碘125粒子组织间植入治疗癌性疼痛的疗效与安全性

目的:探讨碘125粒子组织间植入治疗肿瘤患者癌性疼痛的临床效果与不良反应.方法:将200例中晚期恶性肿瘤癌痛患者随机分作观察组与对照组,观察组予以碘125粒子组织间植入治疗,对照组予以药物治疗,观察与比较两组患者疼痛视觉模拟评分(VAS)、疼痛缓解率、平均镇痛时间及不良反应.结果:治疗后观察组与对照组VAS评分均明显减少,治疗后1d两组VAS无统计学差异(P＞0.05),治疗后7、30 d观察组VAS显著低于对照组(P＜0.05);观察组疼痛缓解率(88.0％)明显高于对照组(64.0％),有统计学差异(x2=5.908,P＜0.05);治疗后观察组平均疼痛时间显著较对照组短(￡=7.342,P＜0.05);观察组不良反应发生率(3.0％)明显低于对照组(11.0％).结论:碘125粒子组织间植入治疗癌性疼痛的效果确切,具有迅速与持久的镇痛效果,不良反应少,值得临床借鉴.     

新疆乌鲁木齐市常住居民甲状腺功能、甲状腺自身抗体与尿碘变化的分析

目的 了解新疆乌鲁木齐市居民甲状腺疾病知晓率及年龄分布的差异, 分析甲状腺功能、甲状腺自身抗体与尿碘相关性及其变化规律。方法 2013年5月采用横断面方法随机抽取乌鲁木齐市1 995名常住居民, 其中健康成年人1 906名, 年龄18~84岁, 平均(46.3±14.2)岁, 男性占30.4%, 女性占69.6%。采集一次性随机晨尿10 ml测定尿碘, 静脉血测定促甲状腺素(TSH)、血清游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)、甲状腺球蛋白抗体(TgAb)、甲状腺过氧化物酶抗体(TPOAb)。结果 (1)调查居民中新诊断甲状腺功能异常者213例(11.2%, 其中女性占78.4%), 甲状腺功能亢进(甲亢)者占2.7%, 甲状腺功能减低(甲减)者占8.5%;TgAb阳性率为23.2%, TPOAb阳性率为16.6%;人群尿碘M=134.5 μg/L, 人群中碘缺乏占32%, 碘适宜占58%, 碘过量占10%;甲状腺功能正常组和异常组比较、抗体阳性组与阴性组比较其尿碘水平的差异均无统计学意义。(2)将人群划分18~、45~和≥60岁3个年龄组, 则显示随年龄增长TSH水平有明显差异, 且女性高于男性(P<0.001);甲状腺功能正常人群中, TSH水平为抗体阳性组明显高于阴性组(P<0.000 1)。(3)≥60岁与<60岁人群比较, 甲减患病率显著增加(P=0.008), 但甲亢患病率无明显差别, 抗体阳性率亦无明显差异。结论 乌鲁木齐市社区居民甲状腺功能、自身抗体与尿碘水平无明显相关, 女性甲状腺功能异常、抗体阳性率均高于男性, 抗体阳性组TSH水平明显高于阴性组, 老年人群甲减患病率显著增高, 应对该人群定期监测。     

Smallpox vaccine,ACAM2000: Sites and duration of viral shedding and effect of povidone iodine on scarification site shedding and immune response

The U.S. Department of Defense vaccinates personnel deployed to high-risk areas with the vaccinia virus (VACV)-based smallpox vaccine. Autoinoculations and secondary and tertiary transmissions due to VACV shedding from the vaccination site continue to occur despite education of vaccinees on the risks of such infections. The objectives of this study were to investigate, in naïve smallpox vaccinees, (a) whether the vaccination site can remain contagious after the scab separates and (b) whether the application of povidone iodine ointment (PIO) to the vaccination site inactivates VACV without affecting the immune response. These objectives were tested in 60 individuals scheduled to receive smallpox vaccine. Thirty individuals (control) did not receive PIO; 30 subjects (treatment) received PIO starting on post-vaccination day 7. Counter to current dogma, this study showed that VACV continues to shed from the vaccination site after the scab separates. Overall viral shedding levels in the PIO group were significantly lower than those in the control group (p = 0.0045), and PIO significantly reduced the duration of viral shedding (median duration 14.5 days and 21 days in the PIO and control groups, respectively; p = 0.0444). At least 10% of control subjects continued to shed VACV at day 28, and 3.4% continued to shed the virus at day 42. PIO reduced the proportion of subjects shedding virus from the vaccination site from day 8 until days 21–23 compared with control subjects. Groups did not differ significantly in the proportion of subjects mounting an immune response, as measured by neutralizing antibodies, IgM, IgG, and interferon-gamma enzyme-linked immunospot assay. When applied to the vaccination site starting on day 7, PIO reduced viral shedding without altering the immune response. The use of PIO in addition to a semipermeable dressing may reduce the rates of autoinoculation and contact transmission originating from the vaccination site in smallpox-vaccinated individuals.     

电针加碘离子导入治疗肩周炎疗效观察及护理

目的观察电针加碘离子导入治疗肩周炎的临床疗效。方法肩周炎患者126例采用电针加碘离子导入治疗,同时加强护理,指导康复训练。结果126例患者经过3个疗程后进行疗效评定,治愈110例,好转16例,有效率100%。结论电针加碘离子导入治疗肩周炎同时进行恰当护理和功能训练,效果满意。     

体素内不相干运动扩散成像及血氧水平依赖成像评估碘对比剂致兔急性肾损伤

目的 采用体素内不相干运动扩散成像（IVIM-DWI）和血氧水平依赖（BOLD）成像评估非离子型双聚体等渗碘对比剂对兔肾功能的影响。方法 将25只新西兰雄性兔均分为5组。对实验组（1、24、48、72 h组）分别在注射碘克沙醇后1、24、48、72 h行IVIM-DWI和BOLD扫描并采集血液，基线组注射等量生理盐水。扫描结束后处死兔，取肾脏进行组织病理学观察。结果 相比基线组，1 h组肾脏皮、髓质ADC值、D值、f值下降，D^*值下降至最低，R2^*值升高；24 h组肾皮质、髓质ADC值、D值、f值降至最低，D^*值升高，R2^*值最高；72 h组肾皮质、髓质R2^*值仍低于基线值（P均<0.05），D^*值基本恢复至基线水平，而髓质D值、f值仍未恢复至基线水平（P均<0.05）。病理显示各实验组存在不同程度肾小球及肾小管损伤。1 h组缺氧诱导因子1α和血红素加氧酶表达升高，24 h组最高；48、72 h组血肌酐及尿素氮均高于基线组（P均<0.05）。结论 IVIM-DWI联合BOLD可有效评估碘对比剂诱导的急性肾损伤兔肾脏病理生理变化。     

Influence of Perchlorate on the Secretion of Non-Thyroxine Iodine by the Normal Human Thyroid Gland

Abstract. Several authors have postulated that endogenous iodide produced by the deiodination of iodotyrosines in the thyroid feeds into a different thyroidal iodide compartment than transported iodide which enters the gland from outside. One argument for the existence of two separate iodide compartments is the observation that under certain experimental conditions perchlorate completely discharges transported iodide from the thyroid, while it has no such effect on endogenous iodide. This latter observation however has not been confirmed by all studies and remained controversial. – We therefore reinvestigated the effect of perchlorate on the secretion of endogenous iodide by a new, sensitive method. Five normal volunteers received tracer amounts of iodide-¹²⁵I p.o. and 11 days later thyroxine-¹³¹I I.V. Two days later the following serial measurements were started: serum protein-bound labelled iodine (PB¹²⁵I, PB¹³¹), serum total thyroxine and urinary excretion of ¹²⁵I, ¹²⁷I and ¹³¹I. – In the control period the non-thyroxine iodine secretion calculated from the above measurements was 40 μg/day. Under perchlorate 200 mg three times daily this value rose significantly to 66 μg/day. Non-thyroxine iodine comprises the secreted triiodothyronine plus the secreted endogenous iodide. Assuming that the former value remained constant, our data show that perchlorate indeed discharges part, though not all, of the endogenous iodide. These data do not rule out a second iodide compartment, but they are also compatible with a simple one compartment model.     

Accreditation in Belgium: a 10 Years’ Experience

Purpose : Toxic adenoma is one of the main causes of hyperthyroidism. We investigated the efficacy of surgery in the treatment of toxic adenoma.

Methods : Serum thyroid stimulating hormone (TSH) measurement, ultrasound and scintigraphy of the thyroid were made for diagnostic purpose. The safety of surgery was evaluated by postoperative clinical course of patients. The efficacy of surgery was determined by the function of the remaining thyroid tissue.

Results : The incidence of hyperthyroidism was 53% in surgically treated patients with nodular goitre in our iodine deficient region. The cause of thyrotoxicosis was toxic adenoma in 15 patients (14%). Suppressed serum TSH levels indicated the hyperthyroidism in all of 15 patients. Solitary solid adenoma was found by ultrasonographic examination, and solitary autonomous hot nodule by thyroid scintigraphy. Surgical treatment consisted of unilateral total lobectomy. It was the primary treatment in 13 patients. Two patients had surgery as secondary treatment after unsuccessful primary radioactive iodine application. The early postoperative clinical course of all patients was uneventful. Thirteen patients who had surgery as primary treatment had normal thyroid function postoperatively contrary to other two patients who became hypothyroid after having unsuccessful radioiodine therapy, and surgery as the secondary treatment. Conclusions : The incidence of hyperthyroidism and toxic adenoma is high in our surgically treated patients with nodular goitre. The diagnosis of toxic adenoma is not difficult by serum TSH measurements, and ultrasound and nuclear imaging of the thyroid. Surgery is effective and safe, and the treatment of choice for patients with toxic adenoma in order to control radically the hyperthyroidism and to achieve the goal of providing the euthyroid status.     

高碘致甲状腺兴奋与抑制的实验研究

本文通过实验证实,服高碘后 T_3、T_4升高,为甲状腺兴奋的表现,并使甲状腺组织内有机碘增加,产生压迫抑制以及后期出现碘抑制等现象。通过各项指标测定结果,指出和讨论了以下观点:1、无机碘兴奋甲状腺,使 T_3、T_4分泌和有机碘合成增加。2、有机碘蓄积,形成压迫抑制,使 T_3、T_4分泌减少;3、大剂量或长期服碘容易产生碘抑制,主要抑制碘运输。     

尿中碘的过硫酸铵消化-砷铈催化分光光度测定方法

目的 介绍修订后的尿碘测定标准新方法，即尿中碘的过硫酸铵消化．砷铈(As^3 、Ce^4 )催化分光光度测定方法，建议各级实验室应尽快应用。方法 按“研制生物样品监测检验方法指南”(WS/T68-1996)的规定，对我国现行的尿碘测定方法标准进行了修订，并对修订后的新方法进行方法学评价。结果 修订后的新方法尿碘检测范围为0～300μg/L；最低检测量为3μg／L(取样量为0．25m1)；精密度：测定尿碘为63．3、129．8、252．5μg/L时，变异系数(CV)分别为5．5％、2．8％、4．4％(n=6)；准确度：对低、中、高碘3种尿样加碘标平均回收率分别为101．3％、97．6％、95．8％(n=6)，总平均回收率为98．3％(范围：92．6％～107．0％)；测定低、高2种尿碘标准物，其结果与给定值的相对偏差分别为4．9％和1．0％(n=6)；该方法的砷铈反应除了在水浴控温条件下进行，还可以直接在20～35℃之间某一稳定的室温条件下进行测定。结论 修订后的新方法比原标准方法更加简便易操作，并提高了测定的精密度和准确度。     

口服不同剂量的碘化油微囊防治地方性甲状腺肿的疗效及有效期观察

本文报告1990～1991年在缺碘性疾病流行区新疆托克逊县观察了一次性口服不同剂量(400、300和200mg)碘化油微囊的防治疗效及尿碘排泄。结果表明,在服药后半年和1年甲状腺肿患病率在不同剂量组均有不同程度的下降,治愈率均有不同程度的提高,但与对照组比较无论患病率还是治愈率均无显著差异(P>0.05)。不同剂量组之间服药后1月内尿碘排泄有随剂量增大相应增高的趋势(P<0.01),但至第三个月时无论是不同剂量组之间还是与对照组之间均未见显著差异(P>0.05)。从而提示,口服碘化油微囊能否作为防治缺碘性疾病的长效补碘方法,很值得商榷。