ABSTRACT
Objective To evaluate the efficacy of Shenfu Decoction in treatment of critically ill patients with spleen-kidney yang deficiency type low triiodothyronine syndrome (LT3S). Methods Totally 110 critically ill patients with spleen-kidney yang deficiency type LT3S were randomized into two groups. Control group used standard Western treatment; Treatment group was given the combination of Western treatment and Shenfu Decoction; each group was treated for 7 d. The therapeutic effect indexes were serum T3, serum T4, serum TSH, APACHE II score, hospital day, results of treatment, and therapeutic efficacy of TCM syndromes. Results After treatment, the APACHE II score in control and treatment groups have been significantly improved (P < 0.05, 0.001). Compared with control group, the score in treatment group declined more drastically, and difference between two groups was statistically significant (P < 0.05); The serum T3 levels have been significantly improved in both groups and improved more in treatment group, and the difference between two groups was statistically significant (P < 0.05); The hospital day of treatment group was shorter than control group after treatment, and the difference between two groups was statistically significant (P < 0.05); The symptoms score progressed in both groups after treatment and have been significantly improved in treatment group, and the difference between two groups was statistically significant (P < 0.05); The treatment group had more significant clinical curative effect after treatment (P < 0.05). Conclusion Shenfu Decoction in critically ill patients with spleen-kidney yang deficiency type LT3S could improve the clinical curative effect, progress the TCM syndromes and results of treatment, and shorten the hospital stay.
ABSTRACT
3T3-L1 adipocytes transfected with TSH receptor (TSHR) shRNA were incubated with bovine TSH.The concentration of tumor necrosis factor (TNF)-α in culture medium was measured by enzyme linked immunosorbent asssy.Protein level of insulin receptor substrate 1 (IRS-1) was quantified by Western blotting.Tyrosine phosphorylation of IRS-1 was measured by immunoprecipitation.The results showed that 1 mIU/ml TSH significantly sitmulated TNF-α release in 3T3-L1 adipocytes [(341.85 ± 12.00 vs 522.67 ± 36.22) ng/L,P＜0.01],along with the decreases in IRS-1 protein expression and its tyrosine phosphorylation (P＜ 0.01).These effects disappeared when TSHR expression was down-regulated with RNA interference in 3T3-L1 adipocytes.In addition,WP9QY,a TNF-α antagonist,blocked TSH-decreased IRS-1 expresssion.These results suggest that TSH downregulates IRS-1 protein expression and its tyrosine phosphorylation through stimulating production of TNF-α,and thus contributes to the development of insulin resistance.
ABSTRACT
Objective To investigate the association between preoperative serum TSH level and differentiated thyroid cancer (DTC).Methods The relationship between TSH concentration and differentiated thyroid cancer in 400 qualified patients with thyroid nodules was retrospectively analyzed from January 2009 to December2011 in our hospital.Based on the TSH values,the patients were divided into five groups.Results Preoperative serum TSH level in DTC group was higher than that in benign thyroid nodales group [(2.94 ± 1.74 vs1.92 ± 1.45) μ IU/ml,P＜0.01].The risk of DTC increased as serum level of TSH rose in the patients with thyroid nodule.The incidences of DTC were 27.8％,34.0％,40.0％,63.4％,and 70.2％ respectively in groups with TSH＜0.27,0.27-1.44,1.45-2.19,2.20-4.20,and ＞4.20 μIU/ml groups.TSH level in the group with cervical lymph node metastasis was higher than that without metastasis (P＜0.01).Conclusions The likelihood of thyroid cancer increases with increased serum TSH concentration.High TSH level seems to be associated with lymph node metastasis.Preoperative serum TSH level might be a risk predictor for DTC.