Thyroid stimulating hormone receptor(TSHR) is thought to be a significant candidate for genetic susceptibility to Graves' disease(GD).However,the association between TSHR gene polymorphism and the risk of GD remains controversial.In this study,we investigated the relationship between the two conditions by meta-analysis.We searched all relevant case-control studies in PubMed,Web of Science,CNKI and Wanfang for literature available until May2015,and chose studies on two single nucleotide polymorphisms(SNPs):rs 179247 and rsl2101255,within TSHR intron-1.Bias of heterogeneity test among studies was determined by the fixed or random effect pooled measure,and publication bias was examined by modified Begg's and Egger's test.Eight eligible studies with 15 outcomes were involved in this meta-analysis,including 6,976 GD cases and 7,089 controls from China,Japan,Poland,UK and Brazil.Pooled odds ratios(ORs) for allelic comparisons showed that both TSHR rsl79247A/G and rsl2101255T/C polymorphism had significant association with GD(OR=1.422,95%CI=1.353—1.495,P〈0.001,P_(heterogeneity)=0.448;OR= 1.502,95%CI:1.410-1.600,P〈0.001,P_(heterogeneity)=0.642),and the associations were the same under dominant,recessive and co-dominant models.In subgroup analyses,the conclusions are also consistent with all those in Asian,European and South America subgroups(P〈0.001).Our meta-analysis revealed a significant association between TSHR rsl79247A/G and rsl2101255T/C polymorphism with GD in five different populations from Asia,Europe and South America.Further studies are needed in other ethnic backgrounds to independently confirm our findings.
Wei QianKuanfeng XuWenting JiaLing LanXuqin ZhengXueyang YangDai Cui
目的 :探讨超声引导下注射硬化剂聚桂醇治疗甲状腺囊肿的临床疗效及安全性。方法 :采用超声引导经皮穿刺囊腔内注射聚桂醇,治疗甲状腺囊肿共78例。治疗前所有囊肿均接受甲状腺穿刺及细胞病理学检查,以排除恶性病变。治疗时尽量将囊液抽吸净,然后注入约1/3囊腔容积量的聚桂醇进行硬化治疗,每周1次,根据囊肿的缩小情况,共治疗1-4次。结果:178例囊肿共进行166次硬化治疗,3个月后囊肿容积平均缩小71.6%±35.3%,与治疗前相比有显著差异(P〈0.01);治疗总有效率84.6%(66/78),治愈率52.6%(41/78);2不同容积大小的囊肿治愈率有统计学差异(P〈0.01),容积〉5 m L的囊肿治愈率显著高于容积〈5 m L者(P〈0.01),但不同容积囊肿的治疗有效率无统计学差异(P〉0.05);3治疗前后患者甲状腺功能及甲状腺相关抗体滴度无显著变化;4治疗的并发症发生率低,无严重不良反应。结论:超声引导下注射聚桂醇治疗甲状腺囊性病变简单易行、临床效果好,不良反应少,可作为甲状腺囊肿的首选治疗方法之一。