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.

Background The incidence of brain metastases in patients with breast cancer is approximately 10％-16％,and survival after diagnosis of brain metastases is usually short.This study was designed to evaluate the risk factors associated with brain metastases in advanced breast cancer patients,with a view to help predict patient groups with high risk of brain metastases.Methods In total,295 patients with advanced breast cancer were evaluated.All patients were pathologically confirmed and metastatic lesions were confirmed pathologically or by imaging.All patients were examined at least once every 6 months with head CT or MRI.Patients showing symptoms underwent immediate inspection,and brain metastatic lesions were confirmed by head CT and/or MRI.Results At a median follow-up of 12 months from the occurrence of metastases,brain metastases had occurred in 49 patients (16.6％).In our univariate analysis,variables significantly related to increased risk of brain metastases were hormone receptor-negative tumors,epidermal growth factor receptor 2 (HER2)-positive tumors,and multiple distant metastases.Patients with dominant tumor sites in soft tissue,or defined as Luminal A subtype,tended to have a lower risk of brain metastases than patients with visceral metastases,Luminal B subtype,triple-negative subtype or HER2-enriched subtype tumors.Conclusions Our results strongly suggest that factors such as Luminal B,triple-negative,and HER2-enriched subtypes are high risk factors for brain metastases.These data,therefore,provide pivotal clinical evidence towards a comprehensive understanding of the risk factors of brain metastases in advanced breast cancer patients.

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 investigate the iodine nutritional level and thyroid function of pregnant and lactating women in rural areas of Jilin province. Methods The investigation sites were selected from rural areas of three towns (Baoshan, Mingcheng and Yantongshan of Panshi county, Jilin province) in 2009. The pregnant and lactating women were selected as subjects in these three towns. The blood samples were collected and the thyroid function (including serum TT3, TT4, FT3, FT4) were measured with chemiluminescence, and serum thyroglobulin antibodies(TgAb), thyromicrosome antibody(TMAb), and thyroglobulin(Tg) were measured with radioimmunoassay (RIA). The urine samples were collected three times within one month and were measured for iodine concentration by As-Ce catalytic spectrophotometry method. Results In the pregnant women, serum TT3 was higher than that of healthy pregnant women, accounted for 14.3%(8/56), while serum TT4, TT3, FT4 were lower than those of healthy pregnant women, accounted for 3.6%(2/56),5.4% (3/56), and 1.8%(1/56), respectively. In the lactating women,serum TT3 was higher than that of healthy lactating women, accounted for 3.6%(2/56), while serum TT4, FT4 were lower than those of healthy lactating women, accounted for 1.8%(1/56), respectively. Five per cent to 20% of the pregnant and lactating women had higher TgAb and TMAb. Conclusions Existing salt iodine level is appropriate for pregnant women and lactating women, but there was a tendency towards hypothyroid in some women. Routine monitoring of urinary iodine and thyroid function should be carried out among pregnant and lactating women.

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 evaluate the predictive value of admission plasma amino-terminal pro-B type natriuretic peptide(NT-proBNP)on in-hospital mortality in patients with decompensated heart failure.Methods Plasma NT-proBNP levels were measured in patients with decompensated heart failure within 24 hours after admission with ELISA method.The NT-proBNP levels were compared between survivals and dying patients in hospital.ROC analyses were performed to evaluate the predictive value of admission plasma NT-proBNP on in-hospital mortality and to identify the optimal NT-proBNP cut-point for predicting in hospital mortality.A binary logistic regress analyses was used to evaluate if NT-proBNP was an independent predictor for in-hospital mortality.Results A total of 804 patients with decompensated heart failure were enrolled in his study(293 valvular heart diseases,219 ischemic cardiomyopathy,141 dilated cardiomyopathy,14 hypertrophic cardiomyopathy,21 restrictive cardiomyopathy,39 hypertensive heart disease,41 chronic pulmonary heart disease and 36 adult congenital heart disease)and 96 patients were in class Ⅱ,450 in classⅢand 258 in cases Ⅳ according to NYHA Classification.During hospitalization,64 deaths were recorded and the on admission plasma NT-proBNP levels of patients died during hospitalization were significantly higher than those of survivals[4321.1(3063.8,6606.5)pmol/L VS.1921.6(873.9,3739.2)pmol/L,P＜0.01].Area under receiver operating characteristic curve(AUC)of NT-proBNP to predict in-hospital death was 0.772(95%CI:0.718-0.825,P＜0.01),the optimal plasma NT-proBNP cut-point for predicting in-hospital mortality Was 3500 pmol/L,with a sensitivity of 70.3%,a specificity of 72.0%,an accuracy of 71.9%.a positive predictive value of 17.8%and a negative predictive value of 96.6%.Patients whose NT-proBNP levels were equal or more than 3500 pmol/L had a much higher in hospital mortality(17.8%)compared with those with NT-proBNP levels of less than 3500 pmol/L (3.4%),P＜0.01.Binary logistic regress analyses demonstrated that admission plasma NT-proBNP,pneumonia,heart rate and NYHA class were independent predictors for in-hospital mortality in patients with decompensated heart failure(P＜0.05 or 0.01)and admission plasma NT-proBNP Was the strongest predictor for in-hospital mortality.Conclusions Admission plasma NT-proBNP level was an independent predictor for in-hospital mortality in patients with decompensated heart failure.The optimal NT-proBNP cut point for predicting in-hospital mortality was 3500 pmol/L in this patient cohort.