Ultrafast pulse wave velocity technique for evaluating changes of carotid artery elasticity in Hashimoto thyroiditis patients with euthyroidism

Objective To explore the value of ultrafast pulse wave velocity(UFPWV)technique for evaluating changes of carotid artery elasticity in Hashimoto thyroiditis(HT)patients with euthyroidism.Methods Conventional ultrasound and UFPWV for carotid artery were prospectively performed in 91 HT patients with euthyroidism(HT group)and 81 healthy subjects(control group).Clinical data and ultrasonic parameters were compared between groups.Spearman correlation analysis was performed to observe the correlations of carotid pulse wave velocity in end of systole(PWV-ES)with clinical indexes and other ultrasonic parameters in HT group.Multiple stepwise linear regression analysis was used to screen the independent impact factors of increased carotid PWV-ES in HT group.Results Significant differences of thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TgAb),total cholesterol(TC),low density lipoprotein and neutrophil-lymphocyte ratio(NLR)were found between groups(all P<0.05).The carotid PWV-ES in HT group was significantly higher than that in control group(P<0.05),while no significant difference of carotid artery intima-media thickness(CIMT)nor carotid pulse wave velocity in beginning of systole(PWV-BS)was found between groups(both P>0.05).Carotid PWV-ES in HT group was positively correlated with patients'age,body mass index,TPOAb,TC,triglyceride,NLR and CIMT(r=0.217—0.707,all P<0.05).Patients'age,TPOAb and NLR were all independent impact factors of increased carotid PWV-ES in HT patients with euthyroidism(all P<0.05).Conclusion UFPWV technique could be used to evaluate changes of carotid artery elasticity in HT patients with euthyroidism,among which PWV-ES was relatively sensitive.

桥本方治疗桥本甲状腺炎临床观察

目的以西药富希康为对照,评估益气养阴、调节免疫力的自拟方桥本方治疗桥本甲状腺炎的临床疗效。方法选择甲状腺功能[游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)]正常且中医证属气阴两虚的桥本甲状腺炎患者74例,年龄18~70岁,随机分为试验组与对照组,每组患者各37例,试验组治疗予中药汤剂桥本方口服,对照组予富希康口服。观察两组治疗前后中医症状改善以及相关实验室指标[FT3、FT4、TSH、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)、干扰素-γ(IFN-γ)、肿瘤坏死因子(TNF-α)、白细胞介素2(IL-2)、白细胞介素10(IL-10)、白细胞介素6(IL-6)、白细胞介素8(IL-8)]的变化情况。结果(1)试验组治疗总有效率(71.43%,25/35)明显优于对照组(34.29%,12/35)(P<0.01)。(2)试验组可有效改善患者的各项中医证候。(3)试验组和对照组均可有效降低TGAb、TPOAb滴度,其中TGAb试验组优于对照组;TPOAb两组间比较,差异无统计学意义。(4)试验组和对照组均可降低IL-2水平,但两组间比较,差异无统计学意义;试验组可升高IL-8水平,降低IFN-γ、TNF-α水平,而对照组未见此变化,其中IL-8两组间比较差异有统计学意义,其余两组间比较,差异无统计学意义。结论益气养阴法可明显改善气阴两虚型桥本甲状腺炎患者的中医证候,显著降低TGAb、TPOAb滴度,值得临床进一步推广使用。

Coeliac disease in Dutch patients with Hashimoto’s thyroiditis and vice versa

AIM: To define the association between Hashimoto’s thyroiditis and coeliac disease in Dutch patients. METHODS: A total of 104 consecutive patients with Hashimoto’s thyroiditis underwent coeliac serological tests (antigliadins, transglutaminase and endomysium antibodies) and HLA-DQ typing. Small intestinal biopsy was performed when any of coeliac serological tests was positive. On the other hand, 184 patients with coeliac disease were subjected to thyroid biochemical (thyroid stimulating hormone and free thyroxine) and thyroid serological tests (thyroglobulin and thyroid peroxidase antibodies). RESULTS: Of 104 patients with Hashimoto’s thyroiditis, sixteen (15%) were positive for coeliac serology and five patients with documented villous atrophy were diagnosed with coeliac disease (4.8%; 95% CI 0.7-8.9). HLA-DQ2 (and/or -DQ8) was present in all the five and 53 patients with Hashimoto’s thyroiditis (50%; 95% CI 43-62). Of 184 patients with coeliac disease, 39 (21%) were positive for thyroid serology. Based on thyroid biochemistry, the 39 patients were subclassified into euthyroidism in ten (5%; 95% CI 2-9), subclinicalhypothyroidism in seven (3.8%; 95% CI 1.8-7.6), and overt hypothyroidism (Hashimoto’s thyroiditis) in 22 (12%; 95% CI 8-16). Moreover, four patients with coeliac disease had Graves’ disease (2%; 95% CI 0.8-5) and one patient had post-partum thyroiditis. CONCLUSION: The data from a Dutch population confirm the association between Hashimoto’s thyroiditis and coeliac disease. Screening patients with Hashimoto’s thyroiditis for coeliac disease and vice versa is recom- mended.

Simultaneous development of diabetic ketoacidosis and Hashitoxicosis in a patient treated with pegylated interferon-alpha for chronic hepatitis C

Classical interferon-alpha has been shown to be correlated with the development of a variety of autoimmune disorders. A 38 year-old female patient developed simultaneously diabetic ketoacidosis and hyperthyroidism 5 mo following initiation of treatment with pegylated interferon-α and ribavirin for chronic hepatitis C. High titers of glutamic acid decarboxylase, antinuclear and thyroid (thyroid peroxidase and thyroglobulin) antibodies were detected. Antiviral treatment was withdrawn and the patient was treated with insulin for insulin-dependent diabetes mellitus and propranolol for hyperthyroidism. Twelve months after cessation of pegylated interferon-α therapy the patient was euthyroid without any medication but remained insulin-dependent.

Dynamic analysis of subway station subjected to internal blast loading

The study was motivated by the fact that explosion inside the subway structure may not only cause direct life loss,but also damage the subway structure and lead to further loss of lives and properties.The propagation law of explosion wave in the subway station was analyzed and a simplified model of overpressure in the subway station was also proposed.Whereafter,the improved dynamic cam-clay model of soil and the concrete damaged plasticity constitutive model were used for the dynamic analysis of the subway station.Meanwhile,the influences of soil stiffness and burial depth on the dynamic response of the subway station were looked into.The results show that the multi-peak overpressure in the subway station does not appear,and large stresses concentrate on the central column and the floor slab of the subway station,so some special reinforcement measures should be taken in these parts.The effect of soil stiffness and burial depth on the stress of the central column is little;however,the effect on the stress of the station side wall is relatively obvious.

Advances in the relationship between Hashimoto’s thyroiditis and thyroid cancer

In recent years,the incidence of Hashimoto’s thyroiditis and thyroid cancer has shown a rapid growth trend.These two diseases have severely affected the public health.Many epidemiological studies have shown that thyroid cancer is often associated with Hashimoto’s thyroiditis.Hashimoto’s thyroiditis may promote the occurrence of thyroid cancer,as well as affecting the progression of the tumor,lymph node metastasis,and even the prognosis of patients.In this paper,the relationship between Hashimoto’s thyroiditis and thyroid cancer and the pathogenesis of thyroid cancer are reviewed regarding molecular mechanism,clinical pathology,and serology.

Structural Optimization of Concrete Slab Frame Bridges Considering Investment Cost

The present study investigates computer-antomated design and structural optimization of concrete slab frame bridges considering investment cost based on a complete 3D model. Thus, a computer code with several modules has been developed to produce parametric models of slab frame bridges. Design loads and load combinations are based on the Eurocode design standard and the Swedish design standard for bridges. The necessary reinforcement diagrams to satisfy the ultimate and serviceability limit states, including fatigue checks for the whole bridge, are calculated according to the aforementioned standards. Optimization techniques based on the genetic algorithm and the pattern search method are applied. A case study is presented to highlight the efficiency of the applied optimization algorithms. This methodology has been applied in the design process for the time-effective, material-efficient, and optimal design of concrete slab frame bridges.

Cost Impact of Increasing Heavy Vehicle Loads on Bridges

This study aimed to investigate the cost impact of meeting the increase in freight demand by doubling the truck weight （AS 1 ）, doubling the traffic volume （AS2）, or legalizing a new-proposed-truck of 97-kip weight instead of the currently legal 80-kip truck （AS3）. The State of Michigan＇s average daily traffic database of year 2001 has been used as a case study. The study was applied only on the very common US Bridge with RC （reinforced concrete） deck over steel girder. Sampling criteria also includes the age of the bridges. The study covered the four-cost-impact categories provided by the NCHRP （National Cooperative Research Program）. The current truck weight and double traffic volume （AS2） show the best scenario to meet the increase in freight demand. However, doubling the truck weight with the current traffic volume （AS 1） was the worst scenario. The use of the proposed 97-kip truck with the current traffic volume （AS3） compromises both, meeting the increase in freight demand and the cost impact.

Environmental Impact Optimization of Reinforced Concrete Slab Frame Bridges

The main objective of this research is to integrate environmental impact optimization in the structural design of reinforced concrete slab frame bridges in order to determine the most environment-friendly design. The case study bridge used in this work was also investigated in a previous paper focusing on the optimization of the investment cost, while the present study focuses on environmental impact optimization and comparing the results of both these studies. Optimization technique based on the pattern search method was implemented. Moreover, a comprehensive LCA （life cycle assessment） methodology of ReCiPe and two monetary weighting systems were used to convert environmental impacts into monetary costs. The analysis showed that both monetary weighting systems led to the same results. Furthermore, optimization based on environmental impact generated models with thinner construction elements yet of a higher concrete class, while cost optimization by considering extra constructability factors provided thicker sections and easier to construct. This dissimilarity in the results highlights the importance of combining environmental impact （and its associated environmental cost） and investment cost to find more material-efficient, economical, sustainable and time-effective bridge solutions.

Clinical Study on Combined Moxibustion and Medication for Hashimoto’s Thyroiditis

Objective： To observe the clinical effect of combined moxibustion and medication for Hashimoto’s thyroiditis. Methods： A total of 85 cases with Hashimoto’s thyroiditis who met the inclusion criteria were randomly allocated into an observation group and a control group. Forty-two cases in the observation group were treated with combined moxibustion with oral Levothyroxine Sodium tablets, whereas 43 cases in the control group were treated with oral Levothyroxine Sodium tablets alone. Then the scores of clinical symptoms and exophthalmos before and after treatment were compared. In addition, the time period for improvement of clinical symptoms in both groups were recorded and compared. Results： After one-month treatment, the scores of clinical symptoms and exophthalmos in the observation group were significantly improved than those in the control group （P0.05）; and it took less time for the cases in the observation group to get improvement compared with the control group. Conclusion： Combined moxibustion and oral Levothyroxine Sodium tablet is an efficient reliable therapy for Hashimoto’s thyroiditis.

A preliminary clinical application of sICAM-1 RIA in three kinds of thyroid disease

To examine serum levels of sICAM 1 from normal controls and patients with thyroid diseases (simple goitre, Graves’ disease or Hashimoto’s thyroiditis) with 125 Ⅰ sICAM 1 RIA established in our lab Methods Using 125 Ⅰ sICAM 1 RIA, serum sICAM 1 levels of 400 healthy individuals as the normal group and 1020 patients with simple goitre (SG), Graves’ disease (GD) or Hashimoto’s thyroiditis (HT) were examined for a comporative chinical study Results The serum level of sICAM 1 ( ±s ) in the normal group was 168 43±36 23 μg/L There was no significant difference between the normal and SG groups ( P 】0 05), whereas the serum levels of sICAM 1 in autoimmune thyroid diseases (GD or HT) were higher than those in the normal or SG groups ( P 【0 05, respectively) After GD patients received one of three medical treatments, their serum sICAM 1 levels decreased ( P 【0 05) After GD patients were treated and their thyroid function decreased to normal, their serum sICAM 1 levels were lower than those in relapsed GD patients ( P 【0 05) Conclusions sICAM 1 RIA can be used to examine autoimmune thyroid diseases Serum levels of sICAM 1 can be used as a parameter in diagnosing autoimmune thyroid disease and in evaluating the effects of therapy, drug administration or relapse in GD

Reflection and prospect on acupuncture-moxibustion in treating Hashimoto's thyroiditis

Objective： To categorize and summarize the clinical and mechanism studies of the past 30 years on the treatment of Hashimoto＇s thyroiditis（HT） with moxibustion, moxibustion plus medication, and acupuncture plus medication, etc., and to analyze the current problems. Methods： The clinical and laboratory studies related to the treatment of HT with acupuncture-moxibustion therapies published before June 2015 were retrieved from MEDLINE, Excerpta Medica Database（EMBASE）, China National Knowledge Infrastructure（CNKI）, Wanfang Academic Journal Full-text Database（Wanfang） and Chongqing VIP Database（CQVIP）. Results： Moxibustion, moxibustion plus medication, and acupuncture plus medication can produce certain therapeutic effects in treating HT. Conclusion： The research on the treatment of HT with acupuncture-moxibustion therapies is rather limited in the amount and content. In the future, standardization should be fortified, specific moxibustion research needs deepening, and the action mechanism of moxibustion should be emphasized.