电化学发光法与放射免疫分析法检测血清甲状腺素的比较

目的探讨电化学发光法与放射免疫法检测血清甲状腺激素的效果差异,为临床甲状腺激素检测提供参考。方法选择我院普外科及内分泌科住院甲状腺疾病患者血清标本340份,分别采用电化学发光法及放射免疫法进行检测,比较两种方法检测血清TSH、FT3、FT4线性范围,相关性及精密度。结果电化学发光法检测血清TSH、FT3、FT4线性范围宽于放射免疫法,两种检测方法检测血清TSH、FT3、FT4具有良好的相关性,电化学发光法检测血清TSH、FT3、FT4精密度高于放射免疫法。结论电化学发光法与放射免疫法检测血清甲状腺激素能够取得相同的检测效果,电化学发光法检测方法简单,线性范围较宽,可重复性较好,更适合临床采用。     

Alterations in hypothalamic-pituitary-adrenal/thyroid (HPA/HPT) axes correlated with the clinical manifestations of depression

The alterations of hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-thyroid (HPT) axes are important neuroendocrine abnormalities in depression. We aimed to identify some potential associations between these alterations and the clinical manifestations of depression in a sample of Chinese origin. 565 depressed patients of Chinese Han region were collected and seven kinds of hormones in HPA and HPT axes were detected. A 17-item Hamilton Depression Rating Scale (HAMD-17) and a 14-item Hamilton Anxiety Rating Scale (HAMA-14) were used to evaluate the baseline condition of each patient. 519 patients were enrolled into analysis. The patients with dysfunction of HPA axis had susceptibility to agitation symptoms (HAMD9 item) and cognitive disorders (HAMD2, 3 and 9 items), while those with normal function of HPA axis had susceptibility to shallow sleep (HAMD5 item). The patients with dysfunction of HPT axis had susceptibility to difficulty in falling asleep (HAMD4 item), weight loss (HAMD16 item) and gastrointestinal symptoms (HAMD12 item). Besides, the patients with dysfunctions of both HPA and HPT axes showed remarkable retardation symptoms (HAMD8 item). These findings might provide some evidences for the clinical subgrouping and management individualization of depressed patients according to the neuroendocrine alterations.     

Diagnosis of pituitary abscess and treatment via transsphenoidal surgery: experience from 15 cases

ObjectivePituitary abscess is an often misdiagnosed, rare clinical disorder. To improve diagnostic accuracy and the efficacy of surgical and antibiotic therapy for patients with pituitary abscess, herein, we retrospectively reviewed 15 patients who presented with pituitary abscesses from 2005 to 2022.DesignRetrospective study.PatientsFifteen patients underwent transsphenoidal surgery and received antibiotic treatment.MeasurementsComplete details regarding medical history, clinical manifestations, laboratory examinations, imaging studies, and treatment strategies were obtained for all patients.ResultsMost patients presented with hypopituitarism and headaches, while some presented with fever, visual disturbances, and diabetes insipidus (DI). Abscesses showed significant annular enhancement post gadolinium injection. In most patients, pituitary abscess can be cured via microscopic or endoscopic drainage of the abscess followed by antibiotic treatment. Complete cure of pituitary abscess was observed in nine patients, with six cases of prolonged hypopituitarism and only one case of recurrence. Long-term hormone replacement therapy was effective in the postoperative management of hypopituitarism.ConclusionsThe typical manifestations of pituitary abscess include hypopituitarism and headaches; the presence of an enhanced ring at the edge of the mass on contrast-enhanced magnetic resonance images (MRI) is highly suggestive of pituitary abscess. We recommend antibiotic treatment for 4–6 weeks postoperatively, based on the results of bacterial cultures or metagenomic next-generation sequencing (mNGS).     

甲状腺素钠联合硒酵母片对甲状腺功能减退症患者的有效性及对血管内皮功能的影响

目的探讨甲状腺素钠联合硒酵母片对甲状腺功能减退症患者的有效性及血管内皮功能的影响。方法选取2017年3月～2018年3月期间我院收治的甲状腺功能减退症的90例患者作为研究对象,根据治疗方式的不同分为研究组与对照组,各45例。对照组采用甲状腺素钠治疗,研究组患者采用甲状腺素钠联合硒酵母片治疗。比较两组患者甲状腺抗体的相关指标,血管内皮功能的相关指标以及出现的不良反应情况等。结果治疗前后两组患者甲状腺抗体的相关指标无显著差异(P0.05),治疗后研究组患者改善程度与对照组比较明显较好;研究组患者的AT-Ⅲ及HDL-C水平与对照组比较显著较高,而TC、CRP、LDL-C以及FIB水平与对照组相比显著降低(P0.05);研究组患者不良反应的总发生率与对照组相比明显降低(P0.05)。结论甲状腺功能减退症的患者采用甲状腺素钠与硒酵母片联合治疗,有助于促进患者甲状腺功能以及血管内皮功能的改善,同时不良反应的情况较少,安全可靠,对预后有积极的促进作用。     

Safety and Efficacy of Radiofrequency Ablation for Nonfunctioning Benign Thyroid Nodules in Children and Adolescents in 14 Patients over a 10-Year Period

PurposeTo evaluate the efficacy and safety of radiofrequency (RF) ablation for nonfunctioning benign thyroid nodules in children and adolescents.Materials and MethodsFourteen pediatric patients (10 female, 4 male; mean age 15.7 ± 2.3 years, range 12–19 years) with nonfunctioning benign thyroid nodules (mean longest diameter 3.7 ± 1.1 cm, range 2.0–5.6 cm) treated with the use of RF ablation from 2005 to 2015 were evaluated. The inclusion criteria for RF ablation therapy were (i) age <20 years, (ii) benign cytological confirmation by ≥2 separate fine-needle aspiration or core needle biopsies, (iii) pressure symptoms or cosmetic problems caused by thyroid nodules, (iv) absence of any suspicious feature as determined with the use of ultrasound (US), (v) normal serum levels of thyroid hormone and thyrotropin, and (vi) follow-up of >6 months. RF ablation was performed with the use of an RF generator and an 18-gauge internally cooled electrode. RF ablation was performed under local anesthesia without conscious sedation or general anesthesia. Changes in nodules on follow-up US, changes in symptomatic and cosmetic scores, and complications arising during or after RF ablation were evaluated.ResultsMean follow-up period was 36.9 ± 21.7 months (range 6–69 months). At last follow-up visits, mean longest nodule diameter and volume had decreased significantly (3.7 ± 1.1 cm vs 1.4 ± 0.9 cm and 14.6 ± 13.3 mL vs 1.7 ± 4.4 mL; P < 0.001). Both cosmetic and compressive symptoms significantly improved (3.8 ± 0.6 vs 1.4 ± 0.6 and 3.4 ± 1.0 vs 0.1 ± 0.4; P < 0.001). The mean number of ablation sessions was 2.1 ± 1.2 (range 1–5 sessions) and no major complication was encountered during or after RF ablation.ConclusionsRF ablation might be a safe and effective treatment modality for nonfunctioning benign thyroid nodules in children and adolescents.     

Increased expression of thyroid hormone receptor alpha and estrogen receptor alpha in breast cancer associated with thyroid cancer

IntroductionBreast cancer co-occurred with thyroid cancer might be associated with thyroid hormone receptor (TR) and estrogen receptor (ER), but few have been reported. We aimed to investigate the expression and prognostic significance of ERs and TRs in such settings.Material and methodsTissue microarrays were constructed from 75 patients with breast and thyroid cancer (BC + TC) who were retrospectively recruited between 1999 and 2012 and 147 with breast cancer only (BC controls). The ERα, ERβ, TRα, and TRβ expression levels were analyzed by immunohistochemistry.ResultsTRα expression was more frequently observed in the BC + TC group than the BC control group both in the normal (51.5% vs 23.3%, respectively, p = 0.009) and cancer tissues (21.6% vs 6.8%, respectively, p = 0.001). The BC + TC group showed greater ERα-positivity in the cancer tissues (79.7% vs 58.7%, respectively, p = 0.002) than the BC control group. The degree of ERα- and TRα-positivity was unchanged by radioactive treatment or serum thyroid stimulating hormone levels. In the BC + TC group, ERα-positivity was associated with earlier disease stage I/IIA (81.0% vs 50.0%; p = 0.031) and lower recurrence rates (8.5% vs 40.0%; p = 0.002). TRα-positivity alone was not associated with any recurrence-free survival-related differences, and ERα- and TRα-negativity were associated with significantly shorter recurrence-free survival (p < 0.001).ConclusionEnhanced ERα and TRα expression in breast cancer is associated with thyroid cancer occurrence, and the observed association with prognosis suggests the possible role of ERs and TRs in the link between breast cancer and thyroid cancer.     

Two possible mechanisms of action of thyroxine on swelling of mitochondria

The effect of thyroxine on various types of swelling of the mitochondria (calcium-, detergent-, valinomycin-, and peroxide-induced) was studied. Under conditions favoring swelling of the mitochondria through phospholipase activation (a low concentration of Mg²⁺ ions, the presence of Ca²⁺ ions in the incubation medium) thyroxine causes swelling of the organelles to develop faster. When the phospholipase mechanism of swelling of the mitochondria is inhibited (high concentrations of Mg²⁺ ions), thyroxine considerably inhibits the development of swelling of the mitochondria induced by lipid peroxidation, by virtue of its antioxidant action.Department of Biophysics and Molecular Pharmacology and Radiology, Medico-Biological Faculty, N. I. Pirogov Second Moscow Medical Institute. (Presented by Academician of the Academy of Medical Sciences of the USSR V. N. Orekhovich.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 83, No. 6, pp. 680–683, June, 1977.     

The Effects of Hypothyroidism on 5-HT1A and 5-HT2A Receptors and the Serotonin Transporter Protein in the Rat Brain

The effects of hypothyroidism on 5-HT_1A and 5-HT_2A receptors and the serotonin transporter protein were studied in thyroidectomized male Wistar rats in two experimental groups: 1) animals kept on an iodine-free diet (hypothyroid rats) and 2) animals kept on thyroxine (15 g/kg) for 21 days (giving normal thyroid hormone levels, euthyroid animals). Sham-operated rats served as controls. Binding of [³H]8-OH-DPAT with 5-HT_1A receptors and [³H]citalopram with the transporter protein in the hippocampus and midbrain showed no changes in hypothyroid rats as compared with controls. Conversely, there were significant decreases in [³H]ketanserin binding to 5-HT_2A receptors in the frontal cortex in hypothyroid rats as compared with controls; this decrease was reversed by thyroxine treatment. Thus, losses of cortical 5-HT_2A receptors appears to be the main consequence of hypothyroidism at the level of the serotonin system of the brain.     

Effect of thyrotropin releasing hormone and thyroxine on cytochrome oxidase activity in the rat adenohypophysis

Thyrotropin releasing hormone (TRH), in a dose of 0.01 and 1.0 g/ml, sharply increased cytochrome oxidase activity in the adenohypophysis of rats fed for 6 weeks with methylthiouracil. This effect of TRH on enzyme activity was blocked by thyroxine (T₄), if added to the incubation medium in a concentration of 20 g/ml. Actinomycin D (20 g/ml) prevented the blocking of cytochrome oxidase by T₄. TRH in a concentration of 0.01 g/ml and T₄, in a dose of 2.0 g/ml, caused no change in cytochrome oxidase activity in the adenohypophysis of intact and partially thyroidectomized rats.Laboratory of Biological Standardization of Hormones, Institute of Experimental Endocrinology and Hormone Chemistry, Academy of Medical Sciences of the USSR, Moscow. (Presented by Academician of the Academy of Medical Sciences of the USSR N. A. Yudaev.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 84, No. 11, pp. 559–562, November, 1977.