Association between third trimester maternal isolated hypothyroxinemia and adverse pregnancy outcomes.

To study the effects of third trimester maternal isolated hypothyroxinemia (serum low free thyroxine and normal thyroid stimulating hormone level) on pregnancy outcomes, we performed a retrospective cohort study in women with singleton pregnancy between February 2009 and June 2012. Pregnant women were assigned to two groups, a hypothyroxinemia group (with maternal isolated hypothyroxinemia in the third trimester and normal thyroid function in the first and second trimesters) and a control group (with normal serum thyroid functions). The pregnancy outcomes, including preterm birth, fetal distress, birth weight, premature rupture of membranes, and Apgar score at one minute after the birth, were recorded and compared between the two groups. A total of 3,945 pregnant women (median age 26 year old) were included in the study, with 195 women in the hypothyroxinemia group and 3,750 women in the control group. Compared with the women in the control group, women in the hypothyroxinemia group had higher incidences of premature rupture of membranes and low Apgar score at one minute after the birth. The multivariate logistic regression analysis showed that the low third trimester serum thyroxine level was the independent risk factor for the premature rupture of membranes and low Apgar score. There were no statistically significant differences in preterm birth, macrosomia, and intrauterine fetal distress between two groups. Third trimester maternal isolated hypothyroxinemia was associated with adverse pregnancy outcomes. The maternal serum thyroxine level should be monitored during late pregnancy and necessary management should be applied to improve the pregnancy outcomes.

Cardiac angiosarcoma with multiple pulmonary metastases: A case report and literature review.

In this report, we describe a 42-year-old man with dyspnea and recurrent hemoptysis who was diagnosed with cardiac angiosarcoma and multiple pulmonary metastases. Before visiting our hospital, he had been misdiagnosed with a lung infection. Bronchoscopy, multiple imaging methods, and extensive laboratory studies failed to identify a clear etiology. Cardiac magnetic resonance imaging and percutaneous lung biopsy revealed cardiac angiosarcoma with multiple pulmonary metastases. Cardiac angiosarcoma is extremely rare and diagnosis is difficult. Diffuse alveolar hemorrhage is not a common manifestation of pulmonary metastases of angiosarcoma and in patients with hemoptysis, clinicians should consider a malignant etiology that is not restricted to the lungs.

Toward the Threshold of Radiation Hazards of U in Chinese Coal through the CART Algorithm.

The high volume of coal used for combustion usually leads to a large amount of coal combustion residues (CCRs), which contain the naturally occurring radioactive materials (NORMs) decayed from U and Th in coals. The high radioactivity of NORMs can cause potential harm to humans if the CCRs are used as building materials. The activities of CCRs not only depend on the concentrations of radionuclides but also largely depend on the variations of ash yields of coal. On the other hand, ash yields significantly vary in coal from less than 1-50%. This indicates that similar concentrations of radionuclides in coal with different ash yields generally do not result in similar activities in CCRs. Therefore, it is significant to build a threshold of U in coals with different ash yield levels. In this research, based on the data of 945 coal samples from China and the selected optimal model using the classification and regression tree algorithm, the threshold of U for the radiation hazard is determined to be 7.98 mg/kg for coals with ash yields higher than 20%, while the threshold of U for the radiation hazard is 5.28 mg/kg for coals with ash yields lower than 20%.

The comfort assessment in healthy adults during constant-flow mode in noninvasive ventilator.

BACKGROUND: From the point of view of machine construction and hydrodynamics, this paper innovatively proposes that the essence of high-flow nasal cannula (HFNC) is a constant-flow mode in noninvasive ventilator (NIVCFM). This study enrolled healthy adults as study subjects to assess the subjective comfort assessed by visual analog scoring scale of NIVCFM/HFNC and objective comfort measured by the noise level generated by NIVCFM/HFNC, aiming to provide a scientific basis for the rational clinical application of NIVCFM/HFNC. METHODS: Forty-four healthy adults participated in this study. The noise generated by NIVCFM/HFNC is measured, and the comfort is evaluated during NIVCFM delivery at flow rates of 0, 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, and 60 L/min. RESULTS: When the ventilator flow rate is 60 L/min, the maximum noise is 65.9 dB, increasing noise by 23.7 dB from a baseline of 42.2 dB at the flow rate of 0 L/min. There was a strong nonlinear positive correlation between the noise level and the flow rates. The median score for dry mouth, nose or throat, dysphagia, sore throat, and other discomfort was 0. The median score for dyspnea was 0 at 0-30 L/min, 1 at 35-55 L/min, and 2 at 60 L/min. CONCLUSIONS: The grater the flow rate, the greater the noise generated by NIVCFM/HFNC (<65.9 dB). The maximum flow rate that most healthy adults can able to tolerate is 30 L/min, and the main discomfort is dyspnea.

Average Linkage Hierarchical Clustering Algorithm for Determining the Relationships between Elements in Coal.

The modes of occurrence of elements in coal are important not only because they can provide insights into the sources of mineral matter in coal but also because they are vital in determining the behavior of their environmental and human health impacts. Besides a number of physical and chemical analyses for determining the modes of occurrence in coal, some statistical methods have been commonly adopted to investigate elements in coal. Among many statistical methods, the hierarchy clustering algorithm is the most common method for deducing modes of occurrence of elements in coal. However, different hierarchical clustering algorithms with a number of similarity measures sometimes result in different modes of occurrence of elements in coal, and subsequently in some cases, such results could be confusing. Therefore, which algorithm is more effective in determining the modes of occurrence in coal deserves to be investigated. In this paper, the data sets of coals from the Adaohai coal mine in Inner Mongolia, China, are used for this performance evaluation. From the analytical results with the average linkage hierarchical clustering algorithm on Adaohai coal samples, many instructive and surprising insights can be concluded. For example, selenium, Be, and Tl do not appear to be in agreement with geochemical principles, that is, substituting for P, associated with rare earth elements, and occurring in Fe-sulfides, respectively. In conclusion, the average linkage hierarchical clustering algorithm with correlation similarity is much better in the analysis of the geological processes than the previous statistical method used in Adaohai coal samples, that is, centroid linkage hierarchical clustering algorithm with Pearson correlation similarity.

Co-exposure to polycyclic aromatic hydrocarbons and phthalates and their associations with oxidative stress damage in school children from South China.

Monohydroxylated polycyclic aromatic hydrocarbons (OH-PAHs), phthalate metabolites (mPAEs), and 8-hydroxy-2'-deoxyguanosine (8-OHdG) in the urine of school children aged 8-11 years from Shenzhen, China were measured in order to investigate oxidative stress damage from co-exposure to PAHs and PAEs. The concentrations of OH-PAHs and mPAEs in urine were 0.36-36.5 (median: 3.86) and 9.48-1609 (median: 240) ng/mL respectively. Gender and age did not influence urinary concentrations of ΣOH-PAHs and ΣmPAEs, but geographical variations (i.e., urban versus suburban) were observed. Levels of 8-OHdG were positively correlated with urinary OH-PAHs and mPAEs, with correlation coefficients (r) varying between 0.160 and 0.365 (p < 0.05). OH-PAHs made a greater contribution to oxidative DNA damage than mPAEs when these two types of pollutants were present at the same concentrations. Human health risks were assessed using the hazard quotient and the hazard index for the cumulative risk of a complex of chemicals. The results demonstrated that risks from PAHs could be neglected, but that 29.5 % of school children may be subject to obvious health risks from PAEs, especially diethylhexyl phthalate.

Insignificant Effect of Isolated Hypothyroxinemia on Pregnancy Outcomes During the First and Second Trimester of Pregnancy.

Objective: Adverse maternal outcomes and perinatal complications are associated with overt and subclinical maternal hypothyroidism. It is not clear whether these complications also occur in women with isolated hypothyroxinemia during pregnancy. The aim of this study was to evaluate the effects of isolated hypothyroxinemia on maternal and perinatal outcomes during pregnancy. Methods: This study included data from 2,864 pregnant women in the first trimester (67 women with isolated hypothyroxinemia, 784 euthyroid women) and the second trimester (70 women with isolated hypothyroxinemia, 1,943 euthyroid women) of pregnancy. Maternal serum samples were collected in the first and second trimesters to examine thyroid hormone concentration. Hypothyroxinemia was defined as a normal maternal thyroid-stimulating hormone concentration with a low maternal free thyroxine concentration and negative thyroid autoantibodies. The following maternal outcomes were recorded: gestational hypertension, gestational diabetes mellitus, placenta previa, placental abruption, prelabor rupture of membranes, and premature delivery. Perinatal outcomes, including fetal growth restriction, fetal distress, low birth weight, intrauterine fetal death, and malformation. The incidence of adverse pregnancy outcomes and perinatal complications was compared between women in the first trimester and second trimester with isolated hypothyroxinemia. Results: There were no significant differences in the incidence rates of adverse maternal outcomes and perinatal complications between patients in the first and second trimesters with isolated hypothyroxinemia. Conclusion: The results of this study indicate that isolated hypothyroidism does not increase the incidence of adverse maternal outcomes and perinatal complications.

Urinary monohydroxylated polycyclic aromatic hydrocarbons in primiparas from Shenzhen, South China: Levels, risk factors, and oxidative stress.

The main objectives of the present study were to investigate urinary monohydroxylated polycyclic aromatic hydrocarbons (OH-PAHs) in 77 primiparas who live in Shenzhen, Guangdong Province, China, and their association with 8-hydroxy-2'-deoxyguanosine (8-OHdG) and human health risks. High detection frequencies of OH-PAHs demonstrated the wide occurrence of chemicals in the human exposure to PAHs. The urinary concentrations of Σ7OH-PAHs ranged from 1.37 to 45.5 ng/mL, and the median concentrations of 1-hydroxynaphthalene (1-OHN), 2-hydroxynaphthalene (2-OHN), 2-hydoxyfluorene (2-OHF), ΣOHPhe (the sum of 1-, 2+ 3-hydroxyphenanthrene), and 1-hydroxypyrene (1-OHP) were 3.00, 2.58, 0.31, 0.44, and 0.51 ng/mL, respectively. In the sum concentration of seven OH-PAHs, 1-OHN accounted for the largest proportion (43.7% of Σ7OH-PAHs), followed by 2-OHN (37.1%), 2-OHF (4.94%), 1-OHP (8.01%), 1-OHPhe (4.79%), and 2+3-OHPhe (1.46%). The present results showed that vehicle exhaust and petrochemical emission are the main sources of PAHs in primiparas in Shenzhen, and inhalation is the most important exposure route. The living conditions have a significant influence on human exposure to PAHs. The concentrations of 8-OHdG were positively correlated with OH-PAH concentrations in urine because evidence suggested that urinary 8-OHdG levels can be considered as a biomarker of oxidative DNA damage. Hazard quotient was used to assess the human health risks from exposure to single compound, and hazard index was used to assess the cumulative risks of the compounds, which demonstrated that the exposure risks from PAHs in primiparas were relatively low.

[Analysis of Non-polar Organic Compounds in PM2.5 by Rapid Thermo-desorption Method Coupled with GC/MS].

Non-polar organic compounds (NPOCs) associated with PM2.5 in the atmosphere were analyzed by automated thermo-desorption (TD) coupled with gas chromatography/mass spectrometry (TD-GC/MS). The analyses for a total of 72 NPOCs were reviewed, including 34 PAHs, one Debenzothiophene, 27 alkanes (C10-C34), 5 hopanes and 5 steranes. Through this improved TD method, operation of filter loadings, TD condition and sample introduction were optimized. The MDL were 0.01-1.0, 0.1-8.0 and 0.50-2.0 ng·m-3 for PAHs, alkanes, hopanes and steranes, respectively. Calibration curve linearities were above 0.9 for all compounds. The TD efficiencies were 95%-100% for PAHs, 81%-100% for alkanes and 83.1%-100% for hopanes and steranes. PM2.5 samples were pretreated by TD and ultrasonic extraction methods separately and analyzed by GC/MS in two laboratories. Results from these two methods were comparable, as the relative biases were less than 30% for most compounds. Analysis results of PM2.5 samples from Linan and Shanghai showed that NPOCs were higher in winter than that in summer. Alkanes were predominant among NPOCs, followed by PAHs. Source analysis by PAH characteristic ratios indicated that fossil fuel burning and coal burning were the main sources of NPOCs in the two sites during the sampling periods.

Association of Cancer Stem Cell Markers With Aggressive Tumor Features in Papillary Thyroid Carcinoma.

BACKGROUND: Identifying accurate prognostic molecular markers for papillary thyroid carcinoma (PTC) is important because many patients with PTC may be erroneously considered to have low-risk tumors. Evidence is also accumulating to support the existence of cancer stem cells in PTC. METHODS: Thirty controls and 167 patients with PTC were selected to establish a tissue microarray to investigate cancer stem cell marker expression in samples from an established pathological database. The protein expressions of CD44, CD133, epithelial cell adhesion molecule (EpCAM), CD45, and CD90 were evaluated by immunohistochemical assay in the tissue microarray. RESULTS: The protein levels of CD44, CD133, and EpCAM were significantly increased in PTC tissue compared with tissue from the controls. A positive correlation was found between cancer stem cell markers and tumor, node, and metastasis staging. CONCLUSIONS: Among a subset of patients with PTC, cancer stem cells detected by immunohistochemistry can be used as prognostic markers to screen for potential tumor dissemination. Whether these cancer stem cell markers are potentially therapeutic targets - and, thus, could be used for effective adjuvant treatment strategies - remains to be seen, and more data are needed.

Associations between thyroid autoantibody status and abnormal pregnancy outcomes in euthyroid women.

We investigated whether thyroid autoantibody status influences pregnancy outcomes in euthyroid women, by comparing abnormal pregnancy outcome rates between those who tested positive for thyroid autoantibodies (Ab+) and those who tested autoantibody-negative (Ab-). Euthyroid pregnant women (n=7,641) underwent tests for serum thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb). The subjects were divided into 4 groups according to thyroid antibody status: TPOAb-/TgAb- (92.9%); TPOAb+/TgAb- (3.2%); TPOAb-/TgAb+ (2.0%); and TPOAb+/TgAb+ (1.9%). The incidence rates of the following abnormal pregnancy outcomes were compared among the 4 groups and analyzed by Fisher's exact test: gestational diabetes, gestational hypertension, placenta previa, placental abruption, premature rupture of fetal membrane (PROM), intrauterine growth restriction, fetal distress, fetal anomalies, stillbirth, preterm birth, and low birth weight. Among the 4 groups, there were no significant differences in age, gestational age, or in the incidence rates of abnormal pregnancy outcomes, except for PROM and low birth weight. The highest incidence rates for PROM and low birth weight were in the TPOAb-/TgAb+ and TPOAb+/TgAb+ subjects, respectively. TgAb positivity and TPOAb positivity were associated with PROM and low birth weight, respectively. Underlying factors that govern the association between thyroid autoantibodies and PROM and low birth weight require further investigation.

Adiponectin and peroxisome proliferator-activated receptor-γ gene polymorphisms and gene-gene interactions with type 2 diabetes.

AIMS: To investigate whether gene polymorphisms of both adiponectin and peroxisome proliferator-activated receptor gamma (PPARγ) influence type 2 diabetes mellitus (T2DM) respectively in the Han people of the Wenzhou region of China and whether the interaction of gene polymorphism between adiponectin and PPARγ influences T2DM in the same subjects. MAIN METHODS: This study included 198 patients with T2DM and 255 healthy individuals. Polymerase chain reaction-restriction fragment length polymorphism analyses were used to detect single nucleotide polymorphisms (SNPs). Logistic regression and multifactor dimensionality reduction (MDR) methods were used to analyze gene-gene interactions. KEY FINDINGS: The frequency distribution of adiponectin SNP11377 was not different (p=0.792), but the frequency of CC, CG and GG genotypes showed the difference between two groups (T2DM: 57.1%, 33.3%, and 9.6%; control: 53.7%, 41.6%, and 4.7%, respectively; p=0.047). Adiponectin SNP45, SNP276 and PPAR γ SNPp12a were equally distributed between the two groups (p=0.586, 0.119, 0.437, respectively), and there were no significant differences in genotype frequencies between the two groups (p=0.751, 0.144, 0.479, respectively). Linkage disequilibrium existed between SNP11377 and SNP45 (p<0.001) and SNP45 and SNP276 (p<0.001). Haplotype analyses showed no significant differences between the T2DM and control groups. According to the logistic regression and MDR gene-gene interaction analyses, SNP11377GG and SNP276GT interactions increased the risk of T2DM (odds ratio=6.984, p=0.012). SIGNIFICANCE: Adiponectin SNP11377 and SNP276 gene-gene interactions are associated with the increased risk of T2DM in this population.