Objective To explore the impact of iodine nutrition on pregnant women after adjusting the iodine content in iodized salt in Hangzhou and provide a scientific basis for supplementation of iodine to pregnant women.Methods After adjusting the iodine content of salt from 2012 to 2014,proportional probability sampling method was used to select 300 families and 100 pregnant women from every county (area,city) of Hangzhou City,and the household salt and urine samples were collected to detect iodine.Results Totally 3 904,3 900 and 3 900 samples of household salts were collected with the medians of salt iodine concentration of 23.77,22.75 and 23.30 mg/kg of each year from 2012 to 2014,respectively.The qualified rate of iodized-salt was 95.87％ (3 550/3 703),97.04％ (3 510/3 617) and 96.53％ (3 564/3 692) and the consuming rate of qualified iodized salt was 90.92％ (3 550/3 904),90.01％ (3 510/3 900) and 91.38％ (3 564/3 900),respectively,from the year 2012 to 2014.Totally 1 300,1 217 and 1 315 urine samples of pregnant women were collected and the median of urinary iodine (MUI) of each year from 2012 to 2014 was 119.90,136.40 and 124.00 μg/L,respectively.Conclusion After adjusting the iodine content of salt in Hangzhou,the salt iodine consumption levels of pregnant women's family are stable,but the level of urinary iodine is low,which should be pay attention to.

Objective To explore the impact of iodine nutrition on 8-10 years old children after adjusting the iodine content in iodized salt in Hangzhou.Methods Twelve counties (areas,cities) were divided into urban,suburban and rural areas in Hangzhou.By population proportion survey (PPS),every county(area,city) was divided into east,west,south,north and middle districts; one school was selected in each district; forty children (half male and half female) aged 8-10 years old in each school were selected; family salt and urine samples of each student were collected.The levels of salt and urinary iodine were measured by picric sodium thiosulfate titrimetric (GB 13025.7-2012) and spectrophotometer method (WS/T 107-2006),respectively.Results Two thousand seven hundred and twenty-five household salt samples were collected.The median of salt iodine,the iodized salt coverage rate,the qualification rate of iodized salt and the consumption rate of qualified iodized salt were 24.00 mg/kg,4.35％(2 571/2 725),91.02％(2 340/2 571) and 85.87％(2 340/2 725),respectively.The medians of salt iodine in urban,suburb and rural areas were 24.10,22.12,24.30 mg/kg,respectively.A total of 2 664 children urine samples were collected.The median of urinary iodine (MUI) of the children was 177.24 μg/L.The MUIs in urban,suburb and rural areas were 175.00,178.55,178.00 μg/L,respectively; in male was 183.00 μg/L and female was 170.50 μg/L.When non-iodized and unqualified iodized salt were taken,the differences of urinary iodine within groups were statistically significant in urban,suburb and rural areas(x2 =18.652,14.686,all P ＜ 0.05).In rural area,the difference of urinary iodine of 8-10 years old children who ingested different types of iodized salt was statistically significant(x2 =39.07,P ＜ 0.05).Conclusion After adjusting the iodine content of salt in Hangzhou,the iodine-nutritional status of 8-10 years old students is at a appropriatelevel.

Objective To investigate the prevalence of thyroid disease in early pregnancy women of Hangzhou,and further to discuss the necessity of screening thyroid function in early pregnant women.Methods From March to October 2013,1 165 cases of women in the center of community health service (or health) for routine prenatal care during early pregnancy were used as research subjects.Household salt,fasting morning urine and serum samples were collected.The salt iodine level was measured by direct titration of sodium thiosulfate.The urinary iodine level was measured by arsenic-cerium contact process method.The levels of serum TSH,FT4,and thyroid peroxidase antibody (TPOAb) were measured by chemiluminescence method.Results The median of urinary iodine of the early pregnancy women was 135.2 μg/L,and only 26.7％ of early pregnancy women' s iodine-nutrition status were optimal.These were no significant difference in median urinary iodine as well as the frequency distribution between urban and suburban(P＞0.05).The abnormal rates of TSH and FT4 in early pregnancy women with negative TPOAb were 6.8％ (71/1 039) and 8.9％ (92/1 039),and the abnormal rates of TSH and FT4 in suburban areas were higher than those in urban areas(P=0.035,P =0.001).The prevalences of hypothyroidism,subclinical hypothyroidism,and hypothyroxinemia in early pregnant women of Hangzhou were 0.3％ (3/1 165),2.0％ (23/1 165),and 4.8％ (56/1 165) respectively,and the prevalence of hypothyroxinemia in suburban areas was significantly higher than that in urban areas (6.1％ vs 3.5％,P =0.040).The positive rate of TPOAb was 9.9％ (114/1 153).The early pregnant women with positive TPOAb have an increased risk of thyroid dysfunction,the ratio of TSH over the reference values was significantly higher than that in the negative group and more prone to subclinical hypothyroidism (OR =3.34,95％ CI 1.29-8.65).Conclusion The early pregnant women in rural areas or with positive TPOAb have an increased risk of abnormal thyroid function,thyroid function and iodine nutrition screening or monitoring should be highlighted.

OBJECTIVE: To investigate the clinical efficacy and advantages of Tianji orthopedic robot assisted cannulated screw internal fixation for femoral neck fracture. METHODS: The clinical data of 41 patients with femoral neck fracture who underwent internal fixation with cannulated screws from January 2019 to January 2022 were retrospectively analyzed. According to different surgical methods, they were divided into Tianji robot group and traditional cannulated screw fixation group (traditional operation group). Among them, there were 18 patients in Tianji robot group including 8 males and 10 females with age of (56.00±4.22) years old, Garden typeⅠ (4 cases), type Ⅱ (11 cases), type Ⅲ (2 cases), and type Ⅳ (1 case). There were 23 patients in the traditional operation group, including 10 males and 13 females, aged (54.87±4.81) years old;there were 5 cases of Garden typeⅠ, 14 cases of type Ⅱ, 3 cases of type Ⅲ and 1 case of type Ⅳ. The operation time, intraoperative blood loss, fluoroscopy times, guide needle placement times, operation costs and other indicators were observed and compared between two groups. Harris score was used to evaluate hip joint function 12 months after operation. RESULTS: The wounds of all patients healed in Grade A without complications. There were significant differences between two groups in terms of operation time, times of intraoperative fluoroscopy, times of guide needle placement, amount of intraoperative bleeding, and operation cost (P<0.05). All 41 patients were followed up for at least 12 months. The fractures of both groups were healed. There was no infection, screw loosening, fracture displacement and femoral head necrosis in Tianji robot group during follow-up;Screw loosening occurred in 2 patients in the traditional operation group during follow-up. At 12 months after operation, Harris hip joint function score of Tianji robot group was higher than that of traditional operation group in daily activity, lameness, joint activity score and total score (P<0.05). CONCLUSION Tianji robot assisted nail placement is a better method for the treatment of femoral neck fracture, which improves the surgical efficiency, is more accurate, has higher success rate of one-time nail placement, shorter operation time, less radiation, and has better hip joint function recovery after surgery.
Male ; Female ; Humans ; Middle Aged ; Robotics ; Retrospective Studies ; Femoral Neck Fractures/surgery* ; Bone Screws ; Fracture Fixation, Internal/methods* ; Treatment Outcome

Objective:To construct a RNAi lentiviral vector targeting rat CD80 gene and detect its effect of gene silencing in NRK and IEC6 cells.Methods:The effective sequence of siRNA targeting rat CD80 gene was confirmed in our previous work.Oligo-DNA fragment containing short hairpin frame was synthesized and reannealed,and then cloned into pGCSIL-GFP lentiviral expression vector.PCR and sequencing analysis were made for verifying the positive clones.The virus packaging plasmids were transfected into 293T cells to harvest shRNA lentivirus.After infection in NRK and IEC6 cells,Real-time PCR was performed to determine the expressing level of CD80.Results:PCR and sequencing revealed that shRNA plasmids was correctly constructed.Virus with a titer of 4×10~8 TU/ml was successfully packaged.CD80 expression in NRK and IEC6 cells could be knockdown by virus infection as characterized by 66.9% and 63.5% decrease of CD80 mRNA in NRK and IEC6 cells respectively,compared with negative control lentivirus.Conclusion:The recombinant lentiviral shRNA expressing vector targeting rat CD80 gene has been successfully constructed and packaged.CD80 mRNA could be down-regulated availably in NRK and IEC6 cells.

Objective To construct an RNAi lentiviral vector targeting rat CD86 gene and detect its effect of gene silencing in dendritic cells. Methods The effective sequence of siRNA targeting rat CD86 gene was confirmed in our previous work. DNA oligo containing short hairpin frame was synthesized and re-annealed, and then cloned into pGCL-GFP lentivind expression vector. PCR and sequencing analysis were made for verifying the positive clones. The virus packaging plasmids were transfected into 293T cells to har-vest shRNA lentivirus. After infection in dendritic cells, real-time PCR and Western blot were performed to determine the expression level of CD86 at mRNA and protein of NC( negative control virus). Results PCR and sequencing analysis revealed that shRNA plasmid was correctly constructed. Virus with a titer of 2×108 TU/ml was successfully packaged. CD86 expression in dendritic cells can be knockdown at both mRNA and protein level by virus infection as characterized by 90.6% decrease of mRNA and significant inhibition of protein compared with NC. Conclusion The recombinant lentiviral shRNA expressing vector targeting rat CD86 gene has been successfully constructed and packaged. CD86 mRNA and protein can be effectively down-regulated in dendritic cells.

Objective: To investigate the epidemiological characteristics of malaria in Hangzhou City from 2004 to 2021, so as to provide the evidence for formulating the post-elimination control strategy for malaria in Hangzhou City. Methods: The epidemic situation of malaria in Hangzhou City from 2004 to 2021 were collected from the National Information System for Disease Control and Prevention in China, and the temporal, spatial and human distributions of malaria cases and the source of malaria infections were analyzed in Hangzhou City during the pre-elimination stage (2004 to 2009), the elimination stage (2010 to 2015) and the post-elimination stage (2016 to 2021). Results: Totally 602 malaria cases were reported in Hangzhou City from 2004 to 2021,and the annual mean incidence of malaria was 0.22/105, 0.20/105 and 0.18/105 during the pre-elimination, elimination and post-elimination stages, appearing a tendency towards a decline. Men accounted for 63.96%, 85.07% and 93.75% of all malaria cases and there were 67.86%, 82.84% and 80.00% of cases at ages of 18 to 50 years during the pre-elimination, elimination and post-elimination stages, both appearing a tendency towards a decline (χ2trend=56.748, P<0.001; χ2trend=39.971, P<0.001). The predominant occupation of malaria cases shifted from farmers or migrant workers to multiple occupations, and the proportion of commercial servants increased from 4.87% during the pre-elimination stage to 24.38% during the post-elimination stage (χ2trend=73.308, P<0.001). The proportion of Plasmodium vivax malaria cases reduced from 96.43% during the pre-elimination stage to 7.50% during the post-elimination stage, and the proportion of P. falciparum malaria cases increased from 3.57% to 71.25%, while P. ovale, P. malariae and mixed infections were identified since 2010. There was a significant season-specific incidence of P. vivax malaria during the pre-elimination stage, and the period between May and October was an epidemic season; however, there was no season-specific incidence of P. vivax malaria during the elimination and post-elimination stages. The regional distribution of malaria cases presented a tendency towards a shift from suburb and rural areas to urban areas (χ2trend=74.229, P<0.001). No local cases were detected in Hangzhou City since 2010, and 94.22% of malaria cases were overseas imported cases after malaria elimination, including 90.61% from Africa. Conclusions oung and middle-aged men were high-risk populations for malaria in Hangzhou City from 2004 to 2021, and overseas commercial servants gradually became the predominant source of malaria infections, with malaria parasite species tending to be diverse. Improving the management of overseas imported cases and timely identification and treatment of cases are major interventions to consolidate malaria elimination achievements in Hangzhou City.

Objective:To understand the epidemiological characteristics of brucellosis in non-occupational population reported in Hangzhou, and provide basis for diagnosis and further prevention and control of brucellosis in non-occupational population.Methods:The basic information, epidemiological characteristics, clinical characteristics and laboratory test data of brucellosis patients reported in Hangzhou from 2008 to 2019 were collected retrospectively. The data were obtained from the case questionnaire of confirmed brucellosis and annual report of brucellosis prevention and control work of Hangzhou Center for Disease Control and Prevention over the years. The epidemiological characteristics, clinical characteristics and diagnosis of brucellosis in non-occupational population were analyzed.Results:From 2008 to 2019, 76 cases of brucellosis in non-occupational population were reported in Hangzhou, accounting for 34.23% (76/222) of the total reported brucellosis cases. In the 76 cases of brucellosis in non-occupational population, there were 47 males and 29 females, the ratio of male to female was 1.62∶1.00; the age was (47.37 ± 16.04) years old, ranging from 6 to 84 years old. The peak incidence of brucellosis in non-occupational population was from March to May, accounting for 59.21% (45/76); the main routes of infection were direct contact and digestive tract, accounting for 80.26% (61/76). The main clinical symptoms were fever (100.00%, 76/76), hyperhidrosis (73.68%, 56/76) and muscle and joint pain (69.74%, 53/76); the diagnosis time was 27 (14, 49) d, and the longest diagnosis time was 190 d. Among them, 39 cases were misdiagnosed, accounting for 51.32% (39/76). Sixty suspected Brucella strains were identified by routine culture of automatic blood culture apparatus in hospital laboratory, and 54 strains of Brucella melitensis were identified by typing, with a coincidence rate of 90.00%. The blood culture rate of patients from 2015 to 2019 (88.46%, 46/52) was significantly higher than that from 2008 to 2014 (58.33%, 14/24), the difference was statistically significant (χ 2=8.968, P < 0.05). Conclusions:From 2008 to 2019, the onset of brucellosis in non-occupational population is seasonal in Hangzhou, the infection mode is diverse, the clinical symptoms are not typical, and it is easy to be misdiagnosed. Blood culture for suspected brucellosis patients in high incidence season is conducive to the early diagnosis of brucellosis.

Objective To explore the impact of iodine nutrition on pregnant women before and after adjusting the iodine content in iodine salt.Methods Twelve counties (areas,cities) in Hangzhou were divided into urban,suburban and rural areas before and after adjusting the iodine content of salt.One survey spot was selected in each district and one hundred pregnant women were selected;family salt and urinary samples of each pregnant woman were collected.The levels of salt and urinary iodine were measured by the methods of picric sodium thiosulfate titrimetric (GB 13025.7-2012) and spectrophotometer (WS/T 107-2006),respectively.Results One thousand two hundred and thirty-nine and one thousand two hundred and thirty-three household salt samples were collected before and after adjusting the iodine content in iodine salt.The median of salt iodine of pregnant women (23.30 mg/kg) before adjusting the iodine content in iodine salt was lower than that after adjusting the iodine content in iodine salt (30.09 mg/kg,x2 =-4.71,P ＜ 0.01).The iodine salt coverage rate and the consumption rate of qualified iodized salt after adjusting the iodine content in iodine salt [93.92％ (1 158/1 233),93.84％ (1 157/1 233)] were higher than those before adjusting the iodine content in iodine salt [91.85％ (1 138/1 239),91.37％ (1 132/1 239),x2 =4.01,5.51,all P ＜ 0.05].The iodine salt coverage rate and the consumption rate of qualified iodized salt in urban and suburb areas after adjusting the iodine content in iodine salt [99.42％ (510/513),100.00％ (203/203),97.86％ (5021513),100.00％ (203/203)] were higher than those before adjusting the iodine content in iodine salt [86.71％ (450/519),98.00％ (196/200),77.26％ (401/519),85.00％ (170/200)],but the iodine salt coverage rate and the consumption rate of qualified iodized salt in rural area before adjusting the iodine content in iodine salt [94.62％ (492/520),86.92％ (452/520)] were higher than those after adjusting the iodine content in iodine salt [85.69％(443/517),76.98％ (398/517),x2=64.22,2.32,100.02,32.90,23.31,17.33,all P ＜ 0.05].One thousand two hundred and thirty-four and one thousand two hundred and thirty-one household urine samples were collected before and after adjusting the iodine content in iodine salt.The median of urinary iodine (MUI,114.80 μg/L) of pregnant women after adjusting the iodine content in iodine salt was lower than that before adjusting the iodine content in iodine salt (168.60 μg/L,x2 =36.92,P ＜ 0.01).The MUIs of pregnant women in urban,suburban,and rural areas (171.30,170.20 and 162.40 μg/L) before adjusting the iodine content in iodine salt were higher than those after adjusting the iodine content in iodine salt (101.00,149.48 and 119.90 μg/L,x2 =-7.78,-2.63,-6.28,all P ＜ 0.01).The differences of urinary iodine between groups were statistically significant in urban,suburban and rural areas after adjusting the iodine content in iodine salt (x2 =32.86,P ＜ 0.01),the MUI of pregnant women in urban areas was lower than those in the suburban and rural areas (x2 =6.70,8.13,all P ＜ 0.05).Conclusions After adjusting the iodine content of salt in Hangzhou,the iodine-nutrition level of pregnant women is decreased.But the consumption rates of qualified iodized salt and the MUIs in urban,suburb,rural areas are different,so the coverage of iodized salt at household level needs to be enhanced and the health education should be highlighted.

Objective To explore the impact of iodine nutrition on children in areas with different iodized-salt covering rate after adjusting the iodine content in iodized salt in Hangzhou.Methods After adjusting the iodine content of salt,every county (area,city) of Hangzhou was divided into east,west,south,north and middle districts;one school was selected in each district,40 children aged 8-10 years old in each school were selected.The goiter rates of 8-10 years old students were examined (WS 276-2007).The family salt and urine samples of each student were collected.The levels of salt and urinary iodine were measured by picric sodium thiosulfate titrimetric (GB 13025.7-2012) and spectrophotometer method (WS/T 107-2006),respectively.Areas were classified according to the coverage rate of iodized salt ＜95％ and ≥95％,and their urinary iodine levels were compared.Results A total of 2 395 samples were collected with a median salt iodine concentration of 23.50 mg/kg and a urinary iodine level of 167.45 μg/L.The goiter rate of children 8-10 years old was 1.75％ (42/2 395).The total iodized-salt covering rate was 93.15％ (2 231/2 395) and the difference was statistically significant between different districts and towns (x2 =153.13,P ＜0.01),but the level was less than 95％ in 6 areas.The urinary median iodine was 151.00 μg/L in the areas where the iodized-salt covering rate was less than 95％,lower than 173.50 μg/L in the areas where the iodized-salt covering rate was more than or equal to 95％ (x2 =-5.28,P ＜0.01).Conclusions After adjusting the iodine content of salt in Hangzhou,the iodine-nutrition status of 8 to 10 years old students is optimal.But the urinary iodine levels are different in areas with different iodized-salt covering rates,so the coverage of iodized salt at household level need to be enhanced and the health education should be strengthen.