甲状腺激素与癌症的相关性研究进展

肿瘤患者甲状腺激素(T3)的代谢会产生异常,在肿瘤浸润深、淋巴结受累多、分期晚、病情重的患者中T3会显著下降。同时肿瘤的治疗(手术、放疗、化疗、靶向治疗、免疫治疗)也会造成T3下降。肿瘤患者T3的改变可以作为判断病情及临床分期、监测疗效、维护生活质量的参考指标,受到临床医生越来越多的关注。     

血清TSH、TSGF与p185蛋白联合诊断乳腺癌的临床意义

目的探讨血清促甲状腺激素(TSH)、肿瘤特异性生长因子(TSGF)水平、p185蛋白阳性率与乳腺癌疾病的相关性。方法选择2016年8月至2018年10月应城市人民医院收治的60例乳腺癌患者作为研究对象,按照TNM分期分为Ⅰ-Ⅱ组(Ⅰ-Ⅱ期患者)36例和Ⅲ-Ⅳ组(Ⅲ-Ⅳ期患者)24例,另选取我院同期健康体检人群60例作为对照组。对比分析3组患者血清TSH、TSGF水平及p185蛋白阳性率及不同病理特征下患者TSH、TSGF水平及p185蛋白阳性率之间的差异,分析联合检测和单独检测之间的差异。结果3组间TSH、TSGF水平及p185蛋白阳性率比较,差异有统计学意义(P<0.05)。与对照组相比,Ⅰ-Ⅱ组和Ⅲ-Ⅳ组患者血清中TSH、TSGF水平及p185蛋白阳性率更高,差异有统计学意义(P<0.05)。不同组织分级、TNM分期以及淋巴结转移情况的乳腺癌患者的TSH、TSGF水平及p185蛋白阳性率比较,差异有统计学意义(P<0.05);而不同肿瘤直径和分子分型的乳腺癌患者的TSH、TSGF水平及p185蛋白阳性率比较,差异无统计学意义(P>0.05)。Spearman相关性分析显示,组织分级、TNM分期、淋巴结转移、病理状态与乳腺癌患者的TSH、TSGF水平及p185蛋白阳性率呈显著相关性(P<0.05)。Logistic多因素分析结果显示,血清TSH(OR=1.019,P=0.001)、TSGF(OR=1.632,P=0.001)、p185蛋白阳性率(OR=1.089,P=0.000)是乳腺癌发生的独立危险因素。ROC诊断曲线结果显示,联合血清TSH、TSGF水平及p185蛋白阳性率的诊断效能显著高于单独指标的诊断效能(P<0.05)。结论乳腺癌患者的血清TSH、TSGF水平及p185蛋白阳性率与病理分期显著相关,且联合检测诊断效能更高,可作为诊断的依据。     

纳米羟基磷灰石/聚酰胺66支撑棒结合同种异体骨治疗ARCOⅢ期股骨头坏死

BACKGROUND: It remains controversial whether patients with ARCO stage III osteonecrosis of the femoral head should be treated with femoreal head preserving surgery, and what the clinical efficacy of femoreal head preserving surgery is.     

重组人甲状旁腺激素(1-34)促成骨作用及在口腔领域的应用

文题释义： 特立帕肽(teriparatide)：即重组人甲状旁腺激素(1-34)(rhPTH 1-34),2002年经美国食品药品监督管理局(FDA)批准应用于骨质疏松症的治疗,是第一代骨合成代谢药。它可以直接刺激新骨的成骨细胞形成,实现有效的合成代谢,在口腔领域的研究也表现出良好的促进种植体-骨结合及牙周再生等效果。 甲状旁腺激素：由甲状旁腺主细胞合成与分泌,是含84个氨基酸残基的单链多肽,位于人类甲状旁腺激素分子氨基端(N-端)的1-34位氨基酸序列是其生物活性部位。甲状旁腺激素是调节人体钙磷内环境稳态及骨代谢的重要激素,间歇低剂量给予甲状旁腺激素对骨骼发挥合成代谢作用。 背景：重组人甲状旁腺激素(1-34)(recombinant human parathyroid hormone 1-34,rhPTH 1-34),即特立帕肽,为甲状旁腺激素氨基端片段,作为骨合成代谢药,因可以直接刺激新骨形成、增加骨量而成为研究热点,也因其强大的成骨效应引起口腔领域的关注与应用。 目的：对特立帕肽的成骨机制、有效性和安全性及其在口腔领域的研究进展进行综述。 方法：第一作者检索近20年PubMed数据库、万方数据库收录的相关文章。英文检索词为“rhPTH(1-34),teriparatide,osteoporosis,stomatology,Jaw,implant-osseointegration,periodontal”,中文检索词为“重组人甲状旁腺激素(1-34),特立帕肽,骨质疏松,口腔医学,颌骨,种植体-骨结合,牙周”。共选取56篇文献进行综述。 结果与结论：特立帕肽可以直接刺激新骨的成骨细胞形成,实现有效的合成代谢,其在口腔领域的研究表现出良好的促进种植体-骨结合、牙周再生、骨缺损愈合及提高正畸稳定性的效果,在口腔领域有良好的应用前景,但仍需要更多更高质量的动物实验及临床研究证实。未来甲状旁腺激素类药物及其类似物可与骨组织工程技术有机结合,更好地促进骨修复,同时也更好地服务于口腔颌面部的修复治疗。 ORCID: 0000-0002-2333-4260(董西玲) 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

Increased fracture risk in patients with type 2 diabetes mellitus: An overview of the underlying mechanisms and the usefulness of imaging modalities and fracture risk assessment tools

Type 2 diabetes mellitus has recently been linked to an increased fracture risk. Since bone mass seems to be normal to elevated in patient with type 2 diabetes, the increased fracture risk is thought to be due to both an increased falling frequency and decreased bone quality. The increased falling frequency is mainly a result of complications of the disease such as a retinopathy and polyneuropathy. Bone quality is affected through changes in bone shape, bone micro-architecture, and in material properties such as bone mineralization and the quality of collagen. Commonly used methods for predicting fracture risk such as dual energy X-ray absorptiometry and fracture risk assessment tools are helpful in patients with type 2 diabetes mellitus, but underestimate the absolute fracture risk for a given score. New imaging modalities such as high resolution peripheral quantitative computed tomography are promising for giving insight in the complex etiology underlying the fragility of the diabetic bone, as they can give more insight into the microarchitecture and geometry of the bone. We present an overview of the contributing mechanisms to the increased fracture risk and the usefulness of imaging modalities and risk assessment tools in predicting fracture risk in patients with type 2 diabetes.     

Comparison of the Inhibitory Effect of Gonadotropin Releasing Hormone (GnRH) Agonist,Selective Estrogen Receptor Modulator (SERM), Antiprogesterone on Myoma Cell Proliferation In Vitro

Uterine myomas are the most common gynecologic tumor in women of reproductive age. Treatment options of uterine myomas consist of surgical, medical and interventional therapy such as uterine artery embolization or myolysis. Given that it is the most common type of tumor in women of reproductive age, the treatment of uterine myomas must prioritize uterine conservation. There are several drugs for medical treatment of uterine myoma such as gonadotropin releasing hormone (GnRH) agonist, selective estrogen receptor modulator (SERM) and antiprogesterone. The objective of this study was to compare the effect of GnRH agonist, SERM, and antiprogesterone in the treatment of uterine myomas in vitro. The effect of drugs was evaluated through the cell viability assay in cultured leiomyoma cells, western blot analysis of proliferating cell nuclear antigen (PCNA), and BCL-2 protein expression. As a result, mifepristone single-treated group represents the most significant reduction in myoma cell viability and proliferation. When pretreated with leuprolide acetate, raloxifene shows more significant reduction in myoma cell viability and proliferation than mifepristone. This study suggests one of the possible mechanisms how medications act on uterine myoma, especially at the molecular level.     

促甲状腺激素、甲状腺球蛋白浓度在甲状腺良、恶性结节诊断中的价值

目的 探讨血清促甲状腺激素（TSH）、甲状腺球蛋白（Tg）浓度变化在甲状腺良、恶性结节诊断中临床价值.方法 选取96例因甲状腺结节病住院患者,比较甲状腺良、恶性结节患者血清TSH、Tg浓度差异,分析血清TSH、Tg浓度与甲状腺良、恶性结节的关系.结果 甲状腺恶性结节组血清TSH浓度（2.55±1.46mIU/L）与甲状腺良性结节组（1.15±1.10mIU/L）比较,差异有统计学意义（P＜0.05）;随血清TSH浓度的升高,甲状腺恶变结节比例升高;甲状腺恶性结节组血清Tg浓度（255.0±60.6ng/mL）高于甲状腺良性结节组（115.0±32.4ng/mL） （P ＜0.05）,不同血清Tg浓度组间甲状腺恶性结节数比例差异无统计学意义（P＞0.05）.结论 血清TSH、Tg浓度检测对甲状腺良、恶性结节诊断中有一定临床意义,血清TSH浓度是预测甲状腺结节恶变的危险因子.     

维吾尔族男性血清性激素结合球蛋白与2型糖尿病及其危险因素的相关性分析

目的 探讨维族男性血清性激素结合球蛋白、性激素与2型糖尿病及其危险因素的关系.方法 用随机对照方法纳入维族男性2型糖尿病患者81例和正常对照组65例,分别测量血压,检测空腹血糖、胰岛素、糖化血红蛋白、血脂、性激素、性激素结合球蛋白,计算体重指数和胰岛素抵抗指数,比较2型糖尿病组和对照组的上述指标水平,并探讨性激素、性激素结合球蛋白与2型糖尿病相关指标及其危险因素的关系.结果 2型糖尿病组空腹血糖、空腹胰岛素、糖化血红蛋白均高于正常对照组,而性激素结合球蛋白、睾酮低于正常对照组,P均小于0.05.应用Pearson相关以及Spearman秩相关作相关分析,维族男性2型糖尿病患者血清性激素结合球蛋白、血清睾酮均分别与体重指数（r=-0.485,r=-0.543）、空腹胰岛素（r=-0.467,r=-0.423）、甘油三酯（r=-0.442,r=-0.351）呈负相关,血清睾酮与高密度脂蛋白（r=0.317）呈正相关,P均小于0.05.结论 在维族男性中,血清性激素结合球蛋白、血清睾酮可能是2型糖尿病的保护因素.