目的：研究泉州市沿海地区人群亚临床甲状腺功能减退症（SC H ）的流行特征，并探讨SC H患者血清促甲状腺素（T S H ）与血压的关系。方法采用整群随机抽样方法调查泉州市21个沿海社区的常住（居住时间≥5年）居民1742人，年龄≥30岁，...目的：研究泉州市沿海地区人群亚临床甲状腺功能减退症（SC H ）的流行特征，并探讨SC H患者血清促甲状腺素（T S H ）与血压的关系。方法采用整群随机抽样方法调查泉州市21个沿海社区的常住（居住时间≥5年）居民1742人，年龄≥30岁，检测血压、游离三碘甲状腺原氨酸、游离甲状腺素和 T S H、空腹血糖、甘油三酯。采用 t检验、多元线性相关分析进行数据统计。结果（1）SC H总患病率3．90％，其中女性4．24％，男性2．99％，男女间差别无统计学意义（ P＞0．05）。（2）从年龄结构看，30～39岁组患病率最高（4．74％），其中女性为5．24％；60～69岁组患病率最低（2．58％）。（3）T S H与舒张压水平呈正相关（β＝0．064，P＜0．05）。结论泉州市沿海地区年轻女性SC H患病率较高；SC H可能是血压升高的危险因素。展开更多
Gastrointestinal duplications are an uncommon congenital abnormality that manifest before the age of two in 80% of cases. Ileal duplication is the most common while colonic duplication, either cystic or tubular, occur...Gastrointestinal duplications are an uncommon congenital abnormality that manifest before the age of two in 80% of cases. Ileal duplication is the most common while colonic duplication, either cystic or tubular, occurs in 10%-15% of cases and remains asymptomatic and undiagnosed in most cases. Mostly occurring in pediatric patients, colonic duplication is encountered in adults in only a few cases. The most common clinical manifestations are abdominal pain and intestinal obstruction. Rarely, duplications present with signs of acute abdomen or acute bleeding. This study reports a case of colonic duplication in an adult who presented with chronic constipation. Complete diagnostic workup was made on several occasions during the previous eight year period, but no pathology was found and chronic constipation was attributed to hypothyroidism caused by long standing Hashimoto thyroiditis. Nultislice CT, performed because of abdominal distension, defined colonic pathology but the definite diagnosis of duplication of the transversal colon was made at operation. The cystic duplication and the adjacent part of the ascending and transversal colon were excised enblock. This study implies that colonic duplication, though uncommon, should be included in the differential diagnosis of chronic constipation even when precipitating factors for constipation, such as hypothyroidism are present.展开更多
Simvastatin,a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor,is widely prescribed to patients with hypercholesteremia and its muscular toxicity has been widely reported.The metabolism of simvastatin depends...Simvastatin,a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor,is widely prescribed to patients with hypercholesteremia and its muscular toxicity has been widely reported.The metabolism of simvastatin depends on the enzymic activity of cytochrome P450 3A4 （CYP3A4） and inhibitors of CYP3A4 can result in clinical events by interacting with simvastatin.Diltiazem is a moderate inhibitor of CYP3A4,which is known to increase the serum concentration of simvastatin.Here we report a patient with unrecognized hypothyroidism who had been stable for more than one year on low-dose simvastatin therapy of hypercholesteremia and rhabdomyolysis occurred with the addition of diltiazem.This is one of scanty reports of rhabdomyolysis induced by simvastatindiltiazem drug interaction,especially in hypothyroid patient.This case reminds the clinicians that although diltiazem as a moderate CYP3A4 inhibitor can be used cautiously with small doses of CYP3A4-dependent statius （eg,simvastatin）,these two commonly used drugs should be avoided in hypothyroid patient.展开更多
AIM： To investigate the prevalence of cholelithiasis among patients treated with ezetimibe. METHODS： A retrospective, case-control study based on computerized medical records from patients of the Clalit Health Servi...AIM： To investigate the prevalence of cholelithiasis among patients treated with ezetimibe. METHODS： A retrospective, case-control study based on computerized medical records from patients of the Clalit Health Services, Sharon-Shomron region, from 2000 to 2009. Patients 20-85 years of age, who had been treated with ezetimibe and statins or statins only for at least 6 too, and who had an abdominal ultrasound were included in the study. Collected data included age, gender, ezetimibe treatment duration, presence of hypothyroidism or diabetes, and existence of cholelithiasis as determined by ultrasound. Ex- cluded were subjects after gallbladder resection, with hemolysis, myeloproliferative or inflammatory bowel diseases, and those treated with ursodeoxycholic acid and fibrates. Patients treated with statins and ezeti- mibe （study group） were compared to patients treated with statins only （control group）. RESULTS： The study group included 25 patients and the control group 168. All patients in the study were treated with statins. The study group included 13 males （52%） and 12 females （48%）, the control group 76 males （45%） and 92 （55%） females （P = 0.544）. The groups did not differ in age （mean age： 68 ± 8 years, range 53-85 years vs mean age： 71±8 years, range 51-85 years; P = 0.153） or in the rate of dia- betic and hypothyroid patients [11 （44%） vs 57 （33%）, P = 0.347 in the study group and 5 （20%） vs 23 （14%）, P = 0.449 in the control group, respectively]. Patients in the study group were treated with ezetimibe for an average of 798±379 d. Cholelithiasis was found in 4 （16%） patients in the study group and in 33 （20%） patients in the control group （P = 0.666）. CONCLUSION： Ezetimibe does not appear to influ- ence the prevalence of gallstones.展开更多
Johanson-Blizzard syndrome(JBS) is a rare autosomal recessive disease characterized by exocrine pancreatic insufficiency,hypoplastic or aplastic nasal alae,cutis aplasia on the scalp,and other features including devel...Johanson-Blizzard syndrome(JBS) is a rare autosomal recessive disease characterized by exocrine pancreatic insufficiency,hypoplastic or aplastic nasal alae,cutis aplasia on the scalp,and other features including developmental delay,failure to thrive,hearing loss,mental retardation,hypothyroidism,dental abnormalities,and anomalies in cardiac and genitourinary systems.More than 60 cases of this syndrome have been reported to date.We describe the case of a male infant with typical symptoms of JBS.In addition,a new clinical feature which has not previously been documented,that is anemia requiring frequent blood transfusions and mild to moderate thrombocytopenia was observed.A molecular study was performed which revealed a novel homozygous UBR1 mutation.Possible explanations for this new association are discussed.展开更多
Objective： The purpose of the study wass to explore the correlation between thyroid function and nodular goiter accompanied with gallstone. Methods： We collected 120 cases about nodular goiter accompanied with galls...Objective： The purpose of the study wass to explore the correlation between thyroid function and nodular goiter accompanied with gallstone. Methods： We collected 120 cases about nodular goiter accompanied with gallstone and 128 cases about nodular goiter and establish 50 healthy control groups. Detected t level of hyrotropic hormone （TSH）, total triio- dothyronine （TT3）, total thyroxine in the peripheral venous blood of these cases in the three groups by using electrochemilu- minescenca immunoassay, measure level of total cholesterol （TC）, high-density tipoprotein cholesterol（HDL-C）, low-density lipoprotein cholesterol （LDL-C） and total bile acid （TBA） levels by using enzymic method, and observed the changes of thyroid function and blood lipid among the three groups. Results： The serum TT3 level in nodular goiter accompanied with gallstone group and the nodular goiter group was significantly lower than that in control group （P 〈 0.01）, and TSH level in the nodular goiter accompanied with gallstone group is significantly higher than that in control group （P 〈 0.01）, There were no statistical significance about difference of TT4 level among the three groups （P 〉 0.05）. Accordingly, TC and LDL-C level in nodular goiter accompanied with gallstone group was significantly higher than that in nodular goiter and control group （P 〈 0.01）, while TBA level in nodular goiter accompanied with gallstone group was significantly lower than that in simple nodular goiter group and control group （P 〈 0.01）. There was no statistical significance about difference of TC and LDL-C level between simple nodular goiter group and control group （P 〉 0.05）. The HDL-C level in nodular goiter accompanied with gallstone group and control group was higher than that in simple nodular goiter group （P 〈 0.01）. Conclusion： The originating etiologic factor of nodular goiter accompanied with gallstone may be related to that the decreased TT3 induced sub-clinical hypothyroidism.展开更多
The aim was to characterize thyroid function in Hispanic hypertensive population. Retrospective study of 1,023 individuals was performed, in which 68.23% had hypertension （74.21% women） and 37.25% had thyroid pathol...The aim was to characterize thyroid function in Hispanic hypertensive population. Retrospective study of 1,023 individuals was performed, in which 68.23% had hypertension （74.21% women） and 37.25% had thyroid pathology. Age, weight, blood pressure, biochemical measurements were recorded, mean age： 53.02 ± 14.80 yr, mean weight： 83.05 ±16.95 kg, thyrotropin-stimulating hormone （TSH） hypertensive patients： 5.55±1.63 μUI/mL and without hypertension： 3,72 ± 1.60 μUI/mL. TSH range concentration distributed by sex indicates： 1.50-2.49 μUI/mL men, 2.50-5.01 μUI/mL women. TSH categories vs. age were positively associated （r = ＋ 0.114, P = 0.044） and hypertension by age was also correlated （r = ＋ 0.178, P = 0.0001）. Significant positive association we found between TSH and diastolic blood pressure （r = ＋ 0.197, P = 0.008）. Systolic and diastolic blood pressure vs. age were positively increasing （r = ＋ 0.410,p = 0.0001; r = ＋0.285, P = 0.0001, respectively）. Prevalence of thyroid pathology in hypertensive subjects are hyperthyroidism 5.87%; hypothyroidism 20.34% （5.73% subclinic） and autoimmune disease 6.25%. High percentage of hypertensive population has concomitant thyroid diseases, more common in women （50-70 years）. Systematic surveillance for occult thyroid dysfunction in patients with hypertension could prevent future cardiovascular disease.展开更多
Objective To analyze heart rate variability (HRV)and its changes with thyroxine treatment in patients with hypothyroidism. Methods HRV was analyzed using 24-hour electrocardiographic recording in 38 patients with hy...Objective To analyze heart rate variability (HRV)and its changes with thyroxine treatment in patients with hypothyroidism. Methods HRV was analyzed using 24-hour electrocardiographic recording in 38 patients with hypothyroidism and 21 normal controls. The changes in HRV were evaluated for the 18 hypothyroid patients after 3 months of thyroxine therapy.Results The time domain measurements of HRV in hypothyroid patients were much lower than those in the control group. As to HRV frequency domain, the high frequency power was significantly higher, but the ratio of low frequency power to frequency power for hypothyroid patients was lower than in the controls. These abnormal changes of HRV measurements in hypothyroid patients were improved after treatment with thyroxine and were associated with recovery of serum concentrations of FT3 and FT4. Conclusions Patients with hypothyroidism often have autonomic neuropathies with a higher level of vagal tone. These abnormalities could be partly improved by thyoxine therapy.展开更多
OBJECTIVE:To evaluate the effectiveness and safety of Chinese herbal medicine(CHM) in the treatmentofsubacutethyroiditis.METHODS: Randomized controlled trials found in PubMed, Cochrane Library, and three Chinese datab...OBJECTIVE:To evaluate the effectiveness and safety of Chinese herbal medicine(CHM) in the treatmentofsubacutethyroiditis.METHODS: Randomized controlled trials found in PubMed, Cochrane Library, and three Chinese databases were selected. RevMan 5.2 software was used to analyze the data with relative risk or mean difference, expressed with 95% of confidence interval. The quality of trials was assessed and gradedthe quality of evidence with GRADE profiler software.RESULTS: Twenty one studies were included. CHM was superior to Western Medicine(include prednisone and NSAIDs) in abating fever, relieving thyroid pain, recovering blood sedimentation, improving thyroid function, and preventing hypothyroidism(P<0.05), while no statistical differences were found in eliminating goiter and reducing relapse rate.CHM plusWestern Medicine were superior toWestern Medicine in abating fever, relieving thyroid pain, eliminating goiter, and reducing relapse rate,while no statistical differences(P>0.05) were found in recovering blood sedimentation and improving thyroid function. The incidence of adverse reactions in treatment group was lower than that in control group(relative risk was 0.12 and 95% confidence interval was 0.03-0.51). The methodological quality of trials is generally poor with a high risk of bias.CONCLUSION: CHM(particularly CHM combined withWestern Medicine) used to treat subacute thyroiditis may improve clinical symptoms and signs,reduce relapse rate, and alleviate the side effects of hormones. Due to poor methodological quality of included trials, further more high-quality studies are warranted to confirm the effectiveness and safety of CHM.展开更多
文摘目的：研究泉州市沿海地区人群亚临床甲状腺功能减退症（SC H ）的流行特征，并探讨SC H患者血清促甲状腺素（T S H ）与血压的关系。方法采用整群随机抽样方法调查泉州市21个沿海社区的常住（居住时间≥5年）居民1742人，年龄≥30岁，检测血压、游离三碘甲状腺原氨酸、游离甲状腺素和 T S H、空腹血糖、甘油三酯。采用 t检验、多元线性相关分析进行数据统计。结果（1）SC H总患病率3．90％，其中女性4．24％，男性2．99％，男女间差别无统计学意义（ P＞0．05）。（2）从年龄结构看，30～39岁组患病率最高（4．74％），其中女性为5．24％；60～69岁组患病率最低（2．58％）。（3）T S H与舒张压水平呈正相关（β＝0．064，P＜0．05）。结论泉州市沿海地区年轻女性SC H患病率较高；SC H可能是血压升高的危险因素。
文摘Gastrointestinal duplications are an uncommon congenital abnormality that manifest before the age of two in 80% of cases. Ileal duplication is the most common while colonic duplication, either cystic or tubular, occurs in 10%-15% of cases and remains asymptomatic and undiagnosed in most cases. Mostly occurring in pediatric patients, colonic duplication is encountered in adults in only a few cases. The most common clinical manifestations are abdominal pain and intestinal obstruction. Rarely, duplications present with signs of acute abdomen or acute bleeding. This study reports a case of colonic duplication in an adult who presented with chronic constipation. Complete diagnostic workup was made on several occasions during the previous eight year period, but no pathology was found and chronic constipation was attributed to hypothyroidism caused by long standing Hashimoto thyroiditis. Nultislice CT, performed because of abdominal distension, defined colonic pathology but the definite diagnosis of duplication of the transversal colon was made at operation. The cystic duplication and the adjacent part of the ascending and transversal colon were excised enblock. This study implies that colonic duplication, though uncommon, should be included in the differential diagnosis of chronic constipation even when precipitating factors for constipation, such as hypothyroidism are present.
文摘Simvastatin,a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor,is widely prescribed to patients with hypercholesteremia and its muscular toxicity has been widely reported.The metabolism of simvastatin depends on the enzymic activity of cytochrome P450 3A4 （CYP3A4） and inhibitors of CYP3A4 can result in clinical events by interacting with simvastatin.Diltiazem is a moderate inhibitor of CYP3A4,which is known to increase the serum concentration of simvastatin.Here we report a patient with unrecognized hypothyroidism who had been stable for more than one year on low-dose simvastatin therapy of hypercholesteremia and rhabdomyolysis occurred with the addition of diltiazem.This is one of scanty reports of rhabdomyolysis induced by simvastatindiltiazem drug interaction,especially in hypothyroid patient.This case reminds the clinicians that although diltiazem as a moderate CYP3A4 inhibitor can be used cautiously with small doses of CYP3A4-dependent statius （eg,simvastatin）,these two commonly used drugs should be avoided in hypothyroid patient.
文摘AIM： To investigate the prevalence of cholelithiasis among patients treated with ezetimibe. METHODS： A retrospective, case-control study based on computerized medical records from patients of the Clalit Health Services, Sharon-Shomron region, from 2000 to 2009. Patients 20-85 years of age, who had been treated with ezetimibe and statins or statins only for at least 6 too, and who had an abdominal ultrasound were included in the study. Collected data included age, gender, ezetimibe treatment duration, presence of hypothyroidism or diabetes, and existence of cholelithiasis as determined by ultrasound. Ex- cluded were subjects after gallbladder resection, with hemolysis, myeloproliferative or inflammatory bowel diseases, and those treated with ursodeoxycholic acid and fibrates. Patients treated with statins and ezeti- mibe （study group） were compared to patients treated with statins only （control group）. RESULTS： The study group included 25 patients and the control group 168. All patients in the study were treated with statins. The study group included 13 males （52%） and 12 females （48%）, the control group 76 males （45%） and 92 （55%） females （P = 0.544）. The groups did not differ in age （mean age： 68 ± 8 years, range 53-85 years vs mean age： 71±8 years, range 51-85 years; P = 0.153） or in the rate of dia- betic and hypothyroid patients [11 （44%） vs 57 （33%）, P = 0.347 in the study group and 5 （20%） vs 23 （14%）, P = 0.449 in the control group, respectively]. Patients in the study group were treated with ezetimibe for an average of 798±379 d. Cholelithiasis was found in 4 （16%） patients in the study group and in 33 （20%） patients in the control group （P = 0.666）. CONCLUSION： Ezetimibe does not appear to influ- ence the prevalence of gallstones.
文摘Johanson-Blizzard syndrome(JBS) is a rare autosomal recessive disease characterized by exocrine pancreatic insufficiency,hypoplastic or aplastic nasal alae,cutis aplasia on the scalp,and other features including developmental delay,failure to thrive,hearing loss,mental retardation,hypothyroidism,dental abnormalities,and anomalies in cardiac and genitourinary systems.More than 60 cases of this syndrome have been reported to date.We describe the case of a male infant with typical symptoms of JBS.In addition,a new clinical feature which has not previously been documented,that is anemia requiring frequent blood transfusions and mild to moderate thrombocytopenia was observed.A molecular study was performed which revealed a novel homozygous UBR1 mutation.Possible explanations for this new association are discussed.
文摘Objective： The purpose of the study wass to explore the correlation between thyroid function and nodular goiter accompanied with gallstone. Methods： We collected 120 cases about nodular goiter accompanied with gallstone and 128 cases about nodular goiter and establish 50 healthy control groups. Detected t level of hyrotropic hormone （TSH）, total triio- dothyronine （TT3）, total thyroxine in the peripheral venous blood of these cases in the three groups by using electrochemilu- minescenca immunoassay, measure level of total cholesterol （TC）, high-density tipoprotein cholesterol（HDL-C）, low-density lipoprotein cholesterol （LDL-C） and total bile acid （TBA） levels by using enzymic method, and observed the changes of thyroid function and blood lipid among the three groups. Results： The serum TT3 level in nodular goiter accompanied with gallstone group and the nodular goiter group was significantly lower than that in control group （P 〈 0.01）, and TSH level in the nodular goiter accompanied with gallstone group is significantly higher than that in control group （P 〈 0.01）, There were no statistical significance about difference of TT4 level among the three groups （P 〉 0.05）. Accordingly, TC and LDL-C level in nodular goiter accompanied with gallstone group was significantly higher than that in nodular goiter and control group （P 〈 0.01）, while TBA level in nodular goiter accompanied with gallstone group was significantly lower than that in simple nodular goiter group and control group （P 〈 0.01）. There was no statistical significance about difference of TC and LDL-C level between simple nodular goiter group and control group （P 〉 0.05）. The HDL-C level in nodular goiter accompanied with gallstone group and control group was higher than that in simple nodular goiter group （P 〈 0.01）. Conclusion： The originating etiologic factor of nodular goiter accompanied with gallstone may be related to that the decreased TT3 induced sub-clinical hypothyroidism.
文摘The aim was to characterize thyroid function in Hispanic hypertensive population. Retrospective study of 1,023 individuals was performed, in which 68.23% had hypertension （74.21% women） and 37.25% had thyroid pathology. Age, weight, blood pressure, biochemical measurements were recorded, mean age： 53.02 ± 14.80 yr, mean weight： 83.05 ±16.95 kg, thyrotropin-stimulating hormone （TSH） hypertensive patients： 5.55±1.63 μUI/mL and without hypertension： 3,72 ± 1.60 μUI/mL. TSH range concentration distributed by sex indicates： 1.50-2.49 μUI/mL men, 2.50-5.01 μUI/mL women. TSH categories vs. age were positively associated （r = ＋ 0.114, P = 0.044） and hypertension by age was also correlated （r = ＋ 0.178, P = 0.0001）. Significant positive association we found between TSH and diastolic blood pressure （r = ＋ 0.197, P = 0.008）. Systolic and diastolic blood pressure vs. age were positively increasing （r = ＋ 0.410,p = 0.0001; r = ＋0.285, P = 0.0001, respectively）. Prevalence of thyroid pathology in hypertensive subjects are hyperthyroidism 5.87%; hypothyroidism 20.34% （5.73% subclinic） and autoimmune disease 6.25%. High percentage of hypertensive population has concomitant thyroid diseases, more common in women （50-70 years）. Systematic surveillance for occult thyroid dysfunction in patients with hypertension could prevent future cardiovascular disease.
文摘Objective To analyze heart rate variability (HRV)and its changes with thyroxine treatment in patients with hypothyroidism. Methods HRV was analyzed using 24-hour electrocardiographic recording in 38 patients with hypothyroidism and 21 normal controls. The changes in HRV were evaluated for the 18 hypothyroid patients after 3 months of thyroxine therapy.Results The time domain measurements of HRV in hypothyroid patients were much lower than those in the control group. As to HRV frequency domain, the high frequency power was significantly higher, but the ratio of low frequency power to frequency power for hypothyroid patients was lower than in the controls. These abnormal changes of HRV measurements in hypothyroid patients were improved after treatment with thyroxine and were associated with recovery of serum concentrations of FT3 and FT4. Conclusions Patients with hypothyroidism often have autonomic neuropathies with a higher level of vagal tone. These abnormalities could be partly improved by thyoxine therapy.
基金Supported by Effectiveness of External Therapy of Traditional Chinese Medicine for Subacute Thyroiditis:a Evaluation Research(sci-tech project,No.WZF2012-12)Research on Professor Wu Ruimin's Academic Thought on Treating Subacute Thyroiditis(research project,No.JJ2010-65)from Beijing Municipality of Traditional Chinese Medicine
文摘OBJECTIVE:To evaluate the effectiveness and safety of Chinese herbal medicine(CHM) in the treatmentofsubacutethyroiditis.METHODS: Randomized controlled trials found in PubMed, Cochrane Library, and three Chinese databases were selected. RevMan 5.2 software was used to analyze the data with relative risk or mean difference, expressed with 95% of confidence interval. The quality of trials was assessed and gradedthe quality of evidence with GRADE profiler software.RESULTS: Twenty one studies were included. CHM was superior to Western Medicine(include prednisone and NSAIDs) in abating fever, relieving thyroid pain, recovering blood sedimentation, improving thyroid function, and preventing hypothyroidism(P<0.05), while no statistical differences were found in eliminating goiter and reducing relapse rate.CHM plusWestern Medicine were superior toWestern Medicine in abating fever, relieving thyroid pain, eliminating goiter, and reducing relapse rate,while no statistical differences(P>0.05) were found in recovering blood sedimentation and improving thyroid function. The incidence of adverse reactions in treatment group was lower than that in control group(relative risk was 0.12 and 95% confidence interval was 0.03-0.51). The methodological quality of trials is generally poor with a high risk of bias.CONCLUSION: CHM(particularly CHM combined withWestern Medicine) used to treat subacute thyroiditis may improve clinical symptoms and signs,reduce relapse rate, and alleviate the side effects of hormones. Due to poor methodological quality of included trials, further more high-quality studies are warranted to confirm the effectiveness and safety of CHM.
