剪切波弹性成像与FNA-Tg对甲状腺乳头状癌侧颈部淋巴结转移的诊断价值

目的：探讨剪切波弹性成像(shear wave elastography,SWE)与细针穿刺洗脱液甲状腺球蛋白(fine-needle aspiration washout thyroglobulin,FNA-Tg)对甲状腺乳头状癌侧颈部淋巴结转移的诊断价值。方法：回顾性分析159例经病理证实为甲状腺乳头状癌(papillary thyroid carcinoma,PTC)的患者资料,对颈部211枚可疑淋巴结进行常规超声、SWE参数平均值(E_mean)、FNA-Tg检查,以术后病理结果为金标准,比较各检测方法的诊断效能。结果：(1)SWE E_mean转移组[(50.96±27.66) kPa]高于非转移组[(32.20±17.34) kPa],差异有统计学意义(t=8.761,P<0.01)。受试者工作特征(receiver operating characteristic,ROC)曲线分析表明,SWE E_mean最佳诊断阈值为40.42 kPa时对PTC颈部淋巴结转移预测价值较高,曲线下面积(area under...     

超声刀用于开放性甲状腺手术的临床研究

目的探讨超声刀在开放性甲状腺手术中应用的安全性和有效性。方法收集我院普外科2005年8月至2006年7月用超声刀行开放性甲状腺切除术326例,选取同期传统手术312例作为对照。比较两组手术时间、切口长度、术后引流量和并发症等指标。结果超声刀组单侧甲状腺叶切除和次全切/全切手术时间分别为(41±13.0)min和(55±16.6)min,传统组为(65±21.7)min和(84±19.4)min,超声刀组平均缩短约27min(P<0.01)。切口长度超声刀组平均4.2cm,比传统组减少2.7cm(P<0.01)。术后引流量差异无统计学意义(P>0.05)。超声刀组有2例发生暂时性喉返神经麻痹,1例低钙性抽搐,传统组有1例喉返神经麻痹,两组差异无统计学意义。未出现其他术中和术后并发症。结论应用超声刀行开放性甲状腺切除术安全可行,可以明显缩短手术时间,减小切口。     

低分化甲状腺癌治疗策略探讨

目的:对低分化甲状腺癌（poorly differentiated thyroid carcinoma,PDTC）的治疗策略进行探讨。方法:回顾性分析电子科技大学医学院附属肿瘤医院头颈外科中心2010年3月至2019年11月收治的31例PDTC患者,比较不同治疗方式对PDTC生存时间的影响,所有患者均接受手术治疗,术后...     

VEGF和VEGF-C在甲状腺癌组织中的表达与临床病理特征的关系

目的探讨血管生长因子（VEGF）和血管生长因子C（VEGF—c）在甲状腺癌、甲状腺良性病变及癌旁正常组织中的表达,以及VEGF和VEGF—C的表达与甲状腺癌临床病理特征的关系。方法采用免疫组化ELiVision法检测64例甲状腺癌、34例甲状腺良性病变及21例癌旁正常组织标本的VEGF和VEGF．C的表达。结果甲状腺癌组织中VEGF的表达在T3-T4组、复发组及转移组的阳性率高于对照组（P〈0．05）,在各亚型中以乳头状癌为最高。淋巴结转移者的VEGF-C阳性表达率高于对照组（P〈0．05）,在不同亚型中的表达差异无统计学意义。对VEGF和VEGF．C在甲状腺癌组织中表达的免疫组化染色分数进行相关分析,显示两者表达同步增高（r=0．502,P〈0．05）。结论VEGF的高表达预示甲状腺癌具有高复发率及高转移率,VEGF可作为诊断和协助判断预后的一项指标,检测VEGF和VEGF-C的表达有助于甲状腺癌临床治疗方式的选择。     

情志干预对甲状腺手术患者康复的影响

目的:探讨情志干预护理对甲状腺手术患者术后康复的影响。方法:将62例患者随机分为观察组、对照组各31例。2组均行常规护理干预,观察组同时给予情志干预,比较2组的康复效果。结果:血压、心率及Zung焦虑自评量表(SAS)和抑郁自评量表(SDS)评分进入手术室30分钟后测定值2组比较,差异有统计学意义(P0.05)。视觉疼痛量表(VAS)评分2组术后8、24小时比较,差异有统计学意义(P0.05)。术后并发症发生率观察组为3.23%,对照组为16.13%,2组比较差异有统计学意义(P0.05)。结论:情志干预护理有利于改善甲状腺手术患者的身心健康状态,促进术后康复。     

中西医结合治疗甲状腺结节研究述评

目的：探讨甲状腺结节中西医结合的临床研究现状。方法：从中西医结合的角度对该病病因、诊断、治疗的临床研究现状进行了阐述。结果：甲状腺结节的发病原因及影响因素仍有待进一步阐明,特别是碘摄入量增加对甲状腺结节等相关疾病的影响需深入研究及探讨,而本病的中医辨证标准以及疗效判断标准也有待进一步研究。结论：中医药在治疗甲状腺结节方面有其独特的优势及良好的疗效。     

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近年来,随着儿科内分泌遗传代谢病专业不断壮大以及与国外学术交流的增多,国内儿科内分泌遗传代谢病领域的研究进展不断创新。2011年10月13-16日第11届全国儿科内分泌遗传代谢病学术会议在山东烟台隆重举行,来自全国各地的450名正式代表出席了会议,会议收到论文168篇,基本反映了我国儿科内分泌遗传代谢病诊治及研究的整体水平。现就2011年国内儿科内分泌遗传代谢     

Thyrotropin receptor autoantibodies and early miscarriages in patients with Hashimoto thyroiditis: a case–control study

Abstract

We have previously hypothesized that early miscarriage in women with Hashimoto thyroiditis might be the result of a cross-reactivity process, in which blocking autoantibodies against thyrotropin receptor (TSHr-Ab) antagonize hCG action on its receptor on the corpus luteum. To test this hypothesis from the clinical perspective, we investigated the presence of TSHr-Ab in Hashimoto thyroiditis patients with apparently unexplained, first-trimester recurrent miscarriages compared to that in Hashimoto thyroiditis patients with documented normal fertility. A total of 86 subjects (43 cases and 43 age-matched controls) were finally included in a case–control study. No difference in the prevalence of TSHr-Ab positivity was detected between cases and controls (Fisher’s exact test, p value?=?1.00). In patients with recurrent miscarriages, TSHr-Ab concentrations did not predict the number of miscarriages (univariate linear regression, p value?=?0.08). These results were robust in sensitivity analyses, including only cases with full investigation or those with three or more miscarriages. We conclude that no role could be advocated for TSHr-Ab in the aetiology of recurrent miscarriages in women with Hashimoto thyroiditis.     

Postpartum thyroid dysfunction in women with autoimmune thyroiditis

Introduction: Autoimmune thyroiditis (AIT) is a predisposing factor for developing postpartum thyroid dysfunction (PPTD).

Aim: To study the characteristics of PPTD in women with AIT.

Methods: Thirty-eight women with pre-existing AIT were included in the study. Thyroid-stimulating hormone, free triiodthyronine, free thyroxine, thyroid peroxidase antibodies, thyroglobulin antibodies were measured and ultrasound evaluation of the thyroid gland was performed in the first trimester of pregnancy and during the first year following delivery.

Results: Thyroid dysfunction was recognized in 68.4% of the patients – 28.9% presented with hypothyroidism and 39.5 % with thyrotoxicosis. The immunological and morphological parameters did not differ between euthyroid women and those with thyroid dysfunction. At the end of the postpartum period restoration of euthyroid state (being on the treatment before pregnancy) was observed in 15.4% of patients with PPTD, while 84.6% required increase of the levothyroxine dose. The analysis found a significantly lower volume of the thyroid gland, shorter duration of the disease, a lower dose of levothyroxine before and during gestation in patients with impaired thyroid function at the end of the postpartum period.

Conclusion: The risk of PPTD in women with AIT predating pregnancy is higher among women with preserved thyroid functional capacity motivating a thorough assessment of thyroid hormone levels and close follow-up of those women during the postpartum period.     

甲状腺相关眼病免疫相关发病机制的研究现状与进展

甲状腺相关眼病（thyroid associated ophthalmopathy，TAO）是Graves病最常见的甲状腺腺外表现，主要表现为上眼睑退缩、水肿、眶周组织红斑和眼球突出，进一步发展可影响患者视力甚至导致失明。TAO的发病机制不完全清楚，由多种因素共同影响，但是目前患者自身免疫的功能异常是TAO的主要发病因素。本文将从细胞免疫、自身抗原和自噬这几个方面阐述TAO免疫相关发病机制研究的现状与进展，为临床工作和相关研究提供参考。