Objective To evaluate the safety and effectiveness of interventional therapy for hyperthyroidism. Methods From 1995 to 2000, 38 cases underwent bilateral super-selective superior thyroid arteries embolization with brown-algae microballs.Results There was no misembolization and mortality. Hyperthyroidism crisis developed in 2 cases. Thirty eight cases were followed-up for 0.5～5 years (the median time was 2.2 years). Medications were needed only in one patient because of relapse and the others were cured. Conclusion This procedure features miniinvasive trauma, less complications and quick recovery. It may be a safe and rational treatment for hyperthyroidism.
42 cases of hyperthyroidism had been operated from 1990-1993.In the preoperative treatment,antithyroid drugs were used togather with thyroxine.Some advantages have been observed,which are better than drugs were used togather with thyroxine.Some advantages have been observed,which are better than thoes of the usual preoperative preparaton.①Patient can be prepared to a complete euthyroid state.②The vascularity of the gland can be reduced to a least degree so that the operative risk of bleeding is will small.③The serum thyroid hormone will not be raised,therefore no thyroid crisis occurs.
Objective To investigate the diagnosis and treatment of pulmonary arterial hypertension ( PAH) due to rare causes. Methods The clinical presentation, laboratory testing, diagnosis and treatment of 4 patients with PAH associated with rare causes in Beijing Anzhen Hospital from January 2001 to March 2008 were analysed retrospectively. Results Primary biliary cirrhosis, hyperthyroidism, antiphospholipid syndrome and pulmonary artery sarcoma may cause PAH, which were improved after corresponding diagnosis and management. Conclusion PAH can result from rare causes. The enhancement of its recognition will help earlier diagnosis and treatment and improve the prognosis.
Objective To evaluate the safety and tolerance of medicinal charcoal enteric-coated tablets in healthy volunteers. Methods A total of 44 healthy volunteers were randomly divided into 6 single-dose groups (0.5 g, 2 g, 4 g, 6 g, 8 g and 10 g) and a multiple-dose group (3 g, 3 times a day, for 14 days). The safety profile and tolerance were evaluated by observing symptoms, vital signs, and laboratory tests. Results No serious adverse event was reported for any volunteer. Abdominal distension occurred in 2 volunteers in the 4 g dose group and the 6 g dose group. One volunteer in the 8 g dose group experienced nausea and vomiting. Transient decrease in white blood cell count was observed in one volunteer in the 10 g dose group. Abdominal distension occurred in 2 volunteers of the multiple-dose group. Conclusion Based on our findings, the maximum tolerated dose of medicinal charcoal enteric-coated tablets in Chinese healthy volunteers is 10 g. The recommended dose for subsequent clinical trials is 3 g, 3 times a day.
ObjectiveTo investigate the succession model for hyperthyroidism and thyroid carcinoma secondary to nodular goiter in iodine deficiency area. MethodsA total of 216 specimens of goiter patients from iodine deficiency area were collected in the former 3rd hospital of Norman Bethune Medical College from January 1980 to December 1994. Twentyfour heteroploid samples were selected by the method of Hedley with Flow cytometry (FCM) analysis. Paraffin-embedded tissues from the same position were used to perform immunohistochemical staining for proliferating cell nuclear antigen (PCNA), laminin (LN), factor Ⅷ related antigen (FⅧ-RAg), and p53. The proliferative activity, stroma change, and angiogenesis were observed. ResultsPCNA label index (PCNA-LI) and proliferation index (PI) consistent in 24 heteroploid samples with PCNA staining were significantly higher value. PCNA positive cells were mainly distributed over nonfollicular parenchymatous structures, small follicles, and multilayered structures with large bubbly follicles. Destroyed basement membrane and necrosis were found by LN staining in PCNA positive position with vigorous reproductive capacity. Combining FⅧ-RAg staining with LN staining, interstitial proliferation and angiogenesis were obvious in follicular epithelial cells with vigorous reproductive capacity, providing nutrition and superior environment for them. ConclusionsThe reproduction of thyroid follicular epithelial cells, interstitial proliferation, and angiogenesis are all involved in tuberosis and hyperthyroidism, forming precancerous lesion, which suggest the succession model of goiter in iodine deficiency area.
ObjectiveTo investigate the significance of carbohydrate antigen 199 (CA199), alanine aminotransferase (ALT), gamma-glutamyl transferase (γ-GT) levels in the diagnosis of liver damage caused by hyperthyroidism. MethodA total of 106 patients confirmed to have hyperthyroid liver damage between February 2012 and February 2014 were selected to form the hyperthyroidism liver injury group (group A). Ninety-five hyperthyroidism patients without liver damage were regarded as the hyperthyroidism without liver injury group (group B). In the same period, 72 healthy subjects were designated to form the control group (group C). Automatic chemiluminescence detector was used to determine free triiodothyronine, free thyroid hormone and CA199, and automatic biochemical analyzer was adopted to measure the levels of γ-GT and ALT. Then we performed the statistical analysis. ResultsThe levels of serum CA199, γ-GT and ALT in group A were significantly higher than those in group B and group C, and the differences were statistically significant (P<0.05). CA199 and γ-GT levels in group B were significantly higher than those in group C (P<0.05). The area under the receiver operating characteristic curve for CA199, γ-GT, ALT was respectively 0.840, 0.895, and 0.818, the maximum Youden indexes were 0.593, 0.703, and 0.578, with the corresponding critical values 37.25 U/mL, 60.81 U/L, and 43.14 U/L, respectively. The parallel dectection of the three indexes improved Youden index to 0.763. ConclusionsCA199, γ-GT and ALT as diagnosis indexes of hyperthyroidism liver damage have good diagnostic value, and combined detection of the three indexes is more favorable for early diagnosis and prediction.
ObjectiveTo analyze and explore the thyroid defunctionalization method for preoperative preparation of hyperthyroidism patients in endoscopic thyroid surgery. MethodsThe clinical data of 45 cases of hyperthyroidism treated with endoscopic surgery in this hospital from June 2009 to June 2014 were analyzed retrospectively. These patients were divided into study group (n=20) and control group (n=25) according to the preoperative preparation method, the study group was prepared with thyroid defunctionalization method, the control group was prepared with antithyroid drugs and iodine. The intraoperative blood loss, conversion to open surgery, and postoperative complications were compared in these two groups. ResultsThe intraoperative blood loss and the operation time of the study group were significantly less than those of the control group﹝intraoperative blood loss: (120.32±50.26) mL versus (200.63±60.95) mL, P < 0.05; operation time: (120.43±40.56) min versus (180.76±50.92) min, P < 0.05﹞. There was no case of conversion to open surgery in the study group, there were three cases of conversion to open surgery in the control group. The incidence of postoperative complications of the study group was significantly lower than that of the control group﹝10% (2/20) versus 24% (6/25), P < 0.05﹞. ConclusionThyroid defunctionalization method is more suitable as compared with the traditional method for the preoperative preparation of hyperthyroidism in endoscopic thyroid surgery.
ObjectiveTo compare the dosimetric differences among flattening filter free intensity modulated radiotherapy (3FIMRT), flattening filter free volumetric modulated arc therapy (3FVMAT), filter free intensity modulated radiotherapy (IMRT), and filter free volumetric modulated arc therapy (VMAT) for hyperthyroidism exophthalmus patients.MethodsComputed tomography (CT) scans of 29 patients, who were diagnosed with hyperthyroidism exophthalmus and treated with radiation therapy between September 2016 and September 2017, were selected for study. Four treatment plans with the same dose prescription and objective constrains were designed for each patient based on their images, consisting of IMRT, VMAT, 3FIMRT, and 3FVMAT. The target dosimetric distribution, normal tissue radiation dose, monitor units, and treatment time of each plan were evaluated.ResultsFour types of plans were all able to satisfy the clinical treatment requirements, and there were no significant differences in maximum dose, mean dose (Dmean), homogeneity index of the targets (P>0.05). For the parameters minimum dose, V50%, conformity index (CI), gradient index of the targets, statistically significant differences were observed among the four kinds of technologies (F=10.920, 35.860, 11.320, 17.790; P<0.05). The CI of IMRT and 3FIMRT were superior to those of VMAT and 3FVMAT, but there was no significant difference between IMRT and 3FIMRT. In terms of Lens Dmean and Brain Dmean, statistically significant differences were observed among the four kinds of technologies (F=5.054, 83.780; P<0.05). For Lens Dmean and Brain Dmean, 3FVMAT achieved better sparing effects when compared with the other three plans. The total monitor units and treatment time did not significantly differ between 3FVMAT and VMAT. The mean monitor units of 3FVMAT were 65.07% and 70.22% less than that of IMRT and 3FIMRT respectively. The mean treatment time of 3FVMAT were 48.1% and 35.24% less than that of IMRT and 3FIMRT respectively.Conclusion3FVMAT can bring more dosimetric advantages for hyperthyroidism exophthalmus radiation therapy when compared with IMRT, 3FIMRT, and VMAT.