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Introduction: Disorders of sex development (DSDs) are congenital abnormalities in which chromosomal, gonadal, and anatomical sex development are atypical. One of these disorders, 46, XY DSD, is particularly difficult to diagnose and manage because its etiology and clinical phenotypes are highly heterogeneous. Methods: We used a gene panel containing 141 genes implicated in DSDs to perform targeted next-generation sequencing (NGS) in 50 patients with 46, XY DSD. Results: Gene variants were detected in 23 patients (46%). Among them, thirteen patients had previously reported pathogenic or likely pathogenic variants, nine patients had novel variants, and one patient had a previously reported variant of uncertain significance. Three of the patients with novel variants were pathogenic and the remaining are variants of uncertain significance; therefore, 16 patients had pathogenic or likely pathogenic variants according to ACMG guidelines, and the overall diagnostic rate of 46, XY DSD was 32%. The most common gene variants were SRD5A2 variants, followed by the AR variant. In addition, we analyzed the association between gene variants and clinical phenotypes. Most patients presented with multiple DSD phenotypes (i.e., two or more DSD phenotypes were observed, such as micropenis, hypospadias, and cryptorchidism), but the phenotype with the highest diagnostic rate was micropenis. Conclusion: Our results indicate that targeted NGS can effectively detect pathogenic gene variants in patients with 46, XY DSD.

Grim-19 (gene associated with retinoid-IFN-induced mortality 19), the essential component of complex I of mitochondrial respiratory chain, functions as a noncanonical tumor suppressor by controlling apoptosis and energy metabolism. However, additional biological actions of Grim-19 have been recently suggested in male reproduction. We investigated here the expression and functional role of Grim-19 in murine testis. Testicular Grim-19 expression was detected from mouse puberty and increased progressively thereafter, and GRIM-19 protein was observed to be expressed exclusively in interstitial Leydig cells (LCs), with a prominent mitochondrial localization. In vivo lentiviral vector-mediated knockdown of Grim-19 resulted in a significant decrease in testosterone production and triggered aberrant oxidative stress in testis, thus impairing male fertility by inducing germ cell apoptosis and oligozoospermia. The control of testicular steroidogenesis by GRIM-19 was validated using the in vivo knockdown model with isolated primary LCs and in vitro experiments with MA-10 mouse Leydig tumor cells. Mechanistically, we suggest that the negative regulation exerted by GRIM-19 deficiency-induced oxidative stress on steroidogenesis may be the result of two phenomena: a direct effect through inhibition of phosphorylation of steroidogenic acute regulatory protein (StAR) and subsequent impediment to StAR localization in mitochondria and an indirect pathway that is to facilitate the inhibiting role exerted by the extracellular matrix on the steroidogenic capacity of LCs via promotion of integrin activation. Altogether, our observations suggest that Grim-19 plays a potent role in testicular steroidogenesis and that its alterations may contribute to testosterone deficiency-related disorders linked to metabolic stress and male infertility.

A rare carotane-type sesquiterpenoid, forkienin A (1), a new eudesmane-type sesquiterpenoid, forkienin B (2), and a new natural eudesmane-type sesquiterpenoid, forkienin C (3), were isolated from the twigs and leaves of Fokienia hodginsii, along with eight known sesquiterpenoids. The structures of the new compounds were elucidated on the basis of their spectroscopic analysis, including 1D and 2D NMR methods. All compounds were evaluated for cytotoxicity against HL-60, SMMC-7721, A-549, MCF-7, and SW480 cell lines.

Muscle-invasive bladder cancer (MIBC) is associated with low survival and high recurrence rates even in cases in which patients receive systemic treatments, such as surgery and chemotherapy. Here, we found that a naturally existing alphavirus, namely, M1, selectively kills bladder cancer cells but not normal cells, findings supported by our observations of changes in viral replication and MIBC and patient-derived MIBC cell apoptosis. Transcriptome analysis revealed that interferon-stimulated genes (ISGs) are expressed at low levels in sensitive bladder cancer cells and high levels in resistant cells. Knocking down ZC3HAV1 (ZAP), an antiviral factor in ISGs, restores M1 virus reactivity in resistant cells, and overexpressing ZAP partially reverses M1 virus-induced decreases in cell viability in sensitive cells. In orthotopic MIBC mice, tail vein injections of M1 significant inhibit tumor growth and prolong survival period, antitumor effects of M1 are stronger than those of the first-line chemotherapy agent cisplatin (CDDP). Treated tumors display enhanced cleaved-caspase-3 signals, which are representative of cell apoptosis, and decreased Ki-67 signals, which are representative of cell proliferation. Moreover, tissue microarray (TMA) analyses of clinical tumor specimens revealed that up to 45.6% of cases of MIBC presented with low ZAP expression, a finding that is prevalent in advanced MIBC. Our results indicate that the oncolytic virus M1 is a novel agent capable of functioning as a precise and effective therapy for MIBC.

Winter wheat (Triticum aestivum) is cultivated across a wide region; however, water is scarce during the growing season of wheat in the Northern Plain of China. Therefore, winter wheat should be irrigated to maintain a stable and high grain yield. The aim of this field study was to develop a water-conserving precision planting pattern for winter wheat that is grown in the Northern China Plain with the purpose of exploring the benefits in maintaining water and effects on wheat productivity. To accomplish this, several production variables and photosynthetic indexes were measured, including the number of stems, the leaf area index (LAI), photosynthetically available radiation (PAR), net photosynthetic rate, and grain yield. The study was carried out during the 2011–2012 and 2012–2013 winter wheat growing seasons. The experiment included a double-row planting pattern (DRPP) and a single-row planting pattern (SRPP), both of which were either irrigated or rainfed. The area of each plot was 9 m2, and the experimental design was a randomized blocks design with three replicates. All results were analyzed with an ANOVA, the F test, and the LSD (p ≤ 0.05) for means comparison. PAR capture ratios in the DRPP were higher than those in the SRPP at 50–120 cm above the ground. The photosynthetic traits of flag leaves under irrigated conditions were not significantly influenced by the respective planting pattern. However, at a growth stage of 80 under the rainfed conditions, the mean photosynthetic rate within flag leaves in the DRPP was higher than that in the SRPP. Furthermore, the DRPP under rainfed conditions was more likely to increase the apparent quantum yield (AQY) of flag leaves than the yield obtained under irrigation. These results suggest that DRPP optimizes the canopy PAR distribution in winter wheat and contributes to the maintenance of a higher photosynthetic capacity in the flag leaves under water stress (the rainfed condition). This relationship may be applied in demonstration trials to encourage winter wheat farmers to incorporate the use of DRPP in the drought-prone areas, which are subjected to insufficient precipitation during the growing stage of wheat in Northern China. O trigo de inverno (Triticum aestivum) é cultivado em uma vasta região; no entanto, a água é escassa durante a estação de crescimento do trigo na Planície do Norte da China. Assim, o trigo de inverno deve ser irrigado para manter um rendimento de grãos estável e elevado. O objetivo deste trabalho de campo foi o de desenvolver um padrão de plantação de precisão que conserve a água para o trigo de inverno que é cultivado na Planície do Norte da China com o propósito de explorar os benefícios da retenção de água e os efeitos na produtividade do trigo. Para isso, diversas variáveis de produção e índices fotossintéticos foram medidos, incluindo o número de hastes, o índice de área da folha (do inglês, LAI - leaf area index), a radiação fotossinteticamente disponível (do inglês, PAR - photosynthetically available radiation), taxa fotossintética líquida e o rendimento de grãos. O estudo foi conduzido durante as estações de crescimento do trigo de inverno em 2011-2012 e 2012-2013. O experimento incluiu um padrão de plantação em fila dupla (do inglês, DRPP - double-row planting pattern) e um padrão de plantação em fila única (do inglês, SRPP - single-row planting pattern), em ambos os casos ou foram irrigados artificialmente ou através da chuva (regadio e sequeiro). A área de cada lote de terra foi de 9 m2, e o delineamento experimental foi um de blocos aleatórios com três repetições. Todos os resultados foram analisados com uma ANOVA, um teste F, e um LSD (p ≤ 0.05) para a comparação das médias. As taxas de captura de PAR no DRPP foram maiores do que aquelas no SRPP a 50-120 cm acima do solo. As características fotossintéticas das folhas-bandeira (do inglês, flag leaves) sob condições de irrigação artificial não foram significativamente influenciadas pelo respectivo padrão de plantação. No entanto, num estágio de crescimento de 80% abaixo das condições de irrigação pela chuva, a taxa fotossintética média dentre as folhas-bandeira no DRPP foi maior que aquela observada no SRPP. Além disso, o DRPP sob condições de irrigação pela chuva foi mais suscetível ao aumento do rendimento quântico aparente (do inglês, AQY - apparent quantum yield) das folhas-bandeira do que o rendimento obtido através da irrigação artificial. Estes resultados sugerem que o DRPP otimiza a distribuição PAR do dossel no trigo de inverno e contribui para a manutenção de uma maior capacidade fotossintética nas folhas bandeira sob estresse hídrico (a condição de sequeiro). Esta relação pode ser aplicada em ensaios de demonstração para encorajar os agricultores de trigo de inverno a incorporar o uso do DRPP em áreas propensas à seca, que estão submetidas a precipitação insuficiente durante a fase de crescimento do trigo no Norte da China.

In the era ofthe knowledge economy, the accounting priority has shifted from tangible assets to intangible assets. The knowledge economy-based intangible assets is gradually emerging as the main impetus for determining the forthcoming cash flow and market value. This paper takes the stocks listed in Shenzhen Securities Exchange as the study object, conducts empiricalstudy and analysis based on the sampling data, including 2008-2010 pershare intangible assets,per share returns, per share net assets after deducting intangible assets and share price,describes the disclosure of intangible assets of such listed companies as Jilin Forest Industry,Zhongfu Industrial, Yihua Timber Industry, Fenglin Group and Palm Landscape and inspects the value relevance of intangible assets. Accordingly, this paper proposes to consolidate the value management of intangible assets of the forestry enterprises and improve their core competítíveness.

Two novel crystalline compounds (1-C10H21NH3)2MnCl4(s) and (1-C11H23NH3)2MnCl4(s), which may be used as solid–solid phase change materials, were synthesized. The compositions and mass fraction purities of the samples prepared were determined by chemical and elemental analyses. The crystal structures of the two compounds were characterised by X-ray crystallography. The lattice potential energies of the two compounds were obtained from crystallographic data. Molar enthalpies of dissolution of the compounds at various values of molality were measured in the double-distilled water at T = 298.15 K by means of an isoperibol solution–reaction calorimeter. According to Pitzer’s unsymmetrical mixing electrolyte solution theory, the values of molar enthalpies of dissolution at infinite dilution and Pitzer’s parameters of the compounds were obtained. Finally, using the values of molar enthalpies of dissolution at infinite dilution ( Δ s H m ∞ ) and other auxiliary thermodynamic data, the enthalpy change of the dissociation of [MnCl4]2−(g) for the reaction [ MnCl 4 ] 2 - ( g ) → Mn 2 + ( g ) + 4 Cl - ( g ) was derived.

A novel compound barium d -gluconate tetrahydrate, Ba[ d -C6H11O7]2 · 4H2O, is synthesized and characterized by chemical analysis, elemental analysis, and X-ray crystallography. Single-crystal X-ray analysis reveals that the compound is formed by two d -gluconate anions, one barium (II) cation and four crystal water molecules. The compound exhibits an outstanding chelate property of d -gluconate anions to barium (II) cations, and the barium (II) cation is ten-coordinated and chelated by six d -gluconate anions. The molecules of the compound are further linked by intermolecular Ba O and O H⋯O interactions to form a 3D supramolecular architecture. The lattice potential energy and ionic volume of the anion are obtained from crystallographic data. In accordance with Hess’ law, a reasonable thermochemical cycle is designed and the standard molar enthalpy of formation of Ba[ d -C6H11O7]2 · 4H2O(s) is calculated as Δ s H m [Ba[ d -C6H11O7]2 · 4H2O, s] = −(4712.85 ± 1.06) kJ · mol−1 by use of an isoperibol solution-reaction calorimeter. Molar enthalpies of dissolution of Ba[ d -C6H11O7]2 · 4H2O(s) at various molalities are measured at T = 298.15 K in the double-distilled water. According to the Pitzer theory, the molar enthalpy of dissolution of the title compound at infinite dilution is calculated to be Δ s H m ∞ = (49.901 ± 1.212) kJ · mol−1. The values of relative apparent molar enthalpies (appH), relative partial molar enthalpies of the solvent ( H ¯ 1) and the compound ( H ¯ 2) at different molalities m/(mol · kg−1) are derived from the experimental values of the enthalpies of dissolution of the compound.

Objective To investigate the effect of fluctuation of blood glucose level on arteriosclerosis in non-diabetic population. Methods Subjects involved in an arteriosclerosis screening of annual physical examination in a Beijing community were studied. The glucose metabolic level of all the subjects was evaluated by 75g oral glucose tolerance test (OGTT), and the fluctuation of blood glucose level was assessed as the difference between 2h plasma glucose level and fasting plasma glucose (ΔPG) level. Brachial-ankle pulse wave velocity (baPWV) was examined to evaluate arteriosclerosis. The influence of glycemic variability and hemoglobin A1c (HbA1c) on arteriosclerosis was compared. Results Six hundred and twenty non-diabetic subjects were involved in present study, and then were divided into quartiles based on ΔPG. The baPWV of Q4 (1431±325cm/s) was higher than that of Q1-Q3 groups (Q1-Q3: 1265±204, 1278±199 and 1307±200cm/s, P

Crystalline bis-(n-dodecylammonium) tetrachlorocuprate (n-C12H25NH3)(2)CuCl4(s) and bis-(n-dodecylammonium) tetrachlorocadmate (n-C12H25NH3)(2)CdCl4(s) were synthesized. Chemical analysis, elemental analysis and X-ray crystallography were applied to characterise the compositions and crystal structures of the two complexes. In accordance with Hess' law, two thermochemical cycles were designed, and the enthalpy changes of the reactions of n-dodecylammonium hydrochloride with CuCl2 center dot 2H(2)O(s) and CdCl2-center dot 2.5H(2)O(s) were determined as Delta H-r(m)degrees(,1) = (32.86 +/- 0.40) kJ . mol(-1) and Delta H-r(m)degrees(,2) = -(5.28 +/- 0.38) kJ . mol(-1) by an isoperibol solution-reaction calorimeter, respectively. Eventually, the standard molar enthalpies of formation of the title compounds were derived to be Delta H-f(m)degrees [(n-C12H25NH3)(2)CuCl4, s] = -(1630.4 +/- 8.0) kJ . mol(-1) and Delta H-f(m)degrees [(n-C12H25NH3)(2)CdCl4, s] = -(1836.2 +/- 8.0) kJ . mol(-1), respectively. (c) 2013 Elsevier Ltd. All rights reserved.

Nickel hydrogen pyridine-2,6-dicarboxylate trihydrate (Ni(HDPC)2·3H2O) was synthesized by the method of liquid phase synthesis. The composition and crystal structure of the complex were determined by chemical analysis, elemental analysis, and X-ray crystallography. Low-temperature heat capacities of the complex were measured over the temperature range from 78 to 353 K. Smoothed molar heat capacities and thermodynamic functions of the complex relative to the standard reference temperature 298.15 K were calculated based on the fitted polynomial equation. A reasonable thermochemical cycle was designed, and the standard molar enthalpies of dissolution for the reactants and products of the synthesis reaction in a selected solvent were measured. Eventually, the standard molar enthalpy of formation of the title complex was derived to be −(2467.9 ± 3.2) kJ mol−1 in accordance with Hess's law.

Copper pyridine 2,6-dicarboxylate trihydrate (Cu(H2DPC)(DPC)center dot 3H(2)O) was synthesized. X-ray crystallography, chemical analysis, and elemental analysis were applied to characterize the structure and composition of the complex. Low-temperature heat capacities of the complex were measured with a small sample automated adiabatic calorimeter. The smoothed molar heat capacities and thermodynamic functions of the complex relative to the standard reference temperature 298.15 K were calculated based on the fitted polynomial equation. A reasonable thermochemical cycle was designed, and the standard molar enthalpies of dissolution for the reactants and products of the synthesis reaction in a selected solvent were measured by an isoperibol solution-reaction calorimeter. Eventually, the standard molar enthalpy of formation of the title complex was calculated as -(2389.92 +/- 2.53) kJ mol(-1) by the Hess thermochemical cycle. In addition, the reliability of the designed thermochemical cycle was verified by UV-vis spectroscopy. (C) 2013 Elsevier B.V. All rights reserved.

Zinc hydrogen pyridine 2,6-dicarboxylate trihydrate (Zn(HDPC)2 · 3H2O) was synthesized. The composition and crystal structure of the complex were determined by chemical analysis, elemental analysis, and X-ray crystallography. Low-temperature heat capacities of the complex were measured with a small sample automated adiabatic calorimeter over the temperature range from 78 K to 379 K. The experimental heat capacities of the complex were fitted by the least-squares method, and a polynomial equation of experimental molar heat capacities versus reduced temperature was obtained. The smoothed molar heat capacities and thermodynamic functions of the complex relative to the standard reference temperature 298.15 K were calculated based on the fitted polynomial equation. A reasonable thermochemical cycle was designed, and the standard molar enthalpies of dissolution for the reactants and products of the synthesis reaction in a selected solvent were measured by an isoperibol solution-reaction calorimeter. The enthalpy change of the synthesis reaction of the titled compound was calculated to be −(15.95 ± 0.43) kJ · mol−1. Eventually, the standard molar enthalpy of formation of the title complex was derived to be −(2582.60 ± 3.02) kJ · mol−1 by the Hess thermochemical cycle. In addition, the reliability of the designed thermochemical cycle was verified by UV–Vis spectroscopy.

Aim An adequate β cell number is important to prevent the onset and development of type 2 diabetes. The aim of this study was to determine if phytoestrogen gesintein has protective effects against high glucose-induced cell apoptosis in human pancreas cells, and to try to determine the possible mechanism for this protection. Methods Human pancreatic β cells were subjected to normal (5 mM) or high glucose (25 mM) with and without the presence of 100nM genistein, and also in the presence and absence of the pure anti-estrogen ICI-182780 (100 nM). Bcl-2 siRNA transfection was performed to investigate if the effect of genistein was also Bcl-2 dependent. Cell proliferation and apoptosis were determined by Tritiated Thymidine Incorporation Assay and Cell Apoptosis Detection ELISA. Estrogen receptor and Bcl-2 mRNA expression was measured by Real-time Quantitative PCR. Results High glucose concentration caused cell proliferation inhibition and apoptosis in cultured human pancreatic β cells, and these effects were significantly reversed by genistein (P

The advances of treatment improved the prognosis of the patients with acute leukemia (AL) in the last decade, but the lack of general biomarker for predicting relapse in AL, which is one of the most important factors influencing the survival and prognosis. DNA methylation of ID4 gene promoter occurred frequently in patients with AL and was found to be highly related to the tumor progression. Based on the previous work of the setup of methylation-specific quantitative PCR system for ID4 gene, this study was designed to investigate the relation between the quantitative indicator of methylation density, percentage of methylation reference(PMR) value, and different disease status of AL. PMR of ID4 was detected by MS-PCR in bone marrow (BM) samples of 17 healthy persons and 54 AL patients in the status of newly diagnosis, complete remission and disease relapse. The results showed that at different disease status, PMR value in newly diagnosed group was significantly lower than that in complete remission group (P = 0.031). Among serial samples, PMR value remained very low at the status of patients with continuous complete remission (1.5‰), and increased along with the accumulation of tumor cells at relapse. In 1 relapse case, the abnormal rise of PMR value occurred prior to morphological relapse. PMR value seemed to be related to body tumor cell load. It is concluded that the quantitative indicator of methylation density and PMR value may reflect the change of tumor cell load in acute leukemia patients. Dynamic monitoring of PMR maybe predict leukemia relapse.

Imatinib has been recognized as the frontline therapy drug in chronic myeloid leukemia (CML), however, only limited patients could achieve complete molecular remission (CMR). Recent clinical and basic proofs indicated an improved treatment outcome by the combination of interferon and Imatinib. This study was purposed to evaluated systematically the efficacy and safety of interferon plus Imatinib in patients with CML. Data from relative clinical trials were from clinical trial of gov and Cochrane Collaboration. A comprehensive literature search was performed from data bases such as pubMed and EM. The results indicated that 7 clinical trials and 12 research papers met the criteria enrolled in study, included 697 cases in total. The combination group had higher complete cytogenetic remission (CCgR) rate than imatinib alone at 6 months (58% vs 42%; P = 0.0001) and 12 months (74% vs 68%; P = 0.004). The major molecular remission (MMR) rate was also higher in the combination group at 6 months (58% vs 34%; P = 0.0001) and 12 months (66% vs 47%; P0.0001). Furthermore, compared with single drug, the combination group had superior CMR rate at 6 months (13% vs 2%; P = 0.0002) and 12 months (14% vs 5%; P = 0.0009). The major adverse effects of combination therapy were rash, asthenia, edema and musculoskeletal events, and combination therapy was more prone to inducing neutropenia, thrombocytopenia and mild anemia. It is concluded that compared with Imatinib alone, the combination of interferon and Imatinib has better clinical efficacy in treating CML with earlier cytogenetic and molecular remission. It is also a safe therapy in spite of slightly weaker tolerance than single drug therapy.

OBJECTIVE The elevated plasma glucose level and/or insulin resistance in diabetes or impaired glucose tolerance play important roles in the pathogenesis of arterial stiffness. The present study investigated whether insulin resistance correlated with arterial stiffness before the development of glucose intolerance. METHODS We conducted a cross-sectional analysis in 872 young to middle-age individuals with normal glucose tolerance (aged 36.2±8.5 years, BMI 24.6±3.1 kg/m2 [mean±SD]). The homeostasis model assessment (HOMA) index was used as a quantitative assessment of the fasting insulin resistance (FIR), and the plasma insulin level after glucose loading was adopted as an index of the post-challenge insulin resistance (PIR). The Matsuda index [ISI (composite)] was used as a measurement of the insulin sensitivity. The arterial stiffness assessed by the brachial-ankle pulse wave velocity (baPWV) was adopted to quantify its independent associations with insulin resistance. RESULTS The univariate linear regression analysis indicated that the fasting plasma glucose level (FPG, β = 68.2; 95% CI 40.9, 95.6; p

Long intergenic noncoding RNAs (lincRNAs) have important roles in biological functions, molecular mechanisms and prognostic values in colorectal cancer (CRC). In this context, the roles of linc-UFC1 remain to be elucidated. In this study, linc-UFC1 was overexpressed in CRC patient tissues and positively correlated with tumor grade, N stage and M stage. Inhibition of linc-UFC1 resulted in cell proliferation inhibition and G1 cell cycle arrest, which was mediated by cyclin D1, CDK4, Rb and phosphorylated Rb. In addition, inhibition of linc-UFC1 induced cell apoptosis through the intrinsic apoptosis signaling pathway, as evidenced by the activation of caspase-9 and caspase-3. An investigation of the signaling pathway revealed that the effects on proliferation and apoptosis following linc-UFC1 knockdown were mediated by suppression of β-catenin and activation of phosphorylated P38. Furthermore, the P38 inhibitor SB203580 could attenuate the apoptotic effect achieved by linc-UFC1 knockdown, confirming the involvement of P38 signaling in the induced apoptosis. Taken together, linc-UFC1 might have a critical role in pro-proliferation and anti-apoptosis in CRC by regulating the cell cycle, intrinsic apoptosis, and β-catenin and P38 signaling. Thus, linc-UFC1 could be a potential therapeutic target and novel molecular biomarker for CRC.

To study the impact of different insulin levels on the conversion from impaired glucose tolerance (IGT) to type 2 diabetes mellitus (T2DM), through analysis of different glycometabolism condition among quinquagenarian population.Subjects enrolled were Beijing habitants who received annual physical examination [including oral glucose tolerance test (OGTT)] in the Chinese PLA General Hospital from 2005 - 2007. According to the OGTT results, the subjects were divided into three groups, including normal glucose tolerance-non-hyperinsulinemia group (NGT-NHIns), IGT-hyperinsulinemia group (IGT-HIns) and IGT-non-hyperinsulinemia group (IGT-NHINS). The prognosis between the year 2009 and 2010 of the three groups was observed. Hyperinsulinemia was diagnosed with fasting serum insulin ≥ 15 mU/L and/or 2-hour serum insulin ≥ 80 mU/L after glucose loading.The rate of case number of conversion to T2DM in IGT-NHIns group (42/133) was higher than that in IGT-HIns group (24/154) or NGT-NHIns group (12/126). The HOMA insulin resistance index (HOMA-IR) of individuals with IGT-NHIns was lower than that of IGT-HIns [0.96 (0.40, 3.53) vs 2.04 (0.59, 23.20), P0.05], while whole body insulin sensitivity index (WBISI) was higher than that of IGT-HIns [7.48 (3.20, 31.35) vs 3.28 (0.86, 7.67), P0.05]. Modified β-cell function index (MBCI) and insulin secretion index (ISI) in IGT-NHIns was poorer than that of IGT-HIns respectively [2.57 (0.58, 10.98) vs 5.17 (1.04, 65.09); 7.66 (0.99, 28.40) vs 17.56 (4.18, 96.46), all P values0.01].The risk of IGT-NHIns progressing into T2DM is higher than that of IGT-HIns. For the prevention of T2DM, individuals with IGT-NHIns should be paid more attention than keeping an eye on IGT-HIns patients. Early control of risk factors could protect β cell function and prevent the progression to T2DM.

Subclinical apoplexy of pituitary functional adenoma can cause spontaneous remission of hormone hypersecretion. The typical presence of pituitary growth hormone (GH) adenoma is gigantism and/or acromegaly. We investigated the clinical characteristics of patients with spontaneous partial remission of acromegaly or gigantism due to subclinical apoplexy of GH adenoma.Six patients with spontaneous remission of acromegaly or gigantism were enrolled. The clinical characteristics, endocrinological evaluation and imageological characteristics were retrospectively analyzed.In these cases, the initial clinical presences were diabetes mellitus or hypogonadism. No abrupt headache, vomiting, visual function impairment, or conscious disturbance had ever been complained of. The base levels of GH and insulin growth factor-1 (IGF-1) were normal or higher, but nadir GH levels were all still1 µg/L in 75 g oral glucose tolerance test. Magnetic resonance imaging detected enlarged sella, partial empty sella and compressed pituitary. The transsphenoidal surgery was performed in 2 cases, and the other patients were conservatively managed. All the patients were in clinical remission.When the clinical presences, endocrine evaluation, biochemical examination and imageology indicate spontaneous remission of GH hypersecretion in patients with gigantism or acromegaly, the diagnosis of subclinical apoplexy of pituitary GH adenoma should be presumed. To these patients, conservative therapy may be appropriate.

Tumors originating from ectopic adrenal tissue are relatively rare. In this article, we describe a case with Cushing's syndrome caused by an ectopic adrenal adenoma. A 38 year-old male patient presenting with cushingoid appearance for 2 years was diagnosed to have ACTH-independent Cushing's syndrome based on endocrinological evaluation. Mutiple radiological examinations detected bilateral adrenal atrophy. When the images were investigated in a more expanded scope, a 3.0×3.5×5.3 cm mass was detected in the anterior of left renal hilum and left renal vein. The mass was successfully resected with intraoperative endoscopy and pathological evaluation revealed an ectopic adrenal tumor. It is suggested that when the endocrinlogically confirmed adrenal neoplasm could not be well and definitely localized, the possibility of ectopic adrenal should be presumed and further radiography examinations should extend to the field where ectopic adrenal usually presents.

A rare case with ectopic adrenocorticotrophic hormone syndrome (EAS) caused by medullar thyroid carcinoma (MTC) in mediastinum was reported. This 49 year-old male patient initially presented with serious and intractable hypokalemia. Endocrine evaluations showed increased levels of adrenocorticotrophic hormone (ACTH) and urinary free cortisol, which could not be suppressed more than 50% by high-dose dexamethasone suppression test. Computed tomography (CT) scan detected a 5×5×5 cm mass at the bottom of thyroid in anterior mediastinum. The patient underwent total thyroidectomy with central compartment and ipsilateral modified radical neck dissection. Pathological examination showed an infiltrating thyroid medullary carcinoma with abundant amyloid deposition, meanwhile immunohistochemical positive for ACTH. After surgery, serum levels of kalium, as well as cortisol and ACTH returned to normal range. During follow-up, the patient's clinical manifestation of Cushing syndrome relieved.