Objective To analyze the effect of adjustments of control strategy on epidemic trend of iodine deficiency disorders (IDD) in Shanxi Province after universal salt iodization (USI),and to provide basis for timely adopting targeted control countermeasure and scientifically adjusting intervention strategy.Methods A method of retrospective analysis was performed to collect data from IDD surveillance at national or province levels after 1995,and from iodized salt surveillance of the province after 2004.According to the statistics and analysis of children's goiter rate,median urinary,median and mean of salt iodine,coverage rate of iodized salt,qualified rate of iodized salt,consumption rate of qualified iodized salt and their relationship.Results Since 1995,the children's goiter rate by palpation and B-ultrasound showed a steady descending trend.The median salt iodine,mean salt iodine and children's median urinary iodine showed a trend of rise→decline→stable→decline.Namely:The three indicators began to rise year by year from 1995 (29.1 mg/kg,31.7 ± 15.0 mg/kg,199.3 μg/L),in 1999 (48.7 mg/kg,53.4 ± 29.4 mg/kg,407.5 μg/L) reached its climax; and then decreased,in 2001 (34.7 mg/kg,36.2 ± 11.9 mg/kg,282.1 μg/L)stoped; which were basically stable from 2001 to 2011; since 2013 (26.0 mg/kg,26.5 ± 6.3 mg/kg,192.0 μg/L),a significant decline began.The rate and edible rate of qualified iodized salt showed a trend of decline→rise→stable.Two indexes began to decline circuitously from 1995 (72.61％,68.25％),and dipped to a low point in 1999 (44.80％,43.67％); then began to rise,until 2002 (94.73％,91.80％) reached basic stability; and remained steady from 2002 to 2013.Conclusions Following the process of prevention and treatment of IDD for more than 30 years in Shanxi Province,with the depth understanding of the range of adequate iodine nutrition,according to the monitoringfeedback mechanism,the strategy of salt iodization has been adjusted several times,the target of continuous elimination of IDD has achieved since 2000 and the levels of iodine nutrition in population are more reasonable.Salt iodization strategy should continue to adhere to.

Objective To research the mechanism of the changes of T lymphocyte subtypes and provide reference for clinically prevention,diagnosis and treatment for NSCLC through analysis of the expression of Th1 ,Th2 in Non-small-cell carcinoma (NSCLC)patients.Methods Whole blood (EDTA anticoagulant treatment)from 60 NSCLC patients and 60 healthy sub-j ects were collected to detect of the expression of CD3 +T cells,CD4+T cells and CD8+T cells on T lymphocytes and the lev-els of Th1 and Th2 cells by flow cytometer (FCM),and the absolute value of T lymphocyte by hematology analyzer.Results Compared with normal control group,after surgery 1~3 days NSCLC groups,the percent of CD3 +T,CD4+T,CD8+T cells and the CD4+/CD8+ ratio in the NSCLC patients before surgery were significantly reduced 58.40±10.27 vs 66.58± 6.84,31.32±8.65 vs 39.40±6.43,34.23±8.00 vs 24.31±8.16,0.96±0.23 vs 1.58±0.23 (t=-6.726~14.916,P<0.05).The percent of CD3 +T,CD4+T,CD8+T cells and the CD4+/CD8+ ratio in the NSCLC patients after surgery 1~3 days were also significantly decreased 56.31±8.00 vs 66.58±6.84,27.72±7.55 vs 39.40±6.43,33.69±7.10 vs 24.31± 8.16,0.87±0.31 vs 1.58±0.23 (t=-6.720~14.367,P<0.05).The percent of CD4+T cells in the NSCLC patients af-ter surgery 4~7 days was increased 33.23±4.13 vs 39.40±6.43(t=6.257,P<0.05).Compared with the control group, within the helper T cell subsets,the cell content of Th1,Th2 cells (× 10/μl)and the Th1/Th2 ratio were significantly changed in different extent in the NSCLC group before surgery 6.79±1.34 vs 12.52±3.56,4.82±0.51 vs 2.32±0.82, 1.39±0.84 vs 5.36±1.42 (t=-20.087~18.630,P<0.05).The content of Th1 cells was lower in the NSCLC patients after 1~3 days and 4~7 days 8.86±1.52 vs 12.52±3.56,7.02±1.27 vs 12.52±3.56 (t=7.339~11.275,P<0.05). Conclusion The NSCLC patients presented immune dysfunction,like T lymphocytes and helper T cells decreased and Th2 cells were clearly in the ascendant.Also,the cytotoxic T cells increased by the stimulation of cancer cells,but they began to decrease after the surgery.

Objective To investigate a feasibility of treatment planning in thoracic esophageal carcinoma with 3-deoxy-3-fluorothymidine (FLT) PET-CT and to compare with fluorodeoxyglucose (FDG) PET-CT based on dosimetric analysis.MethodsTwenty-two patients with esophageal squamous cell carcinoma detected by FLT and FDG PET-CT were enrolled.The gross tumor volumes ( GTV ),clinical target volume(CTV) and planning target volume ( PTV ) were delineated using treatment planning system of Philips Pinnacle3 based on the optimal threshold of FLT and FDG PET-CT respectively,and to make two groups simulation treatment planning.The parameters of dose-volume histograms in two groups planning were compared in the similar direction and ensuring prescribed dose line surround 95% target volume.Results The values of GTV,CTV and PTV in FLT PET-CT planning were less than those of FDG,that dose received by spinal cord in two planning were not significantly yet ( t = - 1.60,- 1.55,all P ＞ 0.05 ).While,the values in mean lung dose,V5,V10,V30,V40 and V50 of bilateral lung,mean heart dose,and V30 of heart in FLT PET-CT planning were significant lower than those of FDG( t = -5.442 - -2.637,all P ＜0.05).Conclusions Compared with FDG,FLT PET-CT based treatment planning brings potential benefits for lungs and heart.

Objective To study the nutritional status of pregnant women in Shanxi Province before and after the implementation of the new standards of iodized salt content,provide the basis for scientific supplementation of iodine for pregnant women.Methods According to the method of population proportion sampling,30 county-level monitoring sites were selected,a primary school was selected from each county (city,district) by the method of simple random sampling and 40 students in 2011 or 50 students in 2014 aged 8-10 years were selected in each school,direct titration was used to detect salt iodine;at the same time,20 pregnant women were selected from each town where the primary school was located and urinary iodine was determined using arsenic cerium catalytic spectrophotometry (WS/T 107-2006).Results A total of 1 182 and 1 437 salt samples was detected in Shanxi Province in 2011 and 2014,the median of salt iodine was 30.5 and 24.1 mg/kg,respectively,and the difference was statistically significant (H =567.45,P ＜ 0.01);it was 95.41％,80.31％,76.62％ of the coverage rate of iodized salt,qualified rate of iodized salt,qualified iodized salt consumption rate in 2014,respectively;which were compared with those in 2011 (97.63％,97.49％,95.18％),the differences were statistically significant (x2 =9.27,232.40,166.25,P ＜ 0.01).A total of 440 and 630 urinary samples of pregnant women were tested in 2011 and 2014,the median of urinary iodine was 279.6 and 177.1 μg/L,respectively,iodine nutrition of pregnant women was more than adequate in 2011,and iodine nutrition was suitable in 2014.The difference was statistically significant (H =153.89,P ＜ 0.01).The proportion of pregnant women's median of urinary iodine less than 150 μg/L in 2014 [41.11％ (259/ 630)] was significantly higher than that in 2011 [8.18％ (36/440),x2 =140.68,P ＜ 0.01].The constituent ratio of 250 to 500 μg/L was significantly decreased [23.65％ (149/630) vs 54.77％ (241/440),x2 =108.33,P ＜ 0.01).Conclusion It is at a reasonable level of iodine nutrition level of pregnant women in Shanxi after the adjustment of iodized salt content,but the ratio of ＜ 150 μg/L is increasing,which needs to be paid attention to.

Objective: To analyze the incidence and microbiological features of blood stream infections (BSI) of patients with hematopoietic stem cell transplantation (HSCT) and to provide laboratory data for empirical use of antibiotic for the HSCT patients with BSI. Methods: The incidence of bloodstream infection, the positive rate of blood culture, bacterial spectrum and drug resistance were analyzed in 1 265 HSCT recipients during 2013 and 2015 were retrospectively studied. Results: Of 1265 patients undergoing HSCT, 1 422 cases of suspected BSI occurred in 784 patients (61.98%) , and 464 patients (59.2%) were in the stage of agranulocytosis (ANC<0.5×10⁹/L) . The detection rate of pathogens in 2013-2015 was about 20% and increase year after year. Of the 401 strains detected, 221 were Gram-negative (G^-) bacteria (55.1%) , 165 Gram-positive (G⁺) bacteria (41.2%) and 15 fungi (3.7%) . Escherichia coli (16.0%) , Staphylococcus epidermidis (15.5%) and Klebsiella pneumoniae (11.2%) were listed the top three. The proportion of multidrug resistant Acinetobacter Bauman and Stenotrophomonas maltophilia was 64.70% and 63.64% respectively, and methicillin resistant Staphylococcus aureus (MRSA) was more than half (57.14%) . The ratio of vancomycin resistant Enterococci (VRE) and carbapenem resistant Enterobacteriaceae (CRE) was 14.29% and 6.78% respectively. More than 40% Enterobacteriaceae bacteria were resistant to three or four generation cephalosporin antibiotics, and less were resistant to the carbapenems (6.4%) . However, many non-fermentating bacteria were highly resistant to these antibiotics and showed diversity among different strains, with a rate of 47.8% resistance to carbapenems. All the Staphylococcus were sensitive to vancomycin, teicoplanin and linezolid. Conclusions The incidence of BSI in patients with HSCT was high, and the pathogens were mainly G^- bacteria. In addition to Enterobacteriaceae, the proportion of non-fermentative bacteria was quite high. No Staphylococcus detected were resistant to vancomycin, teicoplanin and linezolid.

Objective: To evaluate the prognostic significance of early phase full donor chimerism (FDC) after myeloablative allogeneic peripheral blood stem cell transplantation (allo-PBSCT). Methods: The clinical data of 72 hematological patients received myeloablative allo-PBSCT from Feb. 2016 to Jul. 2017 were analyzed retrospectively. The median age was 36.5 years (range 4-59), 44 were males and 28 females. Of the donors, there were 35 HLA matched sibling donors, 27 haploidentical donors and 10 unrelated donors. Polymerase chain reaction amplification of short tandem repeat sequence (PCR-STR) was used to detect donor cell chimerism (DC) rate of recipient bone marrow at one, two and three months after transplantation. Results: The median follow-up was 462 d (range: 47-805 d), 55 cases were still alive, and 45 cases were disease-free survival (DFS) at the end of follow-up. The 2-year overall survival (OS) and DFS were (68.9±7.7)% and (59.5±6.3)%, respectively. A number of 16 cases underwent relapses, with 2-year cumulative incidence of (24.1±5.3)%. The median time of recurrence was 157(32-374) d. Forty cases (55.6%) developed acute graft-versus-host diseases (aGVHD), with median time of 35.5 (13-90) d. Chronic GVHD (cGVHD) occurred in 23 patients (31.9%), with median time of 169 (94-475) d. Univariate analysis found the following factors were not related to OS, DFS or relapse rate (RR), including age, sex, blood type and sex of donor-recipient, occurrence of aGVHD and cGVHD. The OS and DFS in cases reached FDC and no FDC at two months after transplantation were (85.2±6.9)% vs (66.1±7.7)% (P=0.051) and (76.7±7.7)% vs (48.9±8.1)% (P=0.021), respectively. The RR rate in FDC group was lower than that in no FDC group [(16.6±6.8)% vs (30.4±7.8)%, P=0.187, respectively]. Conclusion The present study confirmed the important value for predicting the prognosis with whether or not the patients reached FDC at the early phase after allo-PBSCT. The OS and DFS in cases with FDC at two months after transplantation were significantly higher than those of no FDC patients.

Objective:To discuss the clinical characteristics of the Pneumocystis jirovecii pneumonia (PCP) in the non-HIV-infected blood disease patients, and to analyze its risk factors, treatment methods, prognosis and prevention measures.Methods:A female patient aged 18years old was confirmed as acute myeloid leukemia (AML) , and experienced dyspnea, chest congestion and hypoxaemia during the recovery period of hemogram after chemotherapy.The chest CT showed the bilateral lung diffuse ground glass density images.The patient had a dry cough and the oxygen saturation was gradually decreased to 75％5dafter antibacteriological treatment.A repeat chest CT showed enlarged diffuse ground glass density images on both lungs.Considering about the possibility of PCP, the patient received oral trimethoprim/sulfamethoxazole (TMP/SMX) 1g, once every 6h, in combination with caspofungin.Results:Two days later, the symptoms of the patients were not improved.The patient was transferred to ICU and was diagnosed PCP by bronchoalveolar lavage.The patient was switched to oral TMP/SMX2g, once every 8h, in combination with caspofungin.Meanwhile, the patient received bi-level positive airway pressure ventilation (Bipap) for the increased work of breathing.Five days later, the symptoms of the patients were improved and the Bipap was stopped.The patient got better and discharged 5dlater.The patient continuely received oral TMP/SMX 2g, once every 8hfor 36d.Conclusion:Prevention of PCP should be focused, in the non-HIV-infected blood disease patients receiving chemotherapy.Diagnosis of PCP should be considered in these patients without prevention who once have suspected clinical manifestation of PCP in non-granulocytic phase.Early empirical treatment of PCP and ICU management in the non-HIV-infected blood disease patients with acute respiratory failure are the keys to reduce death and improve the prognosis of PCP.

Objective: To investigate the mechanism of chemokine-like factor superfamily member (CMTM) 5 on the proliferation of multiple myeloma cells. Methods: RT-qPCR method was used to detect the expression and correlation of CMTM5, caspase3 and caspase9 in U266 after decitabine demethylation treatment; U266 transfected with pcDNA3.1 plasmid overexpressed CMTM5, then cell proliferation activity was detected by CCK-8 assay. Results: Compared with the control group, the low-dose demethylation treatment increased mRNA expression of CMTM5, caspase3, and caspase9 in U266, and showed a time-dependent (P<0.01). The up-trend of CMTM5, caspase3, and caspase9 in the high-demethylation drug treatment group was more significant and also showed time-dependent (P<0.001); There was a significant positive correlation between CMTM5 and caspase3 (r=0.937) and caspase9 (r=0.945) in each group (P<0.001). After transfection of U266 with the pcDNA3.1-CMTM5 plasmid, overexpression of CMTM5 inhibited the cell proliferation activity compared with the control and pcDNA3.1-vector group. Conclusion Decitabine has a reductive effect on the low level of CMTM5 in U266 cells, and its recovery level is significantly positively correlated with caspase 3 and caspase9. Re-expression of CMTM5 inhibits the proliferative activity of U266.

Animals ; Apoptosis ; Brain/metabolism* ; Male ; Phosphatidylinositol 3-Kinases/metabolism* ; Rats ; Rats, Sprague-Dawley ; Subarachnoid Hemorrhage/drug therapy* ; Thyroxine/pharmacology*

Adult ; Eosinophilia ; Hematopoietic Stem Cell Transplantation ; Humans ; Hypereosinophilic Syndrome ; drug therapy ; therapy ; Imatinib Mesylate ; therapeutic use ; Leukemia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; therapy ; Receptor, Platelet-Derived Growth Factor alpha