Synthetic pesticides-pyrethroids have been widely used in agriculture and in households. Most of them are the environmental hormone substances. Pyrethroids have toxic effects on animals and humans,inducing teratogenicity,carcinogenicity and mutagenicity. In the present paper,the typical animals-fish,mice and rats were choosen for the health risk assessment,and the research progresses on adverse effects of pyrethroids in nervous toxicology,physiological and biochemical toxicology,reproductive toxicology were summerized,as well as the effects of the animal enzymes and immune system.

Patients often suffered limb dysfunction after stroke. Upper limb and hand function recovered more slowly than lower limb, and became one of the research focuses in rehabilitation medicine. Timely and effective assessments were important to guide the rehabilitation treatment, evaluate the treatment efficacy and predict functional recovery of upper extremity and hand function. The assessment methods of upper limb and hand motor function included subjective evaluations and objective evaluations. The former included different kinds of scales, which involved assessment focusing on muscle, motor pattern, change of upper limb and hand function. While the latter contained biomechanics, neuroelectrophysiology, functional magnetic resonance imaging, upper limb robotic evaluation system and so on. Scales were proved to have good reliability and validity. But they could not show patients' function accurately because of the subjectivity, and the data could not be kept. Evaluation system with computer was applied in clinical practice more and more widely. In this review, we summarized the assessments on upper limb and hand motor function in patients after stroke.

Objective To evaluate comparability of two different assay system for detecting CRP.Methods Following the profile of Clinical and Laboratory Standard Institute (CLSI)document EP9-A2,50 blood samples with anti-coagulant ED-TA-2K were collected from emergency patients at Changhai Hospital.The test result of samples by the i-CHROMA Reader was compared and evaluated with those by Beckman Immage 800.Results The linear regression equation for plasma CRP was:Y=1.076 5X-3.031 5,R2=0.986.The linear regression equation for whole blood CRP was:Y=0.882 6X-1.180 8, R2=0.931 1.For whole blood samples with low HCT (<30.45%).Used correction equation:CRP (after corrected)=CRP (before corrected)/(1-HCT).The regression equation (after corrected)was:Y=1.006 8X-3.612 2,R2=0.950 9.Con-clusion CRP concentration detected by i-CHROMA showed good correlation and comparability compared to laboratory ref-erence system by using plasma samples.Results form whole blood samples with low HCT should be corrected to improve comparability.

Background and purpose: The effects of tumor after radiotherapy and chemotherapy with tumor cell apoptosis have positive correlation. Survivin is an apoptosis suppressor gene, which is overexpressed in lung cancer. The reduction of its expression can increase lung cancer cell apoptosis. RNA interference can speciifcally and effectively blocked the expression of this gene. After accepting a dose of radiation, tumor tissues can raise the rate of gene transduction. The purpose of this study was to investigate the effects of the expression of Survivin gene suppressed by intratumor injection siRNA and radiation in lung cancer. Methods:Mouse subcutaneous transplanted with tumors were randomly divided into four groups:untreated group (group A), group with intratumor injection siRNA (group B), group with radiation (group C), group 4 Gy pre-irradiation combination with intratumor injection siRNA (group D). Two days later, mouse with different treatments were executed by cervical dislocation and stripped the subcutaneous tumors. mRNA and protein levels of Survivin gene were detected by quantitative real-time PCR (qRT-PCR) and Western blot; Cell cycle and cell apoptosis were assayed by lfow cytometry (FCM). Results:The expression of Survivin gene in mRNA and protein levels in group B, C, and D were signiifcantly reduced compared with group A. The differences of Survivin expression in mRNA level between group A and group D were statistically signiifcant. Compared with the other 3 groups, the expression of Survivin gene in group D was signiifcantly reduced, the differences were statistically signiifcant (P=0.036);The proportion of cells in S-phase of group D was (2.70±0.34)%, compared with group B [(8.93±0.75)%] and group C [(6.71±0.51)%], that was significantly reduced. The differences of the proportion of S-phase cells in group A and group D were statistically signiifcant (P=0.034);The rate of cell apoptosis in group D was (25.67 ± 0.65)%, which was signiifcantly increased compared with the rate of cell apoptosis in the other 3 groups, the differences were statistically signiifcant (F=78.82, P<0.05). Conclusion:Pre-irradiation can enhance the transduction rate of siRNA, reduce the expression of Survivin gene in lung cancer, promote cell apoptosis, and increase the sensitivity of the radiotherapy.

The clinical data of 459 patients,who were first diagnosed as HIV/HBV co-infection from January 2007 to December 2013,were retrospectively analyzed.Among all patients,there were 89 cases with CD4 ＜ 50/μl,134 cases with CD4 50-200/μl and 236 cases with CD4 ＞ 200/μl,when HIV infection was diagnosed.In these three groups with different CD4 levels,the HBV DNA positive rates were 49.3％ (37/75),50.5％ (54/107) and 33.7％ (66/196);the HBV viral load were (6.37 ± 1.71) log10 copies/ml,(5.82 ± 1.86) log10 copies/ml and (4.36 ± 1.64) log10 copies/ml;the rates of abnormal liver function were 29.2％ (26/89),29.1％ (39/134) and 10.6％ (25/236);the occurrence rates of end-stage-liver-diseases were 16.9％ (15/89),14.9％ (20/134) and 5.1％ (12/236);the mortality rates were 10.1％ (9/89),9.7％ (13/134) and 3.8％ (9/236),respectively.The HBV DNA positive rates,HBV viral load,the rates of abnormal liver function,the occurrence rates of end-stage-liver-diseases and the mortality rates in CD4 ＞ 200/μl group were lower than that in CD4 ＜ 50/μl group and 50-200/μl group.The results suggest that for HIV and HBV co-infection patients,HBV replication level and prognosis of liver diseases are associated with CD4 + T lymphocyte count.

Objective To investigate the drug resistance and distribution of Staphylococcus aureus isolated from infected pa‐tients in our hospital from 2009 to 2013 ,and provide basis for clinical treatment .Methods Retrospective review was adopted to an‐alyze the antibiotic resistance and the specimen source of 562 SA strains .ATB Expression and ID 32 STAPH were used to identify SA .Antibiotic susceptibility testing was performed by K‐B method .Results 562 SA strains ,including 218 MRSA ,are mainly from secretions ,sputum and pus .Resistance was most frequently observed on penicillin ,followed by erythromycinand clindamycin .None of the isolates was resistant to vancomycin ,amikacin ,nitrofurantoin and linezolid .The resistance rates of MRSA to penicillin ,eryth‐romycin ,cotrimoxazole ,clindamycin ,gentamicin ,cefoxitin ,tetracycline and rifampicin were obviously higher than that of MSSA ,and there are very significant differences between them (P<0 .05) .Conclusion There is a declining trend in the isolation rates of SA and MRSA in our hospital ,but the drug resistance situation remains serious .Vancomycin is still the first option for the cure of MR‐SA infections .Therefore ,strengthening SA resistance monitoring and avoiding misuse of antimicrobial drugs is an effective way to prevent SA infection .

Objective:To explore the epidemic characteristics, clinical features and therapeutic effects of Kala-azar in Yangquan City, Shanxi Province in recent years, and to improve the cognition of Kala-azar.Methods:The clinical data of 17 adult cases of Kala-azar in Yangquan City, Shanxi Province in 2018 and 2019 were collected by retrospective analysis method, the epidemiological characteristics, clinical diagnosis and first diagnosis, clinical manifestations, laboratory and imaging examination, treatment and prognosis of the patients were sorted and analyzed.Results:All 17 patients were from Yangquan City, Shanxi Province, including 15 males and 2 females. The main clinical manifestations were long-term irregular fever (17 cases), anemia (13 cases) and splenomegaly (16 cases). The main manifestations of blood routine included decreased white blood cell count (14 cases), anemia (13 cases), and decreased platelet count (10 cases). The positive rate of rk39 immunochromatographic strip test was 100.00% (14/14). Nine patients underwent bone marrow puncture smear examination, 7 patients were positive for Leishman-Donovan bodies. All patients were treated with sodium pentavalent antimony gluconate (hereinafter referred to as antimonials) for 10 days, the cure rate was 88.24% (15/17), and recurrence rate was 11.76% (2/17).Conclusions:The clinical manifestations of Kala-azar are not typical, and it is easy to be misdiagnosed. Early examination of bone marrow puncture smear and serum antibody should be carried out for suspected patients. Antimonials is still a safe and effective drug for treating Kala-azar.

Objective:To investigate the diagnostic value of mitochondrial associated protein fumarylacetoacetate domain containing protein 1 (FAHD1) and growth differentiation factor-15 (GDF-15) in sepsis.Methods:Based on the database of the whole process of sepsis early warning, diagnosis and treatment management, which was established on the study of sepsis early warning and standardized diagnosis and treatment system, adult patients with suspected infection admitted to the department of critical care medicine of Zhejiang Hospital, Second Affiliated Hospital of Zhejiang University, the First Affiliated Hospital of Sun Yat-Sen University, West China Hospital of Sichuan University, Ningbo First Hospital from May 2014 to October 2015 were enrolled. The basic vital signs, and the main blood routine results, liver and kidney function, blood gas, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) and sequential organ failure assessment (SOFA) score at the time of diagnosis of patients with or without sepsis were analyzed. The preserved serum samples were taken, the levels of procalcitonin (PCT), C-reactive protein (CRP) were detected by electrochemiluminescence method, immunoturbidimetry respectively, and FAHD1 and GDF-15 were detected by enzyme linked immunosorbent assay (ELISA). Univariate and multivariate Logistic regression were used to analyze the risk factors for sepsis diagnose. The indexes' diagnostic efficacy in sepsis were analyzed by receiver operating characteristics curve (ROC curve).Results:A total of 132 patients were enrolled, including 76 cases of sepsis and 56 cases of non-sepsis. Compared with the non-sepsis group, the heart rate in the sepsis group was increased (bpm: 116.4±17.8 vs. 97.4±19.1), while the mean arterial pressure (MAP), platelet count (PLT), arterial partial pressure of oxygen (PaO 2) were significantly decreased [MAP (mmHg, 1 mmHg = 0.133 kPa): 65.8±9.7 vs. 74.7±10.3, PLT (×10 9/L): 120 (69, 204) vs. 163 (117, 239), PaO 2 (mmHg): 83.0 (66.6, 108.0) vs. 108.0 (84.4, 130.0), all P < 0.05], direct bilirubin (DBil), serum creatinine (SCr), lactic acid (Lac), APACHEⅡ score and SOFA score were significantly increased [DBil (μmol/L): 13.00 (5.55, 55.31) vs. 6.20 (2.20, 21.90), SCr (μmol/L): 118.00 (70.00, 191.73) vs. 77.20 (59.65, 110.86), Lac (mmol/L): 2.90 (1.50, 4.10) vs. 1.90 (1.20, 2.80), APACHEⅡ score: 20.0 (16.0, 25.0) vs. 16.0 (10.0, 21.0), SOFA score: 12.0 (8.0, 16.0) vs. 8.0 (5.0, 13.0), all P < 0.05]. In addition, the serum levels of FAHD1, GDF-15, PCT and CRP in sepsis group were significantly higher than those in non-sepsis group [FAHD1 (μg/L): 3.96 (2.25, 5.92) vs. 2.47 (1.03, 3.54), GDF-15 (μg/L): 8.46 (4.37, 19.68) vs. 4.32 (1.74, 10.39), PCT (μg/L): 3.79 (1.37, 11.32) vs. 0.42 (0.12, 2.14), CRP (mg/L): 154.43 (61.33, 283.20) vs. 65.95 (28.15, 144.69), all P < 0.01]. Multivariate Logistic regression showed that serum FAHD1 [odds ratio ( OR) = 1.135, 95% confidence interval (95% CI) was 1.045-1.234], GDF-15 ( OR = 1.090, 95% CI was 1.029-1.155) and CRP ( OR = 1.007, 95% CI was 1.002-1.011) were risk factors for sepsis (all P < 0.05). ROC curve analysis of sepsis showed that the areas under ROC curve (AUC) of serum mitochondrial associated proteins FAHD1 and GDF-15 were 0.727 (95% CI was 0.641-0.802) and 0.677 (95% CI was 0.588-0.757), respectively; and the AUC of classical infection indexes PCT and CRP were 0.767 (95% CI was 0.683-0.837) and 0.680 (95% CI was 0.59-0.760), respectively. There was no significant difference between the AUC of mitochondrial associated proteins and classical infection indexes. The combination of FAHD1, GDF-15, PCT and CRP had the largest AUC, which was 0.809 (95% CI was 0.730-0.874), and the sensitivity was 75.00%, and the specificity was 80.00%. Conclusion:Mitochondrial associated protein FAHD1 and GDF-15 are associated with sepsis, and the diagnostic efficiency is improved when combined with PCT and CRP, which might provide experimental basis for screening diagnostic markers of sepsis.

Objective:To explore the mediating effect of positive emotion on relationship between cognition reappraisal and meaning of life in freshmen.Methods:Totally 192 freshmen[62 males and 130 females,aged 18 to 22 years,mean age (20 ± 2) years] were assessed with the Chinese version of the Emotion Regulation Questionnaire (ERQ),Positive words of the Positive and Negative Affect Scale (PANAS) and Chinese version of the Meaning of Life Questionnaire (MLQ).Interval of 3 months of longitudinal data was used to investigate the mediating role of positive emotions in cognitive reappraisal sense and meaning of life.Results:The EPQ scores were positively correlated with the scores of PA,MLQ-P,and MLQ-S(r =0.17-0.26,Ps ＜ 0.05).The PA scores were positively correlated with the scores of MLQ-P and MLQ-S (r =0.16-0.35,Ps ＜0.05).Bootstrap test showed that positive emotions mediated meaning of life through cognitive reappraisal (95％ CI:0.065-0.295).The structural equation model proved to exhibit an appropriate data fit (x2/df=1.58,RMSEA =0.06,CFI =0.98,GFI =0.95).Conclusion:It indicates that cognitive reappraisal is related to meaning of life and positive emotions,and positive emotions mediate the relationship between cognitive reappraisal and meaning of life among freshmen.

Objective To compare the different front plastic angle with reinforced plastic endotracheal tube guidance by McGrath -5 video laryngoscope for orotracheal intubation in obesity.Methods 1 20 cases with obesity undergoing general anesthesia,ASA gradeⅠ -Ⅲ who planned intubation guidance by McGrath -5 video laryngo-scope,were randomly divided into three group according to different front plastic angle for endotracheal tube:group A (catheter 60°),group B(catheter 75°),C group(catheter 90°),40 cases in each group.General information and air-way evaluation indexes such as Mallampati classification,the degree of open mouth,neck circumference,thyromental distance,atlanto -occipital joint stretch degree preoperatively were recorded.C /L classification with laryngoscopic exposure,the successful rate of first intubation,time of first intubation,cases of second intubation,the incidence of blood stained catheter and postoperative sore throat and hoarseness were recorded also.Results There were no signif-icant differences of patients with general information and airway evaluating indexes such as Mallampati classification, the degree of open mouth,neck circumference,thyromental distance,atlanto -occipital joint stretch degree among three groups(P >0.05).The successful rate of catheter alignment glottal was 97.5% in group B,which was signifi-cantly higher than that of group A(80.0%)and group C(85.0%)(χ2 =8.36,P <0.05).The time of first intuba-tion was 21 (1 0 -65)s in group B,which was significantly shorter than that in group A[30(1 4 -78)s,Z =3.87,P <0.05]and group C[32(9 -80)s,Z =4.32,P <0.05].All patients in three groups had successful intubation firstly or secondly.The incidence rate of blood stained catheter in group B(2.5%)was significantly lower than that in group A(1 0%)and group C(1 5%,P <0.05 ),but there was no significant difference in postoperative sore throat and hoarseness among three groups(P >0.05).Conclusion McGrath -5 video laryngoscope which guided endotracheal tube with front plastic angle at 75°degree has highest success rate of intubation,shortest intubation time,least compli-cation and is suitable for the application of tracheal intubation in obese patients.