Objective To find out the situation of household consumption of iodized salt in Hebei province so as to provide scientific basis for prevention and control of iodine deficiency disorders(IDD). Methods According to the "national iodine deficiency disorders surveillance program (Trial)", the county (city, district) was taken as a unit, township (town) and administrative villages were selected in accordance with the principle of systematic sampling, then households were chosen by random sampling to collect their edible salt in Hebei province from 2007 to 2009. Salt iodine content was detected by direct titration method. Results A total of 48 675, 48 448 and 48 756 salt samples were collected from 2007 to 2009, respectively. The consumption rate of qualified iodized salt from 2007 to 2009 was 91.16%, 91.96% and 96.17%, respectively. There were 24.6%(41/167)and 18.0%(30/167)counties with consumption rate of qualified iodized salt under 90% in 2007 and 2008, respectively. The percentage of counties with consumption rate of qualified iodized salt above 90% was 100.0%(167/167) in 2009. In general there was a significant differences in frequency distribution of consumption rates of qualified iodized salt among the three years(H = 10.778, P ＜ 0.01 ), and the difference was found significant between 2007 and 2009 as well as between 2008 and 2009(all P ＜ 0.05), but was not significant between 2007 and 2008(P ＞ 0.05). Conclusions The consumption rate of qualified iodized salt at household level increases annually from 2007 to 2009. By 2009,the consumption rate of qualified iodized salt in each county is more than 90%, which has reached the national standard stipulated in "the evaluation programs for fulfilling the goal of eliminating IDD at county level".

Objective To investigate the geographical distribution of excessive iodine in drinking water and to demarc aI|e the excessive iodine regions in Hebei Province.Methods In 173 counties of Hebei Province, town was surveyed as an elementary unit.Five villages were sampled according to the direction of east,west, south,north,center in every town.If the water sources were more than 5 in a village,water was sampled according to the direction ofeast,west, south,north, center, respectively;If the water sources were less than 5 in a village, all were sampled:If the village used water of cental supply,only one sample wag collected.Arsenic-cerium catalysis was used to determine the iodine concentration of drinking water.Results Two thousands and forty-nine towns were investigated and 19 352 water samples were determined in Hebei Province.One hundred and seventy- two towns were confirmed to be excessive iodine areas,where the range of water iodine Wag 0.1～2840.4μg/L The water 8amDle with 18 358 had a water iodine median less than 150.0μg/L The areas with water iodine median less than 150.0μg/L,in between 150.0μg/L and less than 300.0μg/L,and equal to or more than 300.0 μg/L accounted for 94.86%,2.92%and 2.22%,respectively.There were 110 towns with water iodine median being between 150.0μg/L and iess than 300.0 μg/L and 62 towns with water iodine median equal to or more than 300 gμ/L.Exeessive iodine towns distributed in 33 counties of 6 cities involving 5 854 960 residents in'Hebei Provmce. MOBt of the water sources with excessive iodine Cangzhou were deep wells and there was a positive correlation between we depth and water iodine concentration (r=0.430,P<0.01), while they were shallow wells in Handan, Xingtai.Hengshui,and no correlation was found between well depth and water iodine concentration(r=-0.060,-0.119.-0.121,P>0.05).Conclusions Six cities have excessive iodine water resotlrees in Hebei Province, mostly in Handan.xingtai,Hengshui and Cangzhou Cities,which all are low-lying land.The water with excessive iodine is hypogene,and the towns with excessive iodine water distributein patchy or spot pattern.

Objective To observe the dynamic changes of prevalence of Keshan disease (KD) in Hebei province from 1990 to 2007, to provide scientific basis for its prevention and treatment. Methods The surveillance data of KD was analyzed according to "the National Scheme of KD Surveillance and the Surveillance of KD" (W/T 78-1996) in Hebei province from 1990 to 2007 by the Institute for Prevention of Endemic Disease in Hebei Province Center for Disease Control and Prevention. The data included physical examination, electrocardiogram (ECG), the chest X-ray film of KD patients and the suspected patients, as well as selenium contents of hair collected in 1990, 1992 and 1999. Results No new cases of acute and subacute types of KD patients were found at the surveillance sites from 1990 to 2007. Thirty-five cases of new latent KD and one case of spontaneous chronic KD were identified respectively. Prevalence of chronic and latent KD ranged from 1.12% (8/713) to 8.18% (27/330) and 2.29% (19/831) to 8.20% (45/549) in Hebei province from 1990 to 2007, respectively. The prevalence of KD in children aged 3 - 14 years old and childbearing woman aged 20 - 45 years old decreased year by year, however population over 45 years old were more likely suffering from KD. The major abnormal changes of ECG in KD) patients were complete fight bundle branch block, ST-T change frequent premature ventricular contraction, and left anterior faseicular block. The prevalence of the heart enlargement in KD patients was 47.00% (211/449) averagely, and the prevalence of heart enlargement of medium grade increased remarkably after 2005 [28.57%(8/28) - 48.39%(15/31)]. The average mortality in chronic KD patients was 18.0%(18/100) from 1990 to 2007. Conclusions The prevalence of KD decreased slowly in Hebei province. Hebei province is still the region with higher prevalence of KD around the country, and the tasks of prevention and treatment of KD is still urgent. Enhancing the surveillance of of KD and carrying out management and treatment of KD patients should be emphasized in the future.

Objective To evaluate the effectiveness of health education on iodine deficiency disorders (IDD) in Hebei, and to provide basic information for development of control strategies. Methods A total of 34 project counties were selected in Hebei province, and 3 townships were chosen in each project county. Heath educational activities were carried out in the classes of grade 5 in the central primary school of each selected township. In the meantime, 3 villages were chosen in each selected township where the health education for women of childbearing age in the community was carried out. Sureys on knowledge of IDD control were conducted in the 34 project counties before and after the health educational activities. Results The knowing rates of IDD control among pupils in all 34 project counties increased from 71.10%(7835/11 019) to 94.84%(10 840/11 430) after health education, with a average increase of 23.74%. The knowing rates of IDD control among housewives increased from 77.02%(4531/5883) to 95.32%(5902/6192), with a average increase of 18.30%. Of which, the knowing rates of IDD control among pupils in Hengshui city increased from 55.56% (750/1350) to 94.89% (1281/1350),with a average increase of 39.33%. The knowing rates of IDD control among housewives in Handan city increased from 65.68%(532/810) to 96.50%(909/942), with a average increase of 30.82%. Conclusions The knowing rates of IDD control among pupils and housewives are remarkably increased after implementing the health education projects. They have better life and health habits, and the project achieves desired effect.

Objective To analyze the status of quality indicators(QI) on specimen acceptability and establish preliminary qual ity specification.Methods Web based External Quality Assessment system was used to collect data of laboratories partici pated in "Medical quality control indicators in clinical laboratory" from 2015 to 2017,including once in 2015 and 2017 and twice in 2016.Rate and sigma scales were used to evaluate incorrect sample type,incorrect sample container,incorrect fill level and anticoagulant sample clotted.The 25th percentile (P25) and 75th percentile (P75) of the distribution of each QI were employed to establish the high,medium and low specification.Results 5 346,7 593,5 950 and 6 874 laboratories sub mitted the survey results respectively.The P50 of biochemistry (except incorrect fill level),immunology and microbiology reach to 6σ.The P50 of clinical laboratory is 4 to 6σ except for incorrect sample container.There is no significant change of the continuous survey results.Based on results in 2017 to establish the quality specification,the P25 and P75 of the four QIs is 0 and 0.084 4 ％,0 and 0.047 6 ％,0 and 0.114 2 ％,0 and 0.078 4 ％,respectively.Conclusion According to the results of the survey,most laboratories had a faire performance in biochemistry,immunology and microbiology,and clinical laboratory needs to be strengthened.Laboratories should strengthen the laboratory information system construction to ensure the actual and reliable data collection,and make a long time monitoring to achieve a better quality.