BACKGROUND Thyrotoxic periodic paralysis(TPP)is an endocrine emergency caused by thyrotoxicosis,manifesting mainly as periodic myasthenia and hypokalemia,and posing a serious threat to the patient's health.Fatigue...BACKGROUND Thyrotoxic periodic paralysis(TPP)is an endocrine emergency caused by thyrotoxicosis,manifesting mainly as periodic myasthenia and hypokalemia,and posing a serious threat to the patient's health.Fatigue,strenuous exercise,alcohol abuse,high carbohydrate intake and insulin injections are common triggers of paralysis.This article reports a case of severe TPP induced by insulin injection,elucidates the characteristics and pathogenesis of the disease,analyses the risk factors for triggering TPP,and hopefully provides more clinical data for TPP patients.CASE SUMMARY A 38-year-old Asian man presented to the emergency department with a oneweek history of limb weakness and worsening half-day.His medical history included poorly controlled type 2 diabetes and he had been switched to Aspart50 a week earlier.He was alert and oriented with upper extremity strength grade 3 and lower extremity strength grade 1.Emergency department tests showed hypokalemia of 1.6 mmol/L.The paramedics administered 1.5 g of potassium intravenously,followed by 4.0 g orally.Weakness in the arms and legs improved.He was referred to endocrinology where he was diagnosed with Graves'disease,with suboptimal control and insulin injections possibly causing TPP.We stopped his insulin and he was discharged with a potassium level of 4.0 mmol/L.CONCLUSION Insulin is a trigger for TPP and should be avoided in patients with hyperthyroidism.Early recognition and treatment of TPP is crucial,especially in patients presenting with hypokalemic periodic paralysis.展开更多
背景:昼夜节律与大多数哺乳动物及昆虫的生命活动息息相关。永恒蛋白基因作为编码永恒蛋白基因-周期蛋白基因复合物的关键成分在产生昼夜节律过程中起到十分关键的作用,但其在昼夜节律中的作用机制仍不清楚。目的:通过整理永恒蛋白基因...背景:昼夜节律与大多数哺乳动物及昆虫的生命活动息息相关。永恒蛋白基因作为编码永恒蛋白基因-周期蛋白基因复合物的关键成分在产生昼夜节律过程中起到十分关键的作用,但其在昼夜节律中的作用机制仍不清楚。目的:通过整理永恒蛋白基因、周期蛋白基因、昼夜节律、环境及隐花色素基因之间的关系,更加全面地认识昼夜循环的入核、积累机制及环境对昼夜节律的影响。方法:应用计算机在Web of Science核心合集、PubMed数据库及CNKI中进行检索,以“永恒蛋白基因,周期蛋白基因,昼夜节律,环境”为中文检索词,以“Timeless,Period,circadian rhythm,environment”为英文检索词,通过全文阅读逐步排除非相关文献,最终纳入126篇文献进行综述。结果与结论:在昼夜时钟中,昼夜自发输出周期蛋白kaput和CYCLE激活永恒蛋白基因/周期蛋白基因,永恒蛋白基因调控周期蛋白基因的入核机制及稳定性,而周期蛋白基因也可以通过一些机制单独入核。酪蛋白激酶2、Shaggy蛋白激酶及双倍时间基因都可以通过磷酸化永恒蛋白基因/周期蛋白基因的方式来调节昼夜节律,参与转录。隐花色素基因介导的永恒蛋白基因降解对转录的完整性有十分重要的作用。环境因素、膳食方式等外界因素均可以通过永恒蛋白基因/周期蛋白基因对昼夜节律产生影响,而限时进食可作为一种改善昼夜节律紊乱的有效方法。展开更多
Using scientific metrological method,this paper analyzed all literature published by top 4 marketing periodicals( JCR,JM,JMR,and MS) in 2009- 2013. It is intended to find out hot issues and frontier topics of current ...Using scientific metrological method,this paper analyzed all literature published by top 4 marketing periodicals( JCR,JM,JMR,and MS) in 2009- 2013. It is intended to find out hot issues and frontier topics of current marketing research through cluster analysis of key words,get to know cooperation and exchange of organizations through analysis of organization cooperative network,explore new topics of marketing researches with the aid of analysis of abrupt change words,and explore evolution path and development rules of marketing researches through co-citation network analysis.展开更多
On March 15,2019,in order to study and implement General Secretary Xi Jinping's speech on deepening reform and cultivating worldclass scientific and technological journals,the eighth working meeting of serial peri...On March 15,2019,in order to study and implement General Secretary Xi Jinping's speech on deepening reform and cultivating worldclass scientific and technological journals,the eighth working meeting of serial periodicals of the People's Medical Publishing House (PMPH),meeting of the ninth editorial board of the Chinese Journal for Clinicians,and the second editorial board of the Global Health Journal were held in Beijing.展开更多
文摘BACKGROUND Thyrotoxic periodic paralysis(TPP)is an endocrine emergency caused by thyrotoxicosis,manifesting mainly as periodic myasthenia and hypokalemia,and posing a serious threat to the patient's health.Fatigue,strenuous exercise,alcohol abuse,high carbohydrate intake and insulin injections are common triggers of paralysis.This article reports a case of severe TPP induced by insulin injection,elucidates the characteristics and pathogenesis of the disease,analyses the risk factors for triggering TPP,and hopefully provides more clinical data for TPP patients.CASE SUMMARY A 38-year-old Asian man presented to the emergency department with a oneweek history of limb weakness and worsening half-day.His medical history included poorly controlled type 2 diabetes and he had been switched to Aspart50 a week earlier.He was alert and oriented with upper extremity strength grade 3 and lower extremity strength grade 1.Emergency department tests showed hypokalemia of 1.6 mmol/L.The paramedics administered 1.5 g of potassium intravenously,followed by 4.0 g orally.Weakness in the arms and legs improved.He was referred to endocrinology where he was diagnosed with Graves'disease,with suboptimal control and insulin injections possibly causing TPP.We stopped his insulin and he was discharged with a potassium level of 4.0 mmol/L.CONCLUSION Insulin is a trigger for TPP and should be avoided in patients with hyperthyroidism.Early recognition and treatment of TPP is crucial,especially in patients presenting with hypokalemic periodic paralysis.
文摘背景:昼夜节律与大多数哺乳动物及昆虫的生命活动息息相关。永恒蛋白基因作为编码永恒蛋白基因-周期蛋白基因复合物的关键成分在产生昼夜节律过程中起到十分关键的作用,但其在昼夜节律中的作用机制仍不清楚。目的:通过整理永恒蛋白基因、周期蛋白基因、昼夜节律、环境及隐花色素基因之间的关系,更加全面地认识昼夜循环的入核、积累机制及环境对昼夜节律的影响。方法:应用计算机在Web of Science核心合集、PubMed数据库及CNKI中进行检索,以“永恒蛋白基因,周期蛋白基因,昼夜节律,环境”为中文检索词,以“Timeless,Period,circadian rhythm,environment”为英文检索词,通过全文阅读逐步排除非相关文献,最终纳入126篇文献进行综述。结果与结论:在昼夜时钟中,昼夜自发输出周期蛋白kaput和CYCLE激活永恒蛋白基因/周期蛋白基因,永恒蛋白基因调控周期蛋白基因的入核机制及稳定性,而周期蛋白基因也可以通过一些机制单独入核。酪蛋白激酶2、Shaggy蛋白激酶及双倍时间基因都可以通过磷酸化永恒蛋白基因/周期蛋白基因的方式来调节昼夜节律,参与转录。隐花色素基因介导的永恒蛋白基因降解对转录的完整性有十分重要的作用。环境因素、膳食方式等外界因素均可以通过永恒蛋白基因/周期蛋白基因对昼夜节律产生影响,而限时进食可作为一种改善昼夜节律紊乱的有效方法。
基金Supported by Project of National Natural Science Foundation(71273102)Fundamental Research Funds for the Central Universities(2012RW004)
文摘Using scientific metrological method,this paper analyzed all literature published by top 4 marketing periodicals( JCR,JM,JMR,and MS) in 2009- 2013. It is intended to find out hot issues and frontier topics of current marketing research through cluster analysis of key words,get to know cooperation and exchange of organizations through analysis of organization cooperative network,explore new topics of marketing researches with the aid of analysis of abrupt change words,and explore evolution path and development rules of marketing researches through co-citation network analysis.
文摘On March 15,2019,in order to study and implement General Secretary Xi Jinping's speech on deepening reform and cultivating worldclass scientific and technological journals,the eighth working meeting of serial periodicals of the People's Medical Publishing House (PMPH),meeting of the ninth editorial board of the Chinese Journal for Clinicians,and the second editorial board of the Global Health Journal were held in Beijing.
