ObjectiveTo investigate current iodine nutritional status of different groups of people in Harbin city, and to provide the basis for development of salt iodization standard and scientific iodine supplementation.MethodsThree urban districts and three surrounding counties were chosen in Harbin,2011.In each chosen urban district and county,one district office (township) was selected,and one residents committee (village) was chosen in each of the district office(township),and 30 households were selected by systematic sampling.Iodized salt,water iodine and iodine intake per capita were investigated.In each of the residents committee (village),20 adults aged 18 - 45,30 pregnant women or lactating women,and 100 school children aged 8 - 10 were selected.Urine samples were collected and urinary iodine level were tested.Salt iodine was determined by direct titration,water and urinary iodine by arsenic cerium catalytic spectrophotometry.Iodine uptake and iodine nutritional status of different populations in Harbin urban and rural areas were compared.ResultsThe edible rate of qunlified iodized salt were 93.3％(84/90) and 96.3％(156/162) in Harbin urban and rural residents,respectively,which were all greater than 90％,and the highest value of salt iodine were 38.3,46.0 mg/kg,respectively,in urban and rural areas,which all did not exceed the upper limit(50 mg/kg) of qualified iodized salt,but there were some samples of salt iodine content below the national standard(20 mg/kg).Water iodine value in urban and rural areas,even the highest value(9.40,8.40 μg/L),was failed to meet the national standard 10 μg/L; salt eaten by rural people perperson a day(8.33 g) was significantly higher than that of the urban people(7.03 g,Z=- 2.750,P ＜ 0.01); in addition to rural children aged 8 - 10,whose urinary iodine value(228.6 μg/L) was higher,the values in urban and rural adults ( 111.3,195.6 μg/L),pregnant women ( 193.0,172.9 μg/L),lactating women ( 128.4,173.7 μg/L)and urban children ( 186.8 μg/L ) were all in appropriate level.The urinary iodine medians ( 195.6,228.6 μg/L )of adults and children in rural were significantly higher than that of urban adults and children(111.3,186.8 μg/L,Z =- 2.294,- 5.434,P ＜ 0.05 or ＜ 0.01,respectively).Population composition of iodine deficiency in both urban and rural adults,lactating and pregnant women[46.7％(28/60),21.6％(13/60) ; 21.1％(19/90),21.3％ (18/89) ; 27.8％ ( 25/90 ),42.2％ (38/90) ] were significantly higher than that of the population composition with iodine excess[4.6％(4/60),5.0％(3/60) ; 16.7％(15/90),16.9％(15/89) ; 4.4％(4/90),0.0％(0/90)],but proportion of iodine excessive population in rural children [26.3％(79/300)] was significantly higher than proportion of iodine deficiency[5.6％(17/300)].ConclusionsThe natural environment of Harbin city is still in the iodinedeficient state.In addition to children in rural areas,the iodine intake and iodine nutrition level is basically appropriate; the risk of disease caused by iodine deficiency in adults,lactating and pregnant women is higher than by iodine excess,but the situation of children in rural is on the opposite.Therefore,we should strengthen the monitoring of different populations,and supplement iodine scientifically based on their need.

Objective To compare the diagnostic value of renal ultrasound scan (RUS) and 99Tcmdimercaptosuccinic acid (DMSA) renal scintigraphy in children with acute pyelonephritis (APN). Methods In all, 165 children with initial clinical diagnosis of APN, aged from 1.5 months to 11 yrs ( median 20 months), were included in the study, all of which were examined with RUS and DMSA renal scientigraphy. The diagnosis with DMSA renal scientigraphy results was taken as the standard reference to evaluate the diagnostic sensitivity and specificity of RUS. Results Of 99 out of all 330 kidneys that were found abnormal on DMSA renal scientigraphy, 31 were abnormal on RUS. Of the rest normal kidneys on DMSA scans renal scientigraphy, 4 were abnormal on RUS. Thus diagnostic sensitivity of RUS for APN was 31.3%(31/99) and specificity was 98.3% (227/231). Conclusions Although RUS provides with high diagnostic specificity for children with APN, its low sensitivity may underestimate the clinical evaluation of APN.More often than not, 99Tcm-DMSA renal scientigraphy is a clinical necesscity for the definite RUS diagnosis.

Objective To investigate the psychological characteristics of patients with allergic rhinitis(AR)and its associated factors.Methods Three hundred and seventy-seven patients with AR were evaluated by the Symptom Checklist-90(SCL-90).The results were compared with a standard,obtained from healthy Chinese population,including factors of gender,age,educational level,medical history of AR,presence of complications,type of allergenic sensitizations and nasal symptoms(using logistic regression analysis).Results An abnormal psychological state was found in 10% of AR patients,13% with deutohealthy,and remaining 77% of AR patients were completely healthy.The SCL-90 scores of the 377 patients were significantly higher than those of the normal standard population,including symptoms of somatization,compulsion,anxiety,rivalry and psychosis(t equals 7.128,3.943,2.777,6.423,7.507,respectively,all P＜0.01).Male patients had worse psychological state than femals,especially in the aspects of compulsion,depression,anxiety,crankiness and psychosis(t equals respectively 2.680,1.977,2.539,2.107,2.844,all P＜0.05).The SCL-90 scores of compulsion and horror were respectively different in different AR case history(F equals respectively 2.379,2.255,all P＜0.05).AR complicated with asthma and eczema was the important factors that influenced patient's psychological status including compulsion,interpersonal sensitivity,depression,crankiness and psychosis(t equals respectively 6.835,8.914,7.254,13.358,6.030,all P＜0.01).There were no statistical differences in different ages,AR types,educational level,allergen types(all P＞0.05).Snuffle,sneeze and snivel had no influence on patient's SCL-90 scores(all P＞0.05).Itchy nose was a major symptom that affect on AR patients' SCL-90 scores of depression(standard regression b=0.126,t=2.076,P＜0.05).Conclusions AR patients' psychological status was worse than that of the healthy adults.

Objective To evaluate the accuracy of quantitative coronary angiography ( QCA ) assessment on target lesion and reference vessel in patients with diabetes mellitus with intravascular ultrasound (IVUS) measurements as golden standard. Methods QCA and IVUS were performed in 52 diabetes mellitus patients [35 males, mean age (62.3 ±7. 1)years]. Regression equation was ascertained with the IVUS derived plaque burden as dependent and QCA derived vessel stenosis as independent variable. The measurement results derived from the two modalities on proximal and distal reference vessels were compared. Result The regression equation (constant = 0. 8286, P = 0. 001) of plaque burden and vessel stenosis derived from two modalities were significantly correlated ( r = 0. 691, P < 0. 001 ) but QCA overestimated the stenosis severity (57. 9% ± 15. 5% vs. 53. 5% ± 12. 9% , P <0. 01 ). Target vessels negative remodeling index in these patient was 0. 87 ±0.23. QCA significantly underestimated the proximal and distal reference segments vessel diameters [ ( 0. 81 ± 0. 24 ) mm, ( 0. 64 ± 0. 17 ) mm, all P < 0. 05 ] as compared to IVUS results. Conclusion Due to the significant negative vessel remodeling, QCA overestimated the stenosis severity and underestimated the reference segments vessel diameters in patients with diabetes mellitus.

Objective To compare the value of intravascular ultrasound (IVUS) and assess the value of quantitative coronary angiography ( QCA) and 64 multi-detector computed tomography ( MDCT) on unstable anginas (UAP) risk stratification. Method A total of 61 UAP patients (low risk; 17, middle risk; 33 and high risk; 11) were recruited, 71 vessels were examined by MDCT, QCA and IVUS. Plaque characteristics (soft, fibrous, calcified and mixed plaques) and plaque burden at minimum area ( ≤50% , 51%-74% and ≥75%) were detected, calculated and analyzed. Results derived from various detection methods were compared. Results Plaque burden detection by QCA was comparable to IVUS results for low and middle risk UAP ( r = 0. 768 and r = 0. 721, respectively; all P < 0. 01 ) but not for high risk UAP ( 67% ± 14% vs. 75% ± 16% , P < 0. 01) due to significant positive vessel remodeling ( remodeling index = 1.21±0.31). The high negative predict value of MDCT for stenosed coronary vessels(87. 8%-96. 3%) was valuable for exclusion of coronary heart disease but MDCT was not able to identify fibrous cap( kappa = 0. 235) and lipid core ( kappa = 0. 245 ) . Extent of remodeling index, external elastic membrane area, minimum lumen area, plaque burden, plaque rupture and thrombosis increased in proportion to increasing risks of UAP patients. Conclusions QCA is a suitable tool for assessing UAP patients with low and middle vessel stenosis but underestimated the stenosis degree in UAP patients with high vessel stenosis. MDCT is valuable for exclusion vessel disease but not useful for identifying soft and fibrous plaque. Soft plaque with positive remodeling index and minimum lumen area <4 mm~2 derived from IVUS could correctly identify UAP patients with high degree of vessel stenosis.

Objective To determine the prevalence and to identify risk factors of peri-procedure electrical storm (ES) in patients with acute myocardial infarction (AMI) underwent emergency percutaneous coronary intervention (PCI).Methods The clinical data of 228 AMI patients underwent emergency PCI were retrospectively analyzed and patients were divided into ES group (n = 39) and non-ES (n = 189) group.ES was referred to spontaneous ventricular tachycardia or ventricular fibrillation occurring twice or more within 24 h and requiring emergency treatment including anti-arrhythm medicine and/or cardioversion or defibrillation.Results ES was diagnosed in 39 out of 228 patients (17.1%) during peri-procedure stage.The incidence of ES in patients with various infarct related arteries (IRA) was as follows:55.6% with left main artery (LM),23.7% with right coronary artery (RCA),12.4% with anterior descending branch (LAD) and 0 with left circumflex artery (LCX).Older age,lager diameter of IRA,higher concentration of CK-MB and cTnT,higher incidence of reporfusion arrhythmia (RA),lower grade of TIMI after PCI and higher mortality were associated with increased risks of ES (The P value was 0.043,0.012,0.036,0.018,0.001,0.049,respectively).Gender,systolic pressure,diastolic pressure,random blood glucose level,white blood count and concentration of hs-CRP were similar between ES and non-ES patients.Logistic analysis showed that the diameter of IRA (OR 2.381,95% CI 1.127-5.028,P = 0.023),TIMI grade of IRA after PCI (OR 4.744,95% CI 1.773-12.691,P = 0.002) and RA (OR 12.680,95% CI 4.360-36.879,P =0.000)were the independent risk factors of per-procedure ES in AMI patients underwent emergency PCI.Conclusions The AMI patients with LM as IRA had the highest incidence of ES during emergency PCI and the diameter of IRA,TIMI grade of IRA after PCI and RA were independent risk factors for the development of ES during peri-PCI stage.

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.