Abstract： With the increasing rise in antidepressant consumption, more and more antidepressants and their metabolic products enter into water and soil environments. This will cause toxicity to animals living in these environments, and antidepressants may be transferred to humans via food chain, leading to human health risks. Based on national and international publications pertaining to environmental pollution and toxic effects of antidepressants during the period between 2005 and 2021, this review summarizes the biological accumulation, acute toxicity, reproductive and developmental toxicity, metabolic effects and biological behavior changes of antidepressants, so as to provide insights into the elucidation of the impact of antidepressants on human health risks.

In the training on AIDS prevention for health education teachers from middle school,we properly illustrate the route of transmission including blood transmission and sexual acts,avoid hurt the blood seller's families' feeling,deal with the relationship of AIDS and the shameful behaviors appropriately,and inspire the students with love by the role-shift thinking.Thus we get the remarkable achievement.

Objective To survey the career identity and satisfaction of family doctors in Pndong New Area of Shanghai municipality.Methods Two hundred and thirty four family doctors were selected with random sampling method from 6 community health centers in Pudong New Area of Shanghai.The survey on career identity and satisfaction was conducted using a self-designed questionnaire.Results The results showed that 37.2％ of participants were very satisfied (8.1％,19/234) or satisfied (29.1％,68/234) with their current career situation.The three lowest satisfaction factors were salary (14.1％,33/234),benefit and social insurance (27.3 ％,64/234),professional reputation and social status (20.9％ 49/234).Meanwhile,the three highest factors were quality of their leadeship (79.5％,186/234),interpersonal relationship(74.4％,174/234) and the institutional management (63.3％,148/234).The survey also showed that 44.5％ and 30.6％ of participants expected their monthly pay as 8 001-10 000 and 5 000-8 000 RMB; 39.1％ thought the current performance evaluation mechanism as effective,while 25.7％ thought the opposite.Conclusion The social status and salary level of family doctors need to be improved; there is also an urgent need to improve the performance evaluation mechanism and other supporting measures.

Objective To analyze the value of multi-slice spiral CT (SCT) scan in staging and subtyping of renal cell carcinoma (RCC). Methods The preoperative kidney SCT data and postoperative pathology results of 64 patients with RCC were retrospectively analyzed. The patients′ ages ranged from 33-78 years (average 54 years). There were 44 males and 20 females in the study group. According to the CUA Guidelines, the staging and subtyping of RCC were performed through the combined information of preoperative SCT attenuation in unenhanced, corticomedullary phase and enhancement pattern. The results were compared with the postoperative histopathological results. Results The SCT results showed 38 cases were clear cell RCC, 14 cases were papillary RCC and 12 cases were chromophobic cell RCC. Histopathological results showed that 40 cases were clear cell RCC, 16 cases were papillary RCC and 8 cases were chromophobic cell RCC. According to the standard of 40 HU of CT attenuation value, the sensitivity, specificity and accuracy were 75%, 79% and 78% for diagnosis of papillary RCC in the unenhanced phase. The sensitivity, specificity and accuracy by the standard of 90 HU of CT attenuation value was 90%, 88% and 89% for diagnosis of clear cell RCC in the corticomedullary phase. In chromophobic RCC, homogeneous enhancement was more common than in papillary RCC and clear cell RCC. There was no significant difference of staging and subtyping of RCC between SCT and pathological results (P>0.05). The accuracy of SCT in staging and subtyping of RCC was 88% in staging, and 89% in subtyping. Conclusions SCT is a useful preoperative tool to stage and subtype RCC

Abstract Recent years have witnessed more attention paid to the health effects of the natural radionuclide 226Ra, and a series of research carried out on the detection methods of 226Ra at home and abroad. The common 226Ra detection methods are emanation scintillation, gamma spectrometry, liquid scintillation counting, alpha spectrometry and alpha counting. Emanation scintillation is mature enough as a classical method, while gamma spectrometry and liquid scintillation counting proceed fast. Due to the radiation of 226Ra, these detection methods still have the problems such as the requirement for large samples, long detection periods, complicated steps, high detection limits and low recovery rates. This paper reviews the five methods above and summarize their advantages and disadvantages, so as to provide the reference for selecting and optimizing the detection methods for different samples as well as perfecting the standard method in China.

Abstract Bisphenols (BPs), which are mainly used in the production of polycarbonates and epoxy resins, are common endocrine disruptors (EDCs) in natural environments. Human mainly exposes to BPs via ingestion and skin. Previous studies have deteted BPs in human urine, serum, and milk samples, and children and pregnant women have a high level of exposure to to BPs. Based on international and national publications pertaining to BPs since 2009, this review describes the exposure to BPs in human urine, serum, and milk and summarizes neuroendocrine dysfunctions, oxidative stress injury and epigenetics changes caused by BPs, so as to provide insights into reducing the exposure to and health risk of BPs.

Iodine is an essential nutrient required for thyroid hormone synthesis and human growth and development. Iodine requirements increase substantially during pregnancy, and insufficient iodine intake may affect the health of pregnant women, and fetal growth and development. Iodized salt-based iodine supplementation is effective to improve maternal iodine levels, reduce risk of thyroid dysfunctions, and plays a vital role in improvements of offspring growth and development and prevention of intellectual disability. However, excessive iodine supplementation during pregnancy may affect maternal thyroid functions and the nerve development of offspring. Precise and personalized iodine supplementation schemes are therefore required tailored to local iodine deficiency degree and pregnant women's individual iodine status. This review summarizes the advances in the impact of iodine supplementation during pregnancy on maternal and offspring health, so as to provide insights into the guidance of iodine supplementation during pregnancy.

Objective To evaluate the performance of community health institutions of Pudong new district.Methods According to the criteria of the Ministry of Health of China,the performance evaluation system appropriate for local area was developed.A cross-sectional survey was conducted at 44 community health centers,and data was analyzed using descriptive statistics,correlation coefficients and multi-factor linear regression.Results The average score of total performance of these 44 community health centers was 78.53.The average scoring rate for institution management,public health service,basic medical care service,CTM service,and comprehensive satisfaction was 68.49％,89.09％,63.51％,87.80％,76.32％,respectively.Degree of informationization (0.477),regional location (0.331) and participating in medical consortia(-0.309)had significant impact on the total performance.Degree of informationization(0.302)and pilots for family doctors(0.301)had significant impact on the basic medical service performance.Conclusion There is a tremendous room for performance improvement for community health institutions in Pudong.Regional location and degree of informationization were the most crucial factors affecting the performance,irrelevant to institutional sizes.Proposals were raised for strengthening the construction of informationization,expanding pilots for family doctors,perfecting the mechanism of medical consortia.

ObjectiveTo evaluate the safety and efficacy of total pelvic reconstruction surgery with Prosima in treatment of pelvic organ prolapse (POP) stage Ⅲ.Methods From July 2010 to December 2011,31 patients with POP stage Ⅲ undergoing total pelvic reconstruction surgery with Prosima were enrolled in this prospective study.Among two cases complicated with stress urinary incontinence underwent transobturator tension-freevaginaltapeconcomitantlywithtotalpelvicreconstructionsurgerywith Prosima.Clinical parameters during peri-operation were recorded and compared.Pelvic organ prolapse quantitative examiuation(POP-Q)andanatomicimprovementinthesepatientsafter surgery were analyzed.Comparisons of pelvic floor impact questionnaire-short form 7 ( PFIQ-7 ) and pelvic organ prolapse-urinary incontinence sexual questionnaire-short form 12 (PISQ-12) in these patients before and after surgery were used to evaluate quality of life and quality of sexual life.ResultsThe mean operating time was (55 ± 13) minutes,mean blood loss was (66 ± 25 ) ml.No severe intraoperative complications were observed.All patients were able to recover spontaneous mieturation within 5 days.Two cases experienced pelvic hematoma with diameters less than 7 cm,and resolved later.Another case was urinary tract infection.At the median follow-up 6 months ( 1 - 15 months),the rate of anatomic success defined as the leading vaginal edge above the hymen was 94％ (29/31).There were significant improvements in Aa,Ba,Ap,Bp,and C (P ＜0.01 ) by POP-Q.Two patients showed recurrent prolapse at 3 months and 1 year after surgery,without the need of further operation.The median score of post-operative PFIQ-7 was 0 point at 6 months and 0 point at 12 months after operation,respectively,which were significantly lower than that of 50 points pre-operation ( P ＜ 0.01 ).And there was no significant difference in the average score of PISQ-12 before and after surgery [ ( 30 ± 6) points versus (31 ± 4) points ] ( P ＞ 0.05 ).The rate of mesh exposure was 16％ ( 5/31 ),all the 5 cases occurred within 6 months and was cut in clinic.There was no case of de novo urinary incontinence and de novo dyspareunia.Conclusions Pelvic rcconstruction surgery with Prosima is safe and efficacy in treatment of POP stage Ⅲ.It could improve quality of life remarkably without influence on sexual quality of life.

Based on the experience of Public-Private Partnership (PPPs) model in domestic and foreign medical field, this study innovatively explored and designed the Build-Transfer-Operate-Transfer (BTOT) operational structure taking the second phase project of ZP Hospital in Pudong New District as a case study.The exploration results showed that the model established the social capital of private non-profit medical institutions by setting up the project company, and used the asset rental and operating management fees in the form of return path.In view of this, the study put forward some relevant countermeasures and suggestions from the aspects of the institution nature and national treatment, property right ownership and risk mitigation, balancing of interests and the cooperation period and solving the core staff etc.All of these measures were taken in order to explore the replicable PPP model in the field of public hospital reform and development.