Objective To study the changes of iodine source and the nutritional status of iodine after termination of iodized salt supply in the areas with different water iodine concentrations in Shanxi province,in order to provide scientific bases for developing strategies on control and prevention of iodine deficiency disorders,and to study the cut-off value of water iodine level where iodized salt supply should be stopped.Methods In 2010 in Shanxi province,6 villages with 100％ of non-iodized salt consumption rate were selected as the survey spots based on the iodine concentration in drinking water of 0-,50-,100-,150-,300-,≥500 μg/L.Villages'iodized salt supply was terminated thoroughly.In each village,20 children aged 8 to 10 were selected.At the same time,women of childbearing age 18 to 50 years old and adult men aged 18 to 60 were selected from the same families as the children.Diet surveys were conducted by the method of 3 days recall on all subjects.Drinking water samples,staple foods,supplementary foods and urinary samples of all subjects were collected and the iodine concentration was determined by arsenic-cerium catalytic spectrophotometry.Results ①In the villages of water iodine 25.9,70.6 μg/L,the medians urinary iodine of children,women and men were all ranged from 100 to 199 μg/L,which meant their iodine nutrition levels were appropriate.In the village of water iodine 109.0 μg/L,the medians urinary iodine of children,women and men were all ranged from 200 to 299 μg/L,which meant their iodine nutrition levels were more than appropriate.In the villages of water iodine 225.8,430.0,581.2 μg/L,the medians urinary iodine of children,women and men were all ≥ 300 μg/L,which meant their iodine nutrition levels were too high.②)In all the 6 villages,the intaking amount of iodine met and exceeded the standard recommended intake of dietary iodine by ICCIDD/UNICEF/WHO (8 to 10-year-old children ≥ 120 μg/d,women of childbearing age and adult men ≥ 150 μg/d).But in the village of water iodine 581.2 μg/L,the iodine intake was exceeded the daily maximum safe intake (children aged 8 to 10 ≤800 μg/d,women of childbearing age and adult man ≤ 1000 μg/d).③The amount of iodine ingestion from drinking water was increased with the water content of iodine.When water iodine exceeded 100 μg/L,the amount of iodine ingestion from drinking water was higher than from food intaking,and became a main resource of iodine in the human body.Conclusions In the counties of iodine concentration in drinking water above 100 μg/L in high iodine areas of Shanxi province,the water iodine becomes the most important source of iodine,and iodine nutritional level is more than appropriate or possible excess.It is recommended that in areas of high water iodine of Shanxi province,the standard cut-point of water iodine value is set to 100 μg/L.

ObjectiveTo investigate the iodine nutritional status of residents in Shanxi province,and to provide a scientific basis for adjustment of control strategies and measures to iodine deficiency disorders (IDD).MethodsIn the 11 cities and 119 counties(cities,districts),except high water iodine townships,9 townships were selected in each county according to their sub-area positions of east,west,south,north and center,4 villages were sampled in each chosen township,and 8 households were selected in each chosen village in every chosen county (cities,districts ) with 9 or more townships.In every chosen county (cities,districts) with 6 to 9 townships,1 township was selected respectively in east,west,south,north and center sub-areas of the township,4 villages were sampled in each chosen township,and 15 households were selected in each chosen village.In the county (cities,districts) with 5 or less townships,all township were selected,4 villages were sampled in each chosen township,and 15 households were selected in each chosen village.Edible salt samples from these households were collected; iodized salt was determined by direct titration.In the 119 counties(cities,districts),1 township was selected,respectively,in east,west,south,north and center sub-areas in each county,and 20 children aged 8 - 10 in each of the selected townships were selected to collect urine samples and urinary iodine was determined by As-Ce catalytic spectrophotometry.Evaluation criteria:median urinary iodine ＜ 100 μg/L was iodine deficiency,100 - 199 μg/L as appropriate,200 - 299 μg/L as more than appropriate,and ≥ 300 μg/L as iodine excess.ResultsMedian iodine of the 34 808 household salt samples was 31.55 mg/kg.The coverage rate of qualified iodized salt was 99.18％(34 521/34 808) and the consumption rate of qualified iodized salt was 97.12％(33 805/ 34 808).In the 11 cities,119 counties(cities,districts),the median of urinary iodine of 11 967 children aged 8 -10 was 244.0 μg/L,of which ＜ 50 μg/L acoounted for 2.6％(312/11 967),50 - 99 μg/L accounted for 6.9％(823/11 967),100- 199 μg/L accounted for 26.3％(3145/11 967),200 - 299 μg/L accounted for 28.7％(3440/11 967),and 300 μg/L or higher accounted for 35.5％(4247/11 967).The medians of urinary iodine in the 9 municipal cities were 200 - 300 μg/L,and other 2 cities were 300 - 400 μg/L At the county level,the medians urinary iodine of children of the 119 counties(cities,districts) were 100 - 199 μg/L that accounted for 15.1％(18/119),200 - 299 μg/L accounted for 63.9％(76/119),and 300 μg/L or higher accounted for 21％(25/119).Conclusions The iodine nutrition level of residents in Shanxi province is more than appropriate.The salt iodine concentration in Shanxi province needs to be reduced,but the space is not wide.

Objective To verify the determination of iodine in foodstuff by dry ashing As3+-Ce4+catalytic speetrophotometry.Methods The mixture of foodstuff powder and the solution of K2CO3,ZnSO4,KClO3 and NaCl was heated and dried at 105℃ for 3 hours,then heated by a adjustable electric heater for around 0.5 hour,transferred into muffle fumace to eremated at 600℃ for 4 hours.The dissolved ash was measured by As3+-Ce4+catalytic speetrophotometry.The linear range of the calibration and sensitivity were tested;The precision and accuracy for three kinds of iodine in samples of difierent pumpkins were tested:The iodine contents of standard urine samples and the American standard materials were tested as well.Results This testing covers iodine ranged from 4.4 ng to 250 ng.The relevance coefficient of standard curve was from-0.9997 to-0.9993.The pumpkin iodine contents detected were 45.8,145.0,195.6 μg/kg,with constant variables of 4.3%,3.0%and 3.9%respectively.The recovery was 96.8%,97.8%and 97.6%for three kinds of iodine in samples[(47.2±2.6),(71.9 4-3.3),(95.9±2.4)μg/kg].The relative error was-6.5%when the American standard materials were assessed.The relative error were 11.0%.10.7%and 10.7%when the standard urine samples of three kinds were tested.Conclusion This method,easy to be pefformed with better precision and accuracy,is suitable to measure food iodine as well as total iodine in urine.

Objective To explore the long-term effect of endemic arsenism on oxidative stress and immune function, and to provide scientific basis for prevention and treatment of the disease in the areas. Methods In 2009, Using cluster sampling and typical investigation, the cross-sectional study was completed. The patient groups and the internal control group were selected in the arsenism areas after 5 years quality improvement of drinking water(Silizhuang village, Daying village and Gucheng village in Shanyin county, Gucheng city, Shanxi province) and they were divided into mild, moderate, severe case and internal control groups, respectively. The external control group was selected in a non-arsenism area(Yangzhuang village in Heshengbu city). The Oxidative stress indicators were determined and analyzed [serum superoxide dismutase (SOD) activity was determined with xanthine oxidase method, glutathione peroxidase(GSH-Px) activity was determined with 2-thio-2-nitrobenzoic acid method, and mmuuity malondisldohyde(MDA) levels was determined with thiobarbituric acid method]. The immune function was determined and analyzed [immunoglobulin G (IgG) was determined with radioimmunoassay method, and serum lysozyme was determined with turbidimetric method]. Results A total of 252 people were surveyed, in which the external control group, the internal control group, mild, moderate and severe patient groups were 56, 57, 49,44 and 46, respectively. Serum SOD activities were (72.19 ± 11.75), (66.96 ± 12.02), (49.79±11.07), (48.54 ±10.56) and (47.68 ± 10.68)kU/L, respectively. The difference of serum SOD activities between the groups was statistically significant(F = 52.42, P ＜ 0.01 ). Serum SOD activities in the external control group were significantly higher than other groups (all P ＜ 0.05). The value in the internal control group was significantly higher than the 3patient groups (all P ＜ 0.05). There were no significant differences between the case groups (P ＞ 0.05). Serum GSH-Px activities of the five groups were (197.41 ± 38.54), (195.02 ± 31.93), (187.26 ± 28.22), (187.24 ± 25.40),(186.88 ± 21.84)U/mg, respectively, and the difference between the groups was not significant(H = 4.21, P ＞0.05). Serum MDA levels of the five groups were (4.51 ± 2.14), (5.88 ± 2.00), (6.44 ± 2.83), (5.89 ± 2.57),(5.88 ± 2.40)μ mol/L, respectively, and the difference between the groups was statistically significant(F = 3.36,P ＜ 0.05). The external control group was significantly lower than other groups(all P ＜ 0.05). No significant difference was observed between other groups(all P ＞ 0.05). Serum IgG levels were(11.16 ± 2.08), (8.15 ± 1.44), (8.77 ±2.54), (9.19 ± 1.97), (8.44 ± 2.52)g/L, respectively, and the difference between the groups was statistically significant(H = 52.92, P ＜ 0.01 ). The external control group was significantly higher than other groups(all P ＜0.05). No significant difference was observed between other groups(all P ＞ 0.05). Serum lysozyme levels were (13.57 ± 5.16), (10.05 ± 3.96), (8.78 ± 3.35), (8.72 ± 3.76), (9.38 ± 4.26)mg/L, respectively, and the difference between the groups was statistically significant (H = 35.00, P ＜ 0.01 ). The external control group was significantly higher than other groups(all P ＜ 0.05). No significant difference was observed between other groups(all P ＞ 0.05). Conclusions The effect of arsenic on the body's oxidative stress response and immune function persists after 5 years of drinking low arsenic water. In addition to intensify arsenic removal from drinking water, it should also strengthen the monitoring of population's health in the diseased areas.

[Objective]To investigate the efficacy and cost analysis ofmicrosurgical clipping and vascular embolization in the treatment of patients with cerebral aneurysms.[Methods]Two hundred and fitly-one patients with cerebral ameurysms,admitted to our hospital from January 2007 to December 2010,were collected in our study;170 patients (174 aneurysms) received microsurgical surgical clipping (clipping group) and other 181 patients (185 aneurysms) were performed vascular embolization (embolization group).Duration of hospitalization,vascular occlusion rate,intraoperative rupture rate,hospital mortality and happening of complications were compared between the 2 groups;and the efficacy were evaluated by modified Rankin scale (mRS) and cost analysis of the 2 treatments were compared 3 months after the surgeries.[Results] The length of hospital stays and cerebral aneurysm rupture rate in patients of the embolization group were significantly shorter/lower than those in the clipping group (P＜ 0.05);the scores of mRS showed no significant differences between the 2 groups (P＞0.05).The cost and sensitivity analysis indicated that the ratio of average cost/good prognosis rate in the clipping group was smaller as compared with that in the embolization group.[Conclusion] The efficacies of microsurgical clipping and embolization in the treatment of cerebral aneurysms are considerable,and both of them have their advantages and disadvantages respectively;however,the microsurgical clipping is cost-effective and economical.

Objective:To understand the current situation of nurses in 52 hospitals in China on mastery of knowledge about skin injury in the elderly based on the background of mixed-mode homogenization training.Methods:Using the convenient sampling method, a total of 1 067 nurses from 52 hospitals in China were selected as the research objects in January 2021. A self-designed questionnaire on knowledge of skin injury in the elderly was used to investigate the nurses through the questionnaire star and univariate analysis was used to analyze the influencing factors. A total of 1 067 questionnaires were distributed and 1 067 valid questionnaires were recovered, and the effective recovery rate was 100%.Results:The knowledge scores of pressure injury, incontinence-associated dermatitis, skin tear and xerosis cutis among 1067 nurses were (95.66±7.37) , (95.65±9.15) , (91.37±15.45) and (87.67±15.91) , respectively. The results of univariate analysis showed that hospital grade was the influencing factor of nurses' knowledge score of pressure injury, skin tear and incontinence-associated dermatitis ( P<0.05) , educational background was the influencing factor of nurses' knowledge score of skin tear ( P<0.05) , professional title was the influencing factor of nurses' knowledge scores of pressure injury, incontinence-associated dermatitis and xerosis cutis ( P<0.05) . Conclusions:Hospitals at all levels need to strengthen the theoretical and practical knowledge training for nurses on skin xerosis and skin tear in the elderly, especially for nurses with primary titles and lower education in grassroots hospitals.

Objective:To retrospectively analyze the treatment status of tyrosine kinase inhibitors (TKI) in newly diagnosed patients with chronic myeloid leukemia (CML) in China.Methods:Data of chronic phase (CP) and accelerated phase (AP) CML patients diagnosed from January 2006 to December 2022 from 77 centers, ≥18 years old, and receiving initial imatinib, nilotinib, dasatinib or flumatinib-therapy within 6 months after diagnosis in China with complete data were retrospectively interrogated. The choice of initial TKI, current TKI medications, treatment switch and reasons, treatment responses and outcomes as well as the variables associated with them were analyzed.Results:6 893 patients in CP ( n=6 453, 93.6%) or AP ( n=440, 6.4%) receiving initial imatinib ( n=4 906, 71.2%), nilotinib ( n=1 157, 16.8%), dasatinib ( n=298, 4.3%) or flumatinib ( n=532, 7.2%) -therapy. With the median follow-up of 43 ( IQR 22-75) months, 1 581 (22.9%) patients switched TKI due to resistance ( n=1 055, 15.3%), intolerance ( n=248, 3.6%), pursuit of better efficacy ( n=168, 2.4%), economic or other reasons ( n=110, 1.6%). The frequency of switching TKI in AP patients was significantly-higher than that in CP patients (44.1% vs 21.5%, P<0.001), and more AP patients switched TKI due to resistance than CP patients (75.3% vs 66.1%, P=0.011). Multi-variable analyses showed that male, lower HGB concentration and ELTS intermediate/high-risk cohort were associated with lower cytogenetic and molecular responses rate and poor outcomes in CP patients; higher WBC count and initial the second-generation TKI treatment, the higher response rates; Ph + ACA at diagnosis, poor PFS. However, Sokal intermediate/high-risk cohort was only significantly-associated with lower CCyR and MMR rates and the poor PFS. Lower HGB concentration and larger spleen size were significantly-associated with the lower cytogenetic and molecular response rates in AP patients; initial the second-generation TKI treatment, the higher treatment response rates; lower PLT count, higher blasts and Ph + ACA, poorer TFS; Ph + ACA, poorer OS. Conclusion:At present, the vast majority of newly-diagnosed CML-CP or AP patients could benefit from TKI treatment in the long term with the good treatment responses and survival outcomes.

Objective: To analyze and compare therapy responses, outcomes, and incidence of severe hematologic adverse events of flumatinib and imatinib in patients newly diagnosed with chronic phase chronic myeloid leukemia (CML) . Methods: Data of patients with chronic phase CML diagnosed between January 2006 and November 2022 from 76 centers, aged ≥18 years, and received initial flumatinib or imatinib therapy within 6 months after diagnosis in China were retrospectively interrogated. Propensity score matching (PSM) analysis was performed to reduce the bias of the initial TKI selection, and the therapy responses and outcomes of patients receiving initial flumatinib or imatinib therapy were compared. Results: A total of 4 833 adult patients with CML receiving initial imatinib (n=4 380) or flumatinib (n=453) therapy were included in the study. In the imatinib cohort, the median follow-up time was 54 [interquartile range (IQR), 31-85] months, and the 7-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.2%, 88.4%, 78.3%, and 63.0%, respectively. The 7-year FFS, PFS, and OS rates were 71.8%, 93.0%, and 96.9%, respectively. With the median follow-up of 18 (IQR, 13-25) months in the flumatinib cohort, the 2-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.4%, 86.5%, 58.4%, and 46.6%, respectively. The 2-year FFS, PFS, and OS rates were 80.1%, 95.0%, and 99.5%, respectively. The PSM analysis indicated that patients receiving initial flumatinib therapy had significantly higher cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) and higher probabilities of FFS than those receiving the initial imatinib therapy (all P<0.001), whereas the PFS (P=0.230) and OS (P=0.268) were comparable between the two cohorts. The incidence of severe hematologic adverse events (grade≥Ⅲ) was comparable in the two cohorts. Conclusion: Patients receiving initial flumatinib therapy had higher cumulative incidences of therapy responses and higher probability of FFS than those receiving initial imatinib therapy, whereas the incidence of severe hematologic adverse events was comparable between the two cohorts.
Adult ; Humans ; Adolescent ; Imatinib Mesylate/adverse effects* ; Incidence ; Antineoplastic Agents/adverse effects* ; Retrospective Studies ; Pyrimidines/adverse effects* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy* ; Treatment Outcome ; Benzamides/adverse effects* ; Leukemia, Myeloid, Chronic-Phase/drug therapy* ; Aminopyridines/therapeutic use* ; Protein Kinase Inhibitors/therapeutic use*