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Background: Serum human chorionic gonadotrophin (hCG) is higher in twin than that in singleton pregnancies. As hCG stimulates the thyroid to produce more free thyroxine (FT4), which may lead to decreased thyroid-stimulating hormone (TSH) levels, the reference ranges of thyroid-related indicators may differ between singleton and twin pregnancies in the first trimester. This study aimed to establish reference ranges for thyroid-related indicators in early twin pregnancies and to compare them with singleton pregnancies. Methods: Data of 820 twin-pregnant women were extracted from the established database of all pregnant women who delivered at Peking University First Hospital from October 2013 to May 2018; 160 who met National Academy of Clinical Biochemistry criteria were included to establish TSH and FT4 reference ranges. We screened 480 (3:1 paired) women with singleton pregnancies from the same database as controls. The Mann-Whitney test for TSH and FT4 levels was applied for comparisons between singleton and twin pregnancies. Results: First-trimester reference ranges (4–12 gestational weeks) for twin pregnancies were: TSH 0.69 (0.01–3.35) mIU/L and FT4 16.38 (12.45–23.34) pmol/L. Median TSH was significantly lower at 7 to 12 gestational weeks than that at 4 to 6 gestational weeks (0.62 vs. 0.96 mIU/L, Z = -1.964, P = 0.049); FT4 was not significantly different between the two groups. Compared to singleton pregnancies, median TSH was significantly lower (0.69 vs. 1.27 mIU/L, Z = -6.538, P = 0.000), and FT4 was significantly higher (16.38 vs. 14.85 pmol/L, Z = -7.399, P = 0.000) in twin pregnancies in the first trimester. Conclusions: Specific reference ranges for thyroid-related indicators for twin pregnancies are needed to avoid a misdiagnosis of thyroid dysfunction. Moreover, establishment of separate reference ranges for 4 to 6 and 7 to 12 gestational weeks in twin pregnancies may be considered. Key words: Twin pregnancy; Reference ranges; Thyroid-stimulating hormone; Free thyroxine

The gestational diabetes mellitus (GDM) diagnostic criteria recommended by the International Association of Diabetes and Pregnancy Study Group (IADPSG) were established based on the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study and have been the most commonly used criteria for determining GDM worldwide. Although individuals from mainland China were not included in the HAPO study, the IADPSG criteria have been used in China since 2011. However, the appropriateness of the criteria for evaluating maternal postpartum outcomes in mainland China are unknown. We conducted this study to determine whether the IADPSG criteria are appropriate for Chinese patients for evaluating long-term maternal postpartum outcomes. Eighty-four patients who were diagnosed with hyperglycemia during pregnancy and had delivery in Peking University First Hospital from February 2007 to December 2009 were enrolled in the study. For patients in Group A, GDM was diagnosed using both the National Diabetes Data Group (NDDG) and the IADPSG criteria, while patients in Group B, gestational impaired glucose tolerance (GIGT) was diagnosed using the NDDG criteria while GDM was diagnosed based on the IADPSG criteria. Anthropometric data, glucose metabolism, lipid profiles, β cell function, and insulin resistance index were evaluated and compared to baseline after 5- to 6-year postpartum period. Patients in group A had significantly higher oral glucose tolerance test (OGTT) fasting, 2-hour and 3-hour plasma glucose levels compared to patients in group B at 24 to 28 weeks of gestation (P

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Objective The study aims to investigate relationships between demands for breast and cervical cancer screening (BCS/CCS) and related health beliefs. Methods The study used cluster-randomized sampling and collected data about demands for BCS/CCS and constructs of health beliefs model (HBM). It calculated indices of perceived risk and seriousness of the cancers and perceived effectiveness, benefits and difficulties of the screening; and performed descriptive and multivariate regression analysis of the demands and the HBM constructs. Results Less than 23.7% of respondents (N = 805) had ever undertaken BCS/CCS but 62.7% reported willingness to receive the service. Demands for BCS/CCS illustrated negative associations (Beta = −0.11 and −0.10) with age but positive (Beta = 0.15 and 0.11) links with education. The absolute values of standardized regression coefficients between the demand and the HBM constructs added up to 0.69 for BCS and 0.64 for CCS respectively, being 4–40 times that of age and education. Conclusions Models incorporating all HBM constructs have substantially greater power than commonly researched single factors in explaining BCS/CCS demands. Practice implications Comprehensive BCS/CCS promotion addressing all HBM constructs in a synergetic way may prove to be more effective.

Rationale: Ectopic adrenal tissue is the adrenal rests along the path from gonads to adrenal glands during embryogenesis. Ectopic adrenocortical adenoma is a rare disease represented with over-production of cortisol by the ectopic adrenocortical tissue. Patient concerns: An 18-year-old Chinese female patient was presented with weight-gain for 6 months. She had elevated plasma cortisol and a solitary mass was revealed using computed tomography scan in the left renal hilum. Diagnosis: The tumor was removed and the immunohistochemical profile indicated an ectopic adrenocortical adenoma. Interventions: After the tumor was removed, the patient was under glucocorticoid replacement therapy in 6-month. Outcomes: During 6-month of follow-up, the patient showed no signs of tumor recurrence. Lessons: Ectopic adrenocortical adenoma is difficult to diagnose due to its low incidence, and the ectopic rests in renal hilum could be misdiagnosed as renal cell carcinoma. This case reminds clinicians to be aware of ectopic site in the diagnosis of adrenocorticotropic hormone (ACTH) independent Cushing's syndrome. Immunohistochemical stain may assist in evaluating the origin of the ectopic rests. A certain rate of local recurrence indicated the need of long-term follow-up.

Many environmental and genetic factors have been contributed to the development of systemic sclerosis (SSc). To determine whether IL-10 gene polymorphisms are associated with SSc, we conducted a meta-analysis approach. A total of eight studies involving 1,034 SSc cases and 1,815 controls were obtained by electronic database, i.e. Embase, Blackwell, Scopus, China National Knowledge Infrastructure database, Chinese Biomedical database, Google searching. We analyzed three gene polymorphisms, including IL-10 -1082G/A (rs1800896), IL-10 -819C/T (rs1800871), IL-10 -3575T/A (rs1800890). The combined odds ratio (OR) with its 95% confidence interval (95% CI) was calculated using fixed or random effect models. We found that IL-10 819C allele might contribute to SSc susceptibility by fixed effect model and IL-10 3575A allele could be an important risk factor for SSc, especially in European descent. No significant heterogeneity were observed. Under random effect model, there was no evidence of statistically significant association between IL-10 1082G/A polymorphism and SSc. Publication bias was absent in all analyses. However, larger scale primary studies are required to further evaluate the IL-10 polymorphism and SSc.

Relationship of prostate cancer with the polymorphism of p53 codon 72 was reported with inconsistent results. The purpose of this study was to quantitatively evaluate the association between p53 codon 72 polymorphism and prostate cancer susceptibility. We performed an extensive search of relevant studies and made a meta-analysis, including 8 studies with 815 prostate cancer cases and 1047 controls. The combined results showed that there were no significant differences in genotype distribution between prostate cancer cases and control on the basis of all studies, CC/GC versus GG (OR = 1.24, 95% CI: 0.93-1.65), GG/GC versus CC (OR = 0.96, 95% CI: 0.60-1.55), GC versus GG (OR = 1.27, 95% CI: 0.91-1.77), CC versus GG (OR = 1.25, 95% CI:0.74-2.12), GC versus CC (OR = 1.09, 95% CI: 0.63-1.87). When stratifying for the race, there were also no statistically significant differences in genotype distribution between prostate cancer cases and controls. This meta-analysis did not provide an evidence of confirming association between p53 codon 72 polymorphism and prostate cancer.

Two new compounds, 1,3-bis(m-carboxylphenyl)-propan-2-one (1) and 2-(m-carboxylphenyl)-3-(m-carboxylbenzyl) succinic acid (2), were isolated from the barks of Cerbera manghas, and their structures were established on the basis of spectroscopic methods.

In this paper, we create an integral-rotation linear-strain model (IRLSM) for the Philippine Sea plate (PHIL) on the basis of the ITRF2000 velocities of 7 sites on the PHIL. Our study indicates that the current-day tectonic motion of PHIL is a clockwise rotation, which is consistent with the rotational direction estimated by NNR-NUVEL-1A, but largely different from the rotational pole position and angle velocity of NNR-NUVEL-1A. Our model can uniformly and accurately describe the current tectonic movement and interior deformation of PHIL as compared with Sella's rigid motion model (RMM). There is an intensive deformation-strain field within the PHIL and there is consistent eastward deformation on the plate. The deformation rate is small near the central tectonic line and large near the eastern and western boundaries, small at the southern and northern ends and large in the central part. The eastward deformation rate on the Mariana Arc is as large as 48.4mm/a. The NS-trending deformation on the plate differs evidently in the eastern and western parts with a very small rate in the eastern part and a larger rate near the Manila Trench in the western part. The northward deformation rate at the north end is 11.3mm/a and the southward deformation rate at the south end is 29.3mm/a. The principal strain field is divided into the eastern and western areas from the central tectonic line. In the eastern area, the tensile strain is very intensive, while the compressive strain is very weak. The principal tensile strain is in near-EW direction, the principal tensile and compressive strain rates increase gradually from the central tectonic line to the east, and the principal tensile strain rate reaches the highest value of 8.58×10−8/a near the southeast boundary (148°E, 15°N). In the western area, the principal compressive strain is very strong in a direction of NW-SE, while the principal tensile strain is rather weak. From the central tectonic line to the west, the principal compressive and tensile strain rates increase gradually and the principal compressive strain rate reaches the maximum value of 5.71×10−8/a near the northwest boundary (122°E, 23°N). Closely related to the intraplate and surrounding tectonic settings, the spatial variation of deformation-strain field of PHIL can be considered as a reflection of tectonic stress field.

Two new phenylpropionic acid derivates, cerberic acids A ( 1 ) and B ( 2 ), were isolated from the bark of Cerbera manghas . Their structures were established on the basis of spectroscopic methods including IR, ESI-FT-ICR-MS, 1D and 2D NMR. Primary bioassays showed that compound 1 possessed weak cytotoxic activity against HepG2, MCF-7, and HeLa cell lines with IC 50 values of 44.7, 52.3, 48.7 μg/ml, respectively.

Background The role of matrix metalloproteinase 9 (MMP-9) expression in non-small cell lung cancer (NSCLC) remains controversial. We performed a systematic review of the literature with meta-analysis. Methods Electronic databases were used to identify published studies before December 1, 2011. Pooled hazard ratio (HR) with 95% confidence interval (95% CI) was used to estimate the strength of the association between MMP-9 expression survival of NSCLC patients. Heterogeneity and publication bias were also assessed. Results The final analysis of 2029 NSCLC cases from 17 studies is presented. The combined HR of 1.84 (95% CI: 1.62–2.09) suggested that MMP-9 over-expression had a poor prognosis in patients with NSCLC. Subgroup analyses also detected significant association. Heterogeneity and publication bias was absent in current meta-analysis. Sensitivity analyses suggested that the summary statistics obtained should approximate the actual average. Conclusion High MMP-9 expression is associated with a poor prognosis in patients with NSCLC.

The new drimane sesquiterpenoids changweikangic acid A (I) and B (II) are isolated from the Chinese patent drug Compound Changweikang which is made from the aqueous extracts of two medicinal plants.

Relationship of gastric cancer with the presence of IL-10-592 polymorphism was reported with inconsistent results. The objective of this study was to quantitatively evaluate the association between IL-10-592 allele polymorphism and gastric cancer susceptibility. We performed an extensive search of relevant studies and made a meta-analysis, including 12 studies with 2,285 gastric cancer cases and 4,236 controls. The combined results based on all studies showed that there were no significant differences in genotype distribution between gastric cancer cases and controls, CC versus CA/AA (OR = 1.05, 95% CI: 0.92–1.18), CC/CA versus AA (OR = 1.16, 95% CI: 0.92–1.46), CC versus CA (OR = 1.03, 95% CI: 0.90–1.17), CC versus AA (OR = 1.10, 95% CI: 0.90–1.34), and CA versus AA (OR = 1.16, 95% CI: 0.92–1.45). When stratifying for the race, it was found that gastric cancer cases had a significantly higher frequency of CC/CA versus AA (OR = 1.31, 95% CI: (1.08–1.59) and a significantly upper frequency of CA versus AA (OR = 1.33, 95% CI: 1.09–1.63) than control in Asians. When stratifying for the location and the Lauren’s classification of gastric cancer, there were no statistically significant differences in genotype distribution between gastric cancer cases and controls. This meta-analysis suggested that IL-10-592 allele polymorphism might be a risk factor for gastric cancer among Asians.