Objective:To master the iodine nutritional level of children aged 8-10 and pregnant women in non-iodine excess areas in Hebei Province, and provide scientific basis and targeted prevention and treatment strategies for prevention and treatment of iodine deficiency disorders.Methods:Iodine nutrition analysis was conducted in 162 counties (cities and districts, hereinafter referred to as counties) of Hebei Province in 2018. Each monitoring county was divided into 5 sampling areas according to east, west, south, north and middle locations. One township/street was randomly selected in each area, 1 primary school was selected in each township/street, and 40 non-boarding students aged 8-10 were selected from each primary school. In each monitoring county, 20 pregnant women were selected from each of the 5 townships/streets. Both children and pregnant women were collected samples for salt and urinary iodine (with a random urine sample) detection. The iodine content of salt was tested using the "General Test Method for Salt Industry-Determination of Iodine" (GB/T 13025.7-2012), and Sichuan salt and other fortified edible salt used the arbitration method. The urinary iodine content was tested using the "Arsenic-Cerium Catalytic Spectrophotometric Determination of Iodine in Urine" (WS/T 107-2006).Results:A total of 31 883 samples of edible salt were collected from children's homes in 162 counties, among which 28 539 were iodized salt, 26 456 were qualified iodized salt, the iodized salt coverage rate was 88.36% (after population standardization), and the qualified iodized salt consumption rate was 81.03% (after population standardization). A total of 31 883 urine samples were collected from children, with the median urinary iodine of 193.13 μg/L. There was one county with a median urinary iodine < 100 μg/L, and the median urinary iodine in 150 counties was 100-299 μg/L. A total of 15 572 salt samples of pregnant women were collected, among which the iodized salt samples were 14 260, the qualified iodized salt samples were 13 363, the iodized salt coverage rate was 90.10% (after population standardization), and the qualified iodized salt consumption rate was 83.54% (after population standardization). A total of 15 569 pregnant women were collected urine samples, the median urinary iodine was 164.86 μg/L, and the number of counties with a median urinary iodine < 150 μg/L was 67.Conclusions:Iodine nutrition of children and pregnant women is appropriate at the provincial level, but children and pregnant women in some counties are at risk of iodine deficiency. In the future, the prevention and treatment of iodine deficiency disorders should focus on the iodine nutrition monitoring of the special needs.

Objective To summarize the medical rescue of Chinese Government Medical Team (Chongqing) in Nepal earthquake region in order to explore the work pattern of transnational medical rescue,and improve the rescue efficiency.Methods From the experience about the post-earthquake medical rescue of Chinese Government Medical Team (Chongqing) in Nepal in 2015,several aspects were worthy to summarize such as the establishment of medical team,the layout of camp site,the work algorithm and process,with the analysis of injury feature and outcome of treatment.Results Under the setting of efficient organization and rational assignment of professional work,special working rules,the mutual transfer treatment and multi-disciplinary treatment were employed for 737 emergency patients.Of them,128 patients were hospitalized (including 63 patients completely recovered,56 patients were of clinical improvement,and 9 patients were critically ill transferred to other hospital for advanced treatment),and post-traumatic complication occurred in 48 cases without death.In addition,148 operations were carried out successfully.Conclusions The earthquake disaster has specific feature such as suddenness,a host of casualties and poor rescue conditions,and overseas rescue is with the presence of the language barrier,the difference in living habit,and the lack of coordination with local rescue system,therefore,rationally assigning personnel and resources and establishing work pattern with flexibility,orderly and good communication are the key to promote the efficiency of transnational medical rescue for the injured patients in earthquake region.

OBJECTIVETo study iodine nutrition of pregnant women in different occasions and thyroid function of their neonates.

METHODSUrinary iodine of pregnant women and their serum T(3), T(4), FT(3), FT(4) were determined by chloric acid-digestion thermostatic assay and RIA, TSH determination by IRMA; neonatal umbilical cord blood TSH was determined by ELISA.

RESULTSMedian urinary iodine of pregnant women were 206.3 microg/L, 161.4 microg/L, 203.3 microg/L at 10 - 14 (first occasion), 23 - 27 (second occasion) and 39 - 40 (third occasion) week but the percentage that lower than 100 microg/L were 14.6%, 17.1%, 11.1% respectively. Serum T(3), T(4) of pregnant women was significantly higher than those women of premarital health inspection (PHIW, P < 0.001). The difference of serum T(3), T(4) of pregnant women at 10 - 14 and 39 - 40 week was not significant. Serum FT(3), FT(4) of pregnant women at 39 - 40 week were 2.61 +/- 0.47 pmol/L and 5.50 +/- 1.57 pmol/L respectively. The difference of serum TSH concentration at third occasion and first occasion of pre-pregnancy was significant but the difference of TSH frequency distribution in three groups was not significant (chi(2) = 1.138, P > 0.5). Blood TSH median neonatal umbilical cord was 1.99 mU/L but the percentage that higher than 5 mU/L was 9.4%.

CONCLUSIONFor those areas with high iodized salt coverage, pregnant women had had sufficient iodine supplement and good thyroid function. The percentage of neonates from iodine sufficient pregnant women with TSH > 5 mU/L was lower than 10%. Using the normal range of nonpregnant FT(3) and FT(4) to estimate the thyroid function of pregnant women could cause mis diagnosis.

Female ; Fetal Blood ; chemistry ; Humans ; Infant, Newborn ; Iodine ; urine ; Pregnancy ; Thyroid Gland ; physiology ; Thyroid Hormones ; blood ; Thyrotropin ; blood

OBJECTIVEUsing the thyroid volume criteria for body surface area (BSA) to assess more precisely the effectiveness of removing iodized salt on the goiter status of children living in areas with excessive iodine in drinking water.

METHODSThree towns with median water iodine (MWI) of 150-300 µg/L were selected by simple random method in Hengshui city of Hebei province of China in May of 2010. A total of 452 and 459 children in the 3 towns were randomly selected to measure thyroid volume by ultrasound. Iodized salt was removed in July of 2010. In October of 2013, 459 children in these 3 towns were selected by simple random method to measure their thyroid volume by ultrasound again. Their goiter status was judged using the criteria of thyroid volume for BSA recommended by the WHO.

RESULTSAfter removing iodized salt, the overall BSA specific goiter prevalence in the three towns significantly decreased from 33% (149/452) to 6% (30/459) (χ² = 100.64, P < 0.001). The BSA specific goiter prevalence in 8, 9 and 10 year-old children decreased respectively from 38% (35/92), 31% (59/193) and 33% (55/167) to 6% (10/164), 7% (11/163) and 7% (9/132) (χ² values were 41.35, 31.66, 29.79, P < 0.001). The BSA specific goiter prevalence in boys and girls decreased from 34% (83/244) and 32% (66/208) to 6% (14/225) and 7% (16/234) (χ² values were 55.01, 45.06, P < 0.001) respectively.

CONCLUSIONThe BSA specific children's goiter prevalence decreased significantly after removing iodized salt from their diet in the HIA in Hebei province.

Body Surface Area ; Child ; China ; Diet ; Drinking Water ; Female ; Goiter ; Humans ; Iodine ; Male ; Prevalence ; Sodium Chloride, Dietary ; Water

Objective To evaluate the results of external quality assessment (EQA) of iodine deficiency disorders laboratories and the network operation in Hebei Province in 2017 in order to further improve the quality of EQA and provide reliable laboratory quality assurance for epidemiological surveillance and control of iodine deficiency disorders. Methods The EQA of salt iodine, water iodine and urinary iodine of iodine deficiency disorders laboratories at provincial, prefectural and county levels in Hebei Province in 2017 was evaluated. Among them, there were 1 provincial, 11 prefectural, and 128 county-level laboratories participated in the national urinary iodine assessment; there were 1 provincial and 11 prefectural-level laboratories participated in the national water iodine assessment; 1 provincial, 11 prefectural, and 30 county-level laboratories participated in the national salt iodine assessment;and 138 county-level laboratories participated in the provincial-level salt iodine assessment. The testing results of water iodine and urinary iodine of all the participatory laboratories were evaluated by using standard Z score generated from laboratories participated in the examination. The testing results of salt iodine were evaluated by using reference value ± uncertainty. Results One provincial and 11 prefectural-level iodine deficiency disorders laboratories in Hebei Province participated in the national urinary iodine, water iodine and salt iodine assessment, the qualified rate was 100.0％(12/12);128 county-level iodine deficiency disorders laboratories participated in the national urinary iodine assessment, the qualified rate was 100.0％(128/128);30 county-level iodine deficiency disorders laboratories took part in the national salt iodine assessment, the qualified rate was 100.0％(30/30);and 138 county-level iodine deficiency disorders laboratories participated in the provincial-level salt iodine assessment, the qualified rate was 94.9％(131/138). Conclusions Iodine deficiency disorders laboratories in Hebei Province in 2017 have remained at a relatively high level in detection quality, and network operation is good. Only a few county-level laboratories failed to pass the examination. Therefore, the key task in the future is to strengthen the detection capacity of county-level laboratories.

Objective:To master the situation of iodine deficiency disorders and iodine nutrition status of the population in Hebei Province, and to evaluate the effect of salt iodization intervention.Methods:According to "National Surveillance Program on iodine deficiency disorders", in 2018, iodine deficiency disorders surveillance was carried out in 162 counties (cities, districts). Each monitoring county (city, district) was divided into 5 sampling areas according to its locations of east, west, south, north and middle. One township/street was selected in each area, 1 primary school was selected in each township/street, and 40 non-boarding students aged 8 - 10 were selected from each primary school. In each monitoring county, 20 pregnant women were selected from each of the 5 townships/streets. Both children and pregnant women were collected urine and salt samples for detection of iodine levels. The thyroid volume of students was detected by B-ultrasound.Results:A total of 31 883 urine samples were collected from children aged 8 - 10 years in 162 counties (cities, districts), with the median urinary iodine of 193.13 μg/L. There was one county (cities, districts) with a median urinary iodine below 100 μg/L, and the median urinary iodine in 150 counties (cities, districts) was 100 - 299 μg/L. A total of 8 941 children aged 8 - 10 years were tested thyroid by B-ultrasound. A total of 232 cases of goiter were detected, and the rate of goiter was 2.59% (232/ 8 941). A total of 15 569 urine samples of pregnant women were tested, the median urinary iodine was 164.86 μg/L, and the number of counties (cities, districts) with a median urinary iodine below 150 μg/L was 67. A total of 47 455 salt samples were tested across the province, including 31 883 salt samples from children's homes and 15 572 salt samples from pregnant women's homes. The iodized salt coverage rate was 88.79%, and the consumption rate of qualified iodized salt was 81.69%.Conclusions:The iodized salt coverage rate and the consumption rate of qualified iodized salt in Hebei Province are all below 90%. The iodine nutrition of children aged 8 - 10 years is at an appropriate level. The thyroid enlargement rate of children is below the national standard, and the iodine nutrition of pregnant women is generally at an appropriate level. But pregnant women in 67 counties (cities, districts) have a risk of iodine deficiency.

Objective:To master the iodine content of drinking water in all counties (cities, districts) and clarify the distribution characteristics of water iodine and the distribution range of water-borne high iodine areas in Hebei Province.Methods:In all counties (cities, districts) of Hebei Province, water samples in townships (towns, street office, hereinafter referred township) were collected according to different water supply methods to detect iodine content in 2017; in townships with a median of water iodine ≥10 μg/L, the administrative village (neighborhood committee, hereinafter referred village) was used as a unit to collect water sample to detect iodine content.Results:A total of 2 199 townships in 168 counties (cities, districts) were surveyed for water iodine. The median range of water iodine of the townships was 0.0 - 1 113.7 μg/L. The median of water iodine in 1 579 townships was < 10 μg/L, accounting for 71.81% of the total; the number of townships with water iodine of 10 μg/L or more was 620. The village water iodine survey was carried out in the townships with water iodine of 10 μg/L or more, the number of villages monitored was 17 930. The number of villages with a median of water iodine of less than 10 μg/L was 2 312 (12.89%), and there were 6 104 villages with water iodine of 100 μg/L or more, accounting for 34.04%. The number of villages with median of water iodine ≥300 μg/L was 1 577 (8.80%). The water-borne high iodine areas in Hebei Province were distributed in 39 counties (cities, districts) of five cities, namely, Cangzhou, Handan, Xingtai, Hengshui and Langfang. They were mainly distributed in sheet shape or spot shape.Conclusion:The water-borne high iodine areas in Hebei Province are widely distributed, in the form of sheet or spot.

Objective:To dynamically investigate the iodine nutritional status of residents in water source high iodine areas in Hebei Province, so as to provide basis for taking targeted prevention and control measures and accurate intervention strategies.Methods:According to the "National Monitoring Program for Water Source High Iodine Areas (2018 Edition)", water source high iodine monitoring was carried out in 5 cities and 35 counties (cities, districts, hereinafter referred to as counties) of Hebei Province. According to the survey results of drinking water iodine of residents of Hebei Province in 2017, the administrative villages with a median water iodine above 100 μg/L were sorted according to the water iodine value. The systematic sampling method was adopted. Five administrative villages were selected in each county, if there were less than 5 administrative villages, all of them were selected (if the median water iodine was > 300 μg/L, at least one village shall be selected). The iodine content in drinking water of residents among the monitoring sites, salt iodine, urinary iodine and thyroid volume of children aged 8 - 10, as well as salt iodine and urinary iodine of pregnant women were tested. Water iodine was detected by the "Method Suitable for the Detection of Water Iodine in Iodine Deficient and High Iodine Areas" recommended by the National Iodine Deficiency Reference Laboratory of the Chinese Center for Disease Control and Prevention. Salt iodine was detected by semi quantitative method. Urinary iodine was detected by "Arsenic Cerium Catalytic Spectrophotometry Method" (WS/T 107-2006). Children's thyroid volume was detected by B-ultrasound.Results:A total of 239 water samples were collected in 167 villages, 35 counties, the median water iodine was 163.95 μg/L, ranging from 5.53 - 930.82 μg/L. A total of 6 772 edible salt samples were monitored, including 3 495 non-iodine salt samples and the rate of non-iodine salt was 51.61% (3 495/6 772). A total of 6 101 urine samples of children were tested, the median urinary iodine was 328.00 μg/L. A total of 6 103 children aged 8 - 10 were carried out B-ultrasound detection of thyroid volume in 35 counties. The goiter rate of children was 5.01% (306/6 103), and the rate of nodules was 0.56% (34/6 103). A total of 713 urine samples of pregnant women were tested, and the median urinary iodine was 221.70 μg/L.Conclusions:The iodine nutrition of children in water source high iodine areas of Hebei Province is at an excess level, and the iodine nutrition of pregnant women is at an appropriate level. In addition to stopping the supply of iodized salt, we should further expand the coverage of water improvement and iodine reduction projects in high iodine areas, and strengthen the monitoring of iodine nutrition status of key populations.

Objective Using the thyroid volume criteria for body surface area(BSA) to assess more precisely the effectiveness of removing iodized salt on the goiter status of children living in areas with excessive iodine in drinking water. Methods Three towns with median water iodine(MWI) of 150-300 μg/L were selected by simple random method in Hengshui city of Hebei province of China in May of 2010. A total of 452 and 459 children in the 3 towns were randomly selected to measure thyroid volume by ultrasound. Iodized salt was removed in July of 2010. In October of 2013,459 children in these 3 towns were selected by simple random method to measure their thyroid volume by ultrasound again. Their goiter status was judged using the criteria of thyroid volume for BSA recommended by the WHO. Results After removing iodized salt, the overall BSA specific goiter prevalence in the three towns significantly decreased from 33%(149/452) to 6%(30/459) (χ2=100.64,P<0.001). The BSA specific goiter prevalence in 8, 9 and 10 year-old children decreased respectively from 38%(35/92), 31%(59/193) and 33%(55/167) to 6%(10/164), 7%(11/163) and 7%(9/132) (χ2 values were 41.35, 31.66, 29.79,P<0.001). The BSA specific goiter prevalence in boys and girls decreased from 34%(83/244) and 32%(66/208) to 6%(14/225) and 7%(16/234) (χ2 values were 55.01, 45.06, P<0.001) respectively. Conclusion The BSA specific children′s goiter prevalence decreased significantly after removing iodized salt from their diet in the HIA in Hebei province.

Objective Using the thyroid volume criteria for body surface area(BSA) to assess more precisely the effectiveness of removing iodized salt on the goiter status of children living in areas with excessive iodine in drinking water. Methods Three towns with median water iodine(MWI) of 150-300 μg/L were selected by simple random method in Hengshui city of Hebei province of China in May of 2010. A total of 452 and 459 children in the 3 towns were randomly selected to measure thyroid volume by ultrasound. Iodized salt was removed in July of 2010. In October of 2013,459 children in these 3 towns were selected by simple random method to measure their thyroid volume by ultrasound again. Their goiter status was judged using the criteria of thyroid volume for BSA recommended by the WHO. Results After removing iodized salt, the overall BSA specific goiter prevalence in the three towns significantly decreased from 33%(149/452) to 6%(30/459) (χ2=100.64,P<0.001). The BSA specific goiter prevalence in 8, 9 and 10 year-old children decreased respectively from 38%(35/92), 31%(59/193) and 33%(55/167) to 6%(10/164), 7%(11/163) and 7%(9/132) (χ2 values were 41.35, 31.66, 29.79,P<0.001). The BSA specific goiter prevalence in boys and girls decreased from 34%(83/244) and 32%(66/208) to 6%(14/225) and 7%(16/234) (χ2 values were 55.01, 45.06, P<0.001) respectively. Conclusion The BSA specific children′s goiter prevalence decreased significantly after removing iodized salt from their diet in the HIA in Hebei province.