亚临床甲亢并周期性瘫痪的临床分析

目的 分析亚临床甲亢并周期性瘫痪的临床特点。方法 测定总T3、总T4、游离T3、游离T4、促甲状腺素，并回顾分析8例亚临床甲亢并周期性瘫痪的临床资料。结果 青壮年男性发病，低钾型周期性瘫痪为主要临床表现，元明显甲状腺功能亢进症表现，测定总T3、总T4、游离T3、游离T4正常，促甲状腺素下降，补钾治疗有效。结论 青壮年男性亚临床甲亢的主要临床特点是低钾型周期性瘫痪。     

对甲亢性周期性瘫痪18例患者的临床治疗体会

目的探讨以周期性瘫痪（periodic parchysis）为主要临床表现的TPP患者的治疗及相关发病因素，并加以分析。方法对18例TPP患者的临床治疗进行回顾分析，检测血中甲状腺游离激素Fr4、F33、TSH，血清钾和血清肌酶的变化情况。结果18例患者均有FT4↑、FT3↑，TSH↓，血钾偏低，有14例患者肌酸激酶、肌酸激酶同工酶升高，12例患者天门冬氨酸转氨酶升高。结论对TPP患者的重要临床观察指标为血中游离甲状腺激素FT4、FT3、TSH，血清钾和血清肌酶的检测，及时控制甲亢和维持血钾正常是治疗关键。     

甲状腺功能亢进性心脏病心力衰竭50例治疗探讨

目的分析甲状腺功能亢进性心脏病（甲亢心）心力衰竭的治疗方法。方法甲亢：药物治疗37例（74％）；^131 I治疗11例（22％）．先药物后手术3例（6％）。心力衰竭：38例（76％）应用洋地黄类药物，43例（86％）应用β肾上腺素能受体阻滞剂，42例（84％）应用血管扩张药物，41例（82％）应用利尿刺，17例（34％）应用抗生素。结果甲亢心症状明显好转43例（86％）；死亡7例（14％）。结论甲亢心心力衰竭治疗的关键是治疗甲亢。此类患者对洋地黄类药物的反应欠佳，晚期易致洋地黄中毒；静脉扩血管制剂的疗效亦欠佳，利尿剂及β受体阻滞剂疗效好。     

奥曲肽联合常规疗法治疗浸润性突眼疗效分析

目的：探讨奥曲肽联合常规疗法治疗浸润性突眼临床效果。方法选取该院2013年6月—2104年6月期间收治的54例甲状腺功能亢进浸润性突眼患者作为研究对象,按照随机分组法将其分为对照组和观察组,每组各27例,对照组患者采取常规治疗,观察组患者在常规治疗基础上联合应用奥曲肽进行治疗,治疗疗程均为3个疗程,每个疗程为2个月。结果经过有效治疗后,对照组患者显效7例,有效11例,无效9例,总有效率为66.7%,观察组患者显效11例,有效14例,无效2例,总有效率为92.6%,观察组总有效率明显高于对照组,两组比较差异具有统计学意义（P＜0.05）。结论奥曲肽联合常规疗法在治疗甲状腺亢进浸润性突眼方面临床效果明显,该方法值得在临床推广应用。     

Orbital mucopyoceles. Two cases and a review

Two patients with superior orbital masses that were initially diagnosed as orbital cellulitis with abscess formation had orbital mucopyoceles, from which Enterobacteriaceae was cultured. Both patients had frontal sinus involvement and one had massive destruction with posterior extension abutting the frontal lobes. The radiology, computerized tomography, surgical procedures, and histopathologic findings pertaining to each case and the disease entity are reviewed. Antibiotic usage is discussed.     

甲眼消合并他巴唑治疗甲状腺机能亢进症突眼的临床观察

目的：观察线中药制剂甲眼消合并把他巴唑治疗甲状腺机能亢进症（简称甲亢）突眼的临床疗效。方法：４３例患者随机分为两组，治疗组（３１例）予以甲眼消、他巴唑治疗，对照组（１２天）予以强的松、他巴唑治疗。３个月为１个疗程，均观察１个疗程，观察两组治疗前后甲亢突眼的临床症状、眼征、甲状腺激素水平的改善情况及在不良反应发生率上的差异。结果：治疗组总有效率（８０．６％），显著提高对照组（５０．０％，Ｐ〈０．０５     

Dysphagia as a Manifestation of Thyrotoxicosis: Report of ThreeCases and Literature Review

Myopathy is frequently associated with thyrotoxicosis. Skeletal muscles are predominantly involved in thyrotoxic myopathy, but dysphagia is extremely rare. We report three cases of thyrotoxicosis with dysphagia and review of the literature of the past 30 years. Most of these patients had antecedent muscle weakness before the onset of dysphagia although some suffered from a sudden onset of bulbar palsy. Either a myopathic or neuropathic pattern was found on electromyography. The incidence of oropharyngeal dysphagia was higher than that of esophageal motility dysfunction. Aspiration pneumonia occurred more accompanied by oropharyngeal dysphagia. The swallowing disorder could be resolved completely within 3 weeks after treatment for thyrotoxicosis. In light of these clinical experiences, early intensive treatment that includes antithyroid agent, beta-blocker, and Lugol solution may be necessary.     

Orbital Decompression for Graves' Disease: Exposure Through lateral Canthal and Inferior Fornix Incision

A surgical procedure is described to perform orbital decompression in patients suffering from orbitopathy in Graves' Disease. The decompression technique employs exposure of the orbit through a lateral incision and an inferior fornix incision. These combined incisions with exposure can be used to perform an antral-ethmoidal decompression (two-wall decompression) or an antral-ethmoidal-lateral wall decompression (three-wall decompression). This present series contains 34 patients who underwent decompression through a 2 1/2-year period ending October 1980. The results of decompression were quantitated by measuring the retroplacement of the globe and in patients with compressive optic neuropathy by improvement in vision. The retroplacement of the globe with the antral-ethmoidal (two-wall decompression) was 4 to 7 mm (average 6 mm), and the retroplacement was 6 to 8 mm in four patients who underwent antral-ethmoidal-lateral decompression (three-wall decompression). All patients with compressive optic neuropathy improved to a final visual acuity of 20/40 or better. Five of 11 patients, with compressive optic neuropathy required postoperative super-voltage irradiation to reach this acuity. Fifty percent of the patients undergoing antral-ethmoidal decompression for proptosis required additional eyelid surgery with recession of upper lid retractors.     

Inferolateral marginal orbitectomy: a simple adjuvant technique for orbital decompression

The number of patients with mild exophthalmos, without severe eye symptoms, who wish to undergo aesthetic orbital decompression, is increasing. Removal of the lateral and inferior orbital walls is a common procedure for mild to moderate exophthalmos. However, the limited space between the globe and the orbital wall is often troublesome for surgeons introducing surgical devices. As a result, the decompression tends to be insufficient in the posterior region of the orbit. We describe a simple adjuvant surgical technique to address this limitation. Through a laterally extended, transconjunctival approach, the inferior and lateral margins of the orbit are removed in a crescent shape before the actual decompression. This manoeuvre widens the working space and offers better visibility, enabling sufficient removal of the orbital walls. The technique presented facilitates the approach to the posterior regions of the orbit, enabling surgeons to more easily perform orbital decompression.     

Thyrotropin receptors in adipose tissue, retro-orbital tissue and lymphocytes.

Thyrotropin (TSH) receptors on retro-orbital muscle and fat have been implicated in the pathogenesis of Graves' exophthalmos and it has been suggested that TSH has a direct effect on human fat metabolism. We have therefore investigated the interaction of biologically active 125I-labelled TSH with membranes prepared from human adipose, retro-orbital and thyroid tissue. Since lymphocytes contain receptors for several polypeptide hormones, TSH binding to lymphocyte membranes was also studied. We were unable to demonstrate TSH receptors in adult human adipose tissue, retro-orbital muscle and fat, or peripheral blood lymphocytes. In contrast, adult and neonatal guinea pig adipose tissue membranes showed similar TSH binding characteristics to guinea pig thyroid membranes.