Objective To investigate relationship of the marrow blast decline index(MBDI)in AML (not APL)at the first inductive treatment for 7-10 days and the prognosis.Methods 109 cases of AML were retrospectively analyzed(not APL),to compare theⅡmarrow blast decline index in AML(not APL)at the first inductive treatment for 7-10 days in the continue relieve group,the relapse group and the non-remission group,analyzed the correlation of the MBDI and continue relapse rate,the MBDI and relapse rate.Results The MBDI mean value is 0.8856 in continue relieve group.significantly higher than that of the relapse group (mean=0.4445)and the non-remission group(mean=0.3903)(P<0.0001).The MBDl positively correlated with continue relapse rate(P<0.01);negatively correlated with relapse rate(P<0.01).Conclusion The marrow blast decline index in AML(not APL) at the first inductive treatment for 7-10 days was significant for early assesment ofthe prognosis.

Objective To evaluate the feasibility and efficacy of catheter-directed thrombolysis (CDT) for the treatment of non-acute (history ＞ 14 days) deep venous thrombosis (DVT) of the lower extremity.Methods Clinical data of 63 patients of non-acute DVT of lower extremities treated by CDT and adjunctive angioplasty and stenting from July 2009 to August 2013 were analyzed retrospectively.Venous recanalization was graded by a thrombus score based on pre-and post-treatment venography.Follow-up was performed by Doppler ultrasound and clinical evaluation.Results A total of 63 limbs with DVT with a mean symptom duration of (22 ± 5) days were treated by a continuous combined with pulse-spray infusion of urokinase of (1.21 ± 0.69) million IU/d for (74 ± 21) hours.Significant recanalization was achieved in 77％ (48 of 63) of the treated limbs.After thrombolysis,percutaneous angioplasty was done for 15 residual lesions and stent placement was performed in 11 iliac veins and 1 femoral vein.Minor bleeding occurred in 6 (10％) patients,no patients suffered from major bleeding or symptomatic pulmonary embolism.During follow up (mean:15 ±6 months),the veins were patent in 45 (71％) limbs.15 (24％) limbs developed mild post-thrombotic syndrome (PTS),and none had severe PTS.Conclusions CDT combined with adjunctive angioplasty and stenting is safe and effective for removal of the clot burden and for restoration of the venous flow in patients with non-acute lower extremity DVT.

Objective:To learn about the fasting blood glucose (FBG) level of adults in different water iodine areas in Shanxi Province, and to study the relationship between high iodine intake in drinking water and blood glucose.Methods:The urinary iodine content and FBG of 18-65 years old residents in the high-water iodine area of Gaoche Village, Wenshui County, Shanxi Province in 2016 (iodine content in drinking water > 100 μg/L) and the low-water iodine area of Maxi Village (iodine content in drinking water < 10 μg/L) were retrospectively analyzed, and the urinary iodine content, FBG level and its abnormal rate of adults in different water iodine areas were compared.Results:A total of 598 subjects were included, including 276 in Gaoche Village and 322 in Maxi Village. The difference of median urinary iodine (422.8, 126.5 μg/L) between Gaoche Village and Maxi Village was statistically significant ( Z = 7.81, P < 0.001). The FBG levels of adults in Gaoche Village and Maxi Village [(6.70 ± 1.87), (6.04 ± 1.23) mmol/L] were significantly different ( t = 5.18, P < 0.001). The difference of FBG level in males [(6.82 ± 1.82), (5.99 ± 1.11) mmol/L] between the two regions was statistically significant ( t = 4.45, P < 0.001), the difference of FBG level in females [(6.59 ± 1.91), (6.07 ± 1.30) mmol/L] was statistically significant ( t = 2.96, P = 0.003). In Gaoche Village and Maxi Village, there was no statistically significant difference in FBG level between males and females ( t = 1.04, 0.52, P = 0.308, 0.564). Comparison of FBG levels in 18-< 45 years old group [(6.31 ± 1.57), (5.79 ± 0.89) mmol/L] and 45-65 years old group [(7.00 ± 2.02), (6.18 ± 1.36) mmol/L] between the two regions, the differences were statistically significant ( t = 3.10, 4.60, P = 0.002, P < 0.001). Moreover, in Gaoche Village and Maxi Village, the FBG level of the 45-65 years old group was higher than that of the 18-< 45 years old group in the same area, and the difference was statistically significant ( t = 3.07, 2.74, P = 0.003, 0.006). The abnormal rate of FBG in adults in Gaoche Village and Maxi Village [28.3% (78/276) and 15.5% (50/322)] was statistically significantly different (χ 2 = 14.32, P < 0.001). Conclusion:Long-term intake of high iodine in drinking water may cause abnormal glucose metabolism.

Objective To investigate the prevalence of hypertension in adults in different water iodine areas and to explore the epidemiological association between high iodine intake in drinking water and hypertension.Methods In 2016,Xiwenzhuang Village of Taiyuan City as an appropriate-indine area,Gaoche Village and Maxi Village of Wenshui County were selected in Shanxi Province as a high-iodine area and a low-iodine area,respectively,and conducted questionnaire surveys,clinical hypertension examinations,and determination of urinary iodine levels of residents aged 18 to 65 years.Results A total of 853 people were investigated,including 283 in high-iodine area,258 in appropriate-indine area and 312 in low-iodine area.The medians urinary iodine in high,appropriate and low iodine areas were 423.0,218.5 and 126.6 μg/L,respectively,and the difference was statistically significant (H =289.7,P ＜ 0.05).The detection rates of hypertension in adults with high,appropriate and low iodine levels were 38.9％ (110/283),41.9％ (108/258) and 34.0％ (106/312),respectively,the difference was not significant statistically between the three groups (x2 =3.87,P ＞ 0.05).There was no significant difference in the detection rate of hypertension among males [45.9％(62/135),50.0％ (53/106),40.8％ (53/130)] in different areas (x2 =2.04,P ＞0.05),and no significant difference in the detection rate of hypertension among females [32.4％ (48/148),36.2％ (55/152),29.1％ (53/182),x2 =1.89,P ＞ 0.05];The difference between the three groups was not significant statistically in the detection rate of hypertension both among the 18-＜ 45 years group and 45-65 years group (x2 =1.22,5.66,P ＞ 0.05).Conclusion Drinking water with excess iodine might not increase the risk of hypertension in adults in Shanxi Province.

Objective To investigate the prevalence of thyroid nodules in the adults in high water iodine area and to reveal the risk factors of thyroid nodules.Methods Questionnaire investigation,determination of urinary iodine and thyroid ultrasound were carried out for residents aged 18 to 65 years old in Gaoche Village of Wenshui County in Shanxi Province,with the exception of pregnant and lactating women.Possible risk factors for thyroid nodules were analyzed.Results Of the 286 residents,89 cases of thyroid nodule were detected and the prevalence rate was 31.1％.The prevalence rate was 25.7％ (35/136) in male and 36.0％ (54/150) in female,there was no significant difference between sex (x2 =2.49,P ＞ 0.05).The average age of the cases with thyroid nodules was (49.6 ± 11.3) years old and was (43.5 ± 11.6) years old in cases without thyroid nodules,there was significant difference between age groups (t =4.11,P ＜ 0.05).The median of urinary iodine of the cases with thyroid nodules was 453.0 μg/L and was 408.4 μg/L in cases without thyroid nodules,there was no significant difference in the median of urinary iodine (Z =-0.616,P ＞ 0.05).The prevalence rate of solitary nodule was 57.3％ (51/89) and multiple nodules 42.7％ (38/89).As to the property nodule,the cyst nodule,the cyst-solid nodule and the solid nodule was 49.4％ (44/89),29.2％ (26/89) and 21.3％ (19/89),respectively.The results of Logistic regression showed that the prevalence of thyroid nodule increased with age (OR =1.048,95％CI:1.024-1.073,P ＜ 0.05) and the multiple nodule increased with age (OR =1.086,95％CI:1.044-1.129,P ＜ 0.05).The cyst nodule was a more common form in women (OR =2.559,95％CI:1.245-5.262,P ＜ 0.05).The prevalence of cyst-solid nodule increased with age (OR =1.125,95％CI:1.065-1.189,P ＜ 0.05).Conclusions The prevalence of the thyroid nodule in adults is high and the thyroid nodules are mainly the cyst nodules.The prevalence of the thyroid nodule is increased with age,especially the multiple nodules and the cyst-solid nodule in high water iodine area.The cyst nodule is a more common form in women.

Objective:To investigate the prevalence of thyroid disease in adults in different water iodine areas and to explore the association between iodine and thyroid disease.Methods:In May of 2016, using cross-sectional survey, Gaoche Village and Maxi Village of Wenshui County were selected in Shanxi Province as a high-iodine area and a low-iodine area, respectively, Xiwenzhuang Village of Taiyuan City as an appropriate-iodine area. Questionnaire surveys, urinary iodine levels, thyroid ultrasound, determination of thyroid function and autoantibody were conducted for permanent residents aged 18 - 65.Results:A total of 898 people were investigated, including 288 in high-iodine area, 324 in low-iodine area and 286 in appropriate-iodine area. The medians urinary iodine were 417.8, 126.6 and 216.5 μg/L in high, low and appropriate-iodine areas, respectively, and the difference was statistically significant ( H = 288.61, P < 0.05). After age and sex standardization, the detection rates of hyperthyroidism in low, appropriate and high-iodine areas were 0.27%, 1.06% and 1.43%, respectively. The detection rates of sub-clinical hyperthyroidism were 0.57%, 0.31% and 0.30%, respectively. The detection rates of hypothyroidism were 1.45%, 1.15% and 1.85%, respectively. The detection rates of sub-clinical hypothyroidism were 19.34%, 28.50% and 32.76%, respectively. The detection rates of thyroid nodule were 20.51%, 20.17% and 33.78%, respectively. The positive rates of anti-thyroglobulin antibodies (TgAb) were 18.13%, 19.41% and 11.99%, respectively. The positive rates of thyroid peroxidase antibody (TPOAb) were 9.25%, 12.04% and 8.97%, respectively. The appropriate-iodine area was used as control, logistic regression analysis showed that only the detection rate of thyroid nodule in high-iodine area was significantly higher than that in appropriate-iodine area [odds ratio ( OR) = 0.488 5, 95% confidence interval ( CI) = 0.327 2 - 0.729 2 , P < 0.05]. Conclusion:In Shanxi Province, the detection rate of thyroid nodules is different in different areas of water iodine, and the detection rate of thyroid nodule in adults in high-iodine area is higher than that in other areas.

Objective:To study the relationship between thyroid volume (TV) and thyroid autoantibodies in patients with autoimmune thyroid disease (AITD), and to explore the factors affecting goiter in patients with AITD.Methods:The newly diagnosed AITD adult patients in the Affiliated Hospital of Shanxi Institute for Endemic Disease Prevention and Control from November 2019 to October 2020 were selected for questionnaire survey, physical examination, thyroid function and thyroid autoantibody test, determination of serum iodine content and thyroid ultrasound, and the correlation between thyroid volume and thyroid autoantibody was analyzed.Results:A total of 147 newly diagnosed adult AITD patients were included, including 63 cases of Graves' disease (GD, 30 males and 33 females) and 84 cases of chronic lymphocytic thyroiditis (HT, 29 males and 55 females). The TV of male and female patients with GD was positively correlated with the levels of thyrotropin receptor antibody (TRAb) ( rmen = 0.515, rwomen = 0.412, P < 0.05). The TV of male and female patients with HT was not correlated with the levels of thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb, rmen = - 0.137, 0.168, rwomen = 0.184, - 0.088, P > 0.05). There were no correlation between TPOAb levels and TGAb levels in male and female HT patients ( rmen = 0.153, rwomen = 0.102, P > 0.05). The TV of male and female patients with GD or HT was not correlated with the serum levels of iodine ( rmen = 0.230, 0.013, rwomen = 0.096, 0.069, P > 0.05). Conclusion:TRAb level is positively correlated with the TV in GD patients.

OBJECTIVE：The establ ish the qu ality standard of Achyranthes bidentata decoction pieces and establish the fingerprint of decoction pieces of different origins. METHODS ：TLC method was used to identify A. bidentata decoction pieces. The contents of water ，total ash and ethanol-soluble extract in A. bidentata decoction pieces were determined according to the method in 2015 edition of Chinese Pharmacopoeia （part Ⅳ）. UV spectrophotometry was used to determine the content of total steroid. The content of β-ecdysterone in A. bidentata decoction pieces was determined by HPLC. HPLC method was used to establish the fingerprint of 10 batches of A. bidentata decoction pieces. Using β-ecdysterone（No. 10 peak）as reference ，similarity evaluation was conducted by using Similarity Evaluation System for TCM Chromatographic Fingerprints （2012 edition），and the common peaks were determined. SPSS 21.0 software was used for cluster analysis and principal component analysis so as to evaluate the comprehensive quality of A. bidentata decoction pieces. RESULTS ：Results of TLC identification showed that the spots with the same color on the corresponding positions of β-ecdysterone and ginsenoside Ro control in chromatogram of test sample. The average water content of 10 batches of A. bidentata decoction pieces was 4.07％ -6.33％ . The total ash content was 5.04％ -6.43％ . The ethanol-soluble extract was 6.57％ -11.12％ . The linear range of total sterone （by β-ecdysterone） and β-ecdysterone were 0.01-0.08 mg/mL and 68.5-479.5 µg/mL （R2＞0.999）， respectively. RSDs of precision ，stability and repeatability tests were all less than 3％. The average recovery rates were 98.85％（RSD＝1.89％，n＝6）and 100.34％（RSD＝ 2.12％，n＝9），respectively. The average contents were 0.34％-0.56％ and 0.07％-0.09％，respectively. There were 24 common peaks in 10 batches of A. bidentata decoction pieces ，and the similarity was all over 0.900. Cluster analysis results showed that 10 batches of A. bidentata decoction pieces could be grouped into 4 categories，among which S 1，S3，S6 and S 10 were one category ， S2，S7 and S 8 were one category ，S4 and S 9 were one category ，and S 5 was one category. The results of principal component analysis showed that the cumulative variance contribution rate of the first four principal components was 86.774％. The order of comprehensive quality is S 8＞S5＞S9＞S4＞S3＞S7＞S6＞S10＞S2＞S1. CONCLUSIONS ：The established quality standard ， content deter mination method and HPLC fingerprint are stable and accurate ，and can be used for the quality evaluation of A. bidentata decoction pieces. Δ 基金项目：国家科技部重点研发计划（No.2018YFC1707105） ＊硕士研究生。研究方向：中药质量控制。E-mail：995354085@

Objective:To master the prevalence of thyroid nodule in adults in different water iodine areas and to explore the association between high iodine intake through drinking water and thyroid nodule prevalence.Methods:Xiwenzhuang Village of Taiyuan City was selected as iodine-adequate area, and Gaoche Village and Maxi Village of Wenshui County as high-iodine area and low-iodine area, respectively, in Shanxi Province. Questionnaire surveys were conducted, thyroid ultrasound was used and urinary iodine levels were determined of residents aged 18 to 65 years. Analysis of the prevalence of thyroid nodules in adults in different wated iodine areas.Results:A total of 868 person were investigated, including 286 in high-iodine area, 270 in iodine-adequate area and 312 in low-iodine area. The medians urinary iodine in high, adequate and low iodine areas were 418.7, 218.5 and 127.1 μg/L, respectively, and the differences were statistically significant ( H = 289.70, P < 0.05). The detection rate of thyroid nodule in adults with high, adequate and low iodine levels were 31.1% (89/286), 27.4% (74/270) and 19.2% (60/312), respectively, the differences were significant statistically among three groups (χ 2 = 11.65, P < 0.05). The detection rates of solitary nodule in adults were 17.8% (51/286), 14.1% (38/270), and 13.1% (41/312), respectively, the differences were not significant statistically among the three groups (χ 2 = 2.83, P > 0.05). The detection rate of multiple nodules in adults were 13.3% (38/286), 13.3% (36/270), and 6.1% (19/312), respectively, the differences were significant statistically among the three groups (χ 2 = 10.89, P < 0.05) high-iodine area and iodine-adequate area have higher detection rates than low-iodine area ( P < 0.05). The thyroid nodules were mainly the cyst nodules in high-iodine area. Conclusions:The detection rate of thyroid nodule in adults is the lowest in adequate iodine nutrition level. More iodine intake is probably a risk factor for thyroid multiple nodules.

OBJECTIVE： To establish pre- column derivatization-HPLC fingerprint of polysaccharide from Achyranthes bidentata，and to determine the contents of monosaccharide components ，so as to provide reference for quality evaluation of A. bidentata decoction pieces. METHODS ：Taking 10 batches of A. bidentata decoction pieces from different manufacturers as samples，the polysaccharides were extracted by water extraction and alcohol precipitation ，hydrolyzed by trifluoroacetic acid ，and then derivatized by 1-phenyl-3-methyl-5-pyrazolone for HPLC analysis. The determination was performed on Hanbon Hedera C 18 column with column temperature of 30 ℃ at the flow rate of 1.2 mL/min. The mobile phase consisted of acetonitrile- 0.02 mol/L ammonium acetate solution （gradient elution ）. The detection wavelength was set at 250 nm，and sample size was 20 μL. HPLC fingerprint was established and similarity evaluation was performed for 10 batches of A. bidentata polysaccharide by using TCM Chromatogramic Fingerprint Similarity Evaluation System （2012A edition ）. The common peak was identified by comparing with the reference substance ，and cluster analysis was performed by using SPSS 25.0 software. The contents of identified monosaccharides were determined by HPLC. RESULTS ：The similarity of 10 batches of A. bidentata polysaccharide were all higher than 0.95. Nine common peaks were fixed and a total of 5 common peaks were identified ，namely anhydrous glucose （peak 1）， mannose（peak 2），rhamnose（peak 4），galacturonic acid （peak 5）and arabinose （peak 7）. Results of cluster analysis showed that S1 sample was classified into one category ；S2，S5，S8 and S 9 samples were clustered into one category ；S3，S4，S6，S7 and S10 samples were clustered into one category. Results of content determination showed that the contents of anhydrous glucose in 10 batches of samples ranged from 6.17 to 17.55 mg/g；those of mannose ranged from 3.31 to 7.66 mg/g；those of rhamnose ranged from 38.80 to 73.97 mg/g；those of galacturonic acid ranged from 2.49 to 8.95 mg/g；those of arabinose ranged from 11.30 to 28.58 mg/g. CONCLUSIONS ：Established pre-column derivatization HPLC fingerprints and content determination method can provide reference for quality evaluation of A. bidentata decoction pieces.