Phthalate esters have been used as the plasticizers for about 80 years. As a kind of environmental hormone and universal pollutants, they are found widely in air dust, industrial waste water, river, soil and solid waste, moreover, they have been detected in food, drinking water and body fluid. In this paper, the new progresses of the effects of phthalate esters on the rodents and human, including reproductive toxicity and liver toxicity, were summarized and the short-term, quick and accumulative actions of phthalates mono-esters, metabolite of phthalate esters, on the rodents and human body were also reviewed.

Phthalate esters are commonly used as plasticizers in many products.They have become widely spread in the environment.Several animal studies have showed that phthalate esters possess endocrine disrupting effects.Phthalate esters have been found in body fluid such as urine,blood and semen.As the base of internal exposure assessment,metabolism of phthalate esters was reviewed in the paper.The main metabolism pathways for phthalate esters and their metabolites in urine were summarized and the levels of metabolites of phthalate esters in different people were compared.

Phthalate esters widely exist in the environment. It has been demonstrated that they are harmful to human bodies. Phthalate mono-esters are the first metabolite of phthalate esters. In general,biotransformation or metabolism of xenobiotics most frequently result in detoxification of the chemical and facilitates excretion from the body. However,this may not be the case for phthalates. In the present paper,metabolism of phthalate esters and the toxicity of the phthalate mono-esters were reviewed,not only the effect of their mutagenesis,teratogenesis and carcinogenesis,but also their toxicity on reproduction,development,hormones,nuclear receptor,inflammation and obesity were included.

[Objective]To investigate the feasibility and merits of the Smith-Peterson osteotomy for the treatment of degenerative lumbar scoliosis. [Methods]Twenty-five patients(11 males,14 females)with degenerative lumbar scoliosis malformations underwent operations from May 2004 to October 2007.The mean average age were 67 years (range,56~77 years).All the patients underwent more than three segments Smith-Peterson osteotomy and lumbar pedicle screw fixation to have the reconstruction of spinal coronal and sagittal plane balance.[Results]The mean duration of surgery were 200 mins(range,150~320 mins),and the average intraoperative blood loss were 1000 ml (range,600~2 000 ml).There were two cases of postoperative cerebrospinal fluid leakage,which were alleviated by pulling drainage tube and oppressing the wound.Postoperative pain and numbness in both lower extremities were aggravated in 2 cases,one of which was recovered completely 3 weeks later,and another 12 weeks later.The mean clinical follow-up were 36 months(range,24~60 months).JOA 29 score was recorded to evaluate the relief of the symptoms.The good-to-excellent rate was 88.2% and the poor rate was 0%.The coronal Cobb's angle was improved from the preoperative average of 23? (range,15?~ 40?) to the postoperative average of 12? (range,8?~ 20?).The sagittal Cobb's angle was improved from the preoperative average of 0 ?(range,-15?~ 15?) to the postoperative average of 33?(range,25?~ 40?).[Conclusion]Smith-Peterson osteotomy is an effective method for the decompression of lumbar spinal stenosis,and is helpful to correct the sagittal deformity of the degenerative lumbar scoliosis.It also has relatively small interference to nerve in the operation.

Objective To explore the diagnostic effect of serum level of cystatin C (CysC) on the renal function after neonatal asphyxia by detection of serum level of CysC, blood urea nitrogen (BUN) and serum creatinine (SCr) and calculation of glomerular filtration rate (GFR) in neonatal asphyxia. Methods The clinical data of 86 neonates with asphyxia (46 cases in mild asphyxia group,40 cases in severe asphyxia group) and 30 neonates without asphyxia (control group) were collected and the serum level of CysC, BUN and SCr were detected at 24 h to 72 h after birth. Results Serum levels of CysC, BUN and SCr were (1.97 ±0.33) mg/L, (4.97 ±2.15) mmol/L, (90.41 ±24.32) μmol/L in mild asphyxia group, (2.65 ±0.41) mg/L, (10.88 ± 3.31) mmol/L, (125.82 ± 45.44) μ mol/L in severe asphyxia group and (1.24 ± 0.35)mg/L, (4.25 ± 2.04) mmol/L, (58.41 ± 19.22) μmol/L in control group, respectively. The differences were significant among three groups and those values in mild and severe asphyxia groups were higher than those in control group. The sensitivity of CysC level to evaluate renal function in mild asphyxia group was better than BUN and SCr level (P＜ 0.05). In neonata] asphyxia, the serum level of CysC had negative correlation with GFR (P ＜ 0.01). Conclusions Serum level of CysC can be adopted to evaluate the renal function after neonatal asphyxia, which is better than BUN and SCr. With a higer level of CysC, the renal function injury may be worse.

ObjectiveTo observe the effect of telmisartan on the level of serum adiponectin and the expression of cardiac adiponectin (APN) receptor 1 in spontaneously hypertensive rats (SHR) in order to explore the role of APN in ventricular remodeling caused by hypertension and the new possible mechanism that telmisartan protects the heart against ventricular remodeling.Methods The sixteen 12-week-old SHR were randomly divided into SHR control group (SHR group, n=8) and SHR+telmisartan group (TEL group, n=8), and eight age-matched male Wistar Kyoto rats were regarded as control group (WKY group). The TEL group was treated with telmisartan 5 mg-1 · kg-1 ·d-1 in a small amount of distilled water and the other two groups were given equal amount of distilled water by gavage.After 8 weeks, the left ventricular end diastolic diameters (LVEDD),thickness of interventricular septal thickness (IVST), left ventricular post wall thickness (LVPWT) and mitral valve blood flow spectrums were recorded by echoeardiograph.The E/A ratio was calculated by velocity of E peak divided by A peak. The left ventricular weight index (LVWI) was calculated. HE staining and Masson staining were used to detect the pathology changes of cardiac tissue and collagen volume fraction (CVF).Serum APN concentration of SHR was detected by enzyme-linked immunosorbent assay (ELISA). The myocardial protein expression of AdipoR1 was detected by in munohistochemical staining.Reverse transcription polymerase chain reactions (RTPCR) method was used to detect the mRNA expression of AdipoRl in myocardium.ResultsThe values of IVST, LVPWT and LVWI were higher, LVEDD and E/A ratio were lower in SHR group than in WKY group.The disordered arrangement of myocardialcells,interstitialfibroblast hypertrophy and hyperplasia were observed in SHR group. The CVF increased in SHR group than in WKY group [(6.22±0.16)％ vs. (3. 18±0. 17)％, P＜0.05]. The concentration of serum APN was significantly lower in SHR group [( 10.96±2. 15)μg/ml vs. (24.32±2. 20)μg/ml, P＜0. 01].The expressions of myocardial AdipoR1 mRNA and protein were significantly lower in SHR group.The values of IVST, LVPWT and LVWI were lower, LVEDD and E/A ratio were higher in TEL group than in SHR group. The arrangement of myocardial cells were relatively ordered and interstitial fibroblasts hypertrophy and hyperplasia were not significant, CVF was decreased in TEL group versus SHR group. The concentration of serum APN was significantly higher in TEL group [(17.71 ± 5.82)μg/ml, P＜0. 01]. The expressions of myocardial AdipoR1 mRNA and protein were significantly higher in TEL group than in SHR group. Conclusions When SHR undergoes ventricular remodeling, the level of serum APN is lower, the mRNA and protein expressions of myocardial AdipoRl are significantly reduced. Telmisartan can reverse the ventricular remodeling and play the role in protecting heart in SHR, which may be due to the serum APN levels increasing, cardiac APN receptor 1 and its mRNA up-regulation.

Objective To evaluate the clinical outcomes of lumbar spinal stenosis treated with three different surgical modalities.Methods One hundred and forty patients were treated with posterior lumbar interbody fusion (PLIF,n =50),transforaminal lumbar interbody fusion (TLIF,n =40) or modified method (n =50).The operation time and intraoperative blood loss were compared.The outcones were evaluated with Japanese Orthopedic Association (JOA) score and visual analogue scale (VAS),and the radiographic findings were also reviewed.Results The operation time was shorter and the intraoperative blood loss was less in modified group than those in other two groups (F =10.02,P ＜0.05).The excellent and good rate was 90％ (45/50) in PLIF group,92％ (37/40) in TLIF group and 90％ (45/50) in modified group.No complication happened in both TLIF group and modified group.Two patients had cerebrospinal fluid leakage in PLIF group.The JOA scores and VAS scores were significantly improved 3 and 6 months after surgery in three groups (F =10.66,9.68,11.03,all P ＜ 0.05).There were no significant differences in JOA scores and VAS scores among three groups before operation (P ＞ 0.05),also in JOA scores after operation among three groups.The VAS scores in TLIF group and modified group 3 and 6 months after operation were significantly lower than those in PLIF group (F =9.46,10.02,all P ＜ 0.05),but there was no significant difference between TLIF group and modified group.Interbody fusion was good in all three groups.Conclusions Three surgical methods have good clinical outcomes for lumbar spinal stenosis.But compared with PLIF and TLIF,the modified method has less blood loss,shorter operation time and less pain after operation.

[ ABSTRACT] AIM:To evaluate the clinical application of single nucleotide polymorphism array ( SNP array) in prenatal diagnosis for screening the abnormality of women with Down’ s syndrome ( DS) .METHODS:The amniotic fluid samples ( n=312) collected by amniocentesis for the DS screening abnormality women were tested by karyotyping and SNP array analysis, respectively.The findings of karyotyping and SNP array analysis were compared.RESULTS:Two cases of trisomy 21 were identified by karyotyping and SNP array analysis, but SNP array analysis failed to identify 6 cases of chro-mosome balanced structural rearrangement.SNP detected 176 cases copy number variants ( CNVs) in 303 cases normal karyotype were detected by SNP, including 106 benign CNVs, 61 variants of unknown significance (VOUS), 9 de novo CNVs, and none of them was pathogenic.The distribution difference of CNVs in DS screening positive group and DS screening positive plus advanced maternal age group was not statistically significant ( P>0.05) .Furthermore, we reported 14 kinds of CNVs for the first time in population.CONCLUSION:SNP array can further assure chromosome microdupli-cation/microdeletion.In normal karyotype fetus of prenatal diagnosis, SNP can detect some clinical significant CNVs.

Objective To investigate the early change of the function of hemostasis and coagulation as well as clinical significance in the full-term newborns recoveried from stifle.Methods To detect the platelet count (PLT),prothrombin time,fibrinogen and D-dimer in early stage of 50 newborns with different degrees of asphyxia recovreied from stifle,and compared with the control group.Results Compared with the control group,there were not obvious change in PLT in asphyxiated full-term newborns(P>0.05),and the differences of prothrombin time,D-dimer and fibrinogen were statistically significant(P<0.01),the more serious degree of asphyxia,the lower of the fibrinogen and higer of the D-dimer.Conclusions The function of hemostasis and coagulation can be changed in early stage of newborns recoveried from stifle.The detection of fibrinogen and D-dimer in early stage of newborns recovefied from stifle has important clinica significance.

BACKGROUND: Cicatricial alopecia always occurs following the scalp trauma, and the optimal repairing method is scalp soft tissue expansion. OBJECTIVE: To verify the repairing effect of scalp soft tissue expansion therapy on the large-scale cicatricial alopecia. DESIGN, TIME AND SETTING: A case report was carried out in the Department of Burn and Plastic Surgery at the 180 Hospital of Chinese PLA (Quangzhou, Fujian, China) between January 1996 and April 2008. PARTICIPANTS: Thirty-six patients of cicatricial alopecia were adopted, with the size arranging 15 cm?9 cm to 24 cm?14 cm. METHODS: Scalp soft tissue expansion was performed in 36 cases of cicatricial alopecia. In later stage, the residual alopecia with small area was removed by scar excision plus suture for several times, treated with transposition repair of local flap and autologous hair transplant carrying hair follicle. The largest area to repair alopecia reached 336 cm2. MAIN OUTCOME MEASURES: Postoperative complications, repairing effect and cicatrix restitution were observed after operation; The elimination of alopecia area, hair density and appearance were detected during follow-ups. RESULTS: Psilotic scar eliminated in all cases, but 11 cases underwent scalp scar excision, transposition of local flap and autologous hair transplant because of wide incisional scar or residual small alopecia. No obvious complications occurred. It was found by a postoperative follow-up of 1-3 years that hair growth was good. CONCLUSION: Skin soft tissue expansion is an ideal method to repair cicatricial alopecia with large area. In later stage, the combination of simple repair methods can obtain better curative effect.