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.

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

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.

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 investigate the effect of isoflurane inhalation during gestation period on plasticity of hippo-campal synapses in offspring rats. Methods Ten healthy pregnant SD rats at 14 day gestation were randomly divided into 2 gorups ( n = 5 each): control group (group C) and isoflurane group (group I). The rats in group C were mechanically ventilated with O2 while in group I the rats inhaled 1.3% isoflurane in O2 for 2 h a day until labor. Four weeks after birth 4 offspring rats from each pregnant rats (2 male, 2 female) were tested for learning and memory abilities using Morris water maze. Then the offspring rats were sacrificed and hippocampi isolated. The synaptic structure of hippocampal CA1 area was examined by trans-electron microscopy. Results Morris water maze test showed that the escape latency was significantly shorter and the number of times of spanning flat roof greater in group C than in group I. The structure of hippocampus was intact in group C but incomplete in group I. Meanwhile the thickness of synaptic density was significantly decreased in group I. Conclusion Isoflurane anesthesia of pregnant rats may induce learning and memory disabilities in offspring rats by inhibiting the plasticity of synaptic structure in hippocampus.

Objective To find out the status of iodine nutrition and the goiter of population in Zhejiang Province after adjustment of salt iodine concentration.Methods From April to June 2013,the probability proportionate to size sampling method was applied in 31 countries in Zhejiang Province to select 1 650 school-age children aged 8-10 to examine thyroid by B ultrasound,to collect urine and salt samples,and to test the iodine level using the colorimetric titration method and the spectrophotometer method.Six hundred and twenty pregnant women were selected to collect urine samples and urinary iodine was tested by the spectrophotometer method.Results The coverage rate of iodized salt and the consumption rate of qualified iodized salt in Zhejiang Province after adjustment of salt iodine concentration were 93.20％ (1 521/1 632) and 89.71％ (1 464/1 632),respectively;and the medians urinary iodine in children and pregnant women were 178.40 μg/L and 127.23 μg/L,respectively;and the goiter and median thyroid volume were 5.27％ (87/1 650) and 3.45 ml,respectively;the P97 thyroid volume of children in Zhejiang Province in the 8,9 and 10 years old groups (4.76,5.29,6.36 ml) were higher than those (4.5,5.0,6.0 ml) in the thyroid volume reference (WS 276-2007);and the correlations between thyroid volume,goiter and urinary iodine were not found.Conclusions After adjustment of salt iodine concentration,the status of iodine nutrition in Zhejiang Province in general is down to optimum level,which indicates that it is appropriate for this adjustment,but the level of iodine nutrition in pregnant women is less than appropriate,which should be pay attention to.

Objective To set up the reference ranges of thyroid hormones for pregnant and lactating woman in Zhejiang.Methods A total of 338 pregnancy,322 lactating women and 139 non-pregnant women (as a control) were selected from 1 079 women in 13 survey sites of Zhejiang as survey subjects,through the questionnaire survey and thyroid B-ultrasound tests from June 2010 to September 2010.The level of urinary iodine was measured by spectrophotometer,and the thyroid hormone [free triiodothyronine (FT3),free (unbound) thyroxin (FT4),triiodothyronine (T3),tetraiodothyronine (T4),thyroid stimulating hormone (TSH)] was measured by automated chemiluminescence immunoassay.Analysis of thyroid hormone 95％ in pregnant women and lactating women.Results The median urinary iodine of all women investigated were in optimal urine levels (150-249 μg/L),which indicated they were in iodine sufficient status.The FT3 index of lactating women was higher than that of pregnant women and non pregnant women (Zlactating-pregnant =3.98,Zlactating-pregnant =2.46,all P ＜ 0.05);the FT4 index level of lactating women was higher than that of pregnant women and non pregnant women (Zlactating-pregnant =2.68,Zlactating-non-pregnant =2.25,all P ＜ 0.05);the T3 index level of lactating women was higher than that of pregnant women and non pregnant women (Zlactating-pregnant =3.51,Zlactating-non pregnant =2.41,all P ＜ 0.05);levels of T4 in lactating women was the highest (Zlactating-pregnant =2.30,Zlactating-pregnant =4.90,Zlactating-non pregnant =1.57,all P ＜ 0.05);TSH index of lactating women and non pregnant women were higher than that of pregnant women (Zlactating-pregnant =2.81,Zlactating-non pregnant =1.68,all P ＜ 0.05).And in pregnant,the 95％ medical reference interval of FT3 was 3.37-6.53 pmol/L,FT4 was 10.68-20.85 pmol/L,T3 was 1.40-2.79 nmol/L,T4 was 72.72-166.41 nmol/L,and TSH was 0.15-4.44 mU/L;in lactating woman,FT3 was 3.39-6.44 pmol/L,FT4 was 10.81-20.33 pmol/L,T3 was 1.44-2.77 nmol/L,T4 was 71.94-164.61 nmol/L,and TSH was 0.25-4.47 mU/L.Conclusion The thyroid hormone levels of pregnant and lactating women are different from those of non-pregnant women,therefore establishing reference data of thyroid hormones for pregnant and lactating women may be a very important step for clinical practice.