抑亢丸联合丙硫氧嘧啶治疗甲状腺功能亢进症的疗效观察

目的探讨抑亢丸联合丙硫氧嘧啶治疗甲状腺功能亢进症的临床疗效。方法选取2018年1月—2020年1月在驻马店市中心医院治疗的甲状腺功能亢进症患者86例,随机分为对照组(43例)和治疗组(43例)。对照组口服丙硫氧嘧啶片,初始剂量100 mg/次,3次/d,服用半个月后,根据甲状腺功能指标调整剂量为50 mg/次,3次/d。治疗组在对照组基础上口服抑亢丸,6g/次,2次/d。两组均连续治疗2个月。观察两组患者临床疗效,同时比较治疗前后两组患者血清游离三碘甲腺原氨酸(FT3)、血清游离甲状腺素(FT4)、三碘甲状腺原氨酸(T3)和甲状腺素(T4)水平,及不良反应情况。结果治疗后,对照组和治疗组临床有效率分别为76.74%和93.02%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者FT3、FT4、T3、T4水平均显著降低(P0.05),且治疗组显著低于对照组(P0.05)。治疗期间,对照组患者药物不良反应发生率为46.51%,显著高于治疗组的16.28%,两组比较差异具有统计学意义(P0.05)。结论抑亢丸联合丙硫氧嘧啶治疗甲状腺功能亢进可明显改善临床症状,促进甲状腺功能指标的恢复,且不良反应低。     

Behavioral habituation to spatial novelty: Interference and noninterference studies

Long-term behavioral habituation (LTH), that is activity decrement upon repeated exposures to spatial novelty, is a relatively simple and ubiquitous form of behavioral plasticity in the animal kingdom, that can be used as a model of nonassociative learning in the freely behaving organism. Several strategies can be followed to tackle upon it. (a) Interference studies pertain to manipulation of the between-exposure interval by a variety of agents of different nature, that are known to interfere with hypothesized “consolidation process(es)” in associative learning paradigms. This approach indicates that LTH is modulated by NMDA receptors, requires polysome aggregation and protein synthesis, a functioning neocortex and both slow wave and paradoxical sleep. Further, it is modulated by endogenously released or exogenously given vasopressin and is not affected by blockade of endogenous opioids, at least through the “mu” receptor type. Moreover, LTH is disrupted by bilateral, electrolytic lesion of the locus coeruleus, but it is only impaired by 6-OH-DA bilateral lesion of the dorsal noradrenergic bundle, and it is facilitated by electrolytic lesion of the medial septal nuclei. (b) Noninterference correlative studies: Individual differences in behavioral variables can be correlated to some components of the architecture of the hippocampus to reveal structure-function relationships. (c) Noninterference maturation studies pertain to the study of the maturation of LTH during postnatal development in a scaled-down Làt-maze in normally reared rats and in rats with deranged rate of body and brain growth by litter size technique, differential stimulation or by perinatal propylthiouracil-induced hypothyroidism. (d) Noninterference development studies pertain to the formation of LTH varying the between-exposure interval. It was studied in albino rats of a Sprague-Dawley, random-bred stock (NRB) and of the Naples High (NHE) and Low-Excitability (NLE) lines. The study was carried out during the light or the dark phase of a 12 : 12LD cycle, by retesting at different inter-exposure intervals. Multivariate analysis of variance showed significant effects of strain, inter-exposure interval and of postexposure sleep or wakefulness. Furthermore, analysis of the temporal pattern showed the formation of LTH to follow a non linear complex function. Further, behavioral habituation consists of emotional and cognitive components that can be separated across different approaches. In conclusion, long-term habituation to a novel environment is a useful model to study experience-induced nonassociative behavioral modifications.     

Graves病女性患者择期怀孕的临床观察

目的探讨寻找一个合适的方案,解决Graves病患者急于怀孕的问题。方法甲亢治疗初始阶段选用甲巯咪唑并做好避孕措施,在甲亢控制稳定并且所用药量比较少的时候改用PTU,以最小维持量控制甲亢,若病情稳定不停药的基础上准备怀孕。结果可以缩短从甲亢治疗到怀孕的时间,妊娠中后期大部分患者可以停药。     

Oral sensory phenotype identifies level of sugar and fat required for maximal liking

A half-century ago, Fischer and colleagues found correlations between food preference and genetic markers of taste [6-n-propylthiouracil (PROP), quinine]. Recently, a number of studies report differences in sweet liking/disliking with taste phenotype or genotype. Here we modeled optimal liking for milk/sugar mixtures using the response surface method among 79 mostly normal weight adults (36 women) who reported low dietary restraint. Two non-overlapping phenotype analyses were performed: a) discordance in PROP versus quinine bitterness and b) number of fungiform papillae (FP, taste papillae on the tongue tip). Although all phenotype groups liked highly sweet and creamy sensations (in liking by sensation models), the fat and sugar levels for hedonic optima varied (in liking by concentration models). Males generally liked higher fat (20 to 40%) and sugar levels, with females disliking unsweetened cream. In quinine/PROP groups, liking peaked at 30% fat/15% sucrose for men and women who tasted 0.32 mM quinine more bitter than 3.2 mM PROP (n=15); a group previously shown to have highest sugar intakes (Duffy et al., 2003). Those tasting PROP more bitter than quinine (n=14) reported greater creamy/sweet sensations, with peak liking at lower fat and sweet levels (3.3% fat/10% sucrose). Generally, those in the high FP group perceived more creamy/sweet sensations with level of liking more influenced by sugar level, especially among high FP females. At high sugar/high fat levels low FP males and females retained this liking while liking fell off for those in the high FP group. In summary, although most liked sweet/creamy sensations, perceptual differences in these sensations varied with oral phenotype, explaining some of the differences in the amount of sugar and fat required to reach hedonic optima. A high affinity for high sugar/high fat mixtures among oral phenotype subgroups has relevance for energy consumption and could explain the link previously observed between oral sensation and body weight.     

不同剂量丙基硫氧嘧啶治疗妊娠合并甲亢及对妊娠结局和凝血功能影响

目的:探索不同剂量丙基硫氧嘧啶治疗妊娠合并甲亢患者妊娠结局及对凝血功能影响。方法:选取2015年1月—2017年12月本院收治的150例妊娠合并甲亢患者,随机分为低剂量组75例(每天给予150mg丙基硫氧嘧啶)和高剂量组75例(每天给予300mg丙基硫氧嘧啶),比较两组妊娠结局、肝功能、甲状腺功能、凝血功能和甲亢治疗效果。结果:治疗后,与低剂量组比较,高剂量组ALP、GGT、TBIL、ALT和AST水平增高,TSH、FT4、FT3、TT4、PT、TT、FIB和DD水平降低,治疗总有效率(92.0%)高于低剂量组(77.3%),剖宫产、早产、妊娠期高血压、心力衰竭、重度子痫及胎儿窘迫、新生儿甲亢、低体重儿等发生率均低于低剂量组(均P<0.05)。结论:高剂量丙基硫氧密啶治疗妊娠合并甲亢,不仅可有效控制甲亢,减轻高凝状态,而且可以改善产妇及新生儿妊娠结局,但药物对患者的肝功能存在一定影响,需密切关注肝功能指标。     

心得安、丙硫氧嘧啶联合甲亢灵治疗甲亢的疗效观察

目的评价心得安、丙硫氧嘧啶片联合甲亢灵片治疗甲亢患者的疗效。方法选择甲亢患者80例,分成观察组和对照组各40例。对照组采用心得安及丙硫氧嘧啶片等西药治疗;观察组在对照组基础上加用甲亢灵片。结果观察组总有效率为95．00％（38／40）高于对照组总有效率80．00％（32／40）,具有显著差异（P〈0．05）。与治疗前比较,两组治疗后血清TT3、TT4、FT3、FT4均明显下降（P〈0．01）。血清TSH明显上升（P〈0．01）。两组治疗后比较,血清TT3、TSH差异有显著性（P〈0．01）。两组不良反应发生率差异不显著（P〉0．05）。结论心得安、丙硫氧嘧啶片联合甲亢灵片治疗甲亢患者疗效佳,而且不良反应也低,建议临床进一步推广应用。     

Intellectual capacity of subjects exposed to methimazole or propylthiouracil in utero

Antithyroid drugs, considered the treatment of choice for hyperthyroidism during pregnancy, may have an adverse effect on intellectual development of the offspring. We examined the intellectual capacity of 31 subjects aged 4–23 years, born to women with Graves disease who received antithyroid drugs throughout pregnancy. Methimazole 40–140 mg/week (n=15) or propylthiouracil 250–1400 mg/week (n=16) was given. I.Q. was assessed using the Wechsler test appropriate for age. Twenty-five unexposed siblings served as controls. The exposed and unexposed groups did not differ with respect to the total I.Q. Both groups scored equally in verbal and performance skills and in each of six main subcategories of the tests. There was no difference between exposure to methimazole and propylthiouracil or between the higher (>40 mg/week and >600 mg/week, respectively) and lower dosages. All children were euthyroid at birth and none had goitre. We conclude that exposure to methimazole or propylthiouracil during pregnancy in doses sufficient to control maternal hyperthyroidism does not pose any threat to intellectual capacity of the offspring.Presented in part at the 10th International Thyroid Congress, Jerusalem, Israel, 9–14 September, 1990. Abstract No. 304     

甲亢灵胶囊联合丙硫氧嘧啶治疗Graves病的疗效观察

目的探究甲亢灵胶囊联合丙硫氧嘧啶片治疗Graves病的临床疗效。方法选取2015年2月—2017年1月于西电集团医院收治的Graves病患者134例为研究对象,所有患者按随机数字表法分为对照组和治疗组,每组各67例。对照组口服丙硫氧嘧啶片,起始剂量100 mg/次,3次/d,至临床症状、甲状腺功能改善后逐渐减量至50~100 mg/d。治疗组在对照组治疗基础上口服甲亢灵胶囊,4粒/次,3次/d。两组均连续治疗6个月。观察两组的临床疗效,比较两组的甲状腺功能和甲状腺体积。结果治疗后,对照组和治疗组的总有效率分别为80.60%、94.03%,两组比较差异有统计学意义(P0.05)。治疗后,两组血清游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)水平均明显下降,血清促甲状腺激素(TSH)水平明显上升,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组这些甲状腺功能指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组甲状腺体积均明显减小,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组甲状腺体积明显小于对照组,两组比较差异具有统计学意义(P0.05)。结论甲亢灵胶囊联合丙硫氧嘧啶片治疗Graves病具有较好的临床疗效,能明显改善患者甲状腺功能,减小甲状腺体积,安全性较好,具有一定临床推广应用价值。     

丙基硫氧嘧啶治疗妊娠合并甲状腺功能亢进54例临床疗效观察

目的探讨丙基硫氧嘧啶治疗妊娠合并甲状腺功能亢进的疗效。方法将108例妊娠合并甲状腺功能亢进的患者平均分为丙基硫氧嘧啶（PTU）组和甲巯咪唑（MMI）组。前者采用PTU,后者采用MMI进行诊治。定期检查两组患者甲状腺功能,测定血清中促甲状腺激素（TSH）、血清游离甲状腺激素（FT4）和血清游离三碘甲腺原氨酸（FT3）的含量,根据监测结果调整药物剂量。结果治疗后,丙基硫氧嘧啶组孕妇的血清FT4和FT3含量比甲巯咪唑组低,且并发症发生率低于甲巯咪唑组,差异具有统计学意义沪〈0．05）。结论门u是目前临床上治疗妊娠期甲状腺功能亢进的首选药物,能够有效缓解甲状腺功能亢进症状,控制病情的发展,不会对孕妇和胎儿造成不良影响,值得在临床上推广应用。     

Marked recovery of functional metabolic activity and laminar volumes in the rat hippocampus and dentate gyrus following postnatal hypothyroid growth retardation: a quantitative cytochrome oxidase study

Similar to cretinism in human children, absence or deficiency of thyroid hormones in rats and mice during early postnatal development results in marked retardation of brain development along with behavioral and cognitive deficits. Less is known about brain recovery from postnatal hypothyroidism. [Farahvar, A., Meisami, E., 2007. Novel two-dimensional morphometric maps and quantitative analysis reveal marked growth and structural recovery of the rat hippocampal regions from early hypothyroid retardation. Experimental Neurology.] found, by means of morphometric maps, that surface areas of hippocampal cortex and its CA1-CA4 regions which were significantly reduced in developing hypothyroid rats, show nearly complete growth recovery upon restoration of thyroid function. Here we explore the ability of hippocampal synapse-rich neuronal fiber layers to show recovery from early hypothyroid growth retardation. Rat pups were made hypothyroid from birth to day 25 (weaning) or up to young adulthood (day 90) by a treatment with the reversible goitrogen, PTU (n-propylthiouracil), in the drinking water. Recovery was induced by withdrawal of PTU at weaning and analysis of cytochrome oxidase (CytOx)-stained serial sections of the hippocampus and dentate gyrus at the ages of 25 and 90 days. CytOx stains the synapse-rich fiber layers of the hippocampal formation (HCF). Volumetric growth of molecular layer, stratum oriens and radiatum and dentate hilar region showed complete or nearly complete recovery from marked and significant growth retardation induced by early postnatal hypothyroidism. Also the reduced CytOx staining intensity in the hypothyroid rat HCF layers showed marked recovery following hormonal restoration. Results indicate remarkable growth plasticity of the HCF and ability of the synapse-rich fiber layers to show complete recovery of metabolic and functional neural activity from deleterious effects of early hypothyroidism. Mitochondrial CytOx is highly localized to the synapse-rich fiber layers of the HCF and its activity and histochemical staining intensity correlates positively with functional metabolic activity of neural tissue. Thus hippocampus and dentate gyrus neuronal fiber layers and their oxidative activity show remarkable ability to recover from the postnatal hypothyroid growth retardation. The results indicate that some brain regions are less vulnerable to early developmental insults and can recover.