Due to the presence of various organotins from numerous anthropogenic sources, a widespread human exposure to these pollutants can be suggested. Human exposed to organotins mainly from dietary besides skin and lung absorption. Based on the exposure routes of organotins to human, such as air, drinking water, food and household commodities, the exposure level of organotins to human and its harmful effects were reviewed. Finally, the methods of human risk assessment of organotins were simply introduced, and the primary problems at present were put forward.

Objective To study the effects of tyrosine kinase receptor B-brain-derived neurotrophic factor (TrkB-BDNF) signal pathway on the secretion of vascular endothelial growth factor (VEGF) and matrix metalloproteinases-9(MMP-9) of neuroblastoma.Methods We used all-trans retinoic acid (ATRA) to induce the high expression of TrkB in the SH-SY5Y cell line,and then added the ectogenid BDNF to activate the TrkB-BDNF and its three downstream signal pathways.TrkB-BDNF signal pathway was inhibited by specific tyrosine kinase inhibitor K252a.The three downstream signal pathway was respectively inhibited by LY294002 (the phosphatidylinositol 3-hydroxy kinase (PI3 K) pathway inhibitor)、U73122 (the phospholipase C pathway inhibitor) 、U0126(the mitogen activated protein kinase pathway inhibitor).Enzyme linked immunosorbent assay was used to detect the concentration of VEGF and MMP-9 protein in the SY5Y cell culture supernatants.Results VEGF [(485.89 ± 109.99) pg/ml] and MMP-9 [(15.73 ± 1.72) pg/ml] protein levels in neuroblastoma cells cultured in serum-free media in the group of ATRA + BDNF were significantly higher than that of the control group and ATRA alone group(P ＜0.05).VEGF [(272.42 ±86.33) pg/ml]and MMP-9 [(5.25 ± 1.44) pg/ml] protein levels in the group of ATRA + BDNF + K252a were significantly lower than those of the ATRA + BDNF group(P ＜ 0.05) and had no significant difference compared with the control group and the ATRA alone group(P ＞0.05).VEGF [(314.12 ±24.68) pg/ml] and MMP-9 [(4.91 ± 1.08) pg/ml] protein levels in the group of ATRA + BDNF + LY294002 were significantly lower than those of the ATRA + BDNF group(P ＜ 0.05) and had no significant difference compared with the control group and the ATRA alone group(P ＞0.05).VEGF [(444.08 ±64.49) pg/ml] and MMP-9 [(13.28 ±3.38) pg/ml] protein levels in neuroblastoma cells cultured in serum-free media in the group of ATRA +BDNF + U73122 had no significant difference compared with the ATRA + BDNF group(P ＞ 0.05).VEGF [(429.97 ± 19.95) pg/ml] and MMP-9 [(13.96 ± 4.45) pg/ml] protein levels in neuroblastoma cells cultured in serum-free media in the group of ATRA + BDNF + U0126 had no significant difference compared with the ATRA + BDNF group(P ＞ 0.05).Conclusion Activation of TrkB-BDNF signal pathway can increase the synthesis and secretion of VEGF and MMP-9 in human neuroblastoma cells.TrkB-BDNF signal pathway may be through activating its downstream PI3K pathway to increase the synthesis and secretion of VEGF and MMP-9 in human neuroblastoma cells.The synthesis and secretion of VEGF and MMP-9 can be inhibited by blocking the TrkB-BDNF signal pathway with K252a or blocking its downstream signal pathway PI3 K with LY294002.

Objective To investigate the potential effect of the redox state of plasma factor Ⅺ (FXI) on the pathogenesis of elderly diabetic hypercoagulability and macroangiopathy.Methods The plasma levels of reduced FXI were detected in elderly type 2 diabetic(T2DM)patients with/without macroangiopathy (T2DM group/DMAP group) and healthy subjects (control group),and variables associated with reduced FXI were analyzed.Results Elderly patients with T2DM had higher plasma levels of reduced FXI as compared with healthy controls.The level of reduced FXI was significantly higher in patients with macroangiopathy than without macroangiopathy [control group:(80.6± 15.6) ％,T2DM group:(94.7 ± 16.0) ％,DMAP group (142.6 ± 36.5) ％,all P＜ 0.05].The multiple stepwise regression analysis showed that plasma levels of triglyceride,cholesterol and HDL-cholesterol were the independent predictors for reduced FXI.Conclusions The plasma level of reduced FXI is increased in elderly T2DM patients with macroangiopathy.The abnormality of lipid profiles may associate with the increment of reduced FXI.These findings maybe provide the novel mechanisms for diabetic hypercoagulability and macroangiopathy.

OBJECTIVE To investigate the clinical degree of satisfaction to sterilizing-supplying center,and to consummate the development of the transition of its decentralized administration to centralized pattern.METHODS We designated the questionnaire of degree of satisfaction(DOS) and carried out the investigation.RESULTS The initiated DOS was 90.6%,the DOS in mid-stage(2006-2007) was 97.3%,and the DOS in the latest stage(2008) was 99.1%.CONCLUSIONS Centralized administration is effective pattern for the development of sterilizing-supplying center and important to ensure the quality of sterile materials and service for clinical medicine.

Objective To evaluate the robustness of body mass index (BMI) adapted tube current selection method for obtaining consistent image quality in MSCT coronary artery imaging Methods Initially one hundred patients in the control group ( C group) underwent cardiac scans using GE 64-row VCT with standard scan protocol (640 mA, 120 kV, 0.35 see, body bewtie, C2 filter). Noise measurement was obtained for each patient using the average of three consecutive slices in the ascending aorta with ROI of 10 mm×10 mm to establish the relationship between BMI, desired image noise (IN) and required mA. An excel table was established to predict the required mA to achieve a desired IN for each patient with different BMI. A second group of one hundred cardiac patients (L group) was scanned with BMI-aclapted mA from the table to evaluate the practicability of this method. BMI, IN, CT dose index(CTDI),effective dose (ED) were all recorded. Results For the control group of 100 patients, the mean values and standard deviations of image quality score (IQS), BMI, IN and ED were 3.71±0.54, 25.08±2.63, 24.56±5.03 and (17.63±1.68 ) mSv (with range of 15-22 msy). Regression analysis indicated linear relationship between BMI and image noise with fixed mA. Using the relationship between tube current and image noise and noise ratio between large bowtie and cardiac bowtie, the following equation for the required tube current Xma to achieve present image noise of Ins for patient with certain BMI value when using cardiac bowtie could be then obtained: Xma = Fma×( k1 x BMI + c1 )/Ina]2, where Fma = 640 mA, k1 = 1. 033, c1 = - 3.2, Ins = 27 in the study. (2) For the patients in L group, the mean values and standard deviations of IQS, BMI, and IN were 3.69±0.53, 25.07±2.91, and 26.61±3.44, respectively. The average tube current used was (469.95±113.45) mA, depending on patient's BMI values. The average effectively dose was(9.08±2.25) mSv. There was no statistically difference between the two groups in image quality( F= 0.068,P=0.794). Conclusions In 64-MSCT cardiac imaging, the use of BMI dependent tube current selection method, in conjunction with dose reduction techniques, can provide individualized scan protocol to obtain consistent image quality across patient population and to optimize dose delivery to patients.

Objectives To explore the correlation between the population characteristics of sero-reactivity with quantitative antibody based-IHA and the transmission parameters,such as epidemic situation,transmission status or infection trend in population.Methods The residents in one endemic administrative village were simultaneously examined by Kato-Katz technique for parasitological stool examination,as well as by immuno-diagnostic technique IHA for detection of IgG antibody against soluble egg antigen for two consecutive years.The results of examination were analyzed and compared on the diagnostic parameters of IHA,the correlation of the changes of positive rates and antibody levels of IHA with the changes of infection trend in population and the distribution of antibody levels between 'the true negative' and 'the true positive'.Results When Kato-Katz technique based on 2 stool samples,each read in 3 thick smears,was used as the reference,the overall sensitivity of IHA was high (from 77.27% to 85.48%) with a relatively poor specificity of lower than 60%,the negative predict value (NPV) was excellent of higher than 94%.The specificity of IHA decreased with the increase of the age in different age-groups of population,showing the highest among the younger less than 15 years old.The distribution trends of positive rates of antibody in different age groups by IHA showed similar to that of egg positive rate detected by Kato-Katz although the positive rates of IHA were higher than these by Kato-Katz,which showed that a higher false positive (from 41.90% to 44.56%) and a certain false negative (from 14.52% to 22.73%)existed in IHA.The positive rate of antibody decreased slowly among the individuals with S.japonicum infection,who received treatment.There was an overlap in the distribution of antibody levels between ' the true negative' and ' the true positive'.Conclusions Under the current schistosomiasis epidemic situation in China,IHA is valuable in the epidemiologic surveys.It should be of further deliberation applying IHA as the screening approaches for identification of target individuals for treatment or determination of the infection rate in community and IHA needs to be combined with the parasitological examination.

Objective To study the effect of anti-epileptic,nootropic drugs on the expression of NCAM and ERK2 in the hippocampus changes on the epileptic rats with cognitive dysfunction.Methods A total of 120Wistar rats were used.20 controls and 100 in which epilepticus with cognitive dysfunction were randomly assigned to 5 groups (n =20/group) that received daily treatments for 30 days with either (1) saline (epilepsy),(2) carbamazine (traditional anti-epileptic),(3) oxcarbazine (new anti-epileptic),(4) aniracetam (brain protective),or (5) donepezil (nootopic).Spatial learning and memory were assessed with a Morris Water Maze (MWM).Hippocampus tissue was assessed for NCAM1 and ERK-2 mRNAs by RT-PCR and proteins by immunochemistry.Results The mean escape latency of the place navigation test:EP group ((67.14 ± 7.37)s)was all higher than NS group (35.78 ± 4.84 s)and there was statistical significance (P ＜ 0.01),carbamazepine group ((81.23 ± 9.46)s) ＞ EP group((67.14 ±7.37)s) ＞ donepezi group((53.75 ±6.74) s) (P＜0.01).Immunohistochemical and RT-PCR result:carbamazepine ＜ oxcarbazepine ＜ epilepsy ＜ aniracetam ＜ donepezi group.Compared with control group,donepezil group ＞ control group (P ＜ 0.01),aniracetam group ＞ control group (P ＜ 0.05).Conclusion ERK-2 expression is decreased and NCAM 1 expression is increased in the hippocampus in the epileptic rats.Thus,both are involved in cognitive dysfunction.Carbamazepine aggravates cognitive dysfunction,whereas donepezil improves cognitive dysfunction associated with epilepsy.

ObjectiveTo evaluate the effect of labor analgesia and the outcome of maternals and neonatals by applying the vitamin B6- folic acid mixture to combined with spinal-epidural analgesia(CSEA) in nulliparous women at latency.MethodsAll the 112 full-term nulliparous parturients were selected and divided into the treated group and controlled group.Nulliparous women in two groups received CSEA,with which the additional vitamin - folic acid mixture was used only in treatment group.The contrast between the analgesic effect in groups,and alalgesic effect-acting period,fentanyl Apgar score and newborn usage were compared between groups also.ResultsThe analgesic effect-acting period and fentanyl dosage in the treated group were significantly decreased.There was significant difference between the 2 ( P ＜ 0.05 ).ConclusionsIt could be effective applying vitamin B6- folic acid mixture at latency in nulliparous women based on CSEA,which could shorten the lumbar hemp effect-acting period and reduce fentanyl narcotic drugs dosage.

Objective To characterize the association between the mean CT value on a scout view and the dependent mA selection method, and to evaluate the clinical value of a mA selection method based on scout view mean CT value in obtaining individualized scan protocol and consistent image quality for patient population on 64-row MSCT CT coronary angiography (CTCA).Methods One hundred patients (group A) underwent CCTA consecutively using standard protocol with a fixed mA.The mean CT value of a fixed ROI (region of interest) from the scout AP view and the CTCA image noise (standard deviation on the root of ascending aorta) were measured.The correlation between CT values and noise was studied establish a formula and a list to determine the required mA for obtaining a consistent CTCA image noise based on the measured SV CT value.Another 100 patients (group B) were scanned using the same parameters as group A except the mA and the CT value was also measured.The mA was determined by the list established previously.The CTCA image quality (IQ) as well as the image noise (IN) and the effective dose (ED) from the two groups were statistically analyzed using t-test.The CT findings for the 32 patients in the group B were also compared with the selective coronary angiography (SCA) results.The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of CCTA for detection of significant stenosis were obtained.Results The formula between the required mA and the CT value was : XmA=FmA×[(K1×CTscout + C1)/INa]2.The CCTA images in B group had statistically higher IN (27.66±2.57,22.22±4.17,t=11.33, P=0.000), but no statistical difference between IQ scores for the two groups (3.29±0.66,3.37±0.67,t=0.009, P=0.990), and ED[(8.72±2.51) versus (12.53±0.90) mSv]was 30% lower for the B group (P<0.01).For the 32 patients in the B group who had SCA, the CCTA sensitivity, specificity, positive predictive value, negative predictive value, and stenosis detection accuracy were 94.92% (56/59), 92.13% (82/89) ,88.89% (56/63) ,96.47% (82/85) and 93.24% (138/148) wspectively for stenosis greater than 50%.Conclusion The mA selection method based on the SV CT value for CCTA in 64-row MSCT provides individualized protocol to obtain consistent image quality and to optimize dose delivery to patients.

Objective To investigate the application value of percutaneous sinus-tract cholangioscopy in the diagnosis and treatment of residual intra-and extra-hepatic bile duct stones.Methods The retrospective cross-sectional study was conducted.The clinical data of 1 045 patients with intra-and extra-hepatic bile duct stones who underwent percutaneous sinus-tract cholangioscopy or stone extraction in the Second Affiliated Hospital of Zhejiang University from January 2003 to June 2016 were collected.Patients received percutaneous sinus-tract cholangioscopy or stone extraction at 6-8 weeks after T tube drainage.Observation indicators:(1) diagnosis and stone extraction situstions:cases with residual stones,stone extraction frequency and clearance rate;the critics of clearance rate are no residual stone dnring operation combined with B ultrasound or T-tube cholangiography;(2) postoperative complications:incidence and management of postoperative complications,prognosis and ClavienDindo classification for postoperative complication;(3) follow-up situation.T-tube was removed when there was no residual stone.Patients were followed up by outpatient examination up to April 2017.B ultrasound reexamination was performed to detect the recurrence of stone once every 3-6 months.Results (1) Diagnosis and stone extraction situstions:among 1 045 patients,results of cholangioscopy showed 147 wihout bile duct stones and 898with bile duct stones.Of 898 patients,2 618 times cholangioscopic explorations for stone extraction were performed,with a maximum frequency of 16 times,and 851 had stones clearance,with a overall clearance rate of 94.77％(851/898).The clearance rates of extra-and intra-hepatic bile duct stones were 100.00％(221/221) and 93.06％(630/677).Of 47 patients with residual stones,16 didn't receive cholangioscopy due to branches stricture or occlusion of intrahepatic duct,13 failed to take out stone due to T-tube dislodgement (9 cases) and improper placement (4 cases) induced closed T-tube sinus tract,7 had T-tube sinus tract duodenal fistula,6 gave up stone extraction,3 was due to longer sinus tract induced bending and 2 was due to T-tube sinus tract fracture.(2)Postoperative complications:among 1 045 patients,297 had level Ⅰ-Ⅱ mild complications and 13 had level Ⅲand above severe complications.The common complications included fever,vomiting,diarrhea and so on;the special complications included T-tube sinus tract duodenal fistula of 13 patients,T-tube sinus tract fracture of 4 patients,rupture of broken stones pole of 3 patients,massive hemobilia of 2 patients,acute pancreatitis of 2patients and cardiac arrest of 1 patient.The above complications were improved by symptomatic and supportive treatments.(3) Follow-up situation:among 1 045 patients,558 received long-term follow-up,with follow-up time of 10-171 months and a median time of 79 months.Eight-four patients had stone recurrence.Of 13 patients with recurrence of extrahepatic bile duct stones,7 took out stones by endoscopic retrograde cholangio pancreatography (ERCP) and 6 underwent reoperations.Of 71 patients with recurrence of intrahepatic bile duct stones,43underwent reoperations and 28 received conservative treatment.Conclusions Percutaneous sinus-tract cholangioscopy for residual intra-and extra-hepatic bile duct stones is safe and effective,with good diagnosis and treatment values and a high clerance rate.The integrity of T-tube sinus-tract is a key of complete stones removal.