Maternal hypothyroidism can cause adverse outcomes for both the pregnancy and fetus, and may affect intelligence quotient of the offspring. This article reviews mainly the diagnosis and treatment of maternal hypothyroidism.

Studies from clinical observation and animal experiments have indicated that maternal subclinical hypothyroidism during the first gestational term may lead to impairment of brain development of offspring, and early diagnosis and effective treatment may prevent the damage. Therefore, we suggest that it is pertinent to screen thyroid function before gestational 8 weeks in pregnant women, especially for those who have risk factors of thyroid diseases. We also suggest that maternal subclinical hypothyroidism should be treated with levo-thyroxine ( L-T4 ) before 12 gestational weeks. Thyroid function should be measured regularly in order to adjust the dosage of L-T4 and reach the goal of treatment on time, so as to protect the brain development of fetus and offspring.

[Summary] We investigated a 12-year-old girl with elevated serum FT3 , FT4 , and TSH levels. The sequence of thyroid hormone receptorβ( TRβ) exons revealed a CCT→ACT transition mutation at nucleotide 453 site within exon10,whichresultedinthesubstitutionofcytosinetoadenosinein(P453T). Pituitarymagneticresonanceimage showed a pituitary micoradenoma. The patient underwent transsphenoidal pituitary adenomectomy. Pathological results exhibited positive TSH-β, GH, prolactin, ACTH, and α-HCG staining for the tumor. This is the first case report with thyroid hormone resistance syndrome and thyrotropin-secreting adenoma.

Objective　To study the effects of prolactin on interactions between Graves′ disease (GD) thyrocytes and autologous peripheral blood mononuclear cells (PBMC) in coculture. Methods　Primary thyrocytes and autologous PBMC were cocultured at various levels of ovine prolactin (oPRL) in vitro. The activation and proliferation of PBMC as well as HLA-DR and CD40 expressions on thyrocytes were determined by immunofluorescent staining and flow cytometry. Results　 With PBMC in GD cocultures, oPRL caused significant increase in the percentage of CD4+CD25+ cells at 200 μg/L ［(13.08±2.54)%, P＜0.01］ and in the proliferative index at 200 μg/L ［(17.82±3.02)%, P＜0.01］ and 1 000 μg/L ［(16.57±2.56)%, P＜0.05］, but not at 12.5 μg/L ［(10.43±2.38)% and (14.08±2.67)%, respectively］ or 50 μg/L ［(9.94±2.54)% and (14.56±2.80)%, respectively)］. The values at 200 or 1 000 μg/L as above were also significantly different from those at 12.5 or 50 μg/L. The percentage of CD40+ cells ［(48.25± 6.63)%，(52.28±6.94)%］ and delta mean fluorescence intensity (dMF; 42.94±10.24，49.51±12.34) were significantly lower in thyrocytes in GD cocultures treated with 200 or 1 000 μg/L oPRL than those untreated ［(58.38±6.62)% and 67.30±20.20］ or treated with two other concentrations of oPRL. The percentage of HLA-DR+ cells ［(46.79±7.51)%, P＜0.01］ and dMF (21.02±5.43, P＜0.01) were significantly higher in the thyrocytes treated with 50 μg/L oPRL than those untreated ［(33.51±8.58)% and 13.91±3.88］ or treated with three other concentrations. There were no significant differences between the dose groups of oPRL but those mentioned above. Conclusions　Prolactin could affect interactions between GD PBMC and autologous thyrocytes and might eventually influence the shift of helper T cells. High prolactin levels might aggravate GD.

Objective To investigate the epidemiology of hyperthyroidism in three rural communities with different iodine intake after universal salt iodization (USI) since 1996 as well as the influence of USI on the incidence of hyperthyroidism. Methods Inhabitants in Panshan community did not take iodized salt whereas inhabitants in Zhangwu and Huanghua communities have taken iodized salt since 1996. The thyroid function, thyroid autoantibodies, urinary iodine concentration and thyroid B ultrasound were performed in 1103, 1584 and 1074 subjects respectively in the three communities and the number of hyperthyroidism patients between 1991 and 1999 was collected to calculate the yearly average incidence of hyperthyroidism. Results The median urinary iodine concentrations in Panshan, Zhangwu and Huanghua were 103 ?g/L, 375 ?g/L and 615 ?g/L, respectively (P0.05) andtheprevalenceofsubclinicalhyperthyroidism was 3.7%, 3.9% and 1.1%, respectively. Comparing the yearly average incidence of hyperthyroidism of 1996～1999 with that of 1991～1995, a significant increased incidence in Panshan, while a slight but insignificant elevated one in Zhangwu and a fixed one in Huanghua were found. Conclusion USI can not result in a raise of the prevalence of active hyperthyroidism as well as subclinical hyperthyroidism. The increase of iodine intake is not the only explanation for the raising of the incidence of hyperthyroidism.

Objective To evaluate the association between maternal thyroid diseases in the first trimester of pregnancy and obstetric complications.Methods A total of 2 517 pregnant women from 10 hospitals in Shenyang during the first 12 weeks of gestation were enrolled in this study.All sera obtained from pregnant women were measured for thyroid-stimulating hormone (TSH),free thyroxine ( FT4 ),and thyroid peroxidase antibody (TPOAb).Collected items include obstetric outcomes and complications.Results Serum TSH above 2.5 mlU/L during the first trimester of pregnancy increased the rate of spontaneous abortion ( 8.69％ vs 6.38％,P =0.048 ),even if subclinical hypothyroidism (9.50％ vs 6.38％,P =0.009).TSH above the gestational special reference range,passive smoking,and over 30 years were independent factors for increasing the rate of spontaneous abortion.Hyperthyroidism and hypothyroidism with drug treatment to maintain normal thyroid function during pregnancy reduced the incidence of spontaneous abortion.Increased or decreased levels of serum TSH and TPOAb(+) were not related with other obstetric complications.Conclusion Serum TSH above the gestational special reference range during the first trimester of pregnancy is a risk factor of spontaneous abortion; maintaining TSH within the normal range by treating hyperthyroidism or hypothyroidism may reduce spontaneous abortion rate.

Objective To analyse the differential expression of miRNAs in the brain of offsprings of hypothyroid and normal rats,and to explore the molecular mechanism underlying the effect of hypothyroidism on brain development in the offspring.Methods Forty-eight female Wistar rats were assigned to (1) control group (n =24),and (2) hypothyroid group after complete thyroidectomy (n =24).Serum TSH and Total thyroxine (T4) were measured one month after the surgery.Brain samples of fetal or postnatal rats were obtained during four different developmental stages:embryonic days (E) 13,E17,postnatal days (P) 0 and P7.The hippocampus and cortex were separated on P7.MiRNAs were isolated from tissues and two samples were used at each time point studied to reduce the influence of individual differences.The brain samples were detected by Gene Chip miRNA arrays (Affymetrix).Results In the brain tissues of fetal or neonatal rats of maternal hypothyroid rats,two miRNAs (mir-206,-324-5p) on E13,three miRNAs (mir-34c,-204,-194) in cortex on P7,and five miRNAs (mir-146b,-532-5p,-384-5p,-215,-212) in hippocampus on P7 were up-regulated by over 2 folds.Five miRNAs (mir-200b,-200c,-217,-672,-139-5p) on E17,one miRNA (mir-376-3p) on P0,and four miRNA (mir-672,-204,-335,-376-3p) in hippocampus on P7 were decreased by 50％ or more.Conclusion The miRNA expression profiles in the rat brain of offspring with maternal hypothyroidism are characterized by miRNA arrays.The identification of a subset of brain expressed miRNAs in the brain may explain the brain development abnormalities resulting from maternal hypothyroidism.

A total of 3 431 subjects aged 18 years or over from Liaoning province were involved in this study.The prevalence of metabolic syndrome(MS) was 19.50%,being 19.79% in men and 18.44% in women, according to the standard of Chinese Diabetes Society in 2004.Villages had the highest prevalence of MS in women,while cities had the lowest;towns had the highest prevalence of MS in men,while villages had the lowest.The prevalence of MS was increased with both aging and income.The peak of MS is turning to the developing district.

Pharmacological method state is a method to explain the principle of Chinese herb according to its external phenomenon such as shape, color, texture, features, and so on. The natural attribute of Chinese herb include shape, color, texture, smell, harvesting time, medicinal parts, chemical components, and so on. Though both of them have different key points, the natural attribute of Chinese herb can also be used to explain its medicinal mechanism. Therefore, the correlation research between pharmacological method state and the natural attribute of Chinese herb has some significance.
Biomedical Research ; Drugs, Chinese Herbal ; pharmacology

ObjectiveTo investigate the effects of maternal rat with marginal iodine deficiency on the nerve and intelligence development in its offspring and the related mechanisms.MethodsThe rat model of marginal iodine deficiency was established on the basis of epidemiological characteristics and iodine metabolism characteristics of rats reported in literatures.Marginal iodine deficiency rats were given 3 μg iodine a day ; normal control rats were given 4 μg iodine daily ; iodine deficiency rats were given 1.2 μg iodine daily,respectively.Western blot was used to detect the protein levels of brain derived neurophic factor (BDNF) and early growth response factor 1 ( EGR1 ) in the hippocampus of 7 days newborn rats.Immunohistochemistry was used to measure c-jun and c-fos expressions in the hippocampal CA1 region of 40 days rats.Water maze method was used to measure the ability of learning and spatial memory.Results FT4 level in rats of marginal iodine deficiency group during pregnancy decreased by about 30％.Seven days after birth,the contents of EGR1 and BDNF proteins in the hippocampus of the offspring from marginal iodine deficiency group were significantly decreased compared with normal control group (both P ＜ 0.05 ).Forty-day-old newborn rats in marginal iodine deficiency group also showed significantly decreased c-jun and c-fos expressions in the hippocampal CA1 region ( both P＜0.05 ),along with a decreased trend of spatial learning and memory ability.Conclusions FT4 level will significantly decrease after pregnancy if rats have marginal iodine deficiency,affecting the expression of related proteins in the brain of newborn rats and having a negative impact on offspring brain development.