.结果:超声诊断与病理诊断的符合率为68%,实质性及囊实性结节性甲状腺肿的结节表现无包膜或包膜不完整,周边无明显的晕环.结节内部及周边血供不丰富,边缘无环形血流,呈星点状或结节间穿行血流,彩色多普勒能量图,在结节血流显示上优于彩色多普勒血流图.结论:应用彩色多普勒超声对结节性甲状腺肿能够提供重要的血流信息,有助于结节性甲状腺肿的诊断及鉴别诊断,对提高超声诊断正确率有重要意义.     

十二指肠结节性病变病理分型及诊断17例

目的:确定十二指肠结节性病变组织病理学特征及分型.方法:统计分析经内镜下被确诊为十二指肠结节性病变患者的资料.对其年龄、性别、类型、症状、最后诊断、相关疾病和组织病理学特点等记录进行回顾性研究.同时亦分析患者血红蛋白、平均细胞体积、血清铁蛋白、白蛋白、免疫球蛋白、腹腔自身抗体、贾第虫和粪便OVA寄生虫,ELISA分析贾第虫的特异性抗原水平.结果:筛选出17例经内镜确诊为十二指肠结节性病变的患者.诊断时平均年龄为28.1岁(17-56岁),男9例,女8例.十二指肠结节性病变中,腹痛(47%)是最常见的临床症状,胃窦结节(41%)是最常见的内镜表现.十二指肠结节性病变的组织病理学评估显示,所有患者均有慢性炎症,嗜酸性粒细胞在隐窝间和上皮内增殖占70.5%,47%的患者存在绒毛萎缩.通过组织学检查和/或特定的蓝氏贾第鞭毛虫粪便抗原阳性实验显示有6例患者感染贾第虫.患者的临床诊断显示某些特征,如腹泻、贾第虫病、分泌型IgA缺乏症和幽门螺杆菌(Helicobacter pylori,H.pylori)胃炎,并且他们中的一些与其他的有相关性.结论:十二指肠结节性病变其黏膜有明显淋巴细胞和/或嗜酸性粒细胞浸润,建议应对造成这一显著炎症反应的微生物学和免疫学病因进行进一步研究.     

Coexistence of nodular regenerative hyperplasia of the liver and pulmonary arterial hypertension in patients with connective tissue diseases: report of three cases and review of the literature

Abstract

Nodular regenerative hyperplasia of the liver (NRH) is known to be a rare condition in patients with connective tissue diseases (CTD). In this report, we document three patients with CTD who had both NRH and pulmonary hypertension (PH). All three patients developed PH during their course and thereafter developed NRH. The clinical course of these patients suggests that circulatory disturbance caused by PH might be a trigger for NRH.     

Nodular Fasciitis of the Oral Cavity with Partial Spontaneous Regression (Nodular Fasciitis)

Nodular fasciitis is a lesion found in the subcutaneous fascia that micoscopically presents as a benign proliferation of fibroblasts and myofibroblasts, which may be mistaken for a sarcoma due to clinically rapid growth. Diagnosis is by histopathology and of the immunohistochemical profile. We describe a case of nodular fasciitis in the oral cavity that demonstrated partial spontaneous regression. The patient was a 32-year-old man with a buccal mucosal mass, which had grown rapidly for 45 days. On microscopic examination, the lesion displayed a well-delineated but not encapsulated proliferation of spindle cells, with a nodular growth pattern. Immunohistochemical analysis showed positivity of the spindle cells for the antibodies against smooth muscle actin and muscle-specific actin (HHF-35). Treatment of such lesions typically involves complete conservative excision, but the lesion may regress eventually in the absence of definitive treatment.     

胸骨后甲状腺肿的诊断与外科治疗(综述)

胸骨后甲状腺肿是最常见的上纵隔占位性病变。胸骨后甲状腺肿多是因胚胎时期甲状腺异常生长发育而导致的位置及形态的异常,一般位于气管和胸骨间的前上纵隔处生长,部分可生长于咽后间隙。由于其恶变可能性大,且压迫症状影响器官功能,一旦发现通常采取手术治疗。目前大多数主要采用低领式切口路径切除胸骨后甲状腺。胸骨后甲状腺的诊断及治疗并不复杂,如何早期发现疾病,把握不同手术适应证是我们主要探讨的问题。     

Histopathological characteristics of human non-tumor thyroid tissues in a long-term model of adenomatous goiter xenografts in the NOD/Shi-scid,IL-2Rγnull mouse

There is a growing need for modeling the human thyroid to link data obtained from animals to humans because of its sensitivity to radiation exposure and endocrine disruption chemicals. In a scid mouse model produced by transplanting human thyroid tissues, leakiness and thymic lymphoma that occurs spontaneously in the scid mouse can complicate the interpretation of experimental results. Considering that the NOD.Cg-Prkdc^scid Il2rg^tm1Sug/Jic mouse (NOD/Shi-scid, IL-2Rγ^null or NOG mouse) may be a better host because this strain has low incidence of leakiness and thymic lymphoma, we have evaluated the potential of a model that allows long-term observation of non-tumor human thyroid tissues in this mouse. We transplanted tissues of human adenomatous goiter into NOG mice and examined the tissues histopathologically. The morphology of human adenomatous goiter tissues was maintained from 24 to 44 weeks after transplantation in NOG mice with no noted differences between donor-matched tissues or the weeks after transplantation. The tissues expressed thyroglobulin protein and mRNA as well as thyroperoxidase. Endothelial cells originating from human were found in the transplanted tissues and were thought to be a characteristic of this model. The intactness of the tissues before transplantation was found to affect the rate of tissue engraftment. From the present results we have concluded that transplanted thyroid tissues in NOG mice maintain the histopathological characteristics of their origin for long terms. Therefore this model was thought feasible for toxicity evaluation.