Objective To investigate the therapeutic effects of Flupentixol and Melitracen with conventional medicine on functional gastrointestinal disease of officers and soldiers.Methods Eighty-two officers and soldiers with functional gastrointestinal disease which defined by the Rome Ⅲ were randomly divided into two groups.The cases in therapy group were treated with Flupentixol and Melitracen combined with conventional medicine,and the cases in control group were simply treated with conventional medicine.The scales changes of clinical eddicacy,sympotoms,depression,anxiety amd the quality of life at the beginning and 8 weeks 'treatment were recorded.Results All offers and soldiers completed the therapy,and the overall response rate was 92.68％ in the therapy group and 70.13％ in the control group(x2 =6.61,P ＜0.05).The general severity score of symptoms,the score of depression and the score of anxiety in the therapy group after treatment were significantly lower than that of before treatment (t =27.76,16.24,16.28 ; P ＜ 0.05),while there were no significant difference in the control group(P ＞ 0.05).The score of the quality of life in the therapy group (SF-36) after treatment was improved significantly than that of before treatment (P ＜ 0.05),and the difference of two group was significant (P ＞ 0.05).Conclusion The therapy scheme of Flupentixol and Melitracen with conventional medicine on offiers and soldiers with functional gastrointestinal disease can improve the total effective rate,clinical symptoms,depression,anxiety and the quality of life.

Objective To build a case database of endemic cretinism,investigate the distribution of existing cretinism,and provide suggestions for prevention of iodine deficiency disorders.Methods In 2011,an existing endemic cretinism case database was established in Gansu Province by verifying and registering the historical cases before 1985,and searching and diagnosing the cases between 1985-2011 in history cretinism areas and IDD high-risk areas according to endemic cretinism and endemic sub-clinical cretinism diagnosis (WS 104-104) and the IDD monitoring program of the central transfer fund at the same time,and analysis the distribution of existing cretinism.Results In 1985 and 2011,cretinism areas were 53 and 41 in Gansu Province,and the endemic cretinism cases werel9 696 and 4 715,respectively;18 cases of endemic cretinism were born between 1985 to1997,7 new cases were born after 1997;nerve cretinism,myxedematous and mixed types among existing cases were 58.8％ (2 766/4 708),9.8％ (461/4 708) and 31.4％ (1 481/4 708),males and females were 69.3％ (3 261/4 708)and 30.7％ (1 481/4 708),respectively.Cases older than 45 accounted for 73.2％ (3 444/4 708);the 7 new cases were all nerve cretinism and 5 cases distributed in ethnic minority areas.Conclusions There are potential dangers of endemic cretinism in the high-risk areas of iodine deficiency disorders due to multiple factors in Gansu Province;the nervous cretinism is the majority which is caused by insufficient iodine intake in early maternal pregnancy.To prevent new endemic cretinism,it is necessary to strengthen measures of emergency iodine supplementation for pregnant women and nursing mothers in the high-risk areas.

Objective To assess iodine nutritional status of lactating women and infants (0-2 years old) in six ecological regions of Gansu Province,and to provide a scientific basis for iodine supplementation of target people.Methods According to different topography and climate conditions,Gansu Province was divided into six ecological regions:the desert region,the Gobi region of Hexi Corridor,the hills and valleys region of Loess Plateau,the Zhongshan Valley of Qinling Mountains,the grassland meadow area of Gannan plateau and the Loess Plateaugully region.Totally 5 counties were selected from each ecological region,and each county was divided into five geographic locations (east,south,west,north and center).In each location,one township was identified and ten samples of lactating women and infants (0-2 years old) were selected randomly and 60 salt samples of residents were collected to determine iodine content.At the same time salt intake of 20 residents was surveyed in three townships as mentioned above.The water samples of all the centralized water supply projects were collected in each county,and one water sample of the decentralized water supply in ten townships with the largest population of each county from east,south,west,north and center locations was collected to determine iodine content.One soil sample was collected to determine iodine content in east,south,west,north and center townships of each county.The urinary iodine and water iodine levels were measured with the method for determination of iodine in urine by As3+-Ce4+ catalytic spectrophotometry (WS/T 107-2006).The direct titration method among thegeneric methods for iodide testing in salt production industry (GB/T 13025.7-2012) was used to determine the salt iodine level,and the arbitration method was adopted for quantitative determination in the case of Sichuan salt or other special salts and the salt intake was estimated based on three day weighed food record.The soil iodine was determined using the amplified colorimetric method.Results Totally 1 476 and 1 461 urine samples of lactating women and infants were collected,and the total urine iodine medians of lactating women and infants (0-2 years old) were 149.05 and 151.34 μg/L,respectively,the urine iodine median of lactating women and infants in each ecological region was at the 100-199 μg/L appropriate level.Not weaning infants urine iodine (155.32 μg/L) was higher than that of the weaning infants (146.30 μg/L),the difference was significant statistically (Z =-2.808,P ＜ 0.05).There was a correlation between urine iodine of not weaning infants aged 0-2 years old and breastfeeding women (r =0.133,P ＜ 0.01),and there was no correlation between weaning infants and breastfeeding women (r =0.045,P ＞ 0.05).About 9 008 salt samples were collected,and the rates of qualified iodized salt intake in the six ecological regions were all higher than 93％.The daily salt intake per person ranged from 4.5 g to 12.6 g,in which the Loess Plateaugully region was the highest with 12.6 g and the grassland meadow area of Gannan plateau was the lowest with 4.5 g.The water iodine median of 1 513 water samples was 3.3 μg/L.The water iodine medians of the rest 4 ecological regions were all less than 5 μg/L except for the desert region (42.4 μg/L) and the Loess Plateau-gully region (30.0 μg/L) of which the median of water iodine was higher than 20 μg/L.The soil iodine median of 155 soil samples was 127 μg/kg,in which the desert region was the lowest with 78 μg/kg and the grassland meadow area of Gannan plateau was the highest with 218 μg/kg.Conclusion Lactating women and infants are in good iodine nutritional status and the present iodized salt concentration can meet the demand of iodine nutrition of lactating women and infants well.

Objective:To evaluate the iodine level of drinking water in different ecological regions in Gansu Province, and to provide a basis for preventing iodine deficiency disorders in accordance with local conditions.Methods:In May to July 2017, according to different topography, landforms and climatic conditions, Gansu Province was divided into six ecological regions: desert area, Hexi Corridor gobi area, Loess Plateau hilly area, Qinling Zhongshan gorge area, Gannan Plateau grassland and meadow area, and Loess Plateau gully area. One county was selected from each of the five districts in the east, west, south, north, and central areas in each ecological regions. Drinking water samples were collected in each county based on the township, and the water iodine content was determined by arsenic-cerium catalytic spectrophotometry.Results:A total of 4 037 water samples were collected in 527 townships of six ecological regions, the water iodine range was 0.10 - 97.60 μg/L, with a median of 2.10 μg/L. Among them, the medians water iodine of the six ecological regions were less than 40 μg/L, the difference between different ecological regions was statistically significant ( H = 1 007.440, P < 0.01); the unified centralized, partially centralized and dispersed water supply water samples were 157, 2 263 and 1 617, and the medians water iodine were 1.61, 2.42, and 1.83 μg/L, respectively, and there was statistically significant difference among different water supply methods ( H = 37.164, P < 0.01). Stratified by water supply method, the differences in water iodine between different ecological regions of the same water supply method were statistically significant ( H = 32.628, 580.630, 391.070, P < 0.01); stratified by ecological region type, the differences of different water supply methods in desert area, Hexi Corridor gobi area, Qinling Zhongshan gorge area, Gannan Plateau grassland and meadow area were statistically significant ( Z = - 2.770, H = 6.369, 9.936, 12.666, P < 0.05). Conclusions:The six ecological regions in Gansu Province are all iodine-deficient areas. The water iodine content varies among different ecological region types and different water supply methods. Surveys on water iodine content and the operating status of water supply facilities should be carried out regularly, and measures should be adjusted in time to prevent and control iodine deficiency disorders in accordance with local conditions.

Objective To master the situation of iodine deficiency disorders (IDD) and the people's iodine nutritional status after implementation of the new salt iodine standard in Gansu Province in 2012.Methods Totally 30 counties (cities) were selected in Gansu Province by population proportionate to size sampling (PPS) method in 2014,and one primary school was selected in each counties (cities).In each selected school,50 children aged 8-10 years old were selected for thyroid examination by B-ultrasound,urine samples were collected for iodine determination,and salt samples were collected for iodine determination from a subset of children included in the study.Totally 20 pregnant women were selected from the towns with the sampled schools and urine samples were collected for iodine determination.Arsenic and cerium catalysis spectrophotometry (WS/T 107-2006) was used to detect urinary iodine content;direct titration (GB/T 13025.7-2012) was used to detect edible salt iodine content.Urinary iodine of children and pregnant women were compared with 2011 (before implementation of the new salt iodine standard).Results The median of salt iodine was 26.6 mg/kg,the iodized salt coverage rate was 99.5％ (1 492/1 500),the qualified rate of iodized salt was 89.3％ (1 333/1 492),and the consumption rate of qualified iodized salt was 88.9％ (1 333/1 500).The thyroid goiter rate of children was 3.2％ (48/1 500);a total of 1 499 urine samples of children were detected,the urinary iodine median was 169.8 μg/L,it was significantly lower than that in 2011 (216.0 μg/L,Z =-6.813,P ＜ 0.05).A total of 600 urine samples of pregnant women were detected,the urinary iodine median was 161.8 μg/L,it was significantly lower than that in 2011 (168.6 μg/L,Z =-3.590,P ＜ 0.05).Conclusion IDD has been controlled after implementation of the new standard of iodized salt and iodine nutrition condition is good.

Objective To investigate the scope and distribution of water iodine in centralized water supply projects,and provide a basis for taking appropriate control measures in Gansu Province.Methods Collected 2 copies of water samples of all the different water supply of centralized water supply project water in the province's 87 counties (cities,districts),the source water iodine of all centralized water supply projects was tested by the method of cerium sulfate catalytic spectrophotometry.The relationship between different water types and different iodine levels in deep well water were analyzed.Results Of the total 1 563 centralized water supply projects,the median of water iodine was 6.38 μg/L,the range was 0.00-182.10 μg/L,the rates were 62.0％ (969/1 563),30.1％ (471/1 563),6.9％ (108/1 563),0.5％ (7/1 563) and 0.5％ (8/1 563) in water iodine level of ＜ 10,10-＜ 50,50-＜ 100,100-＜ 150 and ≥ 150 μg/L.The surface water was 26.7％ (418/1 563),the median of water iodine was 4.42 μg/L,the groundwater was 73.3％(1 145/1 563),the median of water iodine was 8.10 μg/L,the iodine content of surface water was lower than that of the groundwater (Z =-10.089,P ＜ 0.01);in surface water,the rate of river,lake,reservoir and other water source was 55.7％ (233/418),7.7％ (32/418),21.5％ (90/418) and 15.1％ (63/418),and the median was 2.52,31.10,6.65 and 5.40 μg/L,the iodine content between surface water and water sources of different water sources was significant different (x2 =179.976,P ＜ 0.01);in the groundwater,the rate of deep well,shallow well and spring was 55.5％ (635/1 145),41.3％ (473/1 145) and 3.2％ (37/1 145),and the median was 17.90,3.66 and 4.18 μg/L,the iodine content in groundwater from different sources was significant different (x2 =357.346,P ＜ 0.01).Iodine content of different well depth was significantly different (x2 =288.959,P ＜ 0.01),there was a positive correlation between iodine content and well depth (r =0.364,P ＜ 0.01).Conclusions Iodine content of the surface water is generally lower in many water types in Gansu,iodine content is higher in deep well,and there is high iodine deep well water in local areas.It is recommended that water iodine be included in the population iodine nutrition assessment index.

Objective:To analyze the constitution and clinical characteristics of patients with thyroid diseases in Lanzhou, and to provide experience and basis for clinical treatment and prevention of thyroid diseases.Methods:The data of inpatients with thyroid diseases of Anning Branch of General Hospital of Lanzhou Military Region from October 2008 to October 2018 were collected, and the differences of age, gender, occupation, thyroid disease classification and composition, and thyroid hormone levels were analyzed.Results:A total of 375 inpatients data with thyroid diseases were collected, including 114 males and 261 females, accounting for 30.4% and 69.6%, respectively. Thyroid nodules, hypothyroidism, hyperthyroidism, goiter, thyroiditis, thyroid adenoma and thyroid cancer accounted for 12.3% (46/375), 22.9% (86/375), 10.4% (39/375), 7.5% (28/375), 5.9% (22/375), 40.0% (150/375) and 1.1% (4/375), respectively. There were significant differences in hypothyroidism and thyroid adenoma between different genders ( P < 0.05). There were significant differences in hypothyroidism, hyperthyroidism and thyroid adenoma between different age groups( P < 0.05). There were significant differences in hypothyroidism and thyroid adenoma between different occupations ( P < 0.05). The diagnostic coincidence rates of thyroid stimulating hormone (TSH), free triiodothyroine (FT 3) and free thyroine (FT 4) of inpatients with hyperthyroidism were 43.6% (17/39), 79.5% (31/39) and 89.7% (35/39), respectively. The diagnostic coincidence rates of TSH, FT 4 and FT 3 of inpatients with hypothyroidism were 60.5% (52/86), 44.2% (38/86) and 2.3% (2/86), respectively. The patients with thyroid nodules, thyroiditis, goiter and thyroid adenoma mainly had elevated FT 3 and decreased T 3 levels. Conclusions:Thyroid adenoma and hypothyroidism are the main thyroid diseases in Lanzhou. The incidence in women and aged ≥50 years old people is high, and hyperthyroidism tends to be younger. Therefore, it is necessary to strengthen the physical examination and screening of thyroid diseases.

Objective:To investigate the iodine nutritional status of population in Gansu Province, and to provide a scientific basis for policy adjustment of relevant departments.Methods:In 2019, a cross-sectional survey was conducted in 87 monitoring units in 86 counties (districts and cities) of 14 cities (prefectures) in Gansu Province for iodine deficiency disorders (IDD). Instant urine samples and salt samples of children aged 8 to 10 years and pregnant women were collected for detection of urinary iodine and salt iodine. B-ultrasound was used to check the thyroid volume of children in 40 monitoring units.Results:A total of 17 772 children aged 8 to 10 years were investigated. The median urinary iodine (MUI) of children was 197.4 μg/L, the MUI of 14 cities (prefectures) ranged from 160.6 to 233.4 μg/L. There were statistically significant differences in MUI among children of different genders and ages ( P < 0.001). Totally 8 269 children were examined by B-ultrasound, the children's goiter rate was 1.4% (118/8 269). There were statistically significant differences in the thyroid volume among children of different genders and ages ( P < 0.05). A total of 8 605 pregnant women were investigated. The MUI of pregnant women was 178.6 μg/L, and the MUI of 14 cities (prefectures) ranged from 156.5 to 275.0 μg/L. There was no statistical significant difference in MUI among pregnant women in different pregnancies ( P > 0.05). A total of 26 377 samples of salt consumed by children and pregnant women were detected. The median salt iodine was 24.71 mg/kg. The coverage rate of iodized salt and the consumption rate of qualified iodized salt were 99.44% and 93.59%, respectively. Twenty-three counties (districts and cities) failed to meet the elimination standard of IDD in the single indicator. Conclusions:IDD is in a state of continuous elimination in Gansu Province; iodized salt supervision needs to be further strengthened; there is an imbalance of control measures between regions.

Objective:To investigate and analyze the living conditions of patients with Kaschin-Beck disease in Gansu Province, and to provide scientific basis for accurate treatment of the patients.Methods:From 2018 to 2019, case investigation, clinical examination and X-ray examination of patients with Kaschin-Beck disease were carried out in the Kaschin-Beck disease area of Gansu Province. The contents of the survey included basic information of the patients, clinical diagnosis classification, disease information, surgery and drug treatment, etc.Results:A total of 23 909 patients with Kaschin-Beck disease were diagnosed in 37 counties (districts) of 7 cities (states). The patients with grade Ⅰ, grade Ⅱ and grade Ⅲ accounted for 64.04% (15 312 cases), 26.12% (6 244 cases) and 9.84% (2 353 cases), respectively; 90.74% (21 694 cases) of the patients were over 50 years old, Han nationality was 97.15% (23 228 cases), and peasants were 99.25% (23 729 cases). The patients mainly had multiple joint thickening and deformation (89.30%, 21 350 cases) and pain (87.04%, 20 810 cases). Joint thickening and deformation and pain were more common in finger joint, knee joint and ankle joint. The thickening and deformation of the three joints accounted for 89.97% (21 512 cases), 78.18% (18 692 cases) and 63.81% (15 257 cases), respectively; pain accounted for 80.66% (19 285 cases), 78.75% (18 828 cases) and 64.50% (15 422 cases), respectively; 83.83% (20 044 cases) had joint rest pain, 82.63% (19 757 cases) had joint movement pain and 76.03% (18 177 cases) had joint morning stiffness. Surgical treatment was completed in 1.97% (470 cases). Long-term drug treatment (more than 6 months in the whole year) accounted for 47.78% (11 424 cases); the annual cost of drug treatment was mainly less than 500 yuan, accounting for 57.72% (13 800 cases).Conclusions:The quality of life of patients with Kaschin-Beck disease in Gansu Province is low. We should pay more attention to adult patients with Kaschin-beck disease and strengthen management and treatment.

Iodine nutrition is very important to human health, especially for brain development, urinary iodinary is one of the basic indicators reflecting the nutritional status of iodine, and is an important basis for scientific evaluation of iodine nutrition. In order to provide support and assistance for improving the network syetem of iodine nutrition monitoring laboratories, we summarized and explored the construction process, quality control, and management methods of 85 county-level urinary iodine laboratories in Gansu Province from 2016 to 2018.