Glucose and free fatty acid turnover in normal subjects and in diabetic patients before and after insulin treatment

Summary Turnover rates of glucose and free fatty acids were measured, using³H-glucose and¹⁴C-1-palmitic acid as tracers, in insulin-requiring diabetic patients at presentation and after insulin treatment. Correlations were sought with rates of substrate oxidation, determined independently from respiratory exchange, and with plasma hormone concentrations. The rates of appearance of glucose and of free fatty acids were increased in the diabetics to 17.6 and 10.2 mol min^–1 kg^–1 respectively. Both rates fell to normal (13.3 and 7.1 mol min^–1 kg^–1) after insulin. In the untreated state there was an inverse relationship between the rates of utilisation of glucose and free fatty acids (r=0.61; p<0.05). It is suggested that this relationship represents the impairment of peripheral glucose utilisation by free fatty acids and by ketone bodies in vivo, so far only demonstrated in vitro. The tracer calculated rates of glucose utilisation correlated well over a wide range with the respiratory quotient in untreated diabetics, while respiratory quotient was inversely related to free fatty acid turnover rates. In untreated diabetics plasma cortisol and 3,3, 5-triiodothyronine (rT₃) were increased whereas thyroxine and 3,5,3-triiodothyronine (T₃) were decreased. 3,5,3-Triiodothyronine concentration was closely related to the metabolic clearance rate of glucose (p<0.05), while cortisol concentrations correlated with glucose production (p<0.02) and blood ketone body concentration (p<0.02).It is concluded that glucose overproduction is the major contributor to the hyperglycaemia of untreated diabetes.     

甲状腺激素调节仔鼠脑基因差异表达的研究

目的　研究甲状腺激素调节仔鼠脑基因的分子机制。方法　丙基硫氧嘧啶灌胃制备孕鼠甲状腺功能减退模型 ,部分胎鼠出生后予以 T4 替代治疗 ,采用消减抑制杂交技术构建甲状腺激素调节仔鼠脑基因的差异表达文库 ,对部分重组克隆进行序列分析。结果　随机测序 10个表达序列标签 ,同源性分析表明 5个表达序列标签未发现明确的同源物 ,其它表达序列标签与 CDC10 ,酸性核糖体蛋白 P0 ,actin等有较高同源性。结论　甲状腺激素调节仔鼠脑基因的差异表达谱的获得对阐明甲状腺激素对脑发育的分子机理有十分重要的意义     

中西医结合治疗甲状腺乳头状癌17例

目的：观察中西医结合治疗甲状腺乳头状癌的临床疗效。方法：将51例甲状腺乳头状癌者按照随机数字表法分为对照A组,对照B组及治疗组,每组各17例。对照A组给予海藻玉壶汤加减治疗,对照B组口服左旋甲状腺素片,治疗组为上述两种方法的综合治疗。观察甲状腺乳头状癌血清TSH水平及尿碘含量的变化。结果：治疗后促甲状腺激素（TSH）治疗组与对照A组、对照B组比较,差异均有统计学意义（P〈0．05）;治疗后尿碘中位数（MUI）治疗组与对照A组、对照B组比较,差异均有统计学意义（P〈0．05）。结论：中西医结合治疗甲状腺乳头状癌疗效满意。     

Investigation of thyroid blood tests and thyroid ultrasound findings of patients with rosacea

We aimed to investigate the relationship between rosacea and thyroid diseases by analyzing thyroid blood tests and ultrasound findings of our patients recently diagnosed with rosacea. This study was designed as a prospective, single‐center study. Dermatological examination findings, lesion locations were recorded, and rosacea clinical scores were calculated for all study group patients. The control group consisted of completely healthy women presented to our hospital during the study period for check‐up purposes. Serum‐free thyroxine, free triiodothyronine, thyroid‐stimulating hormone, antithyroglobulin antibody, antithyroid peroxidase antibody levels were measured, and thyroid ultrasound examinations were performed for all study participants. The entire study cohort consisted of 123 patients (63 cases and 60 controls). There was no significant difference between the groups in terms of mean patient age (P < .05). Cheek was the most common lesion location (96.8%). There was no difference between the groups in terms of thyroid‐related laboratory parameters. However, anti‐TPO levels differed significantly with increasing disease severity (ie, RCSs). There were significant relationships between cheek lesions and fT4 (P = .021), while nose and chin lesions were associated with fT3 (P = .01, P = .001). Thyroid ultrasound findings revealed that rosacea patients tended to have larger thyroid nodules and more heterogeneous thyroid parenchymas than controls. Our findings indicate that thyroid blood tests, including thyroid autoantibodies, should be tested and thyroid ultrasounds should be performed in patients diagnosed with rosacea. However, these findings need to be validated by prospective studies conducted in larger patient series with more extended follow‐up periods.     

碘充足地区孕妇碘水平及新生儿甲状腺功能分析

  目的  观察安徽省马鞍山市育龄妇女妊娠早、中期甲状腺功能评估指标的动态变化,建立参考值范围,为临床妊娠期甲状腺功能障碍的诊断提供划界值。  方法  纳入2013年5月 — 2014年9月在马鞍山市妇幼保健院开展的前瞻性队列研究中2 378名孕妇,于妊娠 ≤ 14周收集基本人口学信息,并于妊娠早期和中期采集孕妇血清进行甲状腺功能相关指标检测。  结果  妊娠早、中期血清促甲状腺素（TSH）参考值范围分别为0.02～4.94、0.79～6.22 mIU/L。游离甲状腺素（FT₄）的妊娠早、中期参考值分别为13.20～23.85、9.18～15.24 pmol/L。总甲状腺素（TT₄）和总三碘甲状腺原氨酸（TT₃）浓度中位数在妊娠6～13周随孕周的增加呈上升趋势,24～28周时趋于稳定。TSH在妊娠早期与中期呈显著正相关（r = 0.591,P < 0.001）,同样,在血清FT₄、TT₄、TT₃中也发现了类似的正相关（r分别为0.447、0.537、0.532,P < 0.001）。  结论  妊娠期甲状腺功能相关指标（TSH、FT₄、TT₄、TT₃）在妊娠早、中期存在差异并显著关联;建立地区性妊娠期甲状腺激素参考值范围有利于当地妊娠期甲状腺疾病的筛查、诊断和治疗。     

海洛因依赖者垂体-甲状腺轴变化

目的：观察海洛因依赖者垂体-甲状腺轴神经内分泌变化。方法：采集海洛因依赖者及健康对照者血样,检测促甲状腺素（TSH）、游离三碘甲状腺原氨酸（FT3）和游离甲状腺素（FT4）。结果：强制组急性戒断期TSH降低,FT3和FT4与对照组无统计学差异;戒断后第30天TSH仍低,而凡升高,FT4降低;戒断后第90天TSH与对照组无统计学差异,FT3与FT4仍分别处于升高与降低状态。自愿组TSH降低,FT3和FT4与对照组无统计学差异。结论：相关激素在海洛因依赖及戒断期处于紊乱状态,某些激素恢复较慢。     

Associations between Dynamic Vitamin D Level and Thyroid Function during Pregnancy

Optimal Vitamin D (VitD) status and thyroid function are essential for pregnant women. This study aimed to explore associations between dynamic VitD status and thyroid function parameters in each trimester and throughout the pregnancy period. Information on all 8828 eligible participants was extracted from the Peking University Retrospective Birth Cohort in Tongzhou. Dynamic VitD status was represented as a combination of deficiency/sufficiency in the first and second trimesters. Thyroid function was assessed in three trimesters. The associations between VitD and thyroid function were assessed by multiple linear regression and generalized estimating equation models in each trimester and throughout the pregnancy period, respectively. The results indicated that both free thyroxine (fT4; β = 0.004; 95%CI: 0.003, 0.006; p < 0.001) and free triiodothyronine (fT3; β = 0.009; 95%CI: 0.004, 0.015; p = 0.001) had positive associations with VitD status in the first trimester. A VitD status that was sufficient in the first trimester and deficient in the second trimester had a lower TSH (β = −0.370; 95%CI: −0.710, −0.031; p = 0.033) compared with the group with sufficient VitD for both first and second trimesters. In conclusion, the associations between VitD and thyroid parameters existed throughout the pregnancy. Maintaining an adequate concentration of VitD is critical to support optimal thyroid function during pregnancy.     

比较钾离子通道开放剂米诺地尔和阻断剂格列本脲对MCAO …

为验证钾通道开放剂或阻断剂对脑梗塞与左甲状腺素造成损伤是否有益,用ＭＣＡＯ和左甲状腺素造成脑缺血损伤,用苄普地尔,米诺地尔和格列本脲治疗。左甲状腺素加重ＭＣＡＯ造成的脑缺血性损害,大鼠给予左甲状腺素,１ｍｇ／ｋｇ ｐｏ１０ｄ,而后施行ＭＣＡＯ（大脑中动脉结扎）。苄普地尔,米诺地尔,格列本脲,在最后３ｄ平行经,左甲状腺素组血清中Ｔ３及Ｔ４分别增加２．８倍及３．４倍（Ｐ〈０．０１）。药物治疗组Ｔ３,Ｔ     

甲状腺素对大鼠胰岛β细胞作用和机制的研究

目的研究甲状腺素对大鼠胰岛β细胞功能的影响及其机制。方法采用放射免疫测定法和电镜技术,观察甲状腺素对大鼠血清葡萄糖、胰岛素、肿瘤坏死因子(TNF)、白介素-1β(IL-1β)水平的影响和胰岛β细胞超微结构的改变。结果甲状腺素600μg.kg-1.d-1,灌胃(ig),连续14 d,大鼠血清胰岛素水平明显降低,而血糖含量、IL-1β水平则显著升高,同时电镜发现大鼠胰岛β细胞的超微结构呈现退行性改变。结论甲状腺素大剂量长期应用对大鼠胰岛β细胞内分泌功能有抑制作用,其机制与细胞因子IL-1β分泌增多,诱导胰岛β细胞凋亡有关。