Objective To analyze the residents' iodine nutrition level of Yunfu City in Guangdong Province from 2009 to 2016,in order to provide evidence for making prevention strategy of iodine deficiency disorders.Methods Four surveys on salt iodine levels,four surveys on urinary iodine levels of children aged 8-10 years old,two surveys on urinary iodine levels of pregnant women and one survey on iodine content in drinking water were carried out according to the prevention and control planning for endemic disease in Guangdong Province in Yunfu City from 2009 to 2016.Salt iodine was determined by direct titration (GB/T 13025.7-1999,GB/T 13025.7-2012),urinary iodine was determined by arsenic cerium catalytic spectrophotometry (WS/T 107-2006,WS/T 107.1-2016),water iodine was determined by the national iodine deficiency disease reference laboratory recommended method.Results In 2009,2011,2015 and 2016,1 464,1 464,1 500,1 500 salt samples and 500,388,1 000,1 000 children were investigated,the medians of salt iodine levels were 30.3,28.1,24.8,and 24.8 mg/kg,respectively,and the medians of children urinary iodine levels were 208.3,188.3,143.1 and 165.2 μg/L,respectively.Five hundred,five hundred pregnant women were investigated in 2015 and 2016,and the medians of pregnant women urinary iodine levels were 101.0 and 96.4 μg/L,respectively.A total of 1 149 samples of drinking water were investigated in 2011-2016,the median of water iodine was 2.8 μg/L.Conclusion Yunfu is an iodine deficiency city,after adjusting the iodine content of edible salt in 2012,iodine nutrition in children is at an appropriate level,but the iodine intake level of pregnant women is relatively lower,so prevention and treatment of iodine deficiency disorders and urinary iodine monitoring should be strengthened in pregnant women.

BACKGROUND: Intensive phototherapy (IPT) and exchange transfusion (ET) are the main treatments for extreme hyperbilirubinemia. However, there is no reliable evidence on determining the thresholds for these treatments. This multicenter study compared the effectiveness and complications of IPT and ET in the treatment of extreme hyperbilirubinemia. METHODS: This retrospective cohort study was conducted in seven centers from January 2015 to January 2018. Patients with extreme hyperbilirubinemia that met the criteria of ET were included. Patients were divided into three subgroups (low-, medium-, and high- risk) according to gestational week and risk factors. Propensity score matching (PSM) was performed to balance the data before treatment. Study outcomes included the development of bilirubin encephalopathy, duration of hospitalization, expenses, and complications. Mortality, auditory complications, seizures, enamel dysplasia, ocular motility disorders, athetosis, motor, and language development were evaluated during follow-up at age of 3 years. RESULTS: A total of 1164 patients were included in this study. After PSM, 296 patients in the IPT only group and 296 patients in the IPT plus ET group were further divided into the low-, medium-, and high-risk subgroups with 188, 364, and 40 matched patients, respectively. No significant differences were found between the IPT only and IPT plus ET groups in terms of morbidity, complications, and sequelae. Hospitalization duration and expenses were lower in the low- and medium-risk subgroups in the IPT only group. CONCLUSIONS In this study, our results suggest that IPT is a safe and effective treatment for extreme hyperbilirubinemia. The indication of ET for patients with hyperbilirubinemia could be stricter. However, it is necessary to have a contingency plan for emergency ET as soon as IPT is commenced especially for infants with risk factors. If IPT can be guaranteed and proved to be therapeutic, ET should be avoided as much as possible.
Child, Preschool ; Exchange Transfusion, Whole Blood/adverse effects* ; Humans ; Hyperbilirubinemia, Neonatal/therapy* ; Infant ; Infant, Newborn ; Kernicterus/therapy* ; Phototherapy/methods* ; Retrospective Studies