Perchlorate is a new emerging environmental pollutant that is very stable and persistent,and it can diffuse rapidly in the environment. The environmental problems caused by perchlorate have attracted a great attention from many environmental scientists. However,up to now,a few reports on perchlorate pollution have been reported in China. In this paper,for perchlorate as an environmental pollutant,the sources,characteristics,detecting methods and toxicological effect on human body were reviewed,and the further research topics were presented.

Objective To study thyroid hormone changes in women with pre-eclampsia patients,the characteristics of thyroid disease and its relationship with pre-eclampsia.Methods From May 2011 to December 2012 171 patients with pre-eclampsia who delivered in Shengjing Hospital of China Medical University were recruited as prc-eclampsia(PE) group,among which 114 cases were defined as early onset pre-eclampsia (EP) group and 57 cases were defined as late onset pre-eclampsia (LP) group.And 171 healthy women with same age and same stage of pregnancy were selected as the control group.Their blood pressures were normal and they had no obstetrical complications.Serum thyrotropin (TSH),free triiodothyronine (FT3) and free thyroxine (FT4) levels were determined by solid-phase chemiluminescent enzyme immunoassay method (CMIA).Thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) were measured by electro-chemiluminescent assay (ECLIA).The positive rate was calculated (TPOAb ＞ 5.6 U/L,TGAb ＞ 4.1 U/L were defined as positive result).The relationship between TSH,FT3,FT4 level and blood pressure was analyzed in women with pre-eclampsia.Results (1) The median values of TSH,FT4 and FT3 in PE group were 3.4 mU/L,(12.0 ± 3.0) pmol/L and(3.9 ± 0.9) pmol/L.In the control group,they were 1.9 mU/L,(13.4 ± 2.4) and (5.0 ± 1.3) pmol/L.There were statistically significant differences between the two groups(P ＜ 0.01).In EP group,the median values of TSH,FT4 and FT3 were 3.3 mU/L,(12.1 ± 3.4) pmol/L and (3.8 ± 0.9) pmol/L.The differences between EP group and the control group were statistically significant (P ＜ 0.01).In LP group,the median values of TSH,FT4 and FT3 were 3.4 mU/L,(11.9 ± 3.1) pmol/L and (3.9 ± 1.0) pmol/L.There were statistically significant differences compared to the control group(P ＜0.01).While there was no difference between EP group and LP group (P ＞ 0.05).(2) The positive rate of TPOAb and TGAb in PE group were 15.2％ (26/171)and 21.6％ (37/171),and were 12.3％ (21/171) and 14.6％ (25/171) in the control group.There was statistically significant difference in the TGAb positive rate (P ＜ 0.01),but the difference in TPOAb positive rate was not statistically different(P ＞0.05).The TPOAb positive rates in EP group and LP group were 12.3 ％ (14/114) and 21.1％ (12/57),respectively,with no statistically significant difference (P ＞ 0.05).And the positive rates of TGAb in EP group and LP group were 21.9％ (25/114)and 21.1％ (12/57),respectively,with no statistically significant difference(P ＞ 0.05).The positive rate of TPOAb in LP group and in the control group had statistically significant difference(P ＜0.01).(3) The morbidity of thyroid disease in PE group and in the control group were 47.4％ (81/171) and 16.4％ (28/171),with statistically significant difference (P ＜ 0.01).(4) The morbidity of subclinical hypothyroidism or hypothyroidism in PE group and in the control group were 45.0％ (77/171) and 16.4％ (28/171),with statistically significant difference(P ＜0.01).(5) The morbidity of subclinical hyperthyroidism in PE group and in the control group were 2.3 ％ (4/171) and 1.8 ％ (3/171),with no statistically significant difference (P＞0.05).(6) In PE group,women with TSH level of 0.3-3.3 mU/L had systolic pressure of(170 ± 21)mmHg (1mmHg =0.133 kPa)and diastolic pressure of(112 ± 15) mmHg; women with TSH ＞ 3.3 mU/L had systolic pressure of(166 ± 21)mmHg and diastolic pressure of(109 ± 13)mmHg.There was no statistically significant difference(P ＞ 0.05).But the diastolic pressure in EP group and LP group had statistically significant difference(P ＜ 0.01).In PE group,no correlation was found among TSH,FT4 levels and systolic pressure,diastolic pressure(P ＞ 0.05).FT3 level was negatively correlated to diastolic pressure (r =-0.172,P =0.023).Conclusions It is common that pre-eclampsia is complicated with thyroid dysfunction,mainly subclinical hypothyroidism.Thus it is nessesary to test thyroid hormone and thyroid antibodies in women with pre-eclampsia.The decrease of FT3 and FT4,the increase of TSH and the presence of TPOAb and TGAb are related with the presence of pre-eclampsia.

Objective To study effects of different degree of hypothyroidism in severe preeclampsia (S-PE) pregnant women on renal function and the correlation between them.Methods 46 S-PE patients with subclinical hypothyroidism (SCH) registered for treatment in the Shengjing Hospital of China Medical University from May 2011 to March 2013 were selected into SCH group,and 23 S-PE with overt hypothyroidism (OH) were selected into OH group,and 109 S-PE with normal thyroid stimulating hormone (TSH) levels were selected into simple group.Thyroid hormone and kidney function tests were analyzed in pregnant women with S-PE.We made an analysis of the relative risk of the detection rate of abnormal renal function and also the relationship between the levels of thyroid hormone and serum uric acid,serum urea and creatinine in patients with S-PE.Results (1) In SCH group serum TSH was (6.1±3.2) mU/L,free triiodothyronine (FT3) was (4.0±0.6) pmol/L,free thyroxine (FT4) was (11.8± 1.5) pmol/L; in OH group serum TSH was (5.2± 1.3) mU/L,FT3 was (3.7±0.6) pmol/L,FT4 was (9.3±0.5) pmol/L; in simple S-PE group serum TSH was (1.9±0.8) mU/L,FT3 was (4.0±0.8) pmol/L and FT4 was (11.9±1.9) pmol/L.TSH in SCH group was significantly higher than that in simple S-PE group (P＞0.01),the difference of in SCH and OH group were not statistically significant (P＞0.05).The difference of FT3 in three groups were not statistically significant (P＜0.05) ;FT4 in OH group was significantly lower than thoes in SCH and simple groups (P＜0.05).(2)Serum uric acid,creatinine and urea levels in OH group was (436± 114),(75± 15) μmol/L and (6±3)mmol/L,in simple S-PE group they were (378± 114),(65 ±22) μmol/L and (5±3) mmol/L.In comparison,the differences was statistically significant(P＜0.05).The differences were not statistically significant in SCH and OH groups (P＞0.05).(3)The abnormal detection rate of uric acid was significantly higher in SCH than that in OH group [46％ (21/46) versus 22％ (5/23),OR=3.0,P＜0.05].The comparison of remaining index has no statistical significance(P＞0.05).(4)In SCH group there was a significant inverse correlation of serum FT3 with serum urea levels,serum creatinine and serum uric acid (r=-0.32,-0.58,-0.35,P＜0.05).There was not a correlation of serum TSH,FT4 with indicators of renal function (P＞0.05).In OH group there was a negative correlation between FT3 and serum creatinine concentrations (r=-0.40,P＜0.05).In OH group there was not a correlation of FT3 with serum uric acid and urea (P＞0.05).There was a positive correlation between TSH and serum creatinine in simple S-PE group (r=0.20,P=0.04).There was not a correlation between TSH and serum urea(r=0.04,P=0.65),and serum uric acid (r=0.12,P=0.20).Conclusions There was effect of different hypothyrosis state in pre-eclampsia patients on renal function.Serum uric acid,urea and creatinine concentrations in S-PE pregnant women with OH were significantly higher than those in simple S-PE group with normal TSH.There was a negative correlation between FT3 and serum creatinine in S-PE.Hence the thyroid function should be regularly monitored in S-PE patients to find damage of renal function and management hypothyrosis.

Objective To investigate treatment effects of levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis with severe dysmenorrhea in a prospective cohort study. Methods From December 2006 to December 2014, patients of symptomatic adenomyosis diagnosed by transvaginal ultrasound in outpatient or inpatient clinics of Peking Union Medical College Hospital were given the treatment of LNG-IUS. Before and after placement of LNG-IUS, all the patients′parameters were recorded prospectively, including symptoms and scores of dysmenorrhea, menstruation scores, biochemical indicators, physical parameters, carrying status of LNG-IUS, menstruation patterns and adverse effects. Changes of scores and patterns of pain during follow-up were analyzed. Results Totally 1 100 women meets inclusion criteria, among which 640 cases (58.18%, 640/1 100) had severe dysmeorrhea, with median follow-up period of 35 months (range 1-60 months), and accumulative carrying rate of 65% at 60 months follow-up. After placement of LNG-IUS, scores of pain and ratio of severe dysmenorrhea had decreased significantly compared with baselines (all P<0.01), the scroes of visual analog scale (VAS) were 8.1 ± 0.9, 5.5 ± 2.4, 4.6 ± 2.4, 3.3 ± 2.2, 2.2 ± 2.1, 2.2 ± 1.8, 1.4 ± 1.6 and 1.3 ± 1.3 at 0, 3, 6, 12, 24, 36, 48 and 60 months respectively. During 36 months after placement of LNG-IUS, scores of pain had improved significantly compared with preceding period (all P<0.01). We found no universal dependent factors predicting improvement of pain, which was neither relevant with simultaneous changes of menstruation patterns nor adverse effects (all P>0.05). Conclusion LNG-IUS is effective for adenomyosis of severe dysmenorrhea. Improvement of pain is independent on patients characters, menstruation patterns or adverse effects.

Objective To investigate treatment effects of levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis with menorrhea in a prospective study. Methods From December 2006 to December 2014, patients of symptomatic adenomyosis diagnosed by transvaginal ultrasound in outpatient or inpatient clinics of Peking Union Medical College Hospital were given the treatment of LNG-IUS. Before and after placement of LNG-IUS, all the patients′parameters were recorded prospectively, including scores of menstruation blood loss, carrying status of IUS, symptoms and scores of dysmenorrhea, biochemical indicators, physical parameters, menstruation patterns and adverse effects. Changes of pictorial chart scores of menstruation and distribution of anemia during follow-up were analyzed. Results Totally 1 100 women meets inclusion criteria, among which 618 cases (56.18%, 618/1 100) had severe menorrhea, with median follow-up period of 28 months (range 1-60 months), and accumulative carrying rate of 66% at 60 months follow-up. After placement of LNG-IUS, compared with baselines, pictorial chart scores and ratio of menorrhea had decreased significantly (all P<0.01), the scroes of menstruation were 157±34, 94±35, 70±33,67 ± 18, 67 ± 20, 65 ± 19, 66 ± 19, 65 ± 21 at 0, 3, 6, 12, 24, 36, 48 and 60 months respectively. During 24 months after placement of LNG-IUS, pictorial chart scores and distribution of anemia had improved significantly compared with preceding period (all P<0.01). We found no dependent factors predicting improvement of pictorial chart scores of menorrhea, which was neither relevant with simultaneous changes of menstruation patterns nor adverse effects (all P>0.05). Conclusions LNG-IUS is effective for adenomyosis of menorrhea. Improvement of menstruation blood loss is independent on patients characters, menstruation patterns or adverse effects.

Objective To investigate the changes of mestruation patterns and adverse effects during the treatment of levonorgestrel-releasing intrauterine system (LNG-IUS) for symptomatic adenomyosis in a prospective cohort study. Methods From December, 2006 to December, 2014, patients of symptomatic adenomyosis diagnosed by transvaginal ultrasound in Peking Union Medical College Hospital were given LNG-IUS. Before and after placement of IUS, all patients′ parameters were recorded, including carrying status of IUS, symptoms and scores of dysmenorrhea, menstruation scores, biochemical indicators, physical parameters, menstruation patterns and adverse effects. Risk factors for changes of menstruation patterns and adverse effects, and their impact on treatment effects were analyzed. Results Totally 1 100 cases met inclusion criteria, with median age 36 years (range 20-44 years), median follow-up 35 months (range 1-108 months). During follow-up changes of menstruation patterns increased significantly with amenorrhea and shortened-menstruation being the most common manifestations. On 3, 6, 12, 24, 36, 48 and 60 months after the placement of LNG-IUS, 0, 5.8%(43/744), 6.9%(47/682), 10.1%(60/595), 17.3%(87/502), 27.2%(104/383) and 29.6%(82/277) patients achieved amenorrhea respectively (P<0.01). Total and subclassification of adverse effects decreased significantly (P<0.01). Within 12 months and >12 months after placement, abdominal pain and body weight increasing ≥5 kg/year were the most common adverse effects. Changes of menstruation patterns, total and subclassifications of adverse effects were neither dependent on patient parameters, treatment modes and treatment effects, nor could predict future LNG-IUS carrying status (all P>0.05). After taking out of LNG-IUS, most changes of menstruation and adverse effects disappeared. Conclusions During the treatment of LNG-IUS for symptomatic adenomyosis, changes of menstruation patterns increase gradually with amenorrhea and shortened-menstruation being the most common manifestations, while adverse effects decrease significantly. Changes of menstruation patterns or adverse effects neither have any risk factor nor have impact on treatment effects.

In recent years,the overall incidence of cancer and mortality have been on an upward trend,cancer becomes a public health problem that seriously endangers human health in the world. Currently,except for radiotherapy and surgery to cancer treatment,chemotherapy plays an important role in greatly improving the survival rate of cancer patients. However,most of chemothera-pies have drug-resistance and toxic effects on patients. In order to overcome these shortcomings,some natural phytochemicals have been used as chemosensitizers in chemotherapies. These natural phytochemicals not only increase the sensitivity of tumor cells to ther-apeutic drugs,but it also reduces their resistance and toxic effects on patients. Therefore,this review summarizes the sensitization of natural phytochemicals to target drug therapies and their possible mechanisms.

γ-Tocotrienol(γ-T3)is a common phytochemical belonging to a major subclass of natural vitamin E,mainly de-rived from palm oil and rice bran.Compared to saturated tocopherol(TOC),the γ-T3 side chain contains unsaturated bonds and forms isoprene chains.γ-T3 has therapeutic activity for various chronic diseases with broad potential applications,especially in inhib-iting tumor proliferation and invasion.With deeply research,more and more evidence suggests that γ-T3 plays an important role in inhibiting cancer cell migration and metastasis,inducing tumor cell apoptosis,arresting cell cycle and regulating cancer-related sig-naling pathways.Therefore,this article will review the anti-cancer effects and mechanisms of γ-T3.

Objective To establish the gestational month-specific reference intervals for thyrotropin and thyroxine in Han nationality women in iodine sufficient area of China. Methods In iodine sufficient area of China, 120 non-pregnant women and 1 118 pregnant women at gestational ages from 4 to 36 week (4 weeks≈1 month) were collected according to the strict criteria. Urinary iodine excretion and serum thyrotropin (TSH), total thyroxine (TT4), free thyroxine (FT4), thyroid peroxidase antibody (TPOAb) levels were determined in all subjects. Results During pregnancy, serum TSH increased at week 4, and then began to decrease with the lowest level at week 12, which was 35% lower than the non-pregnant level." After that, serum TSH increased gradually and finally became stable during the third-trimester of pregnancy (T3) when the level was 29% higher than that of non-pregnant controls. Serum TT4 elevated dramatically during the first-trimester with peak at week 16, which increased by 70% compared with the non-pregnant level, then slightly decreased, and became steady with 50% increasing compared with non-pregnant level. Serum FT4 initially increased slightly with peak at week 4, and then decreased gradually until the beginning of T3 without obvious fluctuation during T3. Conclusion The gestational month-specific reference intervals for TSH, TT4 and FT4 are necessary for the early diagnosis of maternal subclinical hypothyroidism and hypothyroxinaemia.

Objective To investigate the prevalence of hypothyrodism during the first half of pregnancy in the Han nationality women in iodine-adequate area. Methods TSH, FT4 and thyroid peroxidase antibody (TPOAb) levels were detected in 4 800 pregnant women during the first half of pregnancy. Both gestational age-specific reference intervals and population-based reference intervals of thyroid function were applied and the corresponding prevalences of hypothyroidism were compared with each other. Results Based on the gestational age-specific reference intervals, the prevalences of overt hypothyroidism at 4th and 8th weeks of gestation were 1.03%, 0.37% respectively. At 4th, 8th, 12th, 16th and 20th weeks of gestation, the prevalences of subclinical hypothyroidism were 4.59%, 6.15% , 4.68%, 4.53%, 5.96% respectively, while those of hypothyroxinemia were 3.69%, 1.11%, 2.92% , 1.29%, 2.29%, respectively. According to the pepulation-based reference intervals, the rates of missed diagnosis of subclinical hypothyroidism were 0.18%, 2.85%, 4.10%, 3.24%, 3.21% while those of hypothyroxinemia were 3.45%, 0.66%, 2.34%, 1.29%, 1.83%, respectively. During 4th, 8th, 16th weeks of gestation, the positive rates of TPOAb in the group with subclinical hypothyroidism were significantly higher than those with euthyroidism. The prevalences of subclinical hypothyroidism in TPOAb positive group were obviously higher than those in TPOAb negative group at 4th, 8th, 12th, 16th gestational weeks. Conclusion The rates of missed diagnosis of subclinical hypothyroidism and hypothyroxinemia during the first half of pregnancy were decreased by applying the gestational age-specific reference intervals in this prospective study. Positive TPOAb is a risk factor for subclinical hypothyroidism during the first half of pregnancy.