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Morphological Diversity of Pretibial Myxedema and Its Mechanism of Evolving Process and Outcome: A Retrospective Study of 216 Cases 216例胫骨前黏液性水肿的形态学多样性及其机制演变过程和结果的回顾性研究
IF 2.1 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2016-08-25 DOI: 10.1155/2016/2652174
C. Lan, Yi Wang, Xia Zeng, J. Zhao, Xiaoxi Zou
Background. Pretibial myxedema (PTM) is a rare dermopathy. The morphologic features and mechanism of its evolving process are not reported in large case series. Methods. 216 cases with PTM were retrospectively reviewed to analyze demographics, history, lesional morphology and its evolving process, histopathology and immunohistochemistry, serum TRAb levels, treatment, and outcome. Results. First appearing lesions evolved into 6 variants that were correlated with serum TRAb levels. Subvariants were caused by different kinds and frequencies of local trauma. The evolving process could be classified into 4 stages that were correlated with serum TRAb levels and perivascular infiltration of CD8+ and CD4+ lymphocytes. Serum TRAb levels at remission and in nonrecurred cases became lower than those before therapy and in recurred cases, respectively, but increased when PTM relapsed. TRAb level in nodule variant went down invariably with the extension of course and its autoimmune activity had a trend to stop but in other 5 variants TRAb levels fluctuated. Their autoimmune activities had no trends to stop and clinically worsen through intermittent repeats of active and stable stages. Conclusions. In the chronic course of PTM, nodule variant is self-limited and other 5 variants are not self-limited. PTM needed early treatment to avoid severe variants.
背景。胫前黏液性水肿是一种罕见的皮肤病。其形态特征及其演变过程的机制尚未在大型病例系列中报道。方法:回顾性分析216例PTM患者的人口统计学、病史、病变形态及其演变过程、组织病理学和免疫组化、血清TRAb水平、治疗和转归。结果。首次出现的病变演变成6个与血清TRAb水平相关的变体。不同类型和频率的局部创伤引起亚变异。其演变过程可分为4个阶段,与血清TRAb水平和血管周围CD8+和CD4+淋巴细胞浸润相关。缓解期和未复发期血清TRAb水平分别低于治疗前和复发期,但在PTM复发时升高。结节变异体TRAb水平随病程延长而下降,其自身免疫活动有停止的趋势,而其他5个变异体TRAb水平波动。他们的自身免疫活动没有停止的趋势,并通过间歇性重复的活跃和稳定阶段在临床上恶化。结论。在PTM慢性病程中,结节变异体是自限性的,其他5种变异体是不自限性的。PTM需要早期治疗以避免严重的变异。
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引用次数: 9
Significance of Interleukin-6 in Papillary Thyroid Carcinoma 白细胞介素-6在甲状腺乳头状癌中的意义
IF 2.1 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2016-03-13 DOI: 10.1155/2016/6178921
T. Kobawala, T. Trivedi, K. Gajjar, Darshita H. Patel, G. Patel, N. Ghosh
This study sought to reveal the significance of IL-6 in papillary thyroid carcinoma by determining its circulating levels, tumoral protein, and mRNA expressions. As compared to the healthy individuals, serum IL-6 was significantly higher in patients with benign thyroid diseases and PTC. Further, its level was significantly higher in PTC patients as compared to patients with benign thyroid diseases. ROC curves also confirmed a good discriminatory efficacy of serum IL-6 between healthy individuals and patients with benign thyroid diseases and PTC. The circulating IL-6 was significantly associated with poor overall survival in PTC patients. IL-6 immunoreactivity was significantly high in PTC patients as compared to the benign thyroid disease patients. Significantly higher IL-6 mRNA expression was also observed in the primary tumour tissues of PTC patients than the adjacent normal tissues. The protein expression of IL-6 at both the circulating and tissue level correlated with disease aggressiveness in PTC patients. Moreover, a significant positive correlation was observed between the IL-6 protein and mRNA expression in the primary tumours of PTC patients. Finally in conclusion, IL-6 has an important role in thyroid cancer progression. Thus targeting IL-6 signalling can help in clinical management of thyroid carcinoma patients.
本研究旨在通过检测IL-6在甲状腺乳头状癌中的循环水平、肿瘤蛋白和mRNA表达,揭示IL-6在甲状腺乳头状癌中的意义。与健康人相比,良性甲状腺疾病和PTC患者血清IL-6明显升高。此外,与良性甲状腺疾病患者相比,PTC患者的水平明显更高。ROC曲线也证实了血清IL-6在健康个体与良性甲状腺疾病和PTC患者之间具有良好的区分功效。循环IL-6与PTC患者较差的总生存率显著相关。与良性甲状腺疾病患者相比,PTC患者IL-6免疫反应性明显高。PTC患者原发肿瘤组织中IL-6 mRNA的表达也明显高于邻近正常组织。循环和组织水平IL-6蛋白表达与PTC患者疾病侵袭性相关。此外,在PTC患者原发肿瘤中IL-6蛋白与mRNA表达呈显著正相关。总之,IL-6在甲状腺癌的进展中具有重要的作用。因此靶向IL-6信号可以帮助甲状腺癌患者的临床治疗。
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引用次数: 35
Effect of Preoperative Nerve Block on Postthyroidectomy Headache and Cervical Pain: A Randomized Prospective Study 术前神经阻滞对甲状腺切除术后头痛和颈椎疼痛的影响:一项随机前瞻性研究
IF 2.1 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2016-03-13 DOI: 10.1155/2016/9785849
Sunil Malla Bujar Barua, A. Mishra, K. Kishore, S. Mishra, G. Chand, G. Agarwal, A. Agarwal, A. Verma
The aim of the current study was to investigate the efficacy of greater occipital nerve (GON) block and bilateral superficial cervical plexuses (BSCP) blocks in alleviating postoperative occipital headache and posterior neck pain after thyroidectomy. This randomized prospective study consisted of 75 women undergoing total thyroidectomy. Patients were randomized into three groups: Group I (n = 25): patients receiving GON, Group II (n = 25): patients receiving bilateral (BSCP) blocks, and Group III (n = 25): patients receiving no block. Assessment of occipital headache, posterior neck, and incision site pains was made at 12 hours and 24 hours after extubation by Visual Analogue Scale (VAS). In comparison to Group III significantly fewer patients in Groups I and II experienced occipital headache at 12 (p = 0.006) and 24 hours (p = 0.005) and also posterior neck pain at 24 hours (p = 0.003). Mean VAS scores at 12 and 24 hours for occipital headache (p = 0.003 and p = 0.041) and posterior neck pain (p = 0.015 and p = 0.008) were significantly lower in Group I. The differences between Groups II and III were not significant except for the occipital headache at 12 hours. The efficacy of GON block is superior to BSCP blocks in alleviating postthyroidectomy occipital headache and posterior cervical pain.
本研究的目的是探讨枕大神经(GON)阻滞和双侧颈浅丛(BSCP)阻滞对缓解甲状腺切除术后枕头头痛和后颈疼痛的疗效。这项随机前瞻性研究包括75名接受甲状腺全切除术的妇女。患者被随机分为三组:第一组(n = 25):接受GON的患者,第二组(n = 25):接受双侧(BSCP)阻滞的患者,第三组(n = 25):不接受阻滞的患者。分别于拔管后12小时和24小时采用视觉模拟评分法(VAS)评估枕部头痛、后颈和切口部位疼痛。与III组相比,I组和II组在12小时(p = 0.006)和24小时(p = 0.005)时出现枕部头痛的患者明显减少,24小时后颈部疼痛(p = 0.003)。第1组枕部头痛(p = 0.003和p = 0.041)和后颈疼痛(p = 0.015和p = 0.008)的12和24小时VAS平均评分显著低于第1组。第2组和第3组之间除12小时枕部头痛外,差异无统计学意义。在缓解甲状腺切除术后枕头头痛和颈后疼痛方面,骨甾体素阻滞的疗效优于BSCP阻滞。
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引用次数: 6
Safety and Effectiveness of Total Thyroidectomy and Its Comparison with Subtotal Thyroidectomy and Other Thyroid Surgeries: A Systematic Review 全甲状腺切除术的安全性和有效性及其与甲状腺次全切除术和其他甲状腺手术的比较:系统综述
IF 2.1 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2016-02-24 DOI: 10.1155/2016/7594615
Ashwini Aithal Padur, Naveen Kumar, A. Guru, Satheesha Nayak Badagabettu, Swamy Ravindra Shanthakumar, M. Virupakshamurthy, J. Patil
Diseases associated with the thyroid gland are one of the most frequently seen endocrine disorders across the globe. Total thyroidectomy is currently the preferred treatment for many thyroid diseases. Controversies exist among surgeons regarding safety of total thyroidectomy due to the risk associated with it like postoperative hypoparathyroidism or recurrent laryngeal nerve damage. Since, in the recent years, the incidence of thyroidectomy is in increasing trend in south Indian population, this review aims to study the available data regarding the appropriateness and safety of total thyroidectomy and compares it with subtotal thyroidectomy and other thyroid surgeries. This is a retrospective comprehensive review of various articles and publications regarding total and partial thyroidectomy performed across the world. Many retrospective studies and few prospective studies suggest that the incidence of transient hypocalcemia is higher after total thyroidectomy than after subtotal thyroidectomy, but the incidence of other complications including recurrent laryngeal nerve palsy and postoperative hematoma is not significantly different between the two procedures. Hence in our review we found that total thyroidectomy is safe and cost effective with low complication rates and provides little significant advantage of being safer procedure compared to subtotal thyroidectomy.
与甲状腺相关的疾病是全球最常见的内分泌疾病之一。甲状腺全切除术是目前许多甲状腺疾病的首选治疗方法。由于术后甲状旁腺功能减退或喉返神经损伤等风险,外科医生对全甲状腺切除术的安全性存在争议。由于近年来,甲状腺切除术在印度南部人群中的发病率呈上升趋势,本综述旨在研究有关甲状腺全切除术的适宜性和安全性的现有数据,并将其与甲状腺次全切除术和其他甲状腺手术进行比较。这是一个回顾性的综合审查各种文章和出版物关于全甲状腺和部分甲状腺切除术在世界各地进行。许多回顾性研究和少数前瞻性研究表明,甲状腺全切除术后短暂性低钙血症的发生率高于甲状腺次全切除术后,但喉返神经麻痹和术后血肿等其他并发症的发生率在两种手术之间无显著差异。因此,在我们的综述中,我们发现甲状腺全切除术是安全且经济有效的,并发症发生率低,与甲状腺次全切除术相比,其安全性没有明显的优势。
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引用次数: 40
Prenatal Exposures to Multiple Thyroid Hormone Disruptors: Effects on Glucose and Lipid Metabolism 产前暴露于多种甲状腺激素干扰物:对葡萄糖和脂质代谢的影响
IF 2.1 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2016-02-17 DOI: 10.1155/2016/8765049
Deborah Molehin, M. Dekker Nitert, K. Richard
Background. Thyroid hormones (THs) are essential for normal human fetal development and play a major role in the regulation of glucose and lipid metabolism. Delivery of TH to target tissues is dependent on processes including TH synthesis, transport, and metabolism. Thyroid hormone endocrine disruptors (TH-EDCs) are chemical substances that interfere with these processes, potentially leading to adverse pregnancy outcomes. Objectives. This review focuses on the effects of prenatal exposures to combinations of TH-EDCs on fetal and neonatal glucose and lipid metabolism and also discusses the various mechanisms by which TH-EDCs interfere with other hormonal pathways. Methods. We conducted a comprehensive narrative review on the effects of TH-EDCs with particular emphasis on exposure during pregnancy. Discussion. TH imbalance has been linked to many metabolic processes and the effects of TH imbalance are particularly pronounced in early fetal development due to fetal dependence on maternal TH for proper growth and development. The pervasive presence of EDCs in the environment results in ubiquitous exposure to either single or mixtures of EDCs with deleterious effects on metabolism. Conclusions. Further evaluation of combined effects of TH-EDCs on fetal metabolic endpoints could improve advice provided to expectant mothers.
背景。甲状腺激素(THs)是人类胎儿正常发育所必需的,在调节葡萄糖和脂质代谢中发挥重要作用。促甲状腺激素向靶组织的递送依赖于促甲状腺激素合成、转运和代谢等过程。甲状腺激素内分泌干扰物(TH-EDCs)是干扰这些过程的化学物质,可能导致不良妊娠结局。目标。这篇综述的重点是产前暴露于TH-EDCs组合对胎儿和新生儿糖脂代谢的影响,并讨论了TH-EDCs干扰其他激素途径的各种机制。方法。我们对TH-EDCs的影响进行了全面的叙述性回顾,特别强调怀孕期间的暴露。讨论。促甲状腺激素失衡与许多代谢过程有关,由于胎儿依赖母体促甲状腺激素来正常生长发育,促甲状腺激素失衡对胎儿早期发育的影响尤为明显。环境中普遍存在的EDCs导致无处不在的暴露于单一或混合的EDCs,对代谢产生有害影响。结论。进一步评估促TH-EDCs对胎儿代谢终点的综合影响,可以为孕妇提供更好的建议。
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引用次数: 17
Incidental Papillary Thyroid Microcarcinoma in an Endemic Goiter Area 地方性甲状腺肿区偶发的甲状腺乳头状小癌
IF 2.1 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2016-02-02 DOI: 10.1155/2016/1784397
E. Gürleyik, G. Gurleyik, B. Karapolat, U. Onsal
Clinical and pathological characteristics of incidental papillary thyroid microcancer cases, surgical, medical, and nuclear treatment methods, and patients' outcome were studied during follow-up period of 102 months. We studied 37 patients with incidental papillary thyroid microcancer (I-PTM). The surgical procedure was total thyroidectomy in 29 and hemithyroidectomy in 8 patients. Size, multifocality, and bilateralism of PTM foci, thyroid capsule invasion, and presence of lymphovascular invasion were histopathological parameters. We analysed adjuvant medical and nuclear treatment and patients' outcome during follow-up period of 102 (61–144) months. The prevalence rates of I-PTM were 9.4% in 395 thyroidectomy cases. Histopathological examination reported unifocal disease in 30 and multifocal disease in 7 (18%) patients. Multifocal disease was bilateral in 6 (20.1%) patients. The mean size of the PTM foci was 4.88 mm. The rate of thyroid capsule invasion was 5.4%. All patients received a suppressive dose of LT4 to achieve a low serum TSH level. Adjuvant surgical and nuclear treatment was not performed in our cases. We did not find any negative changes in blood chemistry and ultrasound imaging, and any unfavourable events as locoregional and systemic recurrence. In conclusion, diagnosis of I-PTM is common that multifocality and bilateralism appear as pathologic features. The prognosis is excellent after surgical treatment and TSH suppression. Routine adjuvant nuclear treatment is unnecessary in majority of patients.
随访102个月,研究偶发甲状腺乳头状微癌的临床病理特点、手术、内科及核治疗方法及患者预后。我们研究了37例偶发甲状腺乳头状微癌(I-PTM)。手术方式为全甲状腺切除术29例,半甲状腺切除术8例。PTM病灶的大小、多灶性和双侧性、甲状腺囊浸润和淋巴血管浸润是组织病理学参数。我们分析了102(61-144)个月的随访期间的辅助医疗和核治疗以及患者的预后。395例甲状腺切除术患者中I-PTM患病率为9.4%。组织病理学检查报告30例为单灶性疾病,7例为多灶性疾病(18%)。6例(20.1%)为多灶性双侧病变。PTM病灶的平均大小为4.88 mm。甲状腺包膜侵犯率为5.4%。所有患者均接受抑制剂量的LT4以达到低血清TSH水平。我们的病例没有进行辅助手术和核治疗。我们没有发现任何血液化学和超声成像的负面变化,以及任何不利的事件,如局部和全身复发。总之,I-PTM的诊断是常见的,多灶性和双侧表现为病理特征。经手术治疗及抑制TSH后预后良好。常规辅助核治疗在大多数患者中是不必要的。
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引用次数: 10
Quercetin-Induced Cell Death in Human Papillary Thyroid Cancer (B-CPAP) Cells 槲皮素诱导人甲状腺乳头状癌细胞死亡
IF 2.1 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2016-01-20 DOI: 10.1155/2016/9843675
E. M. Altundag, Tolga Kasacı, A. Yılmaz, B. Karademir, S. Koçtürk, S. Koçtürk, Y. Taga, A. Yalçın
In this study, we have investigated the antiproliferative effect of quercetin on human papillary thyroid cancer cells and determined the apoptotic mechanisms underlying its actions. We have used different concentrations of quercetin to induce apoptosis and measured cell viability. Apoptosis and cell cycle analysis was determined by flow cytometry using Annexin V and propidium iodide. Finally, we have measured changes in caspase-3 and cleaved poly(ADP-ribose) polymerase (PARP) protein expression levels as hallmarks of apoptosis and Hsp90 protein expression level as a marker of proteasome activity in treated and control cells. Quercetin treatment of human papillary thyroid cancer cells resulted in decreased cell proliferation and increased rate of apoptosis by caspase activation. Furthermore, it was demonstrated that quercetin induces cancer cell apoptosis by downregulating the levels of Hsp90. In conclusion, we have shown that quercetin induces downregulation of Hsp90 expression that may be involved in the decrease of chymotrypsin-like proteasome activity which, in order, induces inhibition of growth and causes cell death in thyroid cancer cells. Thus, quercetin appears to be a promising candidate drug for Hsp90 downregulation and apoptosis of thyroid cancer cells.
在这项研究中,我们研究了槲皮素对人甲状腺乳头状癌细胞的抗增殖作用,并确定了其作用的凋亡机制。我们用不同浓度的槲皮素诱导细胞凋亡并测定细胞活力。Annexin V和碘化丙啶用流式细胞术检测细胞凋亡和细胞周期。最后,我们测量了caspase-3和cleaved poly(adp -核糖)聚合酶(PARP)蛋白表达水平的变化,作为细胞凋亡的标志,以及Hsp90蛋白表达水平的变化,作为蛋白酶体活性的标志。槲皮素处理人甲状腺乳头状癌细胞后,细胞增殖下降,caspase活化细胞凋亡率升高。此外,槲皮素通过下调Hsp90水平诱导癌细胞凋亡。总之,我们已经证明槲皮素诱导Hsp90表达下调,这可能参与了胰凝乳蛋白酶样蛋白酶体活性的降低,从而诱导甲状腺癌细胞生长抑制并导致细胞死亡。因此,槲皮素似乎是一个很有希望的候选药物,用于甲状腺癌细胞的Hsp90下调和凋亡。
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引用次数: 47
Significance of TNF-α and the Adhesion Molecules: L-Selectin and VCAM-1 in Papillary Thyroid Carcinoma TNF-α与粘附分子l -选择素、VCAM-1在甲状腺乳头状癌中的意义
IF 2.1 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2016-01-11 DOI: 10.1155/2016/8143695
T. Kobawala, T. Trivedi, K. Gajjar, Darshita H. Patel, G. Patel, N. Ghosh
Circulating levels of TNF-α and the adhesion molecules L-Selectin and VCAM-1 as well as their expression in the primary tumors of patients with benign thyroid diseases and papillary thyroid carcinoma (PTC) have been determined in this study. The serum levels of TNF-α, L-Selectin, and VCAM-1 were significantly higher in patients with both benign thyroid diseases and PTC as compared to the healthy individuals. However, the levels of only TNF-α and L-Selectin, and not VCAM-1, were significantly higher in patients with PTC in comparison to those observed in patients with benign thyroid diseases. Further the expression of TNF-α and L-Selectin was also significantly higher in the primary tumors of PTC patients, relative to the benign thyroid diseases. The expression of L-Selectin and VCAM-1 significantly correlated with aggressive tumor behavior. In PTC patients, the circulating TNF-α levels significantly positively correlated with the levels of L-Selectin, while TNF-α immunoreactivity was significantly associated with VCAM-1 expression. Serum TNF-α was found to be a significant prognosticator for OS in PTC patients. Overall the results signify that the interaction between TNF-α and the adhesion molecules may have a role in thyroid carcinogenesis and understanding this complexity may offer potential therapeutic targets for better management of thyroid cancer.
本研究测定了良性甲状腺疾病和甲状腺乳头状癌(PTC)原发肿瘤中循环TNF-α、粘附分子l -选择素和VCAM-1的水平及其表达。良性甲状腺疾病和PTC患者血清TNF-α、l -选择素和VCAM-1水平均显著高于健康人。然而,与良性甲状腺疾病患者相比,PTC患者中只有TNF-α和l -选择素的水平明显升高,而VCAM-1的水平则没有升高。TNF-α和l -选择素在PTC患者原发肿瘤中的表达也明显高于良性甲状腺疾病。l -选择素和VCAM-1的表达与肿瘤侵袭性行为显著相关。PTC患者循环TNF-α水平与l -选择素水平显著正相关,TNF-α免疫反应性与VCAM-1表达显著相关。血清TNF-α被发现是PTC患者OS的重要预后指标。总的来说,这些结果表明TNF-α和粘附分子之间的相互作用可能在甲状腺癌变中起作用,了解这种复杂性可能为更好地治疗甲状腺癌提供潜在的治疗靶点。
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引用次数: 20
Corrigendum to "How to Treat a Signal? Current Basis for RET-Genotype-Oriented Choice of Kinase Inhibitors for the Treatment of Medullary Thyroid Cancer". “如何处理信号?”以ret基因型为导向选择治疗甲状腺髓样癌的激酶抑制剂的当前基础”。
IF 2.1 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2016-01-01 Epub Date: 2016-06-28 DOI: 10.1155/2016/2168046
Hugo Prazeres, Joana Torres, Fernando Rodrigues, Joana P Couto, João Vinagre, Manuel Sobrinho-Simões, Paula Soares

[This corrects the article DOI: 10.4061/2011/678357.].

[这更正了文章DOI: 10.4061/2011/678357.]
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引用次数: 0
The Relationship between Population T4/TSH Set Point Data and T4/TSH Physiology. 人群T4/TSH设定点数据与T4/TSH生理的关系
IF 2.1 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2016-01-01 Epub Date: 2016-03-31 DOI: 10.1155/2016/6351473
Stephen Paul Fitzgerald, Nigel Geoffrey Bean

Context. Population studies of the distribution of T4/TSH set points suggest a more complex inverse relationship between T4 and TSH than that suggested by physiological studies. The reasons for the similarities and differences between the curves describing these relationships are unresolved. Methods. We subjected the curve, derived from empiric data, describing the TSH suppression response to T4, and the more mathematically derived curve describing the T4 response to TSH, to the different possible models of population variation. The implied consequences of these in terms of generating a population distribution of T4/TSH equilibrium points (a "population curve") were generated and compared to the empiric population curve. The physiological responses to primary hypothyroidism and hyperthyroidism were incorporated into the analysis. Conclusions. Though the population curve shows a similarly inverse relationship, it is describing a different relationship than the curve describing the suppression of TSH by T4. The population curve is consistent with the physiological studies of the TSH response to T4 and implies a greater interindividual variation in the positive thyroid T4 response to TSH than in the central inhibitory TSH response to T4. The population curve in the dysthyroid states is consistent with known physiological responses to these states.

上下文。T4/TSH设定点分布的人群研究表明,T4和TSH之间的负相关关系比生理学研究表明的更为复杂。描述这些关系的曲线之间的相似和不同的原因尚未解决。方法。我们将从经验数据得出的描述T4对TSH抑制反应的曲线,以及更数学化的描述T4对TSH反应的曲线,应用于不同可能的种群变异模型。在生成T4/TSH平衡点(“人口曲线”)的人口分布方面,这些隐含的后果被生成并与经验人口曲线进行比较。对原发性甲状腺功能减退和甲状腺功能亢进的生理反应纳入分析。结论。尽管总体曲线显示出类似的反比关系,但它描述的关系与描述T4抑制TSH的曲线不同。人群曲线与TSH对T4反应的生理研究相一致,表明甲状腺T4对TSH的阳性反应比中枢抑制TSH对T4的反应有更大的个体差异。甲状腺功能障碍状态的人口曲线与已知的对这些状态的生理反应是一致的。
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引用次数: 25
期刊
Journal of Thyroid Research
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