75例亚急性甲状腺炎的临床研究

目的 :探讨亚急性甲状腺炎 (SAT)的诊断治疗。方法 :回顾性总结分析 1 990～ 2 0 0 0年经治的 75例SAT的临床资料。结果 :女性发病多于男性 ,发病年龄 30～ 5 0岁者占 6 9 3% ;全部病人均有甲状腺肿大及触痛 ;T3、T4增高者占 6 2 4 % ;甲状腺摄13 1Ⅰ功能低于正常者占 5 8 9% ;甲状腺核素 ( 99mTCO4 )显像检查提示甲状腺功能低于正常者 78 4 % ;血清T3、T4增高而甲状腺摄13 1Ⅰ率降低 ,呈分离现象者占 5 3 5 % ;82 6 %的患者经强的松治疗效果良好。结论 :应重视病史询问和甲状腺触诊 ;核医学检查是诊断本病的重要方法 ;T3、T4与甲状腺摄13 1Ⅰ率的分离现象为SAT的特征性表现 ;认为甲状腺核素显像检查与吸13 1Ⅰ率之间有较好的平行关系 ;

Effect of Calpain inhibitor I on glucocorticoid receptor-dependent degradation and its transactivation ability

Objective: To investigate the effect of Calpain inhibitor I on glucocorticoid receptor-dependent proteasomal degradation and its transcriptional activity. Methods: After Raw-264.7 cells were treated with Calpain inhibitor I, dexamethasone, or both for about 12 h, the change of glucocorticoid receptor was detected by western blot analysis. COS-7 cells were transfected with PRsh-GRα expression vector and glucocorticoid-responsive receptor pMAMneo-CAT, then the effect of Calpain inhibitor I on glucocorticoid receptor transcriptional activation ability was determined by CAT activity. Results: The glucocorticoid receptor levels decreased after RAW-264.7 cells were treated with dexamethasone for 12 hours, which effect can be inhibited by Calpain inhibitor I to some extent. CAT activity assay showed that Calpain inhibitor I enhance glucocorticoid receptor transcriptional activity. Conclusion: Calpain inhibitor I can inhibit the down-regulation of dexamethasone on glucocorticoid receptor, and enhances glucocorticoid receptor transactivation ability.

Arctic spring: the arrival biology of migrant birds

On arrival in the Arctic, migrant birds must adjust their physiology and behavior to unpredictable snow cover, weather, food sources and predator pressure. In other words they must be resistant to environmental perturbations (stress) so that they can migrate to their tundra nesting areas and settle on territories as soon as possible. They can then begin breeding as soon as when environmental conditions become favorable. They do this partly by using micro-habitats such as areas where snow depth is low, and patches of tundra that melt out rapidly (especially near willows Salix sp). Ground temperatures increase dramatically within hours after exposure to sun; and invertebrate activity begins simultaneously. Wind speeds are attenuated almost completely within 10 cm of the ground in willows and tussock tundra. The combination of these conditions provides an ideal refuge, especially for passerine migrants in early spring. However, if conditions worsen, the birds can leave. There are adjustments of the adrenocortical responses to stress because arctic conditions in spring are potentially severe, at least compared with wintering grounds to the south. Secretion of corticosterone in response to acute stress is enhanced at arrival in males, accompanied by a decrease in sensitivity to negative feedback and a change in responsiveness of the adrenal cortex cells to adrenocorticotropin. There is also an increase in levels of corticosterone-binding globulin (CBG) so that the actions of corticosterone are buffered according to the severity of environmental conditions. Regulation at the level of genomic receptors, particularly the low affinity glucocorticosteroid-like receptor for corticosterone in brain and liver, may be important; and non-genomic actions of corticosterone may play a major role too. In other words, the hormone-behavior system associated with arrival biology is highly flexible.

Effects of high dose glucocorticoid on expression and mRNA transcription of corticotropin releasing hormone in hypothalamus paraventricular nucleus of rats

Objective： To explore the effect of high dose of glucocorticoid （GC） on the synthesis of corticotropin releasing hormone （CRH） and transcription of its mRNA in hypothalamus paraventricular nuclei （PVN） in order to investigate its difference with that of traditional GC effects and to add a new possible explanation to the mechanism of clinical applications of high dose of GC. Methods： A total of 60 rats were divided into 5 groups： blank control, 10^-6 mol/L dexamethasone （DEX） group, 10^-9 mol/L DEX group, 0.9% saline group and GR blocking group （10^-2mol/L RU486）. All agents were administrated through the femoral vein. CRH protein expression was measured by immunohistochemistry and laser confocal scanning microscopy （LCSM）; CRH mRNA level was explored by in situ hybridization. Results： 10^-6 mol/L DEX made CRH mRNA transcripted after 20 min and its protein expressed in PVN after 30 min, while normal level of DEX and 0.9% saline could not. If GR was blocked in advance, the effect of high dose of DEX disappeared. Conclusion ： High dose of GC can have CRH increased in PVN, which differs to the effect of traditional GC. And mGRH may play an important role in the effect of high dose of GC but not classic iGR.

A Small Solitary Pulmonary Nodule Discovered by ^(18)F-fluorodeoxyglucose Positron Emission Tomography and CT: Rare Infection Instead of Rare Tumor

THE causes of Cushing＇s syndrome are mainly di- vided into adrenocorticotropic hormone （ACTH） dependent and independent. ACTH dependent hypercortisolism represents excess ACTH se-creting by the pituitary or tumor outside the pituitary; and the latter one is also called as ectopic ACTH syndrome. Thorax is the most common location of causative lesions for ectopic ACTH syndrome, and the size of lesion is too small to be detected in some cases.1＇ 2 Cryptococcal pneumonia usually occurs in immunocompromised patients and excess cortisol production can theoretically produce a state of immunodeficiency. Development of cryptococcal pneumonia concomitant with Cushing syndrome （CS） was rare. Here, we report a case of pulmonary nodule in a patient with CS differentiated with ectopic ACTH-producing tumor. Crypto- coccal pneumonia was diagnosed followinglung resection.

Effect of Xylazine-Ketamine Anesthesia on Blood ACTH, Cortisol, Adrenaline, Insulin and Glucose in Ovariohysterectomized Cats

A study has been carried out with fourteen healthy mature cats in order to determine the effect of a xylazine-ketamine anesthetic protocol （group X/K） on blood concentrations of adrenaline, ACTH （adrenocorticotropic hormone）, cortisol, insulin and glucose in comparison with a control group （group K--no anesthesia and surgery）. The animals were randomly allocated in two groups （n = 7）. The premeditation in the experimental group was made with xylazine 2 mg/kg intramuscularly. Induction and maintenance of anesthesia were made with ketamine 10 mg/kg intramuscularly. Ovariohysterectomy was performed upon occurrence of deep anesthesia. Blood specimens were obtained at 0, 30, 60, 120 min and 24 h from the two groups. Pronounced decrease in blood ACTH, cortisol, and adrenaline in group X/K was determined by the 30 min. Significant hyperglycemia together with hyperinsulinemia in the X/K group was established at the 120 min from the beginning of the anesthesia. Anesthesia with xylazine and ketamine led to reduction of the blood levels of stress hormones immediately after the beginning of anesthesia and caused a remarkable hyperglycemia with hyperinsulinemia.

Inhibiting effects of low-molecular weight heparin and adrenocortical hormone on hemolysis of red cells in patients with paroxysmal nocturnal hemoglobinuria in vitro

OBJECTIVE: To study the effects of low-molecular weight heparin (LMWH) and adrenocortical hormone (dexamethasone) on the hemolysis of red cells of patients with paroxysmal nocturnal hemoglobinuria (PNH) in vitro. METHODS: Using Ham's test and micro-complement lysis sensitive test (mCLST), the changes in hemolysis of red cells from 6 typical PNH cases were examined after adding LMWH and dexamethasone in different concentrations into the test solution in vitro. The effects of LMWH and dexamethasone on the coagulation of the tested blood samples were also studied using the activated partial thromboplastin time (APTT) test. RESULTS: Both LMWH and dexamethasone inhibited the hemolysis of PNH red cells, and they also showed a synergistic effect. The inhibiting effects were dose-dependent. Moreover, a tolerable dose of LMWH induced a limited prolongation of APTT. Dexamethasone showed two possible mechanisms in the inhibition of PNH red cells hemolysis through Ham's test and mCLST, respectively: (1) inhibiting both antibodies binding to red cells and (2) the initiation of the activation of complement 3 (C3). LMWH could inhibit hemolysis as determined by both Ham's test and mCLST, which indicated that LMWH could block the activation of complement cascade. CONCLUSIONS: Both LMWH and dexamethasone could inhibit hemolysis in PNH, and they showed a synergistic effect. Their mechanisms of inhibiting hemolysis differed from each other. Furthermore, a tolerable dose of LMWH induced a limited prolongation of APTT. LMWH might be useful for controlling acute hemolysis in patients with PNH and reducing the dose of adrenocortical hormone.