Levels of phthalate internal exposure levels in pregnant women and influencing factors / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the levels and influencing factors of phthalate internal exposure in pregnant women (gestation age ≤ 16 weeks).</p><p><b>METHODS</b>During April to June in 2013, 1 020 pregnant women (gestation age ≤ 16 weeks) who had established the maternal care manual were recruited in maternal and child health hospital of Siming District, Xiamen city. Participators were asked to complete a questionnaire to obtain information on socio-demographic characteristics, lifestyle behaviors, and antenatal examination and to provide a urine sample. Finally, 998 pregnant women who provided a urine sample and completed the questionnaire were enrolled. Adopting systematic sampling method, 100 ones were selected randomly among 998 pregnant women. High performance liquid chromatography-electrospray ionization-tandern mass was used to determine the concentration of five phthalate monoesters in each urine, including mono-n-methyl phthalate (MMP), mono-ethyl phthalate (MEP), mono-butyl phthalate (MBP), mono-benzyl phthalate (MBzP), mono-ethylhexyl phthalate (MEHP). Based on the measurements and questionnaire data, multivariate logistic regression was used to analyze the association between the phthalate monoester levels and potential influential factors.</p><p><b>RESULTS</b>The detection rates of MMP, MEP, MBP, MBzP and MEHP in 100 pregnant urine samples were 94%, 93%, 87%, 83%, 99%, respectively. And the urinary median uncorrected concentrations of MMP, MEP, MBP, MBzP and MEHP in 100 urine samples were 20.56, 17.62, 10.15, 2.03, and 5.12 ng/ml, respectively. Specific gravity-corrected concentration were 20.81, 20.36, 12.88, 2.58, 5.00 ng/ml, respectively. The results of multivariate logistic regression analysis indicated that: education degree was negatively associated with urinary concentration of MMP, MEP, MBP, MBzP and MEHP, OR (95% CI) were 0.495 (0.253-0.966), 0.380 (0.191-0.755), 0.379 (0.186-0.774), 0.401 (0.196-0.819), 0.373(0.183-0.762), respectively. Participants who had hair permed and dyed during pregnancy had higher urinary level of MBP and MBzP, OR (95% CI) were 12.867 (1.240-133.525), 15.982 (1.367-186.911), respectively; Participants who use cosmetics during pregnancy had higher urinary level of MEP and MBP, OR (95% CI) were 2.977 (1.012-8.757), 4.440 (1.485-13.272), respectively; plastic bottled water consumption was positively associated with urinary concentrations of MEP and MEHP, OR (95% CI) were 3.780 (1.417-10.083), 2.699 (1.039-7.010), respectively; annual household income was negatively associated with urinary concentration of MMP, OR (95% CI) was 0.597 (0.372-0.959); individuals who took medications during pregnancy had higher urinary level of MEHP than non-takers, OR (95% CI) was 4.853 (1.084-21.732).</p><p><b>CONCLUSION</b>Pregnant women whose gestation age was less than 16 weeks are generally exposed to phthalate. Phthalate internal exposure levels are significantly associated with most measured factors and the influencing factors with different phthalates internal exposure levels are different.</p>

Diagnostic value of serum Golgi protein-73 (GP73) combined with AFP-L3% in hepatocellular carcinoma: a meta-analysis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the diagnostic value of serum Golgi protein-73 (GP73) combined with the AFP-L3% test for hepatocellular carcinoma.</p><p><b>METHODS</b>Comprehensive electronic and manual searches were performed to retrieve relevant studies on GP73 combined with AFP-L3% for diagnosis of hepatocellular carcinoma. After screening of the studies according to inclusion criteria and extraction of the data,meta-analysis was performed in Meta-disc 1.4 and Stata 12.0.</p><p><b>RESULTS</b>Eleven studies that met the inclusion criteria were selected from the total 138 references with potential relevance.The threshold effect was not found in the GP73 combined with AFP-L3% for the diagnosis of liver cancer.However,heterogeneity was found in this meta-analysis. The pooled sensitivity and specificity of GP73 combined with AFP-L3% was 0.853 and 0.960 respectively. The area under summary receiver operating characteristics curve was 0.948, and the Q index was 0.888.</p><p><b>CONCLUSION</b>GP73 combined with AFP-L3% can significantly improve the diagnostic sensitivity and specificity to a high level, and can improve the diagnosis rate of hepatocellular carcinoma.</p>