Objective To compare selenium content in hair samples of people in Kaschin-Beck disease (KBD) areas and non KBD areas two months after stopping selenium salt in Shaanxi Province,to provide a scientific basis for KBD control and prevention.Methods In September 2012,four historical KBD areas were selected,including Yongshou,Yuyang,Linyou and Nanzheng,four villages were selected as monitoring sites according to the four directions as east,west,south and north in each county.Meanwhile,four non KBD areas were selected,including Wugong,Mizhi,Qishan and Chenggu,which adjacent to the survey counties and were similar to the survey counties in environment and production and living conditions.Four villages were selected as monitoring sites according to the four directions as east,west,south and north in each county.Lianhu District in Xi'an city was selected as a urban non KBD area.Four communities were selected in the east,west,south and north as the monitoring sites.In each monitoring point,hair samples of 8 children aged 7-12 years old (gender balanced) and 8 adults over the age of 16 (gender balanced) were selected to determine the hair selenium.Samples were disposed by wet digestion method,the selenium content was determined by 2,3-diaminonaphthalene fluorescence method.Results A total of 256 hair samples were collected in the four KBD counties,256 hair samples in four non KBD counties,64 hair samples in one urban district.The average of hair selenium in each monitoring point was ≥0.25 mg/kg.Compared the hair selenium content in KBD areas,rural non KBD areas,and urban non KBD areas [(0.40 ±0.23),(0.42 ± 0.28),(0.37 ± 0.38) mg/kg],the differences were not statistically significant (F =0.045,P ＞ 0.05).In KBD areas,the hair selenium content of 37 people was ＜ 0.20 mg/kg,accounting for 14.45％;28 people was 0.20-＜ 0.25 mg/kg,accounting for 10.94％;127 people was 0.25-＜ 0.50 mg/kg,accounting for 49.61％;64 people was ≥ 0.50 mg/kg,accounting for 25.00％.In non KBD areas,the hair selenium content of 67 people was ＜ 0.20 mg/kg,accounting for 20.94％,28 people was 0.20-＜ 0.25 mg/kg,accounting for 8.75％;143 people was 0.25-＜ 0.50 mg/kg,accounting 44.69％;82 people was ≥0.50 mg/kg,accounting for 25.63％.Compared the hair selenium content of children aged 7-12 and adults in KBD areas,rural non KBD areas,and urban non KBD areas [children:(0.45 ± 0.29),(0.47 ± 0.31),(0.33 ± 0.12) mg/kg;adults:(0.41 ± 0.25),(0.37 ± 0.25),(0.40 ± 0.49) mg/kg],the differences were not statistically significant (F =0.007,0.024,all P ＞ 0.05).Compared the hair selenium content in different gender in KBD areas,rural non KBD areas,and urban non KBD areas [maile:(0.43 ± 0.23),(0.43 ± 0.26),(0.40 ± 0.51) mg/kg;female:(0.38 ± 0.22),(0.41 ± 0.31),(0.34 ± 0.18) mg/kg],the differences were not statistically significant (F =0.872,3.589,all P ＞ 0.05).Conclusion Two months after stopping to supply selenium salt in 2012 in Shaanxi Province,the hair selenium content of residents in KBD areas has not dropped significantly.Since this survey is carried out only 2 months after taking the measure,it is necessary to continue to monitor the selenium level in KBD areas.

Objective To know the prevalent trend of goiter in Shaanxi province and to provide the basic data for making the control strategy. Methods In 2002, with the population proportionate sampling, the investigation was conducted according to China National Criteria for Diagnosis and Grade Division of Endemic Goiter GB16004-1995. Results The prevalence rate of goiter was 6.52%, the number of patients with visible goiter was 317 000 in Shaanxi province. Conclusion It was not proper to evaluate the population iodine nutrition by the goiter rate of children aged 8-10 years, it may aggrandize the serious degree of IDD. Up to now, the number of patients with visible goiter is decreased by 659 000 and no new Cretinism patient has been found in Shaanxi.

0.05). Conclusion High fluoride may cause children intelligence decrease.

Objective To evaluate the urinary iodine detection ability of Iodine Deficiency Disorder Laboratory in Shaanxi Province,and to test the quality of laboratory construction.Methods In Shaanxi Province,ten city-level and 107 county-level urinary iodine labs of Center for Disease Control and Prevention or Institute for Endemic Disease Prevention and Control were selected in 2018,and two urinary iodine quality-control samples were measured by As3+-Ce4+ catalytic spectrophotometry.The results of urinary iodine quality control were evaluated through standard Z score generated from all the participatory labs.Results All 117 labs had feedback their testing results.There was one lab with an inter-laboratory |Z| score≥3,and 3 labs with inter-laboratory |Z| score≥3,and the qualified rate was 96.58％ (113/117).In 107 county-level urinary iodine labs,there was one lab with an interlaboratory | Z| score ≥ 3,and 3 labs with inter-laboratory | Z[score ≥ 3,and the qualified rate was 96.26％ (103/107).Conclusions The construction of urinary iodine lab has achieved great results in Shaanxi Province,the testing ability of iodine determination laboratory is maintained at a high level,which has laid a solid foundation for prevention and treatment of iodine deficiency disorders in Shaanxi Province.

Objective To explore the relationship between plasma homocysteine levels and diabetic peripheral neuropathy (DPNP). Methods A crossectional analysis was conducted on 227 patients with type 2 diabetes. Peripheral neuropathy was confirmed using electromyography (EMG). The risk factors possibly associated with diabetic neuropathy or plasma homocysteine levels were analyzed in relation to likelihood of occurrence of DPNP. Results Eighty patients with neuropathy and 147 patients without neuropathy were included. Plasma homocysteine levels were significantly higher in patients with diabetic neuropathy [( 12. 6 ± 3.6 ) μmol/ L] than without diabetic neuropathy [( 8. 2 ± 0. 9 ) μmol/L] ( P ＜0. 001 ), and the relationship remained significant after adjusting for duration of diabetes, glycosylated hemoglobin A1c (HbA1c), age, renal status, serum folate acid and vitamin B12, and metformin [OR 1.15( 1.02-1.28 ) ,P ＜ 0. 05]. In addition, per increase of 4. 0 μmol/L plasma homocysteine was closely related to the occurrence of neuropathy after controlling for per unit increase of other confounding factors [OR 1.17(0. 94-1.33), P ＜ 0. 05]. Conclusions Hyperhomocysteinemia was an independent risk factor for the occourence of diabetic peripheral neuropathy.

Objective To understand selenium content in hair samples of children in Kashin-Beck diseased and non-disease areas in Shaanxi Province,and to provide decision-making basis for prevention and treatment of Kashin-Beck disease.Methods In July 2016,two history serious diseased areas Linyou County and Yongshou County were selected as monitoring counties in Shaanxi Province;Fengxiang County and Liquan County were selected as non-disease monitoring counties.According to stratified random sampling,in the 7-12 year old resident children at each monitoring county,5 males and 5 females were taken from each age group,and their hair samples were collected.Samples were digested by wet digestion method,the contents of selenium were determined by 2,3-diaminonaphthalene fluorescence method.Judging criteria:selenium content ＜ 0.20 mg/kg was a selenium deficiency,0.20-＜ 0.25 mg/kg was a selenium edge deficiency,0.25-＜ 0.50 mg/kg was a selenium nutrient medium level,≥0.50 mg/kg is a selenium nutrient high level.Results A total of 240 hair samples were collected,120 cases in the diseased and non-diseased areas,respectively.The selenium contents of children in the diseased and non-disease areas was (0.28 ± 0.13),(0.33 ± 0.13) mg/kg,and the means were between 0.25-＜ 0.50 mg/kg.There was no significant difference in the selenium content in the children between diseased and non-disease areas (t =2.753,P ＞ 0.05).In diseased and non-disease areas,there were 36 and 20 children with selenium content ＜ 0.20 mg/kg,accounting for 30.00％ and 16.67％;15 and 11 children with selenium content 0.20-＜ 0.25 mg/kg,accounting for 12.50％o and 9.17％;61 and 75 children with selenium content 0.25-＜ 0.50 mg/kg,accounting for 50.83％ and 62.50％;8 and 14 children with selenium content ≥0.50 mg/kg,accounting for 6.67％ and 11.67％.There were no significant differences in the selenium contents of hair in boys [(0.27 ± 0.13),(0.33 ± 0.12) mg/kg] and girls [(0.30 ± 0.13),(0.33 ± 0.13) mg/kg] between diseased and non-disease areas (t =2.793,1.219,P ＞ 0.05).Conclusions The selenium contents of children of Kashin-Beck diseased areas in Shaanxi Province are close to the levels of selenium in non-disease areas,and most children are in the medium or high levels of selenium.

Objective To investigate the potential association of Ghrelin(GHRL)gene polymorphisms susceptible to schizophrenia by case-control study.Methods Six hundred and thirty-four patients,six hundred and six healthy control subjects were recruited.Four SNPs rs696217,rs26802,rs27647 and rs26311 were detected by the polymerase chain reaction-based-restriction fragment length polymorphism analysis.Results No significant differences in genotype or allele frequencies of the four SNPs were observed between schizophrenic patients and healthy controls (Pvalues of genotype frequencies were 0.649,0.944,0.410,0.826;P values of allele frequencies were 0.773,0.992,0.301,0.723).However,seven haplotypes(GAAG,GAGC,GAGG,GCGC,GCGG,TAGC,TAGG)showed significant differences in frequency between schizophrenic and control groups(P values were 0.011,0.001,1.76×10-6,9.84×10-10,1.38×10-9,2.12×10-5,2.57×10-6).Conclusion These data suggest that the GHRL gene may not be associated with susceptibility to schizophrenia in the Chinese Han population.However,the haplotype of GA may be the susceptive factor of schizophrenia.

Objective To compare postoperative three-dimensional conformal radiotherapy (3DCRT) and conventional radiotherapy (CR) in patients with non-small-cell lung cancer (NSCLC). Methods From Nov. 2002 to Mar. 2006,162 patients with stage ⅠB～ⅢB NSCLC receiving postoperative radiotherapy in our department were restrospetcively analyzed. Among them,86 received 3DCRT and 76 re-ceived CR. The survival outcome, pattern of failure and treatment-related side effects in both groups were an-alyzed. Results The median follow-up was 29.4 months in the 3DCRT group and 24 months in the CR group. The 1-,2- and 3-year local-regional free survival was 97.5% ,83.2% and 83.2% in 3DCRT group, and 84.3% ,76.0% and 65.6% in CR group(χ2= 5.46, P = 0.019), respectively. No statistically signifi-cant difference was found in the overall survival, disease-free survival or distant metastasis-free survival be-tween the two groups. The local-regional failure rate was statistically different between the two groups (14.5% vs 33.3% ,χ2 =7.70,P =0.006). The incidence of distant metastasis in the two groups was simi-lar. Radiation pneumonitis of NCI CTC grade 2-3 occurred in 10 patients(11.6%)in 3DCRT group and 18 (23.7%) in CR group,which was statistically different(χ2 =4.10,P=0.043). Conclusions Postopera-tive 3DCRT for NSCLC provides a better local-regional control and lower incidence of radiation pneumonitis compared with CR.

Objective To compare selenium content in hair samples of people in Kaschin-Beck disease (KBD) areas and control areas in Shaanxi Province two years after stopping the selenium salt prevention,and to provide a scientific basis for development of targeted prevention measures and for decision-making.Methods In July 2014,the four KBD counties of Yongshou,Yuyang,Linyou and Nanzheng were selected as survey counties,meanwhile,four non KBD counties of Wugong,Mizhi,Qishan and Chenggu were selected as rural control groups and Lianhu District in Xi'an City was selected as a urban settlement control county.Four villages (communities) were selected as monitoring sites according to four directions as east,west,south and north in each county.In each monitoring site,hair samples of 8 children aged 7-12 years old (gender balanced) and 8 adults over the age of 16 (gender balanced) were selected to determine hair selenium.Samples were prepared by wet digestion method,the content of selenium was determined by 2,3-diaminonaphthalene fluorescence method.Results A total of 576 hair samples were collected.The average hair selenium in each monitoring site was more than 0.20 mg/kg.Hair selenium was compared in KBD areas,rural non KBD areas,and urban non KBD areas,the differences were not statistically significant [(0.35 ± 0.18),(0.41 ± 0.28),(0.46 ± 0.19) mg/kg,F =1.544,P ＞ 0.05].In KBD areas and non KBD areas,there were 45 and 45 people with selenium content ＜ 0.20 mg/kg,accounting for 17.58％ and 14.06％;47 and 25 people with selenium content 0.20-＜ 0.25 mg/kg,accounting for 18.36％ and 7.81％;113 and 159 people with 0.25-＜ 0.50 mg/kg,accounting for 44.14％ and 49.69％;51 and 91 people with ≥0.50 mg/kg,accounting for 19.92％ and 28.44％.Hair selenium content of children aged 7-12 and adults was compared in KBD areas,rural non KBD areas,and urban non KBD areas [children:(0.43 ± 0.35),(0.38 ± 0.19),(0.50 ± 0.16) mg/kg;adults:(0.32 ± 0.17),(0.38 ± 0.19),(0.42 ± 0.21) mg/kg],the differences were not statistically significant (F =2.131,1.789,P ＞ 0.05).Hair selenium content was compared in different gender in KBD areas,rural non KBD areas,and urban non KBD areas [male:(0.35 ± 0.18),(0.44 ± 0.33),(0.52 ± 0.15) mg/kg;female:(0.35 ± 0.19),(0.38 ± 0.22),(0.41 ± 0.21) mg/kg],the differences were not statistically significant (F=1.598,1.790,P ＞ 0.05).Conclusion Two years after stopping the selenium salt prevention in Shaanxi Province,the selenium of population in Kashin-Beck disease areas in Shaanxi Province exceeds the human health threshold (0.20 mg/kg),and most people are in the medium or high levels of selenium,and are close to the levels of selenium in non-endemic areas.

Objective To investigate health-related quality of life (HRQOL) and influencing factors in adult patients with Kashin-Beck disease (KBD) in Shaanxi Province for improving health-related quality of life of KBD patients.Methods By the two-stage cluster random sampling method,data of 901 cases of KBD patients with the disease severity of grade 1 and higher were collected from higher KBD incidence areas of Baoji,Xianyang and Tongchuan in Shaanxi Province in February 2016.The Chinese version of SF-36 (including 8 dimensions:physical functioning,role-physical,bodily pain,general health,vitality,social functioning,role-emotional,mental health) was used to measure the HRQOL.Multiple linear regression was used to analyze the influencing factors of HRQOL.Results In 901 cases of KBD patients,male accounted for 55.49％ (500/901),female accounted for 44.51 (401/901).The median age of patients was 58 (22-83) years old.According to the severity of disease criteria,patients with grade Ⅰ were 37.18％ (335/901),patients with grade Ⅱ were 53.50％ (482/901) and patients with grade Ⅲ] were 9.32％ (84/901).The scores of each dimension of SF-36 scale in patients of male patients had higher scores in GH and MH than women [GH:35 (25,50) vs 30 (20,45),MH:56 (48,72) vs 56 (44,68),.9 ＜ 0.05].There were significant differences in PF,RP,BP,GH,VT and SF scores among different age groups (P ＜ 0.05).Similarly,there were significant differences in PF,RP,GH,VT,SF,RE and MH scores among patients with different educational levels (P ＜ 0.05).Married group was only higher in the PF and SF scores than other marital status groups [PF:55 (40,75) vs 50 (35,65),SF:62 (50,75) vs 50 (38,75),P ＜ 0.05].As expected,there were significant differences in the scores of PF,BP,GH and SF between the severity of diseases.There were also significant differences in the scores of PF,BP,GH,VT,SF and MH in KBD patients from different regions (P ＜ 0.05).According to multiple linear regression analysis results,male was the conservation factor of GH and MH scores compared with female;age was a risk factor for PF,RP,BP,GH,VT and SF scores;compared with the illiterate,primary school education was a protective factor for PF and RE scores,junior high school and above were PF,RP,VT,SF,RE and MH scores protective factors;compared with degree Ⅰ KBD,degree Ⅱ and degree Ⅲ were risk factors for PF,BP,GH and SF scores;compared with Baoji area,Xianyang area was a protective factor of SF score,however,Tongchuan area was a protective factor for PF,GH,VT,SF and MH scores.Conclusions KBD has severely damaged the HRQOL of patients.Priority should be given to age,educational attainment and severity of the disease for developing measures to improve KBD patients' HRQOL in different regions.