Prevalence of autoimmune thyroid disorders in a Spanish multiple sclerosis cohort

The aim of the study was to determine the prevalence of thyroid autoimmune disorders in a cohort of untreated multiple sclerosis (MS) patients and compare it with a stratified sample of an adult population. We prospectively studied 93 untreated MS patients. The control group included 401 healthy subjects selected by stratified sampling in a non-iodine-deficient area. Antithyroid antibodies (ATA) (antibodies against peroxidase and thyroglobulin) were considered positive at titres ≥149 IU/ml. Antibodies were positive in 11 MS patients (11.8%; 95% CI 5.3–18.4%). This prevalence was five times higher ( P  = 0.0001) when compared with that in the control population. We found six cases with subclinical hypothyroidism (6.45%; 95% CI 11.4–1.5) in contrast to 2.24% in the control group. Comparing MS with positive and negative ATA, there was a non-significant, slightly higher frequency of low Expanded Disability Status Scale (EDSS) score in the ATA-positive group (81% vs. 73.2%). One year after start of interferon (IFN) treatment, only one patient developed subclinical thyroid dysfunction. MS patients have a higher prevalence of ATA compared with the general population. An initial ATA and thyroid-stimulating hormone (TSH) determination is recommended in all MS patients. A periodic assessment of thyroid function during IFN treatment only seems to be justified in those cases where positive ATA or dysfunction is present before treatment.     

隐睾患儿血清FSH、LH、T水平及其临床意义

目的研究隐睾患儿血中促卵泡激素(FSH)、促黄体激素(LID和睾酮(T)激素水平变化,探讨其临床意义及在隐睾症发病中的作用。方法应用化学发光免疫技术检测42例隐睾症和23例斜疝(对照组)患儿血清FSH、LH、T水平。结果单侧隐睾症组和斜疝组之间血清FSH、LH和T水平无显著性差异(P＞0．05)；(2)双侧隐睾组血清FSH水平高于斜疝组,差别有统计学意义(P＜0．05)；单侧隐睾症组血清FSH高于斜疝组,低于双侧隐睾症组,差别无统计学意义(P＞0．05)。结论(1)血清中性激素LH和T水平的变化在隐睾发生中并不起主要作用；(2)血清FSH水平的升高可能反映睾丸功能损害严重程度。     

Neuroactive Properties of Reproductive Steroids

Migraine is 3 times more common in postpubertal women than in men. Migraine is frequently exacerbated perimenstrually and commonly occurs exclusively at that time. It is often benefited by pregnancy and menopause. Estrogen withdrawal has been implicated as a mechanism for triggering migraines. The mechanism, however, is not well understood. Reproductive steroids have neuroactive properties that can modulate neuronal morphology and physiology. Increasing evidence suggests that circulating reproductive steroid levels regulate the balance of neuroexcitatory and neuroinhibitory activities in some brain regions by influencing synaptic plasticity. Estrogen has neuroexcitatory, whereas progesterone has neuroinhibitory, effects in most preclinical and clinical models. Several neurotransmitter systems that are implicated in migraine vary with reproductive steroid levels during the reproductive cycle. Estrogen stabilization may provide effective treatment in susceptible women, especially for catamenially exacerbated migraine.     

甲状腺微小癌36例临床分析

目的:探讨甲状腺微小癌的诊断和外科治疗经验。方法:36例甲状腺微小癌患者,10例行患侧腺叶切除术,20例行患侧腺叶加峡部切除术,3例行甲状腺次全切除术,加局部淋巴结清扫术1例,加功能性颈淋巴结清扫术2例,术后均服用甲状腺素片80~120mg/d,服药时间维持手术后1~3年,定期复查甲状腺激素水平,以"轻度甲亢"症状为用药标准调整服药用量。2例术后做同位素治疗。结果:术后2例曾出现短暂声音嘶哑,后逐渐恢复,1例出现短期的低钙抽搐。34例术后随访3~10年,平均随访5年,除1例混合型癌伴发肝转移者死亡外,其余无复发和死亡。结论:甲状腺微小癌女性发病较多,以单发癌结节为主,B超、细针穿刺细胞学检查(FNAC)、术中快速冰冻病理检查等方法综合运用能提高甲状腺微小癌的检出率,甲状腺微小癌手术治疗的预后较好。     

儿童甲状腺癌13例临床分析

本文报告１９８５－１９９４年收治的儿童甲状腺癌１３例。年龄７－１６岁。男３岁，女１０例。所有病例无不适，而以颈部肿物就诊。除１例根治术前未做过任何治疗外，其余病例均曾进行过不恰当治疗，颈淋巴结转移１０例，肺转移３例，骨转移１例。病理诊断：乳头状癌１０例，滤泡癌３例。手术以患侧腺叶及峡部切除或加健侧大部分切除为佳。如有颈淋巴结转移应同时行颈部清扫术。本文对儿童甲状腺癌的特征、误诊原因及其治疗进行了计     

A longitudinal study of semen quality in pesticide spraying danish farmers

It was hypothesized that occupational exposure to pesticides during a spraying season causes changes in semen quality that might be detected in a longitudinal study. We analyzed the within-person changes in semen quality and reproductive hormones across a spraying season in groups of farmers using and not using pesticides. A total of 248 men collected two semen samples (participation rate: 32%). The median sperm concentration declined significantly from the first to the second sample in both groups, but there was no statistical difference in the decline between the two groups, unadjusted or adjusted. Only minor changes were found in sperm morphology, vitality, motility, sperm chromatin denaturation (SCSA), and reproductive hormones, and the differences in changes between the two groups were nonsignificant, or, in the opposite direction to the expected. There was no relation between the changes in sperm parameters in relation to pesticide exposure variables. In conclusion, use of pesticides by Danish farmers is not a likely cause of short-term effects on semen quality and reproductive hormones.     

2687例血清甲状腺球蛋白抗体和微粒体抗体测定及其临床意义

报告2687例血清甲状腺球蛋白抗体和甲状腺微粒体抗体的放射免疫测定结果,九类病人的抗体阳性率如下:甲状腺正常病人12.6(30/239)、孤立甲状腺结节16.9%(62/383)、弥漫性甲状腺肿35.4%(226/638)、多结节甲状腺肿54.7%(104/190)、甲亢未治疗77.7%(404/520)、甲亢治疗中67.2%(218/345)甲亢临床已治愈60.3(102/169),原发性甲减80.8%(118/146)、亚急性甲状腺炎35.1%(20/57)。各种甲状腺疾病的总阳性率为51.2%(1254/2448)。对甲状腺自抗体阳性在甲状腺疾病的诊断、治疗、和预后判断上的意义进行了讨论。     

超声引导下注射皮质类固醇治疗狭窄性腱鞘炎

目的 探讨超声引导下注射皮质类固醇治疗狭窄性腱鞘炎的方法及效果。方法 38例狭窄性腱鞘炎患者,按药物注射方法的不同随机分成2组。治疗组(21例)在10-MHz超声引导下向腱鞘内腱周间隙内穿刺注射醋酸强的松龙0.6 ml,对照组(17例)采用闭合穿刺法注射等量药物。注射前及随访时(注射后3周)测定疼痛强度视觉类比评分(Visual analogue score,VAS)。结果 随访时疼痛消失率治疗组为81％、对照组为53％,VAS下降值治疗组为[(6.8±1.9)x±s,下同]对照组为(5.1±3.0)。结论超声引导下将针尖穿刺于腱鞘内腱周间隙的操作简单、准确并可实时观察药物的分布,是治疗狭窄性腱鞘炎的较好方法。     

甲状腺肿瘤X线造影与超声检查对比分析

本文报告了经手术病理证实的53例甲状腺肿瘤,均作了甲状腺造影和B超检查.通过比较分析,我们认为造影对确定肿瘤的良、恶性以及延伸到胸骨后的异位甲状腺肿瘤有其优越性,是一项有效的检查方法;超声则能准确地判断肿瘤的囊、实性,适合碘过敏患者的检查.两种检查各有特点,配合使用有利于对甲状腺肿瘤的诊断和治疗.