Objective To master the status of iodine content in drinking water and iodine nutritional status of population before and after the salt iodine concentration reduction in 2012 in Meizhou City, and to provide a scientific basis for safety assessment of salt iodine content after adjustment of the policy.Methods Using stratified random sampling method, drinking water samples were collected, and iodide content was measured by cerous sulfate catalytic spectrophotometry.Urine samples of children aged 8-10 were collected, in which the iodide content was quantitatively tested by arsenic cerium catalytic spectrophotometry.Samples of household edible salt were collected to determine iodine content by direct titration in 2012 before (September 2011), and after the salt iodine concentration reduction (September 2012 and September 2013).Results A total of 422 water samples were measured, the median iodine content of water was 2.4 μg/L.The water iodine median was 2.1 μg/L in centralized water supply (n =163),and 2.9 μg/L in decentralized water supply (n =259), the difference was statistically significant (U =-2.526, P ＜ 0.05).Totally 800 and 803 urine samples of children aged 8-10 were collected in 2011 and 2012, median urinary iodine was 216.5 and 207.5 μg/L, respectively, which were higher than that in 2013 (n =807, 190.0 μg/L, x2 =17.040,24.868, all P ＜ 0.05).Urinary iodine ≥300 μg/L ratio was significantly decreased (2013 than 2011 and 2012,19.3％ (156/807) vs.26.5％ (212/800) and 24.5％ (197/803), x2 =6.363, 11.695, all P ＜ 0.05), and urinary iodine ＜ 100 μg/L rose in the proportion (2013 than 2011, 18.0％ vs.13.5％, x2 =6.045, P ＜ 0.05).A total of 2 410 household salt samples were tested, and the coverage rate of iodized salt, iodized salt qualified rate, the consumption rate of qualified iodized salt were all higher than 98.8％.Totally 800, 803 and 807 salt samples were collected in 2011, 2012 and 2013, the salt iodine medians were 31.0, 27.7 and 25.4 mg/kg, respectively, the difference between the salt iodine medians was statistically significant (H =91.422, P ＜ 0.05).Conclusions Iodine excess risk is significantly decreased, and the level of iodine nutritional status of the city's population is appropriate after the salt iodine concentration reduction in 2012.The salt iodine concentration adjusted is suitable and safe.

Objective To observe the effect and safety of the human glucagon-like peptide-1 analogue,liraglutide,versus insulin glargine in patients with type 2 diabetes mellitus inadequately controlled with metformin alone.Method Ninty patients with type 2 diabetes mellitus(aged 18-79 years,HbA1C 7.5％-10.0％,body mass index＜40 kg/m2) who had inadequate glycaemic control on metformin were allocated for the research with an open,randomized,parallel controlled clinical research method.The patients kept the original dose of metformin unchanged and were randomly assigned to the liraglutide group or the insulin glargine group according to a proportion of 1 ∶ 1.Liraglutide group started with a dose of 0.6 mg subcutaneous injection qd,changed to 1.2 mg subcutaneous injection qd after one week and kept unchanged until the end of the research.Insulin glargine group started with a dose of 0.1-0.2 U/kg according to the fingertips peripheral blood glucose level before breakfast on the continuous 3 d before every follow-up.At the baseline,after 4 weeks,12 weeks,20 weeks,and 26 weeks of treatment,HbA1C,blood glucose,lipids weight,blood pressure were arranged to measured.86 patients finally completed the study.Results Mean HbA1C and the success rate of HbA1C ＜7％ were similar between liraglutide group and insulin glargine group [(7.06 ± 0.87) ％ vs (7.25 ± 1.20) ％,47.73 ％ vs 45.23 ％,P＞0.05],while the percentage of subjects reaching the composite endpoint of HbA1C＜7％ with no hypoglycemia and no weight gain was significantly higher in liraglutide group than insulin group(P＜0.05) ; Fasting plasma glucose decreased more markedly in insulin glargine group,2 h postprandial plasma glucose was decreased more markedly in liraglutide group(P＜0.05 or P＜0.01).Liraglutide significantly reduced mean body weight by (3.21 ± 1.18) kg,waist circumference by (3.82 ± 1.21) cm,and body mass index by (1.95 ± 0.61) kg/m2 (P＜0.01 or P＜0.05),while in the insulin glargine group there sere rise of respective figure of(2.86 ± 0.43) kg,(1.52 ± 0.56) cm,and (0.61 ± 0.25) kg/m2 (P＜0.05),systolic blood pressure and serum triglyceride declined.There was no serious adverse affect in both groups,the incidence of mild hypoglycemia was significantly less in liraglutide group and has a statistically significant difference (4.55％ vs 21.43％,P＜0.05).Conclusions Liraglutide showed a good effect on reducing weight,systolic blood pressure,blood lipid and in addition to blood glucose control which is comparable to insulin glargine.What is more,liraglutide had good safety and tolerability,which can be regarded as a good choice for patients with type 2 diabetes mellitus inadequately controlled with metformin alone.

Objective To explore the influence of early comprehensive nursing intervention on physical and mental development in children with high risk of cerebral palsy.Methods 150 children with high risk of cerebral palsy who were treated in neonatal intensive care unit(NICU) of Xinxiang central hospital were randomly divided into two groups.78 cases in the intervention group received early comprehensive nursing intervention,including functional training combined with medication and physical treatment method.At the same time,their parents received systematic training and participated in the intervention till the babies reached 2 years old.72 cases in the routine group were given conventional baby care.74 termfor-age neonates who were born in our department of maternity in the same period were selected as the control group,which received conventional baby care.The infants of the routine care group received only conventional baby care.The physical development of the weight,length and head circumference and intelligence of three groups were checked at the age of six months,one year and two years.Results M the age of six months,one and two years old,the physical development were higher significantly in the intervention group than those in the routine group,and had not evident difference with the control group.The mental development index (MDI) of the intervention group was lower than that of the control group at the 6 months,had no obvious difference with the control group at one year old,and was great higher than that of the control group.At the sixth month and one year phychomotor development index (PDI) of the intervention group had no difference with that of the control group,and at two years old were higher than that in the control group.The incidence of the phychomotor development retardment and the cerebral palsy in the intervention group was lower than that in the routine group.Conclusions Early nursing intervention is beneficial to the development of the physical and intelligent development of children with high risk of cerebral palsy.

Objective:To investigate the inhibitory effect and the related mechanism of Yiqi Jianpi Fang on aberrant crypt focus (ACF) in Wister rat colorectal cancer model.Methods:50 Wistar rats were randomly divided into 5 groups:TCM low dose group(TCM solution diluted 3 times,5 mL/kg daily gastric volume),TCM middle dose group (5 mL/kg daily gastric volume),TCM high dose group (15 mL/kg daily gastric volume),model group,normal group.With 10 rats in each group.The colorectal tissues were observed under microscope after methylene blue staining by immunohistochemistry method.Results:Compared with the model group,the number of ACF and large ACF in each TCM group were decreased (P＜0.05),and the number of ACF in the TCM middle dose group reduced most obvious,and the difference was statistically significant (P＜0.05).The proliferation indexs of PCNA in intestinal gland cells 24 h and 48 h after modeling in the TCM groups were higher than those in the model group,and the difference was statistically significant(P＜0.05).The apoptosis index of intestinal gland cells 24 h and 48 h after modeling in the TCM groups were higher than those in the model group,and the difference was statistically significant(P＜0.05).The ectopic expression of β-catenin in TCM groups were lower than that in the model group,and it was highest in the high dose group,than was the low dose group,and the middle group was lowest(P＜0.05).The expression of MMP-7 in TCM groups were lower than that in the model group,and it was highest in the low dose group,than was the high dose group,and the middle dose group was lowest (P＜0.05).Conclusion:Yiqi Jianpi Fang can significantly reduce the number of ACF in Wister rats,inhibit the activation of Wnt signaling in colorectal cancer,reduce the incidence of colorectal cancer,and have a certain preventive effect.

Objective To establish a method of a new type of liver fibrosis model in rats induced by repeated injection of rabbits' liver homogenate. Methods Female Wistar rats were randomly divided into a normal control group (8 rats), a human albumin induced liver fibrosis model group (15 rats) and a rabbits'liver homogenate induced liver fibrosis group (15 rats). The induction of liver fibrosis began with an immune sensitizing period (4 weeks) and was followed by an immune attacking period (8 weeks). After 8 weeks'attacking, all rats were sacrificed under anesthesia. Liver enzymes in serum and hydroxyproline in liver tissue were measured by standard methods and pathological scores were assessed by pathologists. Results The rats' liver weight, ratio of liver weight to body weight in the model group of liver homogenate were significantly increased compared with the normal control group. Serum globulin, tissue hydroxyproline were significantly increased, whereas serum albumin was significantly decreased in the homogenate group. There was only 20.0 percent of liver fibrosis score (2/10) exceeding a degree of 3 in the albumin group whereas 73.3 percent of that (11/15) were exceeding a degree of 3 in the homogenate group and the difference was significant (x2 = 4. 87,P = 0. 027). Conclusion In the study, we established a method of a new type of experimental liver fibrosis model in rats. The method has a significantly high success rate and this model can be used to study the mechanism of liver fibrosis and the efficacy of antifibrotic medicine.

The effects of repaglinide combined with glargine (n=31)on glucose metabolism and β-cell function were observed in the patients with type 2 diabetes after secondary sulfonylureas failure and the results were compared with glimepiride combined with glargine (n=32). The preprandial capillary blood glucose, postprandial capillary blood glucose and HbA1C in both groups after 6-month treatment were significantly reduced as compared with those at baseline (all P＜0.01). The treatment with repaglinide(2 mg tid) plus glargine was more efficient than glimepiride(4 mg qd) plus glargine in improving β-cell function, ameliorating HbA1C and postprandial blood glucose excursions in patients with type 2 diabetes.

Objective To study the relationship between the exposure time of puncture needle of infusion bottle stopper and microbial contamination during clinical intravenous transfusion. Methods A total of 600 cases from November 1, 2014 to January 31, 2015 who have received the clinical intravenous transfusion for investigation were selected.When replacing the infusion bottle (bag), inserting the puncture needle slowly across the bottle stopper and making the needle tip be canted to the transfusion bottle mouth (bag) of the rubber plug, gently squeezing the Murphy's tube until solution was not dripping, recording down the exposure time in the air of the needle tip from medicine droplet to the end. To dip the lower part with sterile swabs and culture the swabs in nutrient broth medium. Meanwhile, to replace the next bottle of medicine and get the remaining 2 ml of liquids into the culture broth medium, after 48 h, both of which medium were switched to blood plate culture cultivation for observing the general situation of the bacteria growth. Results Among the 600 cases of clinical transfusion, 24 cases were positive for sterile swabs microorganisms culture, positive rate was 4.0%, among which microorganisms, 15 cases were gram-positive coccus, 3 cases were gram-negative bacillus, 3 cases were gram-positive bacillus and 3 cases were fungi. Correspondingly, 3 cases were positive for liquid broth culture, positive rate was 0.5%as the gram-positive coccus. The exposure time and broth microbial culture result was statistically significant, while the exposure time and medicinal broth microorganisms culture result possesses had no statistical significance. Conclusions Inserting the puncture needle across the bottle stopper could successfully reduce the liquid drug residues in the infusion bottle (bag), however, which might also cause time-dependent microbial contamination during the exposure process in the air.

To explore the effects of Qushi Huayu Decoction (QSHYD), a compound traditional Chinese herbal medicine, in prevention and treatment of non-alcoholic fatty liver disease (NAFLD) in rats.

BACKGROUND: Angiotensinogen (AGT) gene is the firstly discovered candidate gene for essential hypertension, both the T174M and M235T polymorphisms locate at the second exons of AGT gene, and there is existence of linkage disequilibrium. The polymorphism at A-6G and G-217A sites in promotor region plays an important role in regulating the gene expression, and the products of keep close correlation with the level of blood pressure. OBJECTIVE: To investigate the association between the polymorphism of AGT gene at A-6G, T174M and G-217A sites and the risk for the attack of essential hypertension in Chinese Han population, DESIGN: A cluster sampling and case-control analysis. SETTINGS: Department of Geriatrics and Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University; Southern Research Center of National Human genome; Department of Cardiology, Dongtai People's Hospital of Jiangsu Province. PARTICIPANTS: The experiment was carried out in the countryside of Dongtai county, Yancheng city, Jiangsu province. All the subjects were selected from the countryside of Dongtai county, Yancheng city, Jiangsu province. Totally 177 patients with essential hypertension who had never accepted any drug treatment, were taken as the essential hypertension group, and hypertension was diagnosed according to the diagnostic standard of hypertension set by WHO/ISH in 1999 (systolic blood pressure ≥ 140 mm Hg and/or diastolic blood pressure ≥ 90 mm Hg); Another 86 normal person were taken as the normal control group. ② Inclusive criteria: The enrolled subjects should be Han nationality; long-term local residents but not from other places; able to answer questions clearly; diagnosed by disease history, clinical symptoms, physical signs and assistant examinations; have complete data of investigation of uniform questionnaires by face-to-face interview (including demographic information, profession history, family history and life styles of smoking, drinking, drinking tea, etc.). ③ Exclusive criteria: The patients with secondary hypertension in the essential hypertension group, subjects having family hisory of hypertension in the normal control group, and those with chronic diseases of liver and kidney, and diabetes mellitus in both groups were excluded. METHODS: Peripheral venous blood samples (3 mL) were collected, and DNA was extracted from human peripheral blood with FlexiGene DNA Kit (250). The Primer3 software was applied to design primers, and the polymorphism sites in the primer sequence were excluded. After multiplex polymerase chain reaction (PCR), 3 μL products were selected to detected the amplified results by agarose gel electrophoresis. The successfully amplified PCR products were purified with the QIAquick PCR Purification Kit, and the purified products were fragmentized with Dnase Ⅰ . The fragmentized products of enzyme digestion were labeled with fluorescein by deoxynucleotide terminal transferase. Two allele specific probes and one mismatched probe were designed respectively for each single nucleotide polymorphism. The chips were prepared with the OmniGridTM 100 TLC samler, each probe was repeated for three times to form three matrix. The hyridization solution was degenerated at 95 ℃ for 10 minutes, and then immediately cut on ice. 10 μL hybridization solution was added onto the chip matrix, hybridized at 50 ℃ for 2 hours, then washed and dried. The chips were scanned with the GenePix 4000B laser confocal scanner (Figure 2),and the intensity of the fluorescent signal for each probe was extracted with GenePix Pro, and the allele score of each single nucleotide polymorphism was calculated to judge the genotype. MAIN OUTCOME MEASURES: ① Comparison of the frequencies of genotype distribution at each polymorphism site of AGT gene in both groups; ② Correlation analysis of the polymorphism of AGT gene at A-6G and T-174M sites with the risk for the attack of essential hypertension; ③ Effects of the polymorphism of AGT gene at A-6G, T-174M and G-217A sites on blood pressure.RESULTS: According to the intention-to-treat analysis,all the 263 subjects were involved in the analysis of results. ① At the A-6G site of AGT gene, the frequencies of AA, AG and GG genotypes (P=0.014) and A and G alleles (P=0.004, OR=0.44) had significant differences between the essential hypertension group and normal control group; At the T174M site, the frequencies of CC, CT and TT genotypes (P=0.031) and A and G alleles (P=0.014, OR=0.55) were significantly different; At the G-217A site, no obvious differences were found in the GG, AG and AA genotypes (P=0.722) and G and A alleles (P=0.403, OR=0.80). ② The risk of essential hypertension in the individuals carrying AA genotype of A-6G polymorphism and CC genotype of T174M polymorphism was reduced by 57% (95%CI= 0.23-0.82, P= 0.010) and 56% (95%CI= 0.25-0.79, P= 0.006) respectively. ③ There were no significant differences in the systolic blood pressure, diastolic blood pressure and mean arterial pressure among different genotypes at the A-6G, T174M sites and G-217A sites (F=0.100- 2.911, P ＞ 0.05). CONCLUSION: The AA genope at A-6G and the CC genotype at T174M site of AGT gene may reduce the risk for the attack of essential hypertension in Chinese Hun population, and no significant correlation was found between the genotype of G-217A polymorphism and the attack of essential hypertension.

Objective To analyze the clinical features,treatment methods,and prognostic factors for early primary pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma.Methods A retrospective analysis was performed on the clinical data,treatment outcomes,and survival of 32 patients with early pulmonary MALT lymphoma from March 2001 to September 2013.The median age of those patients was 56 years.Twenty-three patients had stage ⅠE disease and nine had stage Ⅱ E disease.According to the marginal zone B-cell lymphoma prognostic index (MZLPI),twenty-three patients were scored as 0 and nine as 1.Nine patients received radiotherapy,eight patients underwent surgery alone,three patients underwent surgery plus chemotherapy,and twelve patients received chemotherapy alone.The Kaplan-Meier method was adapted for calculating the OS,PFS and the log-rank test was used for survival difference analysis and univariate prognostic analysis.Results The 5-year sample size was 22.The 5-year overall survival (OS) and progression-free survival (PFS) rates were 84.5％ and 73.2％,respectively.Radiotherapy yielded an overall response rate of 100％,including a complete response rate of 66.7％ and a partial response rate of 33.3％.The univariate analysis showed that non-radiotherapy treatment was a prognostic factor for poor PFS.The patients treated with radiotherapy had significantly higher 5-year PFS rates than those treated without radiotherapy (100％ vs.63.0％,P=0.029),while there was no significant difference in 5-year OS rate between these two groups (100％ vs.78.8％,P=0.129).Age older than 60 years,an ECOG score of 2,and an MZLPI score of 1 were prognostic factors for poor PFS (P=0.041,0.018,and 0.044) and OS (P=0.001,0.001,and 0.003).Conclusions The prognostic factors for early pulmonary MALT lymphoma include age,ECOG score,and MZLPI score.Low-dose involved-field radiotherapy (24-30 Gy) can improve local control and survival.