2- (2-thiophenyl) scopolamine glycolate is produced through an ester exchange reaction between scopine and methyl 2, 2-dithienylglycolate, and is used to synthesize tiotropium bromide. In this paper, the treatment process of 12 patients with acute 2- (2-thiophenyl) scopolamine glycolate poisoning was reviewed and their clinical data were analyzed. After a large amount of 2- (2-thiophenyl) scopolamine glycolate was absorbed through the respiratory tract, the poisoning patients presented with central nervous system injury as the main clinical manifestations, accompanied by symptoms such as blurred vision and irritability. After fluid replacement, ovulation induction and symptomatic supportive treatment, all patients improved and were discharged. The patients were followed up. After 6 months, only 3 patients had residual headache and dizziness. It is indicated that early intervention for acute 2- (2-thiophenyl) scopolamine glycolate poisoning has a good prognosis. Meanwhile, occupational protection should be strengthened to prevent the occurrence of poisoning.

Objective:To learn about the sales situation of edible salt in Gansu Province after the reform of salt industry system, and provide scientific basis for improving the prevention and control measures of iodine deficiency disorders (IDD).Methods:In 2022, a cross-sectional study method was used to divide the counties (districts) under 11 cities (prefectures) in Gansu Province into urban, suburban, and rural areas. A stratified sampling method was used to divide each city (prefecture) into five regions (east, west, south, north, and center), and 1 county (district) was randomly selected from each region. From each county (district), 5 - 10 edible salt sales outlets of varying scales were selected in each of the five directions. A questionnaire survey was used to investigate the quantity, type, price of edible salt sold, and IDD education efforts in each county (district) in the past six months. One bag of different types of edible salt sold at each sales outlet was randomly selected as a sample, and information such as the brand, manufacturer, and iodine level indicated on the outer packaging was recorded.Results:A total of 1 189 edible salt sales outlets were surveyed, including 157 large supermarkets, 197 medium-sized supermarkets, 760 small supermarkets (convenience/retail stores), 74 vegetable markets (farmers' markets), and 1 specialty salt store. The outlets were distributed in urban (438), suburban (99), and rural (652) areas. Among them, 12.11% (144/1 189) of the outlets sold both iodized and non-iodized salt. A total of 2 004 036 bags of edible salt were sold in 1 189 sales outlets, with a median sales quantity of 250 bags. There were statistically significant differences in sales quantity among sales outlets of different sizes and locations ( H = 57.97, 39.59, P < 0.001). The overall sales of iodized salt were higher than those of non-iodized salt ( Z = - 6.45, P < 0.001). Sales varied significantly by price ( H = 80.69, P < 0.001). A total of 1 740 samples of edible salt were surveyed, including 38 brands. Among them, China Salt Industry Group Co., Ltd. and its affiliated local companies had the highest sales quantity at 70.86% (1 233/1 740). The proportion of samples with iodine level < 5, 18 - 33, and 21 - 39 mg/kg indicated on the outer packaging was 4.08% (71/1 740), 7.01% (122/1 740), and 88.91% (1 547/1 740), respectively. Among 1 189 sales outlets, 26.24% (312/1 189) were aware of the iodine standard for edible salt in Gansu Province, 32.46% (386/1 189) had set up propaganda signs (slogans) for prevention and control of IDD, 59.13% (703/1 189) were aware of recommending iodized salt to pregnant women, and 51.39% (611/1 189) actively promoted knowledge of IDD prevention and control. Conclusions:After the reform of salt industry system, the sales network system of edible salt in Gansu Province has been improved, with multiple entities, brands, and varieties coexisting in the edible salt market. However, there is still a need to strengthen sales supervision and scientific iodine supplementation health education.

2- (2-thiophenyl) scopolamine glycolate is produced through an ester exchange reaction between scopine and methyl 2, 2-dithienylglycolate, and is used to synthesize tiotropium bromide. In this paper, the treatment process of 12 patients with acute 2- (2-thiophenyl) scopolamine glycolate poisoning was reviewed and their clinical data were analyzed. After a large amount of 2- (2-thiophenyl) scopolamine glycolate was absorbed through the respiratory tract, the poisoning patients presented with central nervous system injury as the main clinical manifestations, accompanied by symptoms such as blurred vision and irritability. After fluid replacement, ovulation induction and symptomatic supportive treatment, all patients improved and were discharged. The patients were followed up. After 6 months, only 3 patients had residual headache and dizziness. It is indicated that early intervention for acute 2- (2-thiophenyl) scopolamine glycolate poisoning has a good prognosis. Meanwhile, occupational protection should be strengthened to prevent the occurrence of poisoning.

Objective:To learn about the sales situation of edible salt in Gansu Province after the reform of salt industry system, and provide scientific basis for improving the prevention and control measures of iodine deficiency disorders (IDD).Methods:In 2022, a cross-sectional study method was used to divide the counties (districts) under 11 cities (prefectures) in Gansu Province into urban, suburban, and rural areas. A stratified sampling method was used to divide each city (prefecture) into five regions (east, west, south, north, and center), and 1 county (district) was randomly selected from each region. From each county (district), 5 - 10 edible salt sales outlets of varying scales were selected in each of the five directions. A questionnaire survey was used to investigate the quantity, type, price of edible salt sold, and IDD education efforts in each county (district) in the past six months. One bag of different types of edible salt sold at each sales outlet was randomly selected as a sample, and information such as the brand, manufacturer, and iodine level indicated on the outer packaging was recorded.Results:A total of 1 189 edible salt sales outlets were surveyed, including 157 large supermarkets, 197 medium-sized supermarkets, 760 small supermarkets (convenience/retail stores), 74 vegetable markets (farmers' markets), and 1 specialty salt store. The outlets were distributed in urban (438), suburban (99), and rural (652) areas. Among them, 12.11% (144/1 189) of the outlets sold both iodized and non-iodized salt. A total of 2 004 036 bags of edible salt were sold in 1 189 sales outlets, with a median sales quantity of 250 bags. There were statistically significant differences in sales quantity among sales outlets of different sizes and locations ( H = 57.97, 39.59, P < 0.001). The overall sales of iodized salt were higher than those of non-iodized salt ( Z = - 6.45, P < 0.001). Sales varied significantly by price ( H = 80.69, P < 0.001). A total of 1 740 samples of edible salt were surveyed, including 38 brands. Among them, China Salt Industry Group Co., Ltd. and its affiliated local companies had the highest sales quantity at 70.86% (1 233/1 740). The proportion of samples with iodine level < 5, 18 - 33, and 21 - 39 mg/kg indicated on the outer packaging was 4.08% (71/1 740), 7.01% (122/1 740), and 88.91% (1 547/1 740), respectively. Among 1 189 sales outlets, 26.24% (312/1 189) were aware of the iodine standard for edible salt in Gansu Province, 32.46% (386/1 189) had set up propaganda signs (slogans) for prevention and control of IDD, 59.13% (703/1 189) were aware of recommending iodized salt to pregnant women, and 51.39% (611/1 189) actively promoted knowledge of IDD prevention and control. Conclusions:After the reform of salt industry system, the sales network system of edible salt in Gansu Province has been improved, with multiple entities, brands, and varieties coexisting in the edible salt market. However, there is still a need to strengthen sales supervision and scientific iodine supplementation health education.

Objective:To evaluate the testing capability of urinary iodine laboratories in Gansu Province and analyze the existing problems.Methods:Z-score method and uncertainty analysis were used to analyze the external quality control assessment results of urinary iodine laboratories in Gansu Province from 2017 to 2021 (data were collected from Gansu Center for Disease Prevention and Control).Results:From 2017 to 2021, the participation rate in the assessment of urinary iodine laboratories in the province was 100.0% (473/473), the feedback rate was 99.8% (472/473), and the pass rate was 91.9% (434/472). The pass rates for assessment from 2017 to 2021 were 82.7% (62/75), 93.9% (93/99), 94.9% (93/98), 92.0% (92/100), and 94.0% (94/100), respectively. The pass rates for provincial, municipal, and county assessments were 5/5, 98.6% (69/70), and 90.7% (360/397), respectively. The proportions of │Z│≤2, 2 <│Z│ < 3, and│Z│≥3 between laboratories in the province were 84.5% (399/472), 9.3% (44/472), and 6.2% (29/472), respectively. The proportions of│Z│≤2, 2 <│Z│ < 3, and│Z│≥3 within the laboratories were 88.6% (418/472), 9.1% (43/472), and 2.3% (11/472), respectively. There was a significant difference in the composition of │Z│ scores between laboratories annually (χ 2 = 24.60, P = 0.002), the proportion of│Z│≤2 increased from 66.7%(50/75) in 2017 to 90.0% (90/100) in 2021. The│Z│ scores between and within provincial laboratories were both ≤2. The proportion of │Z│≤2 between municipal and county-level laboratories was 91.4% (64/70) and 83.1% (330/397), respectively, the proportion of│Z│≤2 within laboratories was 92.9% (65/70) and 87.7% (348/397), respectively. There was no difference in the composition of│Z│ scores between and within provincial, municipal, and county-level laboratories( P < 0.05). The proportion of two concentration quality control blind sample results in the province that were both within the uncertainty range was 89.2% (421/472). From 2017 to 2021, they were 81.3% (61/75), 91.9% (91/99), 84.7% (83/98), 92.0% (92/100), and 94.0% (94/100), respectively, with statistically significant differences (χ 2 = 9.69, P = 0.021); provinces, cities, and counties were 5/5, 95.7% (67/70), and 87.9% (349/397), respectively, with statistically significant differences (χ 2 = 23.60, P = 0.023). Conclusions:Through continuous external quality control assessments of all established urinary iodine laboratories in Gansu Province, the overall testing capacity of urinary iodine laboratories at all levels has been continuously improved. However, in the future, it is still necessary to strengthen laboratory testing capabilities and improve the level of urine iodine detection.

Objective To investigate the role of quality control circle management guided by Party building philosophy in improving patient satisfaction in emergency services.Methods Quality control circle management guided by the Party building philosophy was implemented in May 2023.Two groups of 1 000 emergency patients each were selected,one from April to May 2023(pre-implementation)and the other from April to May 2024(post-implementation).The control group and the observation group were compared across several metrics in terms of satisfaction scores,satisfaction rates,120 emergency call response time,3-minute pre-hospital emergency dispatch rates,and average waiting times for emergency observation patients.Results The ob-servation group demonstrated higher satisfaction scores,satisfaction rates,and higher 3-minute pre-hospital emergency dispatch rates compared to the control group.Additionally,the observation group had shorter emergency call response time and average waiting time in the emergency department,with statistically significant differences(P＜0.05).Conclusion The integration of quality control circle management guided by Party construction philosophy in the management of emergency patients has been shown to address operational issues,optimize service processes,and significantly improve patient satisfaction and experience.This method is worthy of broader application and promotion in clinical practice.

Objective To understand the impact of system reform of salt industry on iodine nutrition of people in Gansu Province, and to provide a scientific basis for policy adjustment of relevant departments. Methods The investigation period (2014-2021) was divided into two sub-periods: before system reform of salt industry (2014-2016) and after system reform of salt industry (2017-2021). Thirty counties were selected according to the method of ^“population proportional probability sampling (PPS)^” in 2014. According to the iodine deficiency disease monitoring program of Gansu Province, from 2016 to 2021, children aged 8-10 years and pregnant women were taken as research objects to collect urine samples for urine iodine detection. Children in 2014 and 2018 were selected to measure thyroid volume. Results A total of 90 989 children urine iodine samples were investigated, and the median urinary iodine (MUI) of children was 194.70µg/L; 7 663 and 83,326 children's urinary iodine samples were investigated in the two periods, the MUI was 180.73 µg/L and 196.00 µg/L, respectively, and the difference was statistically significant (P<0.05). A total of 44 741 pregnant women's urinary iodine samples were investigated, and the MUI of pregnant women was 176.50 µg/L; 4 480 and 40 261 pregnant women's urinary iodine samples were investigated in the two periods, the MUI was 160.61 µg/L and 178.10 µg/L, respectively, and the difference was statistically significant (P<0.05). The thyroid volume of 1 555 children and 8 509 children was investigated in the two periods, the median thyroid volume was 2.70 mL and 2.55 mL , respectively, and the difference was statistically significant (P<0.05). The rates of goiter in children were 3.15% and 1.26%, respectively, and the difference was statistically significant (P<0.05). Conclusion The iodine nutrition of people in Gansu Province has not fluctuated significantly after the reform of salt industry system and has maintained an appropriate level. It is necessary to pay attention to the potential risk of insufficient iodine nutrition level and thyroid health of key populations such as children and pregnant women and strengthen health education of scientific iodine supplementation.

Iodine nutrition is very important to human health, especially for brain development, urinary iodinary is one of the basic indicators reflecting the nutritional status of iodine, and is an important basis for scientific evaluation of iodine nutrition. In order to provide support and assistance for improving the network syetem of iodine nutrition monitoring laboratories, we summarized and explored the construction process, quality control, and management methods of 85 county-level urinary iodine laboratories in Gansu Province from 2016 to 2018.

Objective:To investigate and analyze the living conditions of patients with Kaschin-Beck disease in Gansu Province, and to provide scientific basis for accurate treatment of the patients.Methods:From 2018 to 2019, case investigation, clinical examination and X-ray examination of patients with Kaschin-Beck disease were carried out in the Kaschin-Beck disease area of Gansu Province. The contents of the survey included basic information of the patients, clinical diagnosis classification, disease information, surgery and drug treatment, etc.Results:A total of 23 909 patients with Kaschin-Beck disease were diagnosed in 37 counties (districts) of 7 cities (states). The patients with grade Ⅰ, grade Ⅱ and grade Ⅲ accounted for 64.04% (15 312 cases), 26.12% (6 244 cases) and 9.84% (2 353 cases), respectively; 90.74% (21 694 cases) of the patients were over 50 years old, Han nationality was 97.15% (23 228 cases), and peasants were 99.25% (23 729 cases). The patients mainly had multiple joint thickening and deformation (89.30%, 21 350 cases) and pain (87.04%, 20 810 cases). Joint thickening and deformation and pain were more common in finger joint, knee joint and ankle joint. The thickening and deformation of the three joints accounted for 89.97% (21 512 cases), 78.18% (18 692 cases) and 63.81% (15 257 cases), respectively; pain accounted for 80.66% (19 285 cases), 78.75% (18 828 cases) and 64.50% (15 422 cases), respectively; 83.83% (20 044 cases) had joint rest pain, 82.63% (19 757 cases) had joint movement pain and 76.03% (18 177 cases) had joint morning stiffness. Surgical treatment was completed in 1.97% (470 cases). Long-term drug treatment (more than 6 months in the whole year) accounted for 47.78% (11 424 cases); the annual cost of drug treatment was mainly less than 500 yuan, accounting for 57.72% (13 800 cases).Conclusions:The quality of life of patients with Kaschin-Beck disease in Gansu Province is low. We should pay more attention to adult patients with Kaschin-beck disease and strengthen management and treatment.

Objective:To analyze the characteristics of thyroid diameter and volume of children aged 8 - 10 years in Gansu Province, and to provide a basis for standardizing B-ultrasound examination of children's thyroid volume and establishing a normal reference value of children's thyroid volume.Methods:The data of thyroid volume by B-ultrasound and urinary iodine determination of children aged 8 - 10 years in Gansu Province were from Institute of Endemic Disease, Gansu Center for Disease Control and Prevention. Based on the measured data of thyroid B-ultrasound of 8 - 10 years children in Gansu Province, the characteristics and relationship between thyroid diameter and volume were analyzed by nonparametric test.Results:The medians of urinary iodine of 8, 9, 10 years children ( n = 500, 503, 496) were 166.62, 167.16 and 178.78 μg/L, respectively. The length, width, thickness and volume of the left and right lobes of the thyroid in children were skewed distribution. There was a positive correlation between the left and right diameters (length, width and thickness) and between left and right thyroid volumes ( r = 0.76, 0.85, 0.72, 0.88, P < 0.001). There was no significant difference in the six diameter lines and volume values of thyroid between genders ( P > 0.05), but there was significant difference between ages ( P < 0.001). The means thyroid volume of 8, 9 and 10 years children were 2.6, 2.9 and 3.2 ml, respectively, the medians were 2.5, 2.7 and 3.0 ml, respectively, and the 97th percentile ( P97) were 4.4, 4.9 and 6.5 ml, respectively. The thyroid volume of 10 years group was higher than the current national standard (6.0 ml). The median ranges of thyroid volume of children aged 8, 9 and 10 years at the county level were from 1.8 ml to 4.1 ml, from 1.8 ml to 4.3 ml and from 1.9 ml to 4.4 ml, respectively. There was significant difference in thyroid volume of children at the county level in all age groups ( P < 0.05). Conclusions:Compared with the national standard, the P97 value of thyroid volume of children aged 8 - 10 years in Gansu Province is slightly different. The reference value of thyroid volume should be formulated according to age, and a unified reference value can be used for different genders at the same age.