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.

Objective To evaluate the relationship between dyslipidemia and abdominal aortic aneurysm (AAA), with which as a theory base and proof we may further study about the mechanism of atherosclerosis (AS) leading to AAA. Methods Thirty abdominal aortic aneurysm patients in Guangdong General Hospital from 2013 to 2014 were enrolled into the experimental group and 26 healthy people into the control group. The serum levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), lipoprotein a (Lpa), nonestesterified fatty acid (NEFA), homocysteine (HCY), apolipoprotein A (ApoA) and apolipoprotein B(ApoB)were tested in the study. The statistical significance of the difference of them was examined by the independent two-sample t-test. Result The serum TG and HCY level in the experimental group were significantly higher than those in the control group (P<0.05). The serum ApoA and HDL level in the experimental group were significantly lower than those in the control group (P<0.05). The serum levels of TC, LDL, Lpa, NEFA and Apo B had no significant difference in both groups (P > 0.05). Conclusion The serum levels of TG and HCY are increased and the levels of Apo A and HDL are decreased in patients with AAA.

Objective To observe the changes of renal function in elderly patients with heart failure but normal ejection fraction,and explore its clinical significance. Methods A total of 145 cases diagnosed as coronary artery disease from Department of Geriatric Cardiology in The First Affili?ated Hospital of China Medical University were enrolled in the study. All of the cases were divided into HFPEF group(65 cases)and non HFPEF group(80 cases). All patients underwent cardiac ultrasound,BNP and renal function examination,and the glomerular filtration rate(GFR)was cal?culated. Results The average age of patients in HFPEF group was significantly higher than non HFPEF group(P<0.001),and the incidence of hypertension,diabetes,coronary heart disease,atrial fibrillation,or concomitant incidence of two or more kinds of these disease in HFPEF group was significantly higher than non HFPEF group(P1=0.046,P2<0.001,P3=0.002,P4=0.021,P5<0.001);the GFR of two groups of patients were lower than normal level,but the GFR of HFPEF group was significantly lower than non HFPEF group(P=0.046);E/Em was significantly higher (P<0.001),Em was significantly lower(P=0.002),left atrial diameter was significantly higher(P<0.001),LVEF was significantly lower(P=0.012),BNP values were significantly higher(P=0.001)in HFPEF group than in the non?HFPEF group;There were significant linear correlation between GFR and E/Em(r=-0.428,P=0.001),GFR and the BNP(r=-0.435,P=0.001),E/Em and BNP(r=0.392,P=0.002)in HFPEF group. Conclusion Elderly patients with heart failure but normal ejection fraction were older,and more of them were complicated with hyperten?sion,diabetes,coronary heart disease,atrial fibrillation,or concurrency of these diseases. Glomerular filtration rate was significantly decreased in el?derly patients with HFPEF,which has a significant correlation with diastolic function parameters.

Objective To detect the opening of the myocardial mitochondrial permeability transition pores (MPTP) after intrauterine asphyxia in neonatal rats,and to explore the mechanism of the myocardial hypoxic-ischemic and reperfusion injury caused by the opening of MPTP after asphyxia.Methods Cesarean sections were undertaken in female SD rats at the 21st day after pregnancy.The uterine arteries were clamped for 30 minutes followed by releasing for 1 hour and the pups were allocated into the asphyxia group.The uterine arteries were isolated but not clamped and the pups were allocated into the control group.There were 30 neonatal rats in either group and all of them were sacrificed 24 h after birth.Serum cardiac troponin Ⅰ (cTn Ⅰ) levels were detected by enzyme linked immunosorbent assay.The opening degree of MPTP was detected by fluorospectro-photometry.Myocardial ischemic areas were detected by TTC staining.Tissues from the cardiac apex were taken and the pathologic changes of the myocardium were explored by hematoxylin-eosin staining.SPSS for Windows 13.0 was used for statistic analyses.Results In HE staining slices,the myocardial cells in asphyxia group were disarranged and edematous.In control and asphyxia group,the serum cTn Ⅰ levels were (0.08 ±0.04) μg/L and (0.40 ±0.29) μg/L (P ＜0.01),the myocardial ischemic areas were (8.01 ±3.48) ％ and (42.50 ± 15.90)％ (P ＜0.01),and the opening degrees of MPTP were (118.10 ± 19.10) RFU and (79.40 ± 10.57) RFU (P ＜ 0.01) respectively.The serum levels of cTn Ⅰ,the myocardial ischemic areas,and the opening degrees of MPTP were significantly increased in asphyxia group compared with control group.The serum level of cTn Ⅰ was positive correlated with the opening degree of MPTP in either group(r =-0.384,P ＜ 0.01).Conclusion There are myocardial injuries in neonatal rats after asphyxia,which represent as high level of serum cTn Ⅰ,myocardial ischemia and necrosis.Opening of the myocardial MPTP is one of the causes of myocardial injury.