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Objective To evaluate the utility of clinical characters and variant examinations in discriminating benign from malignant thyroid lesions before operation.Methods We had retrospectively analyzed 1367 cases of thyroid nodule that were operated in Ruijin Hospital from 1999 to 2004.Results Clinical symptoms and signs,ultrasonography and fine needle aspiration(FNA)were all useful in indicating malignant thyroid lesions,especially FNA,whose sensitivity,specificity and diagnostic accuracy were 65.12%,95.08% and 82.69%,respectively.By logistic regression analysis,the thyroid nodule of young patients or solid or hard nodules,or nodules hard,or accompanied with calcification or nonached lymphadenectasis might be maligment nodules.At this time,FNA shoud be performed.Conclusion The above findings emphasize the importance of reviewing carefully and utilizing effectively the clinical information of each patient.
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High expressions of IGF Ⅱ mRNA and protein were demonstrated by RT PCR and IRMA analysis in tumor tissue of a patient with non islet cell tumor induced hypoglycaemia (NICTH). Northern blotting results displayed abundant 6.0, 5.3, 5.0, 4.8 kb IGF Ⅱ transcripts in the tumor. It suggests that autosecretive production of IGF Ⅱ of the tumor plays an important role in the pathogenesis of tumor induced hypoglycemia.
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The acute therapeutic effect of enalapril,an angiotensin converting enzyme inhibitor (ACEI),in reducing blood pressure and urinary albumin excretion rate(UAER) were assessed in 32 NID- DM and 13 essential hypertensive patients.After treatment for three days,24-h blood pressure and UAER in NIDDM patients were reduced significantly.UAER of essential hypertensive patients were reduced while in hypertensive patients UAER were reduced,but blood pressure except night SBP remained unchanged. This study suggests enalapril may have a specific protect effect on kidney which is independent of the de- crease in systemic blood pressure.
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The relationship between abnormal circulating GH-insulin-like growth factor (IGF) axis and hypoglycaemia was explored in 2 cases of non-islet cell tumor associated hypoglycaemia (NICTH). Serum level of IGF-Ⅱ was increased, the levels of GH, IGF-Ⅰ, IGFBP-3 were decreased to some extent, and IGF-Ⅱ/IGF-Ⅰ (molar ratio) was significantly increased in these two cases. In one case, circulating GH-IGF axis returned to normal after complete removal of the tumor. In the diagnosis of NICTH, the abnormal circulating GH-IGF axis is quite valuable and IGF-Ⅱ/IGF-Ⅰ appears to be a more sensitive parameter.
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Objective To evaluate the clinical efficacy and safety of sibutramine (Reductile )in Chinese obese patients. Methods Obese adults (BMI 27～45 kg/m 2) in six research centers received sibutamine 10 mg or placebo one tablet each day with a controlled-energy diet for 24 weeks by randomized, double-blinded, placebo-controlled study. Results For intent-to-treat analysis, 125 sibutramine-treated subjects and 126 placebo-treated subjects were evaluated. After 24 weeks, sibutramine-treated patients lost more weight (6.52?3.95)kg than placebo-treated patients (3.18?3.59)kg(P
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150 cases of pheochromocytoma were presented. There were 90 male and 60 female patients. Majority of the patients were between 20 to 50 years of age. The tumor was found in the adrenals in 120 cases. Out of the 150 cases, 16 were malignant. All patients suffered from high blood pressure, with paroxysmal hypertension in 22, sustained hypertension in 52 and sustained hypertension plus paroxysmal exacerbation in 74. 14 cases had the manifestation of alternating hypo- and hypertension, while 3 of them suffered from hypotensive shock following hypertensive attack. The determinations of catecholamine and its metabolites in blood and urine were of diagnostic value. Two-dimensional ultra-sonography, computerized tomography and 131I-MIBC scan were found very useful in the localization of the tumor.
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Objective To improve the awareness of clinical manifestation, endocrine changes and prognosis in patients with anorexia nervosa (AN). Methods The clinical features and endocrine functions of 28 patients with AN were analysed, and the prognosis was based on the results of 4 months-7 years follow-up of these patients. The change of serum leptin level was observed during different therapeutic periods in 13 patients. Results Most of AN patients were young women (92.9%, 26/28), age of onset was (19.4?3.8)years old and the duration of follow-up was from 4 months to 7 years. Self-starvation, extreme weight loss and amenorrhoea were the characteristic manifestations. This investigation discovered 24 patients with hypofunctional hypothalamus-pituitary-gonad axis, 12 with hyperfunctional hypothalamus-pituitary-adrenal axis, 9 with decreased levels of thyroid hormones, 2 with increased level of GH (n=10), 8 with decreased level of IGF-Ⅰ (n=10). Leptin levels in AN patients (n=9) weresignificantlydecreasedascomparedwiththecontrol group (n=26) 〔(1.21?0.36 vs 7.70?4.15)?g/L, P