Objective:To analyze the external quality control assessment results of salt iodine, urine iodine, and water iodine in iodine deficiency disorders (IDD) laboratories at all levels in Shandong Province, and provide reliable quality assurance for monitoring and prevention of IDD.Methods:The external quality control assessment of salt iodine, urine iodine and water iodine in provincial, municipal and county levels IDD laboratories in Shandong Province from 2017 to 2021 were conducted, and feedback rate and qualification rate were calculated.Results:From 2017 to 2021, the feedback rates and qualification rates of external quality control assessment of salt iodine, urine iodine and water iodine at provincial and municipal levels IDD laboratories in Shandong Province were all 100.0%. The feedback rates of county level laboratories participating in the salt iodine external quality control assessment were all 100.0%. The qualification rate in 2021 was 99.3% (135/136), and the other four years were all 100.0%. The feedback rates of county level laboratories participating in the urine iodine external quality control assessment were all 100.0%. The qualification rates in 2017 and 2021 were 98.4% (122/124) and 97.1% (132/136), respectively, and the other three years were all 100.0%. In 2021, the county level laboratories in Shandong Province participated in the water iodine external quality control assessment for the first year, and the feedback rate and qualification rate of 69 laboratories were both 100.0%.Conclusion:From 2017 to 2021, the detection capacity of IDD laboratories at the provincial and municipal levels in Shandong Province remains at a high level, and the detection capacity of salt iodine and urine iodine in some county level laboratories still needs to be further improved.

Objective To analyze the epidemiological characteristics of new elderly malignant tumor cases in Tongren City from 2018 to 2022, so as to provide a theoretical basis for the prevention and control of elderly malignant tumor in this area. Methods A retrospective analysis of the epidemiological characteristics of cases aged 60 and above who were first diagnosed with malignant tumors by pathology in our hospital from 2018 to 2022 was conducted based on the International Classification of Diseases (ICD-10). Results The incidence rate of elderly malignant tumors in Tongren City increased from 123.83/100 000 in 2018 to 126.14/100 000 in 2022, and the incidence rate showed a trend of first rising and then declining. The top five tumors in incidence rate are lung cancer, rectal cancer, liver cancer, stomach cancer and cervical cancer. The tumor order has changed over the years except lung cancer, which was the first. Lung cancer was the main high incidence tumor among the elderly of all ages. With the increase of age, the number of bladder cancer patients increases significantly, and the number of colon cancer patients also shows an upward trend. The prevalence rate of lung cancer（χ²=16.032，P=0.014) , liver cancer（χ²=8.099，P=0.030) , bladder cancer（χ²=11.274 , P=0.018) , and gastric cancer（χ²=19.387 , P=0.011) in elderly people of different sexes was generally higher in men than in women, and the difference was statistically significant (P<0.05). Conclusion Lung cancer , rectal cancer and liver cancer, as the malignant tumors with high case composition and rapid increase in the elderly, can be the focus of early screening and prevention of malignant tumors in the elderly in Tongren City, and men should pay more attention.

Objective To analyze the literature of leech in medicine using CiteSpace knowledge map,comprehensively understand the research status,hotspots and development trends of component analysis and pharmacological effects of leech,and provide reference for researchers in the field of leech.Methods CiteSpace 6.1 R3 software was used to analyze the relevant literature of leech in the field of medical research in CNKI and Web of Science databases from 1996 to 2022.The bibliometric and visual analysis of the number of articles,authors,research institutions,keyword co-occurrence,clustering and emergence were carried out.Results A total of 1 115 Chinese articles in CNKI database and 237 English articles in Web of Science database were included.The analysis of Chinese and English literature showed that the author Shi Hongzhuan had the largest number of Chinese articles,and the German author Hildebrandt had the largest number of English articles.Shandong University of Traditional Chinese Medicine and Chinese Academy of Sciences were the institutions with the largest number of articles in Chinese and English respectively.The country with the most published English literature is the United States.Chinese and English keyword co-occurrence and cluster analysis showed that Chinese literature focused on the study of its active ingredient hirudin,including molecular structure,pharmacological efficacy,mechanism of treating thrombosis,coronary heart disease,kidney disease and other diseases,and paid attention to the differences in the active ingredients of different types of leeches.In addition,English literature focused on the clinical external use of living leeches.The emergence of keywords suggested that the mechanism of action,the search and synthesis of hirudin analogues,and the pharmacodynamic mechanism of compatibility application were not only the current research hotspots,but also the future hot spots.Conclusion The analysis of leech components,the pharmacological mechanism of leech in the treatment of cardiovascular diseases,chronic kidney diseases and other diseases have always been the research hotspots.Hirudin analogues,the pharmacodynamic mechanism of compatibility application,network pharmacology,molecular docking and so on may be the future research hotspots and trends of leeches.

【Objective】 To evaluate and analyze the impact of COVID-19 epidemic on inventory of red blood cells (RBCs)in local and municipal blood stations in China, and to provide reference for the management of public health emergencies. 【Methods】 Relevant data from 2018 to 2021 were collected, and the differences in the volume of qualified RBCs, the usage efficiency of inventory RBCs, the average daily distribution of RBCs,the blood distribution rate of RBCs prepared by 400 mL whole blood, the difference in the average storage days of RBCs at the time of distribution, the average daily inventory of RBCs and the time of the average daily inventory of RBCs to maintain the distribution in 24 local and municipal blood stations in China during the COVID-19 epidemic and non-epidemic periods were retrospectively analyzed. 【Results】 Compared with non-epidemic periods, the volume of qualified RBCs [(117 525.979 ±52 203.175)U] and the average daily distribution of RBCs [( 156. 468 ± 70. 186) U ] increased significantly, but the usage efficiency of inventory RBCs decreased(97.24%±0.51%) significantly (P<0.05).There was no significant difference in the blood distribution rate of RBCs prepared by 400 mL whole blood(73.88%±20.30%), the average storage days of RBCs distribution(13.040 ±3.486), the average daily stock quantity of RBCs[(2 280.542 ±1 446.538) U ] and the time of the average daily inventory of RBCs to maintain the distribution[(15.062 ±7.453) d] (P>0.5). 【Conclusion】 During the COVID-19 epidemic, the inventory management of RBCs operated well, the overall inventory remained relatively stable, the stock composition and storage period showed no significant change.

Objective:To explore the effects of quality control circle activity in the respiratory function exercise in patients with esophageal cancer.Methods:From June 2018 to June 2019, convenience sampling was used to select 96 patients with esophageal cancer admitted to the Cancer Hospital Affiliated to Zhengzhou University as the research object. According to the principle of computer randomization, patients were divided into experimental group and control group, with 48 cases in each group. Patients in control group were given nursing case based on enhanced recovery after surgery, and experimental group carried out quality control circle activity on the basis of the control group. The correct rate of breathing exercise and the ratio of forced expiratory volume in the first second to forced vital capacity (FEV 1/FVC) were compared between the two groups of patients. Results:After intervention, the correct rate of respiratory function exercise in experimental group was higher than that in control group, and the difference was statistically significant ( P<0.05) . The FEV 1/FVC of experimental group was higher than that of control group one day before discharge, and the difference was also statistically significant ( P<0.05) . Conclusions:Quality control circle activity applied to patients after esophageal cancer surgery can increase the correct rate of patients' respiratory function exercise and effectively improve the patient's lung function.

Objective:To analyze the assessment results of the external quality control and network operation of urinary iodine in local laboratories of Shandong Province, to evaluate the ability of consistent analysis.Methods:In 2016, there were 65 county-level urinary iodine laboratories participated in the provincial external quality control assessment, and there were 124 county-level urinary iodine laboratories participated in the national external quality control assessment in 2017. In 2018, all 137 county-level urinary iodine laboratories in the province participated in the national external quality control assessment. The testing results were analyzed with Z score method (qualified:│Z│≤2; basically qualified: 2 <│Z│ < 3; unqualified:│Z│≥3).Results:The 65 county-level laboratories in Shandong Province were evaluated in the provincial quality control test of urinary iodine in 2016, the feedback rate was 92.3% (60/65), the overall qualified rate was 81.7% (49/60); 124 county-level laboratories in Shandong Province were evaluated in the national quality control test of urinary iodine in 2017, the feedback and qualified rate were both 100.0% (124/124). All the 137 county-level laboratories were evaluated in the national quality control test of urinary iodine in 2018, the feedback and qualified rate were both 100.0% (137/137).Conclusions:The test abilities of urinary iodine in local laboratories of Shandong Province has been increasing continuously, and it has initially reached the detection level required for the full coverage of urinary iodine monitoring in all counties of the province.

Objective:To evaluate the detection ability of water fluoride of county-level laboratories in Shandong Province.Methods:From 2017 to 2019, Shandong Province organized 30, 30 and 37 county-level laboratories to participate in the national water fluoride external quality control assessment and the assessment results were evaluated by Z-ratio score method.Results:From 2017 to 2019, the feedback rate and qualified rate of water fluoride external quality control assessment of county-level laboratories were 100% (30/30, 30/30, 37/37) for three consecutive years.Conclusion:Over the past three years, the water fluoride detection ability of county-level laboratories in Shandong Province has been maintained at a satisfactory level.

Objective To evaluate feasibility of a method for determining low and medium concentrations water iodine by an automatic iodine analyzer (hereinafter referred to as this method).Methods The low (0-10 μg/L)and medium (0-100 μg/L) concentrations water iodine were determined by an automatic iodine analyzer.Methodological experiments were carried out on this method,including standard curve linearity,detection limit,precision experiment,standard recovery experiment,and standard substance determination.Results The absolute values of the linear correlation coefficients of the low and medium concentrations standard curves were ＞ 0.999 0,and the detection limits were 0.32 and 2.60 μg/L,respectively.Precision:the coefficient of variations were all below 2％ (n =18) of low,medium and high iodine concentrations water samples in the range of low and medium concentrations water iodine,and the average recovery rates were 100.7％ and 101.1％ (n =6),respectively.The determination results of the water iodine standard substance GBW 09113d and GBW 09114d were (8.3 ± 0.3)and (61 ± 2) μg/L (n =6),respectively,which were within the given standard values range.Conclusions This method has higher precision and accuracy,less reagent consumption,less time consumption,and simple operation.It is convenient for large-scale detection,and has strong applicability.

Objective To establish a rapid, simple and accurate method for detection of selenium in grain that is suitable in Chinese situation. Methods Nitric acid and perchloric acid(7: 3, v/v) were used to digest the grain samples by heating on a hot plate. Selenium was determined with hydride generation atomic fluorescence spectrometry. Sample detection limit, precision, accuracy(recovery, method characteristics and method control) were studied. And the grain samples of Shandong Province were determined by this method. Results The lowest detection limit was 4 μg/kg. The coefficient of correlation of working curve was 0.999 9. Intra-day precision was 1.32%, day precision was 4.17%. The total average rate of recovery was 100.5% with a range of 96.7% - 105.5%, and the average rates of recovery were 104.0%, 99.0% and 98.4% (n = 6). The determination results of corn reference material [(0.022 ± 0.006) mg/kg] were in the standard value range [(0.021 ± 0.008) mg/kg]. The determination results of the samples [(0.424 ± 0.096) mg/kg] were consistent with the results of national standard fluorescence method [(0.406 ± 0.108) mg/kg]. The contents of selenium in wheat, maize and sweet potato samples from five regions of Shandong Province were:Shanting:(0.030 3 ± 0.025 2),(0.016 8 ± 0.013 5),(0.015 4 ± 0.002 9) mg/kg; Anqiu:(0.020 3 ± 0.000 1), (0.020 4 ± 0.009 9), (0.017 1 ± 0.007 5) mg/kg; Ju'nan:(0.021 3 ± 0.013 9), (0.018 5 ± 0.007 8),(0.019 9 ± 0.003 6)mg/kg;Yishui:(0.025 7 ± 0.006 2),(0.020 6 ± 0.003 2), (0.018 2 ± 0.003 2) mg/kg; Wulian:(0.020 3 ± 0.004 7), (0.020 1 ± 0.008 9), (0.018 4 ± 0.007 3) mg/kg. Conclusions The method has the advantages of higher precision and accuracy, less time, less pollution, less aciduse, easier operation and repeatability.It is very suitable for measuring selenium content in large amount of food samples.

Objective To investigate the status of iodine content in the inner and outer environment of residents in excessive iodine intaking areas in Liaocheng of Shandong Province after stop taking iodized salt.Methods Totally 300 residents from each county (city) were selected for semi-quantitatively examination of their household salt in seven excessive iodine intaking counties (cities) in 2015 and 2016.Five counties were surveyed in 2015,and two other counties were surveyed in 2016.Then one town was selected from every county (city) as test site,one hundred children aged 8-10 (50 males and 50 females) from every test site were selected to measure their household salt iodine level.If the household salt was confirmed a non-iodized salt,water samples and urine samples were collected.Water iodine and urinary iodine contents were measured by arsenic cerium catalytic spectrophotometry (WS/T 107-2006).Results In 2015 and 2016,non iodized salt rates were 97.4％ (1 753/1 800) and 96.6％ (1 738/1 800),respectively in Liaocheng.Totally 686 household drinking water samples were measured.The water iodine levels were 2.7-748.4 μg/L,and the median was 203.4 μg/L.Totally 699 urine samples were measured.The urine iodine levels were 33.6-1 692.0 μg/L,and the median was 486.8 μg/L.The median of children's household water iodine level and median of children's urinary iodine level were significantly positively correlated (r =0.857,P ＜ 0.05).Conclusions The measurement of stop taking iodized salt in excessive iodine intake areas in Liaocheng is well implemented.Some monitoring sites show significant improvement.However,the urine iodine level of most residents is still high.The harmful effects of excessive iodine intaking are still constantly existed in some areas.In the future,in addition to continue to change the water to reduce iodine,it is also necessary to strengthen the health education of residents to improve the residents' awareness of the dangers of excessive iodine.