Radioactive iodine therapy is a safe and effective postoperative treatment for patients with differentiated thyroid cancer. Since 131I is a radionuclide, the patient becomes a living radioactive source after receiving 131I treatment, causing radioactive damage to the surrounding population and the environment. This article reviews the necessity of radiation safety guidance for differentiated thyroid cancer patients undergoing 131I treatment and the content of radiation safety guidance during hospitalization and after discharge, aiming to provide reasonable guidance on radiation safety for these patients. It provides a reference for the formulation of radiation safety management plans in line with national conditions in the future.

Health science popularization is one of the key factors for patients with differentiated thyroid carcinoma treated with 131I to achieve positive survival outcomes. This paper reviews the general situation of health science popularization, the necessity of health science popularization for differentiated thyroid carcinoma treated with 131I and the current implementation situation at home and abroad, in order to provide reference for comprehensive health science popularization for differentiated thyroid carcinoma treated with 131I in clinical practice.

Objective: To explore the role of outdoor activity in the relationship between infancy responsive caregiving trajectories and early childhood development, so as to provide a theoretical basis for the promotion of early child development. Methods: The study participants were drawn from the Shanghai Maternal-Child Pairs Cohort and 4 723 mother-child pairs who completed responsive caregiving questionnaires at 2, 6 and 12 months old were included. Questionnaires were used to assess children s responsive caregiving and average daily hours of outdoor activity at 2 years of age. The Age-Stage Questionnaire, Third Edition (ASQ-3) was used to evaluate children s development problems at 2-5 years old. Group based trajectory model was applied to fit infancy responsive caregiving trajectory. Modified Poisson regression was used to analyze associations between different responsive caregiving trajectory groups and child development, and moderating effects were tested for hours of outdoor activity. Results: Infancy responsive caregiving trajectories were categorized into general group ( n =3 871), declining group( n =160), and fluctuating group( n =646). After adjusting for confounding factors, such as parents educational level, annual household income, maternal progestation body mass index,maternal tobacco exposure during pregnancy,maternal anxiety and depression during pregnancy, maternal age at delivery,maternal gestational age,maternal mode of delivery, children s gender,children s birth weight, and duration of breastfeeding, the results of modified Poission regression analysis showed that compared with the general group, children at the age of 2 in declining and fluctuating group had increased risks of suspected developmental delays in communication, gross motor, fine motor, problem solving, and personal-social scales ( OR =1.41,1.31,1.35,1.23,1.21；1.07,1.08,1.08,1.09,1.06);but children only had increased risk of suspected developmental delays in communication of declining group ( OR =1.08), personal-social scales of fluctuating group ( OR =1.06) at 3-5 years of age ( P <0.05). At lower levels of outdoor activity, children in fluctuating group had reduced scores in communication ( β =-1.41), fine motor ( β =-2.34), problem solving ( β =-1.11) and personal-social scales ( β =-1.99) as compared to general group; and children in declining group had reduced scores in gross motor ( β =-4.78)( P <0.05). While at higher levels of outdoor activity, no differences were found between children in fluctuating, declining groups and those in general group in scores of different scales ( P >0.05). Conclusion Prolonged outdoor activity attenuates the adverse effects of declining and fluctuating trajectories of infancy responsive caregiving on early childhood development.

Objective:To analyze the gene variants in patients with primary distal renal tubular acidosis (dRTA), and explore the correlation between the genotype and phenotype.Methods:The Sanger direct sequencing or whole-exome sequencing was used to identify causal variants and the variation pathogenicity was evaluated according to 2015 American College of Medical Genetics and Genomics (ACMG) standards and guidelines in 44 dRTA patients (37 families) diagnosed in the Affiliated Qingdao Municipal Hospital of Qingdao University and the Affiliated Hospital of Qingdao University from April 2010 to September 2020. The clinical features of the patients were summarized, and the correlation between the genotype and phenotype was investigated.Results:Seven variants of SLC4A1 gene, 17 variants of ATP6V0A4 gene, and 15 variants of ATP6V1B1 gene were identified in 44 patients with dRTA, and of which 11 variants were new ones. According to ACMG guidelines, the pathogenic, likely pathogenic, benign variants among the 39 variants were 22, 16 and 1, respectively. Nine patients were autosomal dominant hereditary dRTA caused by SLC4A1 gene mutation, 4 patients with autosomal recessive hereditary dRTA complicated with Southeast Asian ovalocytosis and anemia were caused by SLC4A1 gene mutation, and 14 patients caused by ATP6V0A4 gene mutation and 8 patients caused by ATP6V1B1 gene mutation were autosomal recessive hereditary dRTA; Two children with dRTA were found to carry one monoallelic defect in ATP6V1B1, and no causal gene mutation was identified in 7 patients. One patient showed incomplete dRTA, and the other 43 patients showed complete dRTA. The prevalence of sensory neural hearing loss caused by ATP6V0A4 and ATP6V1B1 mutation were 2/14 and 6/10 respectively. The frequency of chronic kidney disease in adults, children and infants were 4/4, 2/4, and 1/36, separately. After the drug treatment based on potassium citrate and sodium citrate, the growth and development (28/40) and electrolyte disturbance (41/44) of most patients were significantly improved. Conclusions:The present study has identified 39 variants of SLC4A1, ATP6V0A4 and ATP6V1B1 genes in 44 patients with dRTA, including 11 novel ones. There is a close relationship between genotype and phenotype in dRTA patients and most patients' conditions were improved after proper treatment. This study enriches the human gene mutation database and provides valuable references for diagnosis, treatment and genetic counseling in patients with dRTA.