Introduction: In hyperthyroidism, selective irradiation of the thyroid gland with radioactive iodine is a radical treatment and an alternative to surgery. The aim of this review is to assess the medium-term efficacy o...Introduction: In hyperthyroidism, selective irradiation of the thyroid gland with radioactive iodine is a radical treatment and an alternative to surgery. The aim of this review is to assess the medium-term efficacy of outpatient treatment of hyperthyroidism with iodine-131 in Africa. Methods: We identified the studies carried out in Africa on outpatient radiation therapy between 2016 and 2020. For each article included, we noted the country concerned and the year of publication, the numbers studied, the socio-demographic characteristics of the patients, the indications for radio iodine therapy, the dose administered, the results of the hormonal dosage 6 months after radiation. Results: 13 retrospective studies were included to constitute a total population of 925 patients. The average age was 40.77 years, the sex ratio of 1/5.4 with a clear female predominance. The 3 main etiologies of hyperthyroidism justifying outpatient radio iodine therapy were Graves’ disease (55.89%), toxic multinodular goiter (22.70%) and toxic adenoma (21.40%). The average dose of iodine 131 administered per course is 13.7 mCi. No short-and medium-term complications were reported. The radio iodine therapy was effective in 86.08% (n = 796) of the patients with extremes of 72% and 100%. Conclusion: Radio iodine therapy is effective in Africa. It is simple, inexpensive on an outpatient basis and well tolerated. The introduction of outpatient radio iodine therapy could improve the management of patients with hyperthyroidism in Burkina Faso.展开更多
BACKGROUND Lithium carbonate is used to manage various mood disorders,but it can cause thyroid abnormalities,including goiter,hypothyroidism,and hyperthyroidism.In rare cases,it can lead to giant goiter and subclinica...BACKGROUND Lithium carbonate is used to manage various mood disorders,but it can cause thyroid abnormalities,including goiter,hypothyroidism,and hyperthyroidism.In rare cases,it can lead to giant goiter and subclinical hyperthyroidism,which may require surgical intervention in severe cases.CASE SUMMARY This case represents a rare development of giant goiter and subclinical hyperthyroidism in a schizophrenia patient who was subjected to prolonged lithium carbonate treatment.The enlarged thyroid gland caused pressure on the airway and recurrent laryngeal nerve,which led to respiratory distress,hoarseness,and dysphagia.The immediate danger of suffocation required urgent surgical intervention.In this report,we describe the case of a 41-year-old Chinese woman.This sheds light on the etiology and challenges associated with managing a giant goiter.The patient underwent a subtotal thyroidectomy to relieve airway compression and facilitate airway expansion.Prior to the procedure,the patient was given iodine to prepare.Concurrently,changes were made to the psychiatric medication regimen.Following surgery,the patient's respiratory function and vocal cord functionality improved significantly,and her mental state remained stable.CONCLUSION It is essential to monitor thyroid function,test thyroid antibody levels,and perform thyroid ultrasounds consistently in all patients undergoing long-term lithium carbonate treatment.This vigilance helps prevent severe and potentially life-threatening thyroid enlargement.展开更多
Lithium treatment is usually indicated in bipolar disorder. It is associated with hypothyroidism and very rarely with hyperthyroidism. We report here the results of the exploration of a case of thyrotoxicosis occurrin...Lithium treatment is usually indicated in bipolar disorder. It is associated with hypothyroidism and very rarely with hyperthyroidism. We report here the results of the exploration of a case of thyrotoxicosis occurring during treatment with lithium salts. This was a 16-year-old patient with ongoing lithium treatment for two and a half years who presented with a thyrotoxicosis syndrome without a context of iodine overload or an episode of anterior cervical pain that could suggest subacute thyroiditis or orthopathic sign. The assessment of the exploration of this patient reveals biological hyperthyroidism without anti-TSH receptor antibodies, a normal ultrasound, and white scintigraphy which makes it possible to evoke the diagnosis of subacute thyroiditis (absence of the context of iodine overload). Note the interest in a thyroid assessment before and during treatment with lithium salts. Moreover, scintigraphy occupies a place of choice in the exploration of hyperthyroidism, particularly in the context of normal thyroid ultrasound imaging.展开更多
Cardiovascular complications during hyperthyroidism are dominated by arrhythmias, heart failure and coronary heart disease. Pericardial effusion which is a common complication of hypothyroidism is extremely rare in hy...Cardiovascular complications during hyperthyroidism are dominated by arrhythmias, heart failure and coronary heart disease. Pericardial effusion which is a common complication of hypothyroidism is extremely rare in hyperthyroidism. We report the case of a 45-year-old woman admitted for management of pleuro-pericarditis associated with atrial fibrillation in the context of cardiothyreosis. The treatment consisted of a pericardial puncture associated with synthetic anti-thyroid drugs and anti-tuberculosis drugs with positive clinical and echocardiographic outcomes.展开更多
BACKGROUND Hyperthyroidism often leads to tachycardia,but there are also sporadic reports of hyperthyroidism with severe bradycardia,such as sick sinus syndrome(SSS)and atrioventricular block.These disorders are a cha...BACKGROUND Hyperthyroidism often leads to tachycardia,but there are also sporadic reports of hyperthyroidism with severe bradycardia,such as sick sinus syndrome(SSS)and atrioventricular block.These disorders are a challenge for clinicians.CASE SUMMARY We describe three cases of hyperthyroidism with SSS and found 31 similar cases in a PubMed literature search.Through the analysis of these 34 cases,we found 21 cases of atrioventricular block and 13 cases of SSS,with 67.6%of the patients experiencing bradycardia symptoms.After drug treatment,temporary pacemaker implantation,or anti-hyperthyroidism treatment,the bradycardia of 27 patients(79.4%)was relieved,and the median recovery time was 5.5(2-8)d.Only 7 cases(20.6%)needed permanent pacemaker implantation.CONCLUSION Patients with hyperthyroidism should be aware of the risk of severe bradycardia.In most cases,drug treatment or temporary pacemaker placement is recommended for initial treatment.If the bradycardia does not improve after 1 wk,a permanent pacemaker should be implanted.展开更多
Cold surges(CSs)often occur in the mid-latitude regions of the Northern Hemisphere and have enormous effects on socioeconomic development.We report that the occurrences of CSs and persistent CSs(PCSs)have rebounded si...Cold surges(CSs)often occur in the mid-latitude regions of the Northern Hemisphere and have enormous effects on socioeconomic development.We report that the occurrences of CSs and persistent CSs(PCSs)have rebounded since the 1990s,but the trends related to the frequencies of strong CSs(SCSs)and extreme CSs(ECSs)changed from increasing to decreasing after 2000.The highest-ranked model ensemble approach was used to project the occurrences of various CSs under the SSP1-2.6,SSP2-4.5,and SSP5-8.5 scenarios.The frequencies of the total CSs show overall decreasing trends.However,under the SSP1-2.6 scenario,slight increasing trends are noted for SCSs and ECSs in China.Atmospheric circulations that are characterized by an anomalous anticyclonic circulation with a significantly positive 500-hPa geopotential height(Z500)anomaly at high latitudes along with significant negative anomalies in China were favorable for cold air intrusions into China.In addition,the frequencies of all CS types under the SPP5-8.5 scenario greatly decreased in the long term(2071-2100),a finding which is thought to be related to negative SST anomalies in the central and western North Pacific,differences in sea level pressure(SLP)between high-and mid-latitude regions,and a weaker East Asian trough.In terms of ECSs,the decreasing trends observed during the historical period were maintained until 2024 under the SSP1-2.6 scenario.Compared to the SSP1-2.6 scenario,the Z500 pattern showed a trend of strengthened ridges over the Ural region and northern East Asia and weakened troughs over Siberia(60°-90°E)under the SSP2-4.5 and SSP5-8.5 scenarios,contributing to the shift to increasing trends of ECSs after 2014.展开更多
Climate change affects the activity of global and regional tropical cyclones(TCs).Among all TCs,typical super typhoons(STYs)are particularly devastating because they maintain their intensity when landing on the coast ...Climate change affects the activity of global and regional tropical cyclones(TCs).Among all TCs,typical super typhoons(STYs)are particularly devastating because they maintain their intensity when landing on the coast and thus cause casualties,economic losses,and environmental damage.Using a 3D tidal model,we reconstructed the typhoon(TY)wind field to simulate the storm surge induced by typical STYs.The TY activity was then analyzed using historical data.Results showed a downtrend of varying degrees in the annual frequency of STYs and TCs in the Western North Pacific(WNP)Basin,with a significant trend change observed for TCs from 1949 to 2021.A large difference in the interannual change in frequency was found between STYs and TCs in the WNP and Eastern China Sea(ECS).Along the coast of EC,the frequency of landfall TCs showed a weak downtrend,and the typical STYs showed reverse micro growth with peak activity in August.Zhejiang,Fujian,and Taiwan were highly vulnerable to the frontal hits of typical STYs.Affected by climate change,the average lifetime maximum intensity(LMI)locations and landfall locations of typical STYs in the ECS basin showed a significant poleward migration trend.In addition,the annual average LMI and accumulated cyclone energy showed an uptrend,indicating the increasing severity of the disaster risk.Affected by the typical STY activity in the ECS,the maximum storm surge area also showed poleward migration,and the coast of North China faced potential growth in high storm surge risks.展开更多
From July 1976 to Oct. 1993, propranolol war used to prepare 154 thyrotoxic patients including 95 severe cases. The initial dose of propranolol was gradually increased to 160 mg/d and Lngol's solution war added in...From July 1976 to Oct. 1993, propranolol war used to prepare 154 thyrotoxic patients including 95 severe cases. The initial dose of propranolol was gradually increased to 160 mg/d and Lngol's solution war added in for 10-14 days after the pulse rate had become stable. Just before operation another dose of propranolol was given, and propranolol intake war resumed within 6-8 hours after operation. The thyrotoxic symptonis were controlled The postoperative course in 144 cases was uneventful. High fever and tachycardia developed in 7 patients with severe thyrotoxicosis and were controlled by intravenous hydrocortisone and increased dosape of propranolol. Only one case developed hypaplycemia 12 hours after operation. Our study demonstrated that propranolol combined with iodine is a safe method for preoperative treatment in hyperthyroidism. Although there was no thyroid crisis, we do not recommend propranolol alone as the routine preparation for severe thyrotoxicosis. Preparation with antithyroid drugs is the method of choice if the patient can tolerate.展开更多
The gonadotropin-releasing hormone (GnRH) antagonist protocol has emerged as an efficacious alternative to the GnRH agonist protocol for controlled ovarian hyperstimulation (COH) during in vitro fertilization (IVF) cy...The gonadotropin-releasing hormone (GnRH) antagonist protocol has emerged as an efficacious alternative to the GnRH agonist protocol for controlled ovarian hyperstimulation (COH) during in vitro fertilization (IVF) cycles, and has been demonstrated applicability in infertile female patients with diverse ovarian responses. While the clinical implementation of the antagonist COH protocol has achieved widespread consensus, opportunities for refinement persist. Therefore, this review article focuses on the advantages and disadvantages of GnRH antagonist protocol, the selection of optimal standard doses, and the strategies for adjusting antagonist doses after the premature luteinizing hormone (LH) surge, aiming to provide more reasonable and scientific recommendations for the application of this scheme.展开更多
Storm surge is often the marine disaster that poses the greatest threat to life and property in coastal areas.Accurate and timely issuance of storm surge warnings to take appropriate countermeasures is an important me...Storm surge is often the marine disaster that poses the greatest threat to life and property in coastal areas.Accurate and timely issuance of storm surge warnings to take appropriate countermeasures is an important means to reduce storm surge-related losses.Storm surge numerical models are important for storm surge forecasting.To further improve the performance of the storm surge forecast models,we developed a numerical storm surge forecast model based on an unstructured spherical centroidal Voronoi tessellation(SCVT)grid.The model is based on shallow water equations in vector-invariant form,and is discretized by Arakawa C grid.The SCVT grid can not only better describe the coastline information but also avoid rigid transitions,and it has a better global consistency by generating high-resolution grids in the key areas through transition refinement.In addition,the simulation speed of the model is accelerated by using the openACC-based GPU acceleration technology to meet the timeliness requirements of operational ensemble forecast.It only takes 37 s to simulate a day in the coastal waters of China.The newly developed storm surge model was applied to simulate typhoon-induced storm surges in the coastal waters of China.The hindcast experiments on the selected representative typhoon-induced storm surge processes indicate that the model can reasonably simulate the distribution characteristics of storm surges.The simulated maximum storm surges and their occurrence times are consistent with the observed data at the representative tide gauge stations,and the mean absolute errors are 3.5 cm and 0.6 h respectively,showing high accuracy and application prospects.展开更多
The concept of a virtual human is rapidly fermenting with the boom of the metaverse in 2020.In March 2021,Roblox,a game company focusing on the socialization of teenagers’games and the free realization of UGC,went pu...The concept of a virtual human is rapidly fermenting with the boom of the metaverse in 2020.In March 2021,Roblox,a game company focusing on the socialization of teenagers’games and the free realization of UGC,went public.In its prospectus,Roblox is defined as the concept of the metaverse.Under this background,as the direct embodiment of“virtual identity”and“virtual reality coexisting”under the concept of the metaverse,the emerging definition of virtual human and its representative virtual image has gradually caught the attention of the public.展开更多
The future inundation by storm surge on coastal areas are currently ill-defined.With increasing global sealevel due to climate change,the coastal flooding by storm surge is more and more frequently,especially in coast...The future inundation by storm surge on coastal areas are currently ill-defined.With increasing global sealevel due to climate change,the coastal flooding by storm surge is more and more frequently,especially in coastal lowland with land subsidence.Therefore,the risk assessment of such inundation for these areas is of great significance for the sustainable socio-economic development.In this paper,the authors use Elevation-Area method and Regional Ocean Model System(ROMS)model to assess the risk of the inundation of Bohai Bay by storm surge.The simulation results of Elevation-Area method show that either a 50-year or 100-year storm surge can inundate coastal areas exceeding 8000 km^(2);the numerical simulation results based on hydrodynamics,considering ground friction and duration of the storm surge high water,show that a 50-year or 100-year storm surge can only inundate an area of over 2000 km^(2),which is far less than 8000 km^(2);while,when taking into account the land subsidence and sea level rise,the very inundation range will rapidly increase by 2050 and 2100.The storm surge will greatly impact the coastal area within about 10-30 km of the Bohai Bay,in where almost all major coastal projects are located.The prompt response to flood disaster due to storm surge is urgently needed,for which five suggestions have been proposed based on the geological background of Bohai Bay.This study may offer insight into the development of the response and adaptive plans for flooding disasters caused by storm surge.展开更多
One of the viral terms on Chinese social media these days-“city bu city”–was actually created by a foreign tourist.The tourist,a blogger,used the term,which literally means city or not city,in a short video he film...One of the viral terms on Chinese social media these days-“city bu city”–was actually created by a foreign tourist.The tourist,a blogger,used the term,which literally means city or not city,in a short video he filmed while visiting the Great Wall,wondering whether the place is like a fashionable big city.展开更多
Summary： Intraventricular hydrodynamics is considered an important component of cardiac function assessment. Vector flow mapping （VFM） is a novel flow visualization method to describe cardiac pathophysiological con...Summary： Intraventricular hydrodynamics is considered an important component of cardiac function assessment. Vector flow mapping （VFM） is a novel flow visualization method to describe cardiac pathophysiological condition. This study examined use of new VFM and flow field for assessment of left ventricular （LV） systolic hemodynamics in patients with simple hyperthyroidism （HT）. Thirty-seven simple HT patients were enrolled as HT group, and 38 gender- and age-matched healthy volunteers as control group. VFM model was used to analyze LV flow field at LV apical long-axis view. The follow- ing flow parameters were measured, including peak systolic velocity （Vs）, peak systolic flow （Fs）, total systolic negative flow （SQ） in LV basal, middle and apical level, velocity gradient from the apex to the aortic valve （AV）, and velocity according to half distance （V1/2）. The velocity vector in the LV cavity, stream line and vortex distribution in the two groups were observed. The results showed that there were no significant differences in the conventional parameters such as left ventricular ejection fraction （LVEF）, left ventricular end-diastolic diameter （LVEDD） and left atrium diameter （LAD） between HT group and control group （P〉0.05）. Compared with the control group, a brighter flow and more vortexes were detected in HT group. Non-uniform distribution occurred in the LV flow field, and the stream lines were discontinuous in HT group. The values of Vs and Fs in three levels, SQ in middle and basal levels, AV and V1/2 were higher in HT group than in control group （P〈0.01）. AV was positively correlated with serum free thyroxin （FT4） （r=0.48, P〈0.01）. Stepwise multiple regression analysis showed that LVEDD, FT4, and body surface area （BSA） were the influence factors of △V. The unstable left ventricular sys- tolic hydrodynamics increased in a compensatory manner in simple PIT patients. The present study in- dicated that VFM may be used for early detection of abnormal ventricle contraction in clinical settings.展开更多
BACKGROUND Severe hyperthyroidism is a life-threatening exacerbation of thyrotoxicosis,characterized by high fever and multiorgan failure. The most common medical treatments are administration of antithyroid drugs and...BACKGROUND Severe hyperthyroidism is a life-threatening exacerbation of thyrotoxicosis,characterized by high fever and multiorgan failure. The most common medical treatments are administration of antithyroid drugs and radioactive iodine, and thyroidectomy. In some patients, antithyroid therapy is limited due to serious adverse effects or failure to control disease progression. In some extreme cases,such as thyroid storm, conventional therapy alone does not yield effective and rapid improvement before the development of multiorgan failure.CASE SUMMARY This report describes a Chinese patient with severe hyperthyroidism accompanied by multiorgan failure, who was transferred to the medical intensive care unit of our hospital. The patient presented with palpitations, vomiting,diarrhea, and shortness of breath for a week. Laboratory tests showed elevation of thyroid hormones. Hepatic failure occurred with high aminotransferase levels and jaundice. Given her abnormal liver function and medication history, we could not exclude diagnosis of propylthiouracil-induced hepatic failure.Moreover, she also suffered from heart failure. Therapeutic plasma exchange(commonly known as TPE) and continuous renal replacement therapy(commonly known as CRRT) were used as life-saving therapy, which resulted in notable improvement of clinical symptoms and laboratory tests.CONCLUSION Combined TPE and CRRT are safe and effective for patients with hyperthyroidism and multiorgan failure.展开更多
BACKGROUND Alström syndrome(AS,OMIM ID 203800)is a rare disease involving multiple organs in children and is mostly reported in non-Chinese patients.In the Chinese population,there are few reports on the clinical...BACKGROUND Alström syndrome(AS,OMIM ID 203800)is a rare disease involving multiple organs in children and is mostly reported in non-Chinese patients.In the Chinese population,there are few reports on the clinical manifestations and pathogenesis of AS.This is the first report on the association between AS and Graves’hyperthyroidism.CASE SUMMARY An 8-year-old Chinese girl was diagnosed with AS.Two years later,Graves’hyperthyroidism developed with progressive liver dysfunction.The patient’s clinical data were collected;DNA from peripheral blood of the proband,parents and sibling was collected for gene mutation detection using the second-generation sequencing method and gene panel for diabetes.The association between the patient’s genotype and clinical phenotype was analyzed.She carried the pathogenic compound heterozygous mutation of ALMS1(c.2296_2299del4 and c.11460C>A).These stop-gain mutations likely caused truncation of the ALMS1 protein.CONCLUSION The manifestation of hyperthyroidism may suggest rapid progression of AS.展开更多
Hyperthyroidism refers to a clinical state that results from inappropriately hight hyroid hormone levels in the tissues;.Ⅰ-131 therapy plays a critical role and provides a remarkable curative effect in targeting thyr...Hyperthyroidism refers to a clinical state that results from inappropriately hight hyroid hormone levels in the tissues;.Ⅰ-131 therapy plays a critical role and provides a remarkable curative effect in targeting thyroid diseases. Thyroid cells can take up isotope I-131, which emits not only beta rays but also展开更多
The study was to evaluate factors affecting outcome of 131I therapy in hyperthyroidism for optimizing the method. Data from 213 patients who received 131I treatment from July 2003 to July 2005 in our department were r...The study was to evaluate factors affecting outcome of 131I therapy in hyperthyroidism for optimizing the method. Data from 213 patients who received 131I treatment from July 2003 to July 2005 in our department were retrospectively analyzed. Factors possibly contributing to the outcome of the 131I therapy were analyzed, including gen-der, age, history of antithyroid drug, thyroid volume, duration of disease and radioactive iodine uptake rate. Multivariate analysis was done. The rates of euthyroidism and hypothyroidism were 69% and 8.5%, respectively, after one time 131I therapy. Multivariate analysis of the patients showed no statistically significant factors affecting the outcome of 131I therapy. The study showed that 131I dose can be directly calculated, and this simplifies the dose-determined method and individualizes the therapy.展开更多
Objective:To investigate the clinical significance of serum thyroid stimulating hormone(TSH) receptor antibody(TRAb) levels in pregnant women with Graves'disease,on neonatal hyperthyroidism. Methods:The clinical d...Objective:To investigate the clinical significance of serum thyroid stimulating hormone(TSH) receptor antibody(TRAb) levels in pregnant women with Graves'disease,on neonatal hyperthyroidism. Methods:The clinical data of 68 pregnant women with Graves' disease and their newborns were retrospectively analyzed.Testing indicators included thyroid function tests and TRAb levels during pregnancy,at delivery,and within 2 weeks after birth.The serum TRAb and T_3,T_4,Free T_3,Free T_4,TSH levels were detected by radio receptor assay(RRA) and electrical chemiluminescence immunoassay(ECLIA),respectively. Results:The results showed that serum TRAb levels of the third trimester of pregnancy was positively correlated with that of the umbilical vein(n = 68,r= 0.8494,P<0.01),and that of the newborns(n = 68, r=0.8286,P<0.01).The incidence of neonatal hyperthyroidism was 11.8%(8/68).The serum TRAb levels in the 8 neonates with hyperthyroidism within 2 weeks after birth were 3 times higher than those in the normal neonates.Of these 8 neonates,2 had 15 times higher serum TRAb levels than those of normal neonates within 2 weeks after birth.The thyroid function and TRAb levels of these 2 neonates were still abnormal 6 months later. Conclusions:The risk of hyperthyroidism in newborn whose mother's TRAb levels were high in the third trimester of pregnancy was increased.This study suggests a significant correlation between TRAb levels in pregnant women with Graves' disease and the severity of neonatal hyperthyroidism.展开更多
文摘Introduction: In hyperthyroidism, selective irradiation of the thyroid gland with radioactive iodine is a radical treatment and an alternative to surgery. The aim of this review is to assess the medium-term efficacy of outpatient treatment of hyperthyroidism with iodine-131 in Africa. Methods: We identified the studies carried out in Africa on outpatient radiation therapy between 2016 and 2020. For each article included, we noted the country concerned and the year of publication, the numbers studied, the socio-demographic characteristics of the patients, the indications for radio iodine therapy, the dose administered, the results of the hormonal dosage 6 months after radiation. Results: 13 retrospective studies were included to constitute a total population of 925 patients. The average age was 40.77 years, the sex ratio of 1/5.4 with a clear female predominance. The 3 main etiologies of hyperthyroidism justifying outpatient radio iodine therapy were Graves’ disease (55.89%), toxic multinodular goiter (22.70%) and toxic adenoma (21.40%). The average dose of iodine 131 administered per course is 13.7 mCi. No short-and medium-term complications were reported. The radio iodine therapy was effective in 86.08% (n = 796) of the patients with extremes of 72% and 100%. Conclusion: Radio iodine therapy is effective in Africa. It is simple, inexpensive on an outpatient basis and well tolerated. The introduction of outpatient radio iodine therapy could improve the management of patients with hyperthyroidism in Burkina Faso.
文摘BACKGROUND Lithium carbonate is used to manage various mood disorders,but it can cause thyroid abnormalities,including goiter,hypothyroidism,and hyperthyroidism.In rare cases,it can lead to giant goiter and subclinical hyperthyroidism,which may require surgical intervention in severe cases.CASE SUMMARY This case represents a rare development of giant goiter and subclinical hyperthyroidism in a schizophrenia patient who was subjected to prolonged lithium carbonate treatment.The enlarged thyroid gland caused pressure on the airway and recurrent laryngeal nerve,which led to respiratory distress,hoarseness,and dysphagia.The immediate danger of suffocation required urgent surgical intervention.In this report,we describe the case of a 41-year-old Chinese woman.This sheds light on the etiology and challenges associated with managing a giant goiter.The patient underwent a subtotal thyroidectomy to relieve airway compression and facilitate airway expansion.Prior to the procedure,the patient was given iodine to prepare.Concurrently,changes were made to the psychiatric medication regimen.Following surgery,the patient's respiratory function and vocal cord functionality improved significantly,and her mental state remained stable.CONCLUSION It is essential to monitor thyroid function,test thyroid antibody levels,and perform thyroid ultrasounds consistently in all patients undergoing long-term lithium carbonate treatment.This vigilance helps prevent severe and potentially life-threatening thyroid enlargement.
文摘Lithium treatment is usually indicated in bipolar disorder. It is associated with hypothyroidism and very rarely with hyperthyroidism. We report here the results of the exploration of a case of thyrotoxicosis occurring during treatment with lithium salts. This was a 16-year-old patient with ongoing lithium treatment for two and a half years who presented with a thyrotoxicosis syndrome without a context of iodine overload or an episode of anterior cervical pain that could suggest subacute thyroiditis or orthopathic sign. The assessment of the exploration of this patient reveals biological hyperthyroidism without anti-TSH receptor antibodies, a normal ultrasound, and white scintigraphy which makes it possible to evoke the diagnosis of subacute thyroiditis (absence of the context of iodine overload). Note the interest in a thyroid assessment before and during treatment with lithium salts. Moreover, scintigraphy occupies a place of choice in the exploration of hyperthyroidism, particularly in the context of normal thyroid ultrasound imaging.
文摘Cardiovascular complications during hyperthyroidism are dominated by arrhythmias, heart failure and coronary heart disease. Pericardial effusion which is a common complication of hypothyroidism is extremely rare in hyperthyroidism. We report the case of a 45-year-old woman admitted for management of pleuro-pericarditis associated with atrial fibrillation in the context of cardiothyreosis. The treatment consisted of a pericardial puncture associated with synthetic anti-thyroid drugs and anti-tuberculosis drugs with positive clinical and echocardiographic outcomes.
基金the Clinical Medical Research Center Project of Hainan Province,China,No.LCYX202207Key R&D Plan Project of Hainan Province,China,No.ZDYF2020118.
文摘BACKGROUND Hyperthyroidism often leads to tachycardia,but there are also sporadic reports of hyperthyroidism with severe bradycardia,such as sick sinus syndrome(SSS)and atrioventricular block.These disorders are a challenge for clinicians.CASE SUMMARY We describe three cases of hyperthyroidism with SSS and found 31 similar cases in a PubMed literature search.Through the analysis of these 34 cases,we found 21 cases of atrioventricular block and 13 cases of SSS,with 67.6%of the patients experiencing bradycardia symptoms.After drug treatment,temporary pacemaker implantation,or anti-hyperthyroidism treatment,the bradycardia of 27 patients(79.4%)was relieved,and the median recovery time was 5.5(2-8)d.Only 7 cases(20.6%)needed permanent pacemaker implantation.CONCLUSION Patients with hyperthyroidism should be aware of the risk of severe bradycardia.In most cases,drug treatment or temporary pacemaker placement is recommended for initial treatment.If the bradycardia does not improve after 1 wk,a permanent pacemaker should be implanted.
基金supported by the National Key R&D Program of China(Grant No.2022YFF0801703)the State Key Laboratory of Earth Surface Processes and Resource Ecology(Grant No.2022-GS-01)in China.
文摘Cold surges(CSs)often occur in the mid-latitude regions of the Northern Hemisphere and have enormous effects on socioeconomic development.We report that the occurrences of CSs and persistent CSs(PCSs)have rebounded since the 1990s,but the trends related to the frequencies of strong CSs(SCSs)and extreme CSs(ECSs)changed from increasing to decreasing after 2000.The highest-ranked model ensemble approach was used to project the occurrences of various CSs under the SSP1-2.6,SSP2-4.5,and SSP5-8.5 scenarios.The frequencies of the total CSs show overall decreasing trends.However,under the SSP1-2.6 scenario,slight increasing trends are noted for SCSs and ECSs in China.Atmospheric circulations that are characterized by an anomalous anticyclonic circulation with a significantly positive 500-hPa geopotential height(Z500)anomaly at high latitudes along with significant negative anomalies in China were favorable for cold air intrusions into China.In addition,the frequencies of all CS types under the SPP5-8.5 scenario greatly decreased in the long term(2071-2100),a finding which is thought to be related to negative SST anomalies in the central and western North Pacific,differences in sea level pressure(SLP)between high-and mid-latitude regions,and a weaker East Asian trough.In terms of ECSs,the decreasing trends observed during the historical period were maintained until 2024 under the SSP1-2.6 scenario.Compared to the SSP1-2.6 scenario,the Z500 pattern showed a trend of strengthened ridges over the Ural region and northern East Asia and weakened troughs over Siberia(60°-90°E)under the SSP2-4.5 and SSP5-8.5 scenarios,contributing to the shift to increasing trends of ECSs after 2014.
基金supported by four funds,including the National Key Research and Development Program of China(No.2022YFC3106102)the Marine Science and Technology Innovation Project of Jiangsu Province(Nos.JSZRH YKJ202105,JSZRHYKI202303)+1 种基金the Nantong Social and Livelihood Science and Technology Project(Nos.MS12022009,MS22022082,MS22022083)the Project on Excellent Post-Graduate Dissertation of Hohai University(No.422003470).
文摘Climate change affects the activity of global and regional tropical cyclones(TCs).Among all TCs,typical super typhoons(STYs)are particularly devastating because they maintain their intensity when landing on the coast and thus cause casualties,economic losses,and environmental damage.Using a 3D tidal model,we reconstructed the typhoon(TY)wind field to simulate the storm surge induced by typical STYs.The TY activity was then analyzed using historical data.Results showed a downtrend of varying degrees in the annual frequency of STYs and TCs in the Western North Pacific(WNP)Basin,with a significant trend change observed for TCs from 1949 to 2021.A large difference in the interannual change in frequency was found between STYs and TCs in the WNP and Eastern China Sea(ECS).Along the coast of EC,the frequency of landfall TCs showed a weak downtrend,and the typical STYs showed reverse micro growth with peak activity in August.Zhejiang,Fujian,and Taiwan were highly vulnerable to the frontal hits of typical STYs.Affected by climate change,the average lifetime maximum intensity(LMI)locations and landfall locations of typical STYs in the ECS basin showed a significant poleward migration trend.In addition,the annual average LMI and accumulated cyclone energy showed an uptrend,indicating the increasing severity of the disaster risk.Affected by the typical STY activity in the ECS,the maximum storm surge area also showed poleward migration,and the coast of North China faced potential growth in high storm surge risks.
文摘From July 1976 to Oct. 1993, propranolol war used to prepare 154 thyrotoxic patients including 95 severe cases. The initial dose of propranolol was gradually increased to 160 mg/d and Lngol's solution war added in for 10-14 days after the pulse rate had become stable. Just before operation another dose of propranolol was given, and propranolol intake war resumed within 6-8 hours after operation. The thyrotoxic symptonis were controlled The postoperative course in 144 cases was uneventful. High fever and tachycardia developed in 7 patients with severe thyrotoxicosis and were controlled by intravenous hydrocortisone and increased dosape of propranolol. Only one case developed hypaplycemia 12 hours after operation. Our study demonstrated that propranolol combined with iodine is a safe method for preoperative treatment in hyperthyroidism. Although there was no thyroid crisis, we do not recommend propranolol alone as the routine preparation for severe thyrotoxicosis. Preparation with antithyroid drugs is the method of choice if the patient can tolerate.
基金Hainan Province Major Science and Technology Plan Projects(No.ZDKJ2021037,ZDKJ2017007)National Natural Science Foundation of China(No.81960283),and Co-funded by the Hainan Provincial Academician Innovation Platform Research Project and the Hainan Provincial Clinical Medicine Center Construction Project。
文摘The gonadotropin-releasing hormone (GnRH) antagonist protocol has emerged as an efficacious alternative to the GnRH agonist protocol for controlled ovarian hyperstimulation (COH) during in vitro fertilization (IVF) cycles, and has been demonstrated applicability in infertile female patients with diverse ovarian responses. While the clinical implementation of the antagonist COH protocol has achieved widespread consensus, opportunities for refinement persist. Therefore, this review article focuses on the advantages and disadvantages of GnRH antagonist protocol, the selection of optimal standard doses, and the strategies for adjusting antagonist doses after the premature luteinizing hormone (LH) surge, aiming to provide more reasonable and scientific recommendations for the application of this scheme.
基金The National Natural Science Foundation of China under contract No.42076214.
文摘Storm surge is often the marine disaster that poses the greatest threat to life and property in coastal areas.Accurate and timely issuance of storm surge warnings to take appropriate countermeasures is an important means to reduce storm surge-related losses.Storm surge numerical models are important for storm surge forecasting.To further improve the performance of the storm surge forecast models,we developed a numerical storm surge forecast model based on an unstructured spherical centroidal Voronoi tessellation(SCVT)grid.The model is based on shallow water equations in vector-invariant form,and is discretized by Arakawa C grid.The SCVT grid can not only better describe the coastline information but also avoid rigid transitions,and it has a better global consistency by generating high-resolution grids in the key areas through transition refinement.In addition,the simulation speed of the model is accelerated by using the openACC-based GPU acceleration technology to meet the timeliness requirements of operational ensemble forecast.It only takes 37 s to simulate a day in the coastal waters of China.The newly developed storm surge model was applied to simulate typhoon-induced storm surges in the coastal waters of China.The hindcast experiments on the selected representative typhoon-induced storm surge processes indicate that the model can reasonably simulate the distribution characteristics of storm surges.The simulated maximum storm surges and their occurrence times are consistent with the observed data at the representative tide gauge stations,and the mean absolute errors are 3.5 cm and 0.6 h respectively,showing high accuracy and application prospects.
文摘The concept of a virtual human is rapidly fermenting with the boom of the metaverse in 2020.In March 2021,Roblox,a game company focusing on the socialization of teenagers’games and the free realization of UGC,went public.In its prospectus,Roblox is defined as the concept of the metaverse.Under this background,as the direct embodiment of“virtual identity”and“virtual reality coexisting”under the concept of the metaverse,the emerging definition of virtual human and its representative virtual image has gradually caught the attention of the public.
基金supported by the National Natural Science Foundation of China(42293261)projects of the China Geological Survey(DD20230091,DD20189506,DD20211301)+1 种基金the 2024 Qinhuangdao City level Science and Technology Plan Self-Financing Project(Research on data processing methods for wave buoys in nearshore waters)the project of Hebei University of Environmental Engineering(GCZ202301)。
文摘The future inundation by storm surge on coastal areas are currently ill-defined.With increasing global sealevel due to climate change,the coastal flooding by storm surge is more and more frequently,especially in coastal lowland with land subsidence.Therefore,the risk assessment of such inundation for these areas is of great significance for the sustainable socio-economic development.In this paper,the authors use Elevation-Area method and Regional Ocean Model System(ROMS)model to assess the risk of the inundation of Bohai Bay by storm surge.The simulation results of Elevation-Area method show that either a 50-year or 100-year storm surge can inundate coastal areas exceeding 8000 km^(2);the numerical simulation results based on hydrodynamics,considering ground friction and duration of the storm surge high water,show that a 50-year or 100-year storm surge can only inundate an area of over 2000 km^(2),which is far less than 8000 km^(2);while,when taking into account the land subsidence and sea level rise,the very inundation range will rapidly increase by 2050 and 2100.The storm surge will greatly impact the coastal area within about 10-30 km of the Bohai Bay,in where almost all major coastal projects are located.The prompt response to flood disaster due to storm surge is urgently needed,for which five suggestions have been proposed based on the geological background of Bohai Bay.This study may offer insight into the development of the response and adaptive plans for flooding disasters caused by storm surge.
文摘One of the viral terms on Chinese social media these days-“city bu city”–was actually created by a foreign tourist.The tourist,a blogger,used the term,which literally means city or not city,in a short video he filmed while visiting the Great Wall,wondering whether the place is like a fashionable big city.
基金supported by Independent Innovation Fund of Huazhong University of Science and Technology for Clinical Skills,China(No.2015-01-18-53028)
文摘Summary： Intraventricular hydrodynamics is considered an important component of cardiac function assessment. Vector flow mapping （VFM） is a novel flow visualization method to describe cardiac pathophysiological condition. This study examined use of new VFM and flow field for assessment of left ventricular （LV） systolic hemodynamics in patients with simple hyperthyroidism （HT）. Thirty-seven simple HT patients were enrolled as HT group, and 38 gender- and age-matched healthy volunteers as control group. VFM model was used to analyze LV flow field at LV apical long-axis view. The follow- ing flow parameters were measured, including peak systolic velocity （Vs）, peak systolic flow （Fs）, total systolic negative flow （SQ） in LV basal, middle and apical level, velocity gradient from the apex to the aortic valve （AV）, and velocity according to half distance （V1/2）. The velocity vector in the LV cavity, stream line and vortex distribution in the two groups were observed. The results showed that there were no significant differences in the conventional parameters such as left ventricular ejection fraction （LVEF）, left ventricular end-diastolic diameter （LVEDD） and left atrium diameter （LAD） between HT group and control group （P〉0.05）. Compared with the control group, a brighter flow and more vortexes were detected in HT group. Non-uniform distribution occurred in the LV flow field, and the stream lines were discontinuous in HT group. The values of Vs and Fs in three levels, SQ in middle and basal levels, AV and V1/2 were higher in HT group than in control group （P〈0.01）. AV was positively correlated with serum free thyroxin （FT4） （r=0.48, P〈0.01）. Stepwise multiple regression analysis showed that LVEDD, FT4, and body surface area （BSA） were the influence factors of △V. The unstable left ventricular sys- tolic hydrodynamics increased in a compensatory manner in simple PIT patients. The present study in- dicated that VFM may be used for early detection of abnormal ventricle contraction in clinical settings.
文摘BACKGROUND Severe hyperthyroidism is a life-threatening exacerbation of thyrotoxicosis,characterized by high fever and multiorgan failure. The most common medical treatments are administration of antithyroid drugs and radioactive iodine, and thyroidectomy. In some patients, antithyroid therapy is limited due to serious adverse effects or failure to control disease progression. In some extreme cases,such as thyroid storm, conventional therapy alone does not yield effective and rapid improvement before the development of multiorgan failure.CASE SUMMARY This report describes a Chinese patient with severe hyperthyroidism accompanied by multiorgan failure, who was transferred to the medical intensive care unit of our hospital. The patient presented with palpitations, vomiting,diarrhea, and shortness of breath for a week. Laboratory tests showed elevation of thyroid hormones. Hepatic failure occurred with high aminotransferase levels and jaundice. Given her abnormal liver function and medication history, we could not exclude diagnosis of propylthiouracil-induced hepatic failure.Moreover, she also suffered from heart failure. Therapeutic plasma exchange(commonly known as TPE) and continuous renal replacement therapy(commonly known as CRRT) were used as life-saving therapy, which resulted in notable improvement of clinical symptoms and laboratory tests.CONCLUSION Combined TPE and CRRT are safe and effective for patients with hyperthyroidism and multiorgan failure.
文摘BACKGROUND Alström syndrome(AS,OMIM ID 203800)is a rare disease involving multiple organs in children and is mostly reported in non-Chinese patients.In the Chinese population,there are few reports on the clinical manifestations and pathogenesis of AS.This is the first report on the association between AS and Graves’hyperthyroidism.CASE SUMMARY An 8-year-old Chinese girl was diagnosed with AS.Two years later,Graves’hyperthyroidism developed with progressive liver dysfunction.The patient’s clinical data were collected;DNA from peripheral blood of the proband,parents and sibling was collected for gene mutation detection using the second-generation sequencing method and gene panel for diabetes.The association between the patient’s genotype and clinical phenotype was analyzed.She carried the pathogenic compound heterozygous mutation of ALMS1(c.2296_2299del4 and c.11460C>A).These stop-gain mutations likely caused truncation of the ALMS1 protein.CONCLUSION The manifestation of hyperthyroidism may suggest rapid progression of AS.
基金supported by a fund from the Key Project of Natural Science Foundation of Tianjin [16JCZDJC36100]Medical and Health Technology Innovation Project of the Chinese Academy of Medical Sciences [2017-I2M-1-016]+2 种基金Fundamental Research Funds for the Central Universities [3332018116]PUMC Youth Fund [3332015101]Fundamental Research Funds for CAMS&PUMC [2016ZX310074]
文摘Hyperthyroidism refers to a clinical state that results from inappropriately hight hyroid hormone levels in the tissues;.Ⅰ-131 therapy plays a critical role and provides a remarkable curative effect in targeting thyroid diseases. Thyroid cells can take up isotope I-131, which emits not only beta rays but also
文摘The study was to evaluate factors affecting outcome of 131I therapy in hyperthyroidism for optimizing the method. Data from 213 patients who received 131I treatment from July 2003 to July 2005 in our department were retrospectively analyzed. Factors possibly contributing to the outcome of the 131I therapy were analyzed, including gen-der, age, history of antithyroid drug, thyroid volume, duration of disease and radioactive iodine uptake rate. Multivariate analysis was done. The rates of euthyroidism and hypothyroidism were 69% and 8.5%, respectively, after one time 131I therapy. Multivariate analysis of the patients showed no statistically significant factors affecting the outcome of 131I therapy. The study showed that 131I dose can be directly calculated, and this simplifies the dose-determined method and individualizes the therapy.
文摘Objective:To investigate the clinical significance of serum thyroid stimulating hormone(TSH) receptor antibody(TRAb) levels in pregnant women with Graves'disease,on neonatal hyperthyroidism. Methods:The clinical data of 68 pregnant women with Graves' disease and their newborns were retrospectively analyzed.Testing indicators included thyroid function tests and TRAb levels during pregnancy,at delivery,and within 2 weeks after birth.The serum TRAb and T_3,T_4,Free T_3,Free T_4,TSH levels were detected by radio receptor assay(RRA) and electrical chemiluminescence immunoassay(ECLIA),respectively. Results:The results showed that serum TRAb levels of the third trimester of pregnancy was positively correlated with that of the umbilical vein(n = 68,r= 0.8494,P<0.01),and that of the newborns(n = 68, r=0.8286,P<0.01).The incidence of neonatal hyperthyroidism was 11.8%(8/68).The serum TRAb levels in the 8 neonates with hyperthyroidism within 2 weeks after birth were 3 times higher than those in the normal neonates.Of these 8 neonates,2 had 15 times higher serum TRAb levels than those of normal neonates within 2 weeks after birth.The thyroid function and TRAb levels of these 2 neonates were still abnormal 6 months later. Conclusions:The risk of hyperthyroidism in newborn whose mother's TRAb levels were high in the third trimester of pregnancy was increased.This study suggests a significant correlation between TRAb levels in pregnant women with Graves' disease and the severity of neonatal hyperthyroidism.
