Dibutyl phthalate (DBP) has been found as a ubiquitous environmental pollutant with reproductive and developmental toxicity. The characteristics of reproductive and developmental toxicity of DBP, the mechanisms of the toxicity and effects on human health were reviewed in this paper according to the toxic effects on pregnant animals exposed to DBP, which might provide reference for the further study on toxicity of DBP and preventive measures.

Objective To evaluate the efficacy,local control rate,survival rate and adverse reaction of intensity modulated radiation therapy (IMRT) combind with Tp concurrent chemoradiotherapy (docetaxel and cisphtin) for superior segment of esophageal cancer.Methods Seventy-eight patients with superior segment of esophageal cancer were divided randomly into IMRT combined with TP concurrent chemoradiotherapy group (chemoradiotherapy group) and single IMRT group (radiotherapy group) by double blind method with 39 cases each.The patients in chemoradiotherapy group received chemoradiotherapy,while other patients in radiotherapy group received only radiotherapy.For both groups,the same radiation technic was given with chemoradiotherapy,the total dose was 6 400 cGy/32 f.For the patients in chemoradiotherapy group were also given with TP concurrent chemotherapy weekly.The efficacy,local control rate,survival rate and adverse reaction was observed.Results Complete remission in 17 cases,partial remission in 20 cases,stable in 2 cases,the total effective rate was 94.9％ (37/39) in chemoradiotherapy group.Complete remission in 9 cases,partial remission in 19 cases,stable in 11 cases,the total effective rate was 71.8％ (28/39) in radiotherapy group.There was significant difference in the total effective rate between two groups(P ＜ 0.05).The 3-year local control rate was 69.2％ (27/39) in chemoradiotherapy group,which was higher than that in radiotherapy group[35.9％(14/39)],and there was significant difference(P ＜ 0.05).The 3-year survival rate was 74.4％(29/39) in chemoradiotherapy group,which was higher than that in radiotherapy group [43.6％(17/39)],and there was significant difference (P ＜0.05).Conclusion IMRT combined with TP concurrent chemoradiotherapy can improve the efficacy,local control me,survival rate of esophageal cancer,but can also increase the acute toxic effect.

Objective To investigate the role of PI3K/Akt pathway in mitomycin(MMC) induced apoptosis of liver stem cells.Methods Rat liver stem ceils were stimulated with MMC,and the effect of MMC on the apoptosis rate of WB-F334 cells at different time points(6,12,24 h),as well as the effects of different concentrations of (0.2,0.4,0.6,0.8,1.0 mg/mL) MMC on the cytotoxicity of WB-F334 cells were evaluated;moreover,cells were treated with p38 MAPK inhibitor and PI3K/Akt inhibitor,and the roles of MAPK and PI3K/Akt signaling pathway in MMC mediated apoptosis of WB-F334 cells were explored.Results The apoptosis rate of the MMC-treated WB-F334 increased with time(P＜0.05).Compared with the un-treated control group,different concentrations of MMC had obvious cytotoxicity on liver stem cells,and the cytotoxicity increased with concentration.Western blotting results showed that Akt and MAPK in WB-F334 cells were significantly phosphorylated 15 min after MMC stimulation;the degree of phosphorylation decreased with time,and phosphorylation disappeared after 60 min,suggesting that the p38 MAPK,PI3K/Akt pathway can be activated by MMC;furthermore,when p38 MAPK inhibitor was added to MMC treated cells,the apoptosis rate of p38 MAPK inhibitor treated cells showed no significant difference compared to the un-treated cells(P＞0.05),indicating that the MAPK pathway had no significant effect on MMC induced WP,-F334 cell death;however,when the PI3K/Akt inhibitor(API-2)was added,the apoptosis rate of API-2 treated cells was significantlv decreased compared to the un-treated cells(P＜0.05),indicating that the PI3K/Akt pathway had a significant effect on MMC induced apoptosis of WB-F334 cells(P＜0.05).Conclusion Stimulation of MMC can induce apoptosis of hepatic stem cells WB-F334 through the activation of the PI3K/Akt signaling pathway.

The antibacterial property of silver nanoparticles has resulted in their widespread application in many fields,so the chance of silver nanoparticles exposure for human increased greatly.Thus,there is urgent need to assess the safety of such particle.So far,most toxicological studies of silver nanoparticles mainly focus on the cytotoxicity using different examination endpoint such as morphology,mitochondrial function,cell proliferation,enzyme activity,and so on.In addition,the in vitro studies on the toxicity of silver nanopoarticles are also reported,few of the study on molecule mechanism of toxicity was reported.This review provided a summary of antibacterial mechanism of silver nanoparticles and the current research situation of the safety.The future research direction of toxicological study of silver nanoparticles is also prospected based on the current knowledge.

Objective To investigate the exposure levels of organic pollutants in child-bearing age women body. Methods The blood and urine specimens were collected simultaneously from each of 8 health women, aged 23-32 years, the organics were extracted with hexane and determined qualitatively by gas chromatography-mass spectrometer (GC-MS) for each specimen. Results In blood, 34 kinds of organic compounds had been detected , at average of (8.63?5.01 )kinds per person. Di-n-butyl phthalate (100%) and 14-bate-H-pregna (75.0%) revealed the highest detectable rates. In urine, 39 kinds of organic compounds had been identified, at average of (10.63?1.30) kinds per person, di-n-butyl phthalate(100%), HANFETT(100%), 14-bate-H-pregna(87.5%), docosane (87.5%), di-isobutyl phthalate(75.0%) were the chemicals noticed more frequently. Some kinds of these identified organics compounds were environmental toxic pollutants. Conclusion This study suggested that toxic organic pollutants had existed in child-bearing age women body, phthalic acid esters were the chemicals checked out more frequently. Their potential adverse health effects on women and offspring should be paid highly attention to.

Objective To explore the influence of early comprehensive nursing intervention on physical and mental development in children with high risk of cerebral palsy.Methods 150 children with high risk of cerebral palsy who were treated in neonatal intensive care unit(NICU) of Xinxiang central hospital were randomly divided into two groups.78 cases in the intervention group received early comprehensive nursing intervention,including functional training combined with medication and physical treatment method.At the same time,their parents received systematic training and participated in the intervention till the babies reached 2 years old.72 cases in the routine group were given conventional baby care.74 termfor-age neonates who were born in our department of maternity in the same period were selected as the control group,which received conventional baby care.The infants of the routine care group received only conventional baby care.The physical development of the weight,length and head circumference and intelligence of three groups were checked at the age of six months,one year and two years.Results M the age of six months,one and two years old,the physical development were higher significantly in the intervention group than those in the routine group,and had not evident difference with the control group.The mental development index (MDI) of the intervention group was lower than that of the control group at the 6 months,had no obvious difference with the control group at one year old,and was great higher than that of the control group.At the sixth month and one year phychomotor development index (PDI) of the intervention group had no difference with that of the control group,and at two years old were higher than that in the control group.The incidence of the phychomotor development retardment and the cerebral palsy in the intervention group was lower than that in the routine group.Conclusions Early nursing intervention is beneficial to the development of the physical and intelligent development of children with high risk of cerebral palsy.

Objective To explore the diagnosis and treatment of Dent’s disease.MethodsThe clinical characteristics, treatment process and disease-causing gene mutation were retrospectively analyzed in 6 pediatric patients with Dent’s disease misdiagnosed of nephritic syndrome from January 2014 to August 2015.ResultsIn these 6 male patients aged 4.5-9.8 years old, the main clinical manifestations were nephropathy-level of proteinuria and transient low serum albumin (26-30 g/L) without obvious edema or high serum cholesterol. In 4 patients who had renal biopsy, 2 cases showed mesangial proliferative glomerulonephritis and other 2 cases showed focal segmental glomerulosclerosis. All of 6 patients were treated with at least one immunosuppressive agent after resistance to full dose of hormone and no changes in proteinuria were observed. After admission, the indexes of early renal damage and urinary protein electrophoresis pointed to low-molecular proteinuria. The ratio of alpha 1 micro albumin (α1-MG) / micro albumin (MA) (the early renal damage index) was?>?1, there was hypercalciuria, and renal function was normal. The B ultrasonography showed renal calciifcation in 2 patients. The ifndings in all the patients were in accord with the clinical diagnosis of Dent’s disease. Further genetic analysis conifrmed the presence ofCLCN5 gene mutation in these 6 patients.ConclusionAs a type of rare inherited renal tubular disorder, Dent’s disease is easily misdiagnosed, to which pediatricians need to pay attention. The early renal damage index, α1-MG/MA?>?1, can be regarded as one of the diagnostic criteria of renal tubular proteinuria.

Cholangiocarcinoma is a malignant tumor that occurs in the bile duct epithelium,it is the second most common malignant tumor of the liver and bile duct after hepatocellular carcinoma.Imaging examination is an important method to detect bile duct cancer;the purpose of imaging is to determine the location of the tumor,and the extent of invasion and distant metastasis.Different imaging methods have their advantages and disadvantages,so they should be chosen based on the condition of patients,or be optimized as the combined detection.

Objective To investigate the detection rate and possible factors of hyperhomocysteinemia(HHcy) in children with chronic kidney disease(CKD).Methods The clinical data of children with CKD between July 2012 and September 2016 in the Department of Pediatrics,Peking University First Hospital were retrospectively collected.The homocysteine(Hcy) level of patients were measured.The other data included the general information,diagnosis and laboratory test results.Results Seventy-six pediatric patients with CKD were enrolled including 49 boys and 27 girls.The average age of the patients was (9.9±3.4) years old.The main cause of the patients in the study was primary glomerulopathy(48.7%,37/76 cases),and the rest were congenital and inherited glomerular diseases(36.8%,28/76 cases),secondary glomerular diseases(9.2%,7/76 cases)and renal tubular diseases(5.3%,4/76 cases).Fifty patients (65.8%,50/76 cases) had normal level of Hcy which was 10.40(7.30,11.62) μmol/L.Twenty-six patients(34.2%,26/76) were detected with HHcy whose Hcy level was 17.93(16.76,24.11) μmol/L.The detection rate of HHcy in CKD stage 1,stage 2,stage 3,stage 4 and stage 5 was 13.9%(5/36 cases),22.2%(2/9 cases),50.0%(4/8 cases),57.1%(4/7 cases) and 68.8%(11/16 cases) respectively,and the detection rate increased with CKD stages and the difference was statistically significant (χ2=17.574,P<0.001).The level of Hcy was 10.05(7.04,12.47) μmol/L,11.75(10.78,16.44) μmol/L,13.73(10.09,18.23) μmol/L,15.81(11.12,20.71) μmol/L and 17.39(11.86,24.76) μmol/L in CKD stage 1,stage 2,stage 3,stage 4 and stage 5,respectively.The Kruskal-Wallis test revealed that the distribution of homocysteine in CKD stages had statistically significant difference(P=0.001).Multiple linear regression model showed that creatinine clearance was an independent predicator of HHcy.Conclusions In this study of the CKD patients,the detection rate of HHcy was high and increased with the progression of CKD.HHcy is mainly influenced by creatinine clearance in CKD.The level of Hcy should be monitored regularly in children with CKD and HHcy should be treated with proper measures.

BACKGROUND:Undergoing femoral head replacement in senile osteoporosis patients with intertrochanteric fracture is a chal enging problem.
OBJECTIVE:To explore the clinical effect of the use of joint instal ation and fracture reduction on the treatment of unstable intertrochanteric fractures in elderly patients.
METHODS:A total of 21 elderly patients with unstable intertrochanteric fractures underwent femoral head replacement. Simultaneously, we col ected clinical data of 20 elderly patients with unstable intertrochanteric fractures undergoing internal fixation of dynamic hip screw. Operation time, blood loss amount, time of walking practice after replacement, complications, and Harris score were compared between the two groups. Clinical effects in patients with femoral head replacement were observed.
RESULTS AND CONCLUSION:Al patients were fol owed up for averagely 20 months (ranged from 6 months to 36 months). After replacement, the incision was first healing. The operation time of femoral head replacement was short;blood loss amount was less;the time of walking practice was early. However, no significant difference in Harris score was detected between the two groups (P>0.05). After femoral head replacement, no infection, inversion and shift, or hip joint loose occurred. Results suggested that correct anteversion angle, eccentricity and femoral calcar size should be identified before the implementation of artificial joint replacement for the elderly femoral intertrochanteric fracture. After implantation of the prosthesis, reduction and fixation of trochanter and femoral calcar bony landmarks are simple easily operated surgery. It can reduce blood loss amount, shorten operation time and elevate clinical effects.