伴象皮腿样结节性粘液性水肿的Basedow综合征1例

甲状腺毒症伴胫前牯液性水肿和肢端粗厚(acropachy)不多见，而Basedow综合征(结节性甲状腺肿伴甲亢)伴发严重的全身性粘液性水肿、杵状指、突眼更少见，现报告1例。

毒性弥漫性甲状腺肿(Graves病)中医诊疗

毒性弥漫性甲状腺肿(Graves病,Graves Disease,GD)治疗目的是有效控制及改善临床症状,最终使甲状腺功能恢复至正常状态,并减少复发;目前治疗方法有抗甲状腺药物治疗,放射性碘治疗及甲状腺手术治疗。GD属中"瘿病"、"瘿气"范畴,"瘿者,由忧恚气结所生",证侯分布依次为肝肾阴虚、心肝火旺、脾虚湿盛、脾肾阳虚、痰火内扰;无论病情轻重,肝肾阴虚和心肝火旺都是最主要的证型,均以肝肾阴虚为主。中医药治疗优势独特,可减少西药剂量及副作用,有效降低甲状腺抗体水平,提高患者生活质量并且减少复发。动物实验证实富碘中药可有效恢复缺碘机体甲状腺肿,效果优于单纯补碘,可能与富碘中药在补充碘的同时又增强了抗氧化能力有关;富碘中药安全性仍有争议。GD有冬轻夏重特点,治疗还应注重季节性。针灸治疗GD注重调理脏腑功能,同时调理气血经络。Graves眼病(Graves Ophthalmopathy,GO)分非浸润性眼病和浸润性眼病,"肿胀如杯"、"状如鱼胞"、"鹤眼凝睛",为肝火亢盛、脾虚痰阻、肝肾阴虚、痰瘀内阻等,治疗以滋阴降火为主,佐以养肝明目,活血化瘀,利水消肿;针灸治疗以活血通络,散结消肿为基本大法,亦可取得较好疗效。有待改进的是中医药治疗辨证分型差异较大,很难统一,中药煎服不便;期待采用现代科学手段研究。

巴泽多体育教育思想研究

在综合巴泽多教育理论前期研究基础上,对巴泽多体育教育观进行了探讨,并认为,巴泽多的教育思想的主要脉络为:通过泛爱主义培养"幸福的人"。根据这个思路,巴泽多的体育教育思想概括为"身体健壮是幸福的人之第一要素"。与此主线相关联其他观点是:体育是每日必须的课程;严禁体罚学生;直观教学法;爱国主义教育观。对中国学校体育深化改革具有借鉴与启示的观点是:劳作与体育在学校课程中的重要性;鼓励取代惩罚,注重体育道德发展;适应儿童的自然体育;采用经验、直观体育教学法;快乐体育的学习。

内分泌疾病

日本厚生劳动省间脑垂体功能障碍调查研究组于2006年制定了《亚临床Cushing病诊断和治疗指南》,同时修订了《Cushing病诊断和治疗指南》。关于Cushing病的药物疗法,有报告称生长抑素5型受体激动剂(SOM230,pasireotide)有效。日本用GH治疗成人GH分泌缺乏症得到认可,Basedow病治疗指南、放射性碘内服疗法指南已经制定。对于潜在性甲状腺功能低下症相关的缺血性疾病、脑血管疾病的发病率和死亡率,目前正在研究探讨中,继发性甲状腺功能亢进治疗的Ca受体激动剂正在研发。

Correlation between ^99mTcO₄<sup style="margin-left:-7px;">-</sup>Thyroid Scintigraphy and Blood Test in Primary Hyperthyroidism

Background: The 99mTcO4- thyroid scintigraphy is commonly used for hyperthyroidism diagnosis. Uptake value of 99mTcO4- on thyroid scintigraphy is an indicator of hyperthyroidism activity. Although, the correlation between free T3 value and free T4 value is not necessary clear in primary hyperthyroidism. Introduction: This study investigated the correlation between results of blood test and uptake of 99mTcO4- on thyroid scintigraphy in primary hyperthyroidism. Methodlogy: In this retrspective study, uptake was calculated in patients diagnosed with primary hyperthyroidism (Graves’ disease/Basedow’s disease) based on clinical findings, blood tests, thyroid ultrasound, and 99mTcO4- thyroid scintigraphy (uptake ≥3%) at St. Marianna University School of Medicine Hospital between 1 January 2010 and 31 December 2019. This uptake of 99mTcO4- was compared with results of blood tests. Results: Fifty-four consecutively arriving patients at the hospital (12 men, 42 women;mean age 43.0 ± 14.0 years) were selected. Free T3 (n = 54) was 14.6 ± 6.8 pg/mL, free T4 (n = 53) was 5.0 ± 2.3 ng/mL, and uptake on thyroid scintigraphy was 10.0% ± 7.1%. The correlation coefficients were 0.60 (p < 0.01) between free T4 (all case), 0.39 (p < 0.01) between free T4 (under 7 ng/mL), 0.12 (p = 0.70) between free T4 (above 7 ng/mL) and 99mTcO4- thyroid scintigraphy uptake. Conclusion: In primary hyperthyroidism (Graves’ disease), there is a correlation between free T4 value and 99mTcO4- thyroid scintigraphy uptake, but there is no correlation in patients with high free T4 level.