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.

Objective To understand the distribution and antimicrobial resistance of pathogenic bacteria isolated from patients in the department of infectious diseases in Xiangya Hospital.Methods The distribution and antimicrobial susceptibility testing results of pathogenic bacteria isolated from patients in this department in 2011 -2015 were analyzed retrospectively.Results A total of 560 strains were isolated during 5 years,of which gram-posi-tive bacteria and gram-negative bacteria accounted for 44.1 % (n =247)and 55.9%(n =313)respectively.69.8%(81/116)of coagulase-negative staphylococcus and 24.3%(9/37)of Staphylococcus aureus were methicillin-resistant (MRCNS,MRSA)respectively.Enterococcus was highly susceptible to vancomycin,linezolid,and phosphonomy-cin (>81 %).Enterobacteriaceae remained highly susceptible to carbapenems (88.9%-100.0%),and was suscep-tible to amikacin,cefoperazone/sulbactam,and piperacillin/tazobactam (>84%).Acinetobacter baumannii was the major isolated multidrug-resistant organism (MDRO),isolation rate of imipenem-resistant Acinetobacter baumannii increased from 50.0% in 2011 to 77.8% in 2015,its resistance rate to imipenem was 64.9%.Conclusion The majority of clinically isolated pathogenic bacteria from this department is gram-negative bacilli,and detection rate of MDROs showed an upward trend;antimicrobial agents should be chosen according to distribution and antimicrobial resistance of pathogenic bacteria.

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.

Objective To investigate the clinical and pathological features of microscopic thymoma(MT).Methods The histopathological features of 12 cases of MT were observed by histopathologic and immunohistochemical methods.The pathological morphology,diagnosis,and differential diagnosis were discussed combined with literature.Results 6 cases of MT were accompanied by myasthenia gravis(MG) symptoms.Focal hyperplastic thymic epithelial islands were accompanied by large tracts of mature adipose tissue in 12 cases of MTs,and immunohistochemistry showed CK positive.Cyst formation was found in 5 cases,lymphoid hyperplasia in 7 cases,and vascular proliferation in 5 cases.Conclusions MG may be the clinical manifestation of MT.MT can occur in thymic cortex,medulla and cortex and medulla junction.Since the tumor is small and the lesions are multiple,it can not be found by X-ray or CT examination.Diagnosis depends on histopathological examination.Correct understanding of the clinical and pathological features of MT has guiding significance on the treatment and prognosis judgment of MT.Thymic resection was recommended for MG patients either with or without thymoma.

Objective To analyse the relationship between lymphatic vessels invasion and clinical pathological features of papillary thyroid carcinoma ( PTC ) .Methods The expressions of D2-40 and CK19 were examined in the 104 specimens of PTC using immunohistochemical staining with combined monoclonal antibodies and cocktail double enzyme labeled antibody( D2-40/CK19) stainings.The two methods were compared in the diagnosis of PTC metastasis, and the factors affecting lymphatic vessels formation were analyzed.Results The positive rate of lymphatic vessels invasion was 37.5%(39/104) by using immunohistochemical staining with combined monoclonal antibodies and 53.8%( 56/104 ) by cocktail double enzyme labeled antibody ( D2-40/CK19 ) staining ( P<0.05).The lymph node metastasis rate was 83.9%(47/56) in the group with lymphatic vessels invasion, significantly higher than that without invasion 22.9%(11/48, P<0.01).The age of patients, diameter of primary tumor were the influence factors of lymphatic vessels invasion in PTC patients(P<0.05 and P=0.063).Conclusion Cocktail double enzyme labeled antibody ( D2-40/CK19 ) staining is a better method to detect lymphatic vessels invasion in PTC than immunohistochemical staining with combined monoclonal antibodies.

Objective To investigate the effects of HepG2 and HepG2.2.15 cells steatosis on the mRNA and protein expressions of suppressors of cytokine signaling-3(SOCS-3) and sterol regulatory element binding proteins (SREBP-1c).Methods The cell model of chronic hepatitis B (CHB) combined with nonalcoholic fatty liver disease (NAFLD) was successfully constructed using an oleic acid-induced HepG2 and HepG2.2.15 cells steatosis.Cells were divided into HepG2 cell control group (HepG2 cell control group), HepG2.2.15 cell control group (HepG2.2.15 cell control group), HepG2 cell steatosis group (HepG2 cell steatosis group) and HepG2.2.15 cell steatosis group (HepG2.2.15 cell steatosis group).The expression levels of SOCS-3 and SREBP-1c mRNA were detected by real-time quantitative polymerase chain reaction (PCR).Changes in protein expressions of SOCS-3 and SREBP-1c were measured by western blot.Results SOCS-3 mRNA expression level in HepG2.2.15 cell control group was significantly lower than that in HepG2 cell control group (P<0.01).The level in HepG2 cell steatosis group was also significantly lower than that in HepG2 cell control group (P<0.01).However, the level of SOCS-3 mRNA in HepG2.2.15 cell steatosis group was lower than HepG2.2.15 cell control group with no statistical significance (P=0.173).There was interaction between cells and steatosis (F=25.547, P<0.01).The expression of SREBP-1c mRNA in HepG2.2.15 cell control group was significantly lower than that in HepG2 cell control group (P<0.01), and was significantly higher in HepG2.2.15 cell steatosis group than that in HepG2.2.15 cell control group (P<0.01).There was no significant difference between HepG2 cell steatosis group and HepG2 cell control group (P=1.000).There was interaction between cells and steatosis (F=5.04, P<0.05).Western blot analysis showed that protein levels of SOCS-3 and SREBP-1c in steatosis cells at 48 h and 72 h were significantly higher than those in non-alcoholic steatosis cells.Conclusions Protein expressions of SOCS-3 and SREBP-1c are up-regulated in both steatosis groups.Factorial analysis shows that there is interaction between cells and steatosis.HBV gene could inhibit SOCS-3 mRNA expression and promote the expression of SREBP-1c mRNA in steatosis cells.

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.