简介：AbstractImportance:Graves’ disease (GD) is rare in children under the age of 7 years. Children with this disease exhibit greater thyrotoxicity at diagnosis and require a longer course of medical therapy, compared with pubertal and postpubertal children and adults.Objective:To investigate the clinical features and identify predictors of remission in children under the age of 7 years with GD.Methods:This retrospective study included 77 children who were diagnosed with GD under the age of 7 years and were treated in the Department of Endocrinology, Beijing Children’s Hospital from 2010 to 2018. Clinical manifestations, laboratory data, and follow-up records were collected for all patients. Children who achieved remission of treatment with methimazole were compared with those who had persistent disease to identify which variables were associated with remission; multiple logistic regression and Cox regression analyses were used to evaluate interactions among predictive variables.Results:Sixty-three boys and 14 girls were included; the median age at diagnosis was 4.2 years (interquartile range: 3.2-5.3 years). Forty-six (56.7%) patients had no family history of thyroid disease, 17 patients had family history of thyroid disease and 14 patients with unknown family history. Of the 77 patients, 18 (23.4%) patients achieved remission of treatment with methimazole and 59 patients did not; moreover, 51 (66.2%) had Graves’ ophthalmopathy. Univariate analyses revealed no significant differences between the remission group and non-remission group in terms of age at diagnosis, sex, initial goiter size, or initial thyroid hormone concentration. However, there were a trend of correlation between the initial level of thyroid peroxidase antibody (TPOAb) and remission status (univariate analysis OR 1.002, P = 0.038; multivariate analysis OR 1.004, P = 0.019). Similar results were observed in univariate analysis of the initial thyrotropin receptor antibody (TRAb) level, but this association was not significant in multivariate analysis. Cox regression analyses revealed that children with high TRAb level required longer duration of remission, compared with low TRAb level (OR 0.950, 95% CI 0.904-0.997, P = 0.037).Interpretation:Initial TRAb level was an independent predictor of remission outcome in young children under the age of 7 years with GD. Initial TRAb level may predict the likelihood of remission in patients with young-age-of-onset GD.

简介：摘要2021年7月，欧洲Graves眼病专家组(EUGOGO)发布了新一版Graves眼病(GO)管理指南，在2016版指南的基础上，新版指南重点更新了中重度、活动期GO患者的一线治疗方案，提供了多种二线治疗策略，对病情评估、一般管理、病情针对性管理等方面做了详细的推荐，并增加了疗效评估、新型冠状病毒肺炎疫情下管理、甲状腺功能控制等内容，共包含32条推荐条目，新版指南也指出部分治疗方案用于治疗GO仍需进一步疗效和安全性验证。

简介：摘要目的通过对Graves病(Graves′ disease, GD)和Graves眼病(thyroid associated ophthalmopathy, TAO)患者的T细胞受体(T cell receptor, TCR)测序，鉴定GD和TAO特异性TCR家族，为临床早期精确诊断提供依据。方法于西安交通大学第一附属医院门诊收集9例GD和6例TAO患者。对GD和TAO患者于诊断时采集外周血。收集20例与患者年龄和性别相匹配的健康对照外周血。分离外周血单个核细胞并提取RNA进行TCR免疫组库测序，并进行后续高通量数据挖掘分析。结果GD和TAO患者TCR多样性显著低于健康对照。挖掘TCR高通量测序数据，可分别构建GD和TAO两种疾病的特征性TCR数据库，分别包含157和116个VJ家族。这些VJ家族中存在两种疾病共有的家族，也存在两种疾病各自特有的家族。结论GD和TAO存在共同的发病基础，但是在某种程度上还是拥有不同的优势T细胞克隆，从而介导不同的免疫应答。因此，GD和TAO患者的特征性TCR可作为一种潜在的分子标志物。

简介：Ltmedisease(Lymeborreliosis)iscausedbythetick-bornespiro-elraeteBorreliaburgdooCeri.Erythemamigrans,anearlyskinlesion,isthemostcommonclinicalpresentation.Theorganismmayspread,causingvariouslatermanifestations.

简介：春季是传染性疾病的高发时段，预防工作一定要做到及时、有效。也许从下面的短文中我们可以得到一些启示！

简介：Graves病（Gravesdisease,GD）是一种器官特异性自身免疫病,与桥本甲状腺炎（Hashimotothyroiditis,HT）同属自身免疫性甲状腺疾病（autoimmunethyroiddisease,AITD）,其患病率约为1％～2％。患者主要临床表现为高代谢综合征，部分患者可以出现甲状腺相关眼病（thyroidassociatedophthalmopathy，TAO）、胫前黏液性水肿和（或）肝脏损害。

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简介：LastWednesday,AgricultureSecretaryAnnVenemanannouncedthefirstcaseofmadcowdiseaseintheUnitedStates.Atestseemedtoshowbovinespongiformencephalopathy,orB-S-E.inacowfromWashingtonstate.Thenextday,alaboratoryinWaybridge,England,Confirmed(证实）thecase。

简介：印射响应许多ligands和房间刺激涉及大量的细胞的小径和功能的家族asestransduce信号。MAPK的异常或不恰当的功能现在在从癌症到煽动性的疾病到肥胖和糖尿病的疾病被识别了。在许多房间类型，MAPKERK1/2被连接到细胞增殖。因为在地岬和B-Raf的变化，能激活ERK1/2串联，在许多人的肿瘤被发现，ERK1/2被认为在一些癌症起一个作用。发信号的反常ERK1/2也在polycystic肾疾病被发现了，并且象cardio-facio-cutaneous症候群那样的严肃的发展混乱在ERK1/2串联的部件从变化产生。ERK1/2在区分得好的房间是必要的并且在神经原并且在上皮的极性的维护被连接了到长期的potentiation。另外，ERK1/2为在胰腺的贝它房间的胰岛素基因抄写是重要的，它响应传播葡萄糖的增加生产胰岛素在有机体允许有效葡萄糖利用和存储。导致或镇压的营养素和荷尔蒙胰岛素分泌物以在贝它房间上反映能分泌的需求的一种方式激活或禁止ERK1/2。在这和另外的规章的小径的骚乱可以导致对某些人的混乱的病原学的ERK1/2的贡献。

简介：Asthmadevelopsinaboutoneadultperthousandpopulationperyear,andepidemiologicalstudiesindicatethatabout10%ofcasescanbeattributedtoexposuresatwork.However,occupationalasthmaisidentifiedlesscommonlythanthisinclinicalpractice;anincidenceof800-1000casesperyearisestimatedbytheUKSurveillanceofWork-RelatedandOccupationalRespiratoryDiseasescheme.Occupationalasthmaiseasilymissedbecause,apartfromitsassociationwithwork,

简介：HeartdiseaseistheleadingkillerofAmericans.Butitkillsmorewomenthanmen.TheAmericanHeartAssociationsaysheartdiseaseandothercardiovascular(心血管的)disorderskillaboutfivehundredthousandwomenayear.Thatismorethanthenextsevencausesofdeathcombined.

简介：摘要： Graves病 (GD)是甲状腺功能亢进症的最常见病因。约占全部甲亢的 80%～ 85%，普通人群中本病的患病率约 1%，女性高发，男女之比约为 1： 4～ 6，各年龄组均可发病，高发年龄为 20～ 50岁，多数起病缓慢，少数于精神刺激、感染、创伤等应激后急性起病。因此， Graves病的护理在临床中具有重要意义。

简介：摘要Graves眼病(Graves′ ophthalmopathy，GO)是一种与甲状腺疾病密切相关的自身免疫性疾病。GO临床表现多样，诊疗复杂，治疗手段繁多，缺少对因治疗。治疗方案的选择、疗效的评价以及患者结局的预测需要依赖对病情的评估。本文分析了GO的临床特点，提出了从危险因素、临床活动性、疾病严重度以及生活质量和心理状况评估GO病情的具体方法，倡导临床医生重视GO的病情评估。

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简介：甲状腺相关性眼病（TAO）,顾名思义是指与甲状腺疾病有关的眼病,由于其最常见于Graves病,因此有人对TAO与Graves眼病（Gravesophthalmopathy,GO）不作区分,互相通用。关于命名问题迄今仍然比较混乱,但严格地讲,TAO是大概念,GO是小概念,即GO只是TAO的一种类型。

简介：AbstractBackground:The prevalence rates of freezing of gait (FOG) in Parkinson’s disease (PD) vary widely, ranging from 14.0 to 55.1%. Our aim is to calculate the overall prevalence of FOG in all PD patients with different disease durations and severities.Methods:Using Medline/PubMed/Embase, we carried out a systematic literature search for studies reporting the PD and clinically relevant FOG.Results:After primary screening, a total of 35 studies were identified and further analyzed for inclusion into the analysis, and 29 studies fulfilled the quality criteria and included in this meta-analysis. The overall prevalence of FOG in PD was 39.9% (95% CI 35.3-44.5%). The FOG identified by the freezing of gait questionnaire item 3 may be more prevalent (43.8%, 95% CI 38.5-49.1%) than the FOG identified by the Unified Parkinson’s Disease Rating Scale item 14 (36.0%, 95% CI 29.0-43.1%). Disease duration and severity are both the clinical features associated with the FOG. The highest FOG prevalence rate in PD patients was seen in patients with disease durations ≥ 10 years, at 70.8%, followed that of PD patients with disease durations ≥ 5 years (53.3%), and PD patients with disease durations < 5 years (22.4%). FOG presented in 28.4% of PD patients with Hoehn and Yahr staging (H&Y) score ≤ 2.5, and in 68.4% of PD patients with H&Y score ≥ 2.5.Conclusion:This meta-analysis confirms that the prevalence of FOG in PD is considerable, and highlights the need for accurate identification of FOG in PD.

简介：AbstractBackgroundSince early December 2019, the 2019 novel coronavirus disease (COVID-19) has caused pneumonia epidemic in Wuhan, Hubei province of China. This study aimed to investigate the factors affecting the progression of pneumonia in COVID-19 patients. Associated results will be used to evaluate the prognosis and to find the optimal treatment regimens for COVID-19 pneumonia.MethodsPatients tested positive for the COVID-19 based on nucleic acid detection were included in this study. Patients were admitted to 3 tertiary hospitals in Wuhan between December 30, 2019, and January 15, 2020. Individual data, laboratory indices, imaging characteristics, and clinical data were collected, and statistical analysis was performed. Based on clinical typing results, the patients were divided into a progression group or an improvement/stabilization group. Continuous variables were analyzed using independent samples t-test or Mann-Whitney U test. Categorical variables were analyzed using Chi-squared test or Fisher’s exact test. Logistic regression analysis was performed to explore the risk factors for disease progression.ResultsSeventy-eight patients with COVID-19-induced pneumonia met the inclusion criteria and were included in this study. Efficacy evaluation at 2 weeks after hospitalization indicated that 11 patients (14.1%) had deteriorated, and 67 patients (85.9%) had improved/stabilized. The patients in the progression group were significantly older than those in the disease improvement/stabilization group (66 [51, 70] vs. 37 [32, 41] years, U= 4.932, P= 0.001). The progression group had a significantly higher proportion of patients with a history of smoking than the improvement/stabilization group (27.3% vs. 3.0%, χ2 = 9.291, P = 0.018). For all the 78 patients, fever was the most common initial symptom, and the maximum body temperature at admission was significantly higher in the progression group than in the improvement/stabilization group (38.2 [37.8, 38.6] vs. 37.5 [37.0, 38.4]°C, U= 2.057, P= 0.027). Moreover, the proportion of patients with respiratory failure (54.5% vs. 20.9%, χ2 = 5.611, P = 0.028) and respiratory rate (34 [18, 48] vs. 24 [16, 60] breaths/min, U= 4.030, P = 0.004) were significantly higher in the progression group than in the improvement/stabilization group. C-reactive protein was significantly elevated in the progression group compared to the improvement/stabilization group (38.9 [14.3, 64.8] vs. 10.6 [1.9, 33.1] mg/L, U= 1.315, P= 0.024). Albumin was significantly lower in the progression group than in the improvement/stabilization group (36.62 ± 6.60 vs. 41.27 ± 4.55 g/L, U = 2.843, P = 0.006). Patients in the progression group were more likely to receive high-level respiratory support than in the improvement/stabilization group (χ2 = 16.01, P = 0.001). Multivariate logistic analysis indicated that age (odds ratio [OR], 8.546; 95% confidence interval [CI]: 1.628-44.864; P = 0.011), history of smoking (OR, 14.285; 95% CI: 1.577-25.000; P= 0.018), maximum body temperature at admission (OR, 8.999; 95% CI: 1.036-78.147, P= 0.046), respiratory failure (OR, 8.772, 95% CI: 1.942-40.000; P = 0.016), albumin (OR, 7.353, 95% CI: 1.098-50.000; P = 0.003), and C-reactive protein (OR, 10.530; 95% CI: 1.224-34.701, P = 0.028) were risk factors for disease progression.ConclusionsSeveral factors that led to the progression of COVID-19 pneumonia were identified, including age, history of smoking, maximum body temperature at admission, respiratory failure, albumin, and C-reactive protein. These results can be used to further enhance the ability of management of COVID-19 pneumonia.

简介：摘要Graves病(GD)传统治疗方案虽然有一定疗效，但仍然有必要探究新型疗法。针对GD发病机制，通过消耗B淋巴细胞和作用于促甲状腺素受体(TSHR)所研发的生物制剂，如单克隆抗体，TSHR拮抗剂以及抗原表位等特异性治疗，部分新药有望投入临床使用，通过恢复受损的免疫系统，维持正常甲状腺功能，弥补传统疗法长期用药、诱发或加重Graves眼病以及导致永久性甲状腺功能减退等一系列并发症的不足。甲状腺热消融技术在难治性GD患者中的初步尝试表明其有效且安全。中医药在改善GD患者症状与甲状腺功能方面亦发挥作用。上述方法为未来GD的治疗展现了美好前景，也为临床医师制定最佳治疗方案提供了更多选择。

简介：摘要甲状腺相关性眼病（TAO）是成年人最常见的眼眶疾病的一种，一般认为它属自身免疫性疾病或器官免疫性疾病，MicroRNA（miRNA）是具有调控功能的一类非编码小分子RNA，主要作用是参与基因转录后的表达调控，与眼部细胞的生长、发育、分化、凋亡及代谢功能的维持关系密切。近年来的研究显示，miRNA可能参与GO的发病。本文对近年来miRNA与GO的相关研究进行综述。