Objective:To investigate the external quality control assessment results of iodine deficiency disorders (IDD) laboratories at all levels in Yunnan Province, so as to provide technical support for IDD monitoring.Methods:In 2023, all IDD laboratories at provincial, city (prefecture) and county level in Yunnan Province tested the assessment samples randomly provided by the National IDD Reference Laboratory based on their participation in external quality control assessment projects (urinary iodine, salt iodine, water iodine). For laboratories that do not use fully automatic iodine detectors, urinary iodine detection was carried out using the "Determination of Iodine in Urine - Part 1: As 3+-Ce 4+ Catalytic Spectrophotometry" (WS/T 107.1-2016), salt iodine detection was carried out using the direct titration method in the "General Test Methods in Salt Industry-Determination of Iodine"(GB/T 13025.7-2012), and water iodine detection was carried out using the cerium sulfate catalytic spectrophotometry. The test results were evaluated using standard value ± uncertainty. Results:A total of 146 IDD laboratories in Yunnan Province participated in the external quality control assessment, including 1 at the provincial level, 16 at the city (prefecture) level, and 129 at the county level. The feedback rate and qualification rate of urinary iodine, salt iodine in the provincial, city (prefecture) and county level IDD laboratories were all 100% (146/146). The feedback rate and the qualified rate of urinary iodine, salt iodine and water iodine in county level IDD laboratories were all 100%(17/17).Conclusion:In 2023, all external quality control assessment results of IDD laboratories in Yunnan Province are qualified, with stable testing quality, providing reliable laboratory technical support for IDD monitoring.

Objective:To investigate the external quality control assessment results of iodine deficiency disorders (IDD) laboratories at all levels in Yunnan Province, so as to provide technical support for IDD monitoring.Methods:In 2023, all IDD laboratories at provincial, city (prefecture) and county level in Yunnan Province tested the assessment samples randomly provided by the National IDD Reference Laboratory based on their participation in external quality control assessment projects (urinary iodine, salt iodine, water iodine). For laboratories that do not use fully automatic iodine detectors, urinary iodine detection was carried out using the "Determination of Iodine in Urine - Part 1: As 3+-Ce 4+ Catalytic Spectrophotometry" (WS/T 107.1-2016), salt iodine detection was carried out using the direct titration method in the "General Test Methods in Salt Industry-Determination of Iodine"(GB/T 13025.7-2012), and water iodine detection was carried out using the cerium sulfate catalytic spectrophotometry. The test results were evaluated using standard value ± uncertainty. Results:A total of 146 IDD laboratories in Yunnan Province participated in the external quality control assessment, including 1 at the provincial level, 16 at the city (prefecture) level, and 129 at the county level. The feedback rate and qualification rate of urinary iodine, salt iodine in the provincial, city (prefecture) and county level IDD laboratories were all 100% (146/146). The feedback rate and the qualified rate of urinary iodine, salt iodine and water iodine in county level IDD laboratories were all 100%(17/17).Conclusion:In 2023, all external quality control assessment results of IDD laboratories in Yunnan Province are qualified, with stable testing quality, providing reliable laboratory technical support for IDD monitoring.

Objective:To learn about the current situation of prevention and control of coal-burning-borne endemic fluorosis (coal burning fluorosis for short) in Yunnan Province, and comprehensively evaluate the implementation effect of prevention and control measures.Methods:From August to November 2020, according to the requirements of the Monitoring Program of Yunnan Province for Coal-burning-borne Endemic Fluorosis (2019 edition), monitoring was carried out in all natural villages in the disease areas of 13 counties (cities and districts, hereinafter referred to as counties) of the province, and 30 households were selected from each natural village to monitor the use of stoves and the formation of related healthy living behaviors. At the same time, children aged 8 - 12 years in the natural villages in the disease areas were examined for the prevalence of dental fluorosis. The evaluation for control and elimination of disease areas was carried out in accordance with the Evaluation Approach for Control and Elimination of Priority Endemic Diseases (2019 edition).Results:A total of 392 244 households were investigated, and the rates of qualified improved stoves, the correct utilization of qualified improved stoves and correct drying of corn and pepper were 99.42% (389 982/392 244), 99.70% (388 796/389 982) and 99.07% (388 579/392 244), respectively. A total of 227 057 children aged 8 - 12 years were examined, 9 413 children of dental fluorosis were detected, the detection rate of dental fluorosis was 4.15%, the dental fluorosis index was 0.10, and the prevalence intensity was negative. Taking the county as a unit, except Fuyuan and Zhenxiong, which reached the control standard of the disease area, the remaining 11 counties reached the elimination standard.Conclusion:The prevention and control measures on coal burning fluorosis are implemented well in Yunnan Province and healthy lifestyle has gradually taken shape, with the overall condition of the disease reduced.

Objective:To understand the contents of edible salt iodine and urinary iodine of children and pregnant women in Yunnan Province, and to evaluate the iodine nutrition status, so as to provide a basis for scientific prevention and treatment of iodine deficiency disorders (IDD).Methods:From November to December 2020, one county (city) was selected from each prefecture (city), two townships (towns and streets) were selected from each county (city) and two villages (neighborhood committees) were selected from each township (town and street) from each of the 16 prefectures (cities) in Yunnan Province as the investigation sites. A total of 20 non-boarding children (male and female balanced) aged 8 - 10 years old were selected from each primary school in each village (neighborhood committee) to collect salt and urine samples. A total of 80 children were investigated in each county (city). A total of 20 pregnant women were selected from each township (town and street) to collect salt and urine samples. A total of 40 pregnant women were investigated in each county (city). All salt samples and urine samples were tested for iodine contents.Results:A total of 2 009 salt samples and 2 041 urine samples (1 375 for children, 666 for pregnant women) were collected from children aged 8 - 10 years old and pregnant women in 16 counties (cities) of Yunnan Province. Among them, the median salt iodine was 26.0 mg/kg, the coverage rate of iodized salt was 100.0% (2 009/2 009), the qualified rate of iodized salt was 98.7% (1 982/2 009), and the consumption rate of qualified iodized salt was 98.7% (1 982/2 009). The difference of salt iodine content in key populations in different counties (cities) was statistically significant ( H = 258.98, P < 0.01). The median urinary iodine of children aged 8 - 10 years old was 188.5 μg/L. There was statistically significant difference in urinary iodine content among children of different ages ( H = 29.45, P < 0.01), but there was no statistically significant difference in urinary iodine content among children of different genders ( H = 1.43, P > 0.05). In addition, the median urinary iodine of pregnant women was 141.9 μg/L, 52.1% (347/666) was < 150 μg/L. There was statistically significant difference in urinary iodine content of pregnant women in different counties (cities, H = 88.32, P < 0.01). Conclusions:The qualified rate of iodized salt, the coverage rate of iodized salt and the consumption rate of qualified iodized salt in key populations of Yunnan Province are more than 90%, and the iodized salt supply is good. Iodine nutrition of children aged 8 - 10 years old is at an appropriate level (100 - 199 μg/L); iodine nutrition of pregnant women is in an state of iodine deficiency ( < 150 μg/L). It is suggested to strengthen IDD monitoring and health education among key populations, improve residents' awareness of disease prevention, and make scientific iodine supplementation.

Objective:To investigate clinical characteristics of pediatric psoriasis based on the information systems from two children′s hospitals.Methods:Clinical data on outpatients confirmly diagnosed with pediatric psoriasis were collected from information systems of Beijing Children′s Hospital affiliated to Capital Medical University and Children′s Hospital of Chongqing Medical University from January 1, 2015 to December 31, 2019, and a clinical and epidemiological investigation was conducted. Statistical analysis was carried out by using t test and chi-square test. Results:A total of 5 235 children with psoriasis were included, with the ratio of male to female being 1∶1.08. Their age at the clinic visit ( M [ Q1, Q3]) was 8.37 (6.48, 10.50) years, and the school-age children were the most common population; their age at onset was 7.57 (5.37, 9.82) years. Among the 5 235 children with psoriasis, there were 3 195 (60.82%) with psoriasis vulgaris, 281 (5.37%) with pustular psoriasis, 19 (0.36%) with erythrodermic psoriasis, and 1 (0.02%) with psoriatic arthritis. The trunk (87.76%, 1 097/1 250) was most frequently affected, followed by the limbs (87.68%, 1 096/1 250) , the scalp (62.56%, 782/1 250) , and the face and neck (35.76%, 477/1 250) . Among the 5 235 patients, 4 319 (82.50%) received topical treatments, 177 (3.38%) received systemic treatments, and 832 (15.89%) were treated with antibiotics. Among 3 497 children who received initial treatment regimens, the disease could be controlled in 3 423 (97.88%) without change in treatment regimens, while treatment regimens needed to be adjusted in 2.12%. Conclusions:In the two children′s hospitals, most children with psoriasis developed this condition and visited the clinic at school age, and the predominant clinical type was psoriasis vulgaris. Most skin lesions were extensive, and commonly occurred on the trunk and limbs. Scalp involvement was not uncommon. The condition could be controlled by topical treatments in most children with psoriasis, while a few patients needed systemic treatments.

Objective:To explore the factors affecting the compliance with hormone replacement therapy in children with short stature.Methods:Totally 14 parents of 14 children with short stature who had poor compliance with hormone replacement therapy in the Affiliated Hospital of Nantong University from August to December 2018 were selected by purposive sampling and received semi-structured interview. Colaizzi's 7-step analysis was used to analyze the data.Results:The factors affecting children's compliance with hormone replacement therapy were summarized into 4 themes, namely, parents' failure to cope with the disease, the psychological and physical problems of the children, the excessive financial burden, and the lack of humanistic care.Conclusions:The compliance with hormone replacement therapy in children with short stature is affected by many factors such as their own and social factors. Medical and nursing staff should pay special attention and provide personalized continuous care, and pay attention to humanistic care to improve their treatment compliance and achieve ideal treatment effects.

Objective To understand the current situation on coal-burning-borne endemic fluorosis control and prevention in Yunnan Province,timely discover problems in prevention and control of the disease,and achieve the "13th Five-Year Plan" objectives as scheduled.Methods Simple random sampling method was adopted to conduct investigations in Weixin County,Daguan County of Zhaotong City,and Fuyuan County of Qujing City in the key diseased areas of Yunnan Province in 2017.Three townships from each endemic fluorosis area were randomly selected,and 2 villages of each township were randomly selected.The use of improved stoves (types of stoves,integrity rate and correct use),knowledge and behavior changes of endemic fluorosis prevention among local grade five pupils and housewives or household heads and the condition of endemic fluorosis (dental fluorosis and urinary fluoride situation in children) were investigated in above mentioned villages.Results A total of 532 households were investigated.The consumption rate of self-produced corn and pepper were 53.4％ (284/532) and 44.7％ (238/532),respectively.Totally 81.0％ (431/532) of households burned coal,the average annual coal burning time per household was 6.3 months.Totally 44.5％ (237/532) of the households used the improved iron stove,89.5％ (476/532) used the electric cooker to cook rice,84.2％ (448/532) used the induction cooker to cook,and 36.7％ (195/532)used the portable open stove.The integrity rate of improved stoves and the correct usage rate were 86.9％ (206/237) and 84.0％ (199/237),respectively,among the 237 households using improved stoves.The awareness rate of the prevention and control of coal-burning-borne fluorosis in grade five pupils and housewives or household heads were 85.8％ (921/1 074) and 17.7％ (283/1 596),respectively.The correct drying rates of edible corn and peppers were 66.5％ (189/284) and 52.9％ (126/238),respectively.A total of 3 333 children aged 8-12 years old were examined and the dental fluorosis positive rate was 11.28％ (376/3 333).Totally 377 samples of immediate urine samples were detected,the geometric mean of urinary fluoride content of children was 0.37 (0.06-2.14) mg/L.Conclusions The situation of coal-burning-borne endemic fluorosis in Yunnan Province is effectively controlled,but the correct use rate of improved stoves,the correct drying rate of edible com and peppers are low,and do not meet the requirements of the "13th Five-Year Plan".

Objective To investigate the clinic efficacy of two section and three leaves approach on laparoscopic radical cystectomy (LRC) or robot assisted radical cystectomy (RARC).Methods A retrospective statistical analysis collected a total of 103 cases with bladder cancer undergoing LRC or RARC,from Jan 2013 to Dec 2015 in our center.Those patients were divided into two groups,including two section and three leaves approach group (46 cases) and conventional group (57 cases).The two section,which means that to cut lateral prostate gland and lateral vesical gland respectively,the three leaves include lateral lobe of lateral vesical gland (superior vesical arteries and veins),medial lobe of lateral vesical gland and lateral prostate gland.In two groups,whose age ranged from 35 to 84 years,the median age were (63.3 ± 9.8) years and (63.7 ± 9.1) years,respectively.The median BMI values were (23.2 ± 2.9) kg/m2 and (23.0 ± 2.2) kg/m2,respectively.The occurrence of history of abdominal surgery were 4 (8.7％) cases and 9(15.8％) cases,respectively.In two section and three leaves approach,the ASA scores of 1,2,3 were found in 5,35,6 cases,respectively.In conventional group,the ASA scores of 1,2,3 were found in 12,38,7 cases,respectively.The difference between two groups in age distribution,BMI value,ASA score,history of abdominal surgery,urinary diversion,surgical methods,pathological staging and grading had no statistical significance (P ＞ 0.05).Then,the operation time,the blood loss and the time to remove drainage tube,et al of the above two groups were compared.Patients with BMI≥24 kg/m2 in the two groups were 24 cases and 20 cases,respectively,following the strategy based on BMI ≥24 kg/m2 and BMI ＜ 24 kg/m2 to compare the difference of subgroups in the operation time and the bleeding amount,for the purpose of corroborating the applied effectiveness of two section and three leaves approach compared with the conventional measure on LRC or RARC for patients with BMI ≥ 24 kg/m2.Results All endoscopic operations were completed successfully.No conversion was recorded.In two groups,the median operation time were (255.1 ± 99.3) min and (284.2 ± 171.3) min,respectively,the difference was statistically significant (P =0.011).The blood loss was (233.1 ± 196.9)ml and (272.0 ±268.8) ml,respectively(P =0.009).The time to remove drainage tube were (10.6 ± 5.0) d and (9.9 ± 4.4) d,respectively (P =0.880).In addition,the difference in the intraoperative blood transfusion rate(10.9％ vs.21.1％),occurrence of lymph fistula (13.0％ vs.17.5％),gastric extubation time [(4.3 ± 1.9) d vs.(4.0 ± 1.9) d],time for flatus recovery [(3.9 ±1.2) d vs.(3.7 ± 1.7) d],the incidence of perioperative complications (26.1％ vs.36.8％) and postoperative hospital stay [(13.3 ± 5.5) d vs.(13.5 ± 4.8) d] were no statistical significance (P ＞0.05).The results of comparisons for patients with BMI ≥ 24 kg/m2 between subgroups included the operation time were (264.3 ± 68.1) min and (298.5 ± 80.2) min,respectively.The blood loss were (247.8 ± 199.4) ml and (295.3 ± 204.5) ml,respectively,both of them were statistical significance (P ＜0.05).The two section and three leaves approach was significantly better than those patients operated by conventional method.Conclusions Compared with conventional method undergoing LRC or RARC,two section and three leaves approach could shorten operative time and reduce the blood loss markedly,especially for patients with BMI≥24 kg/m2.

Objective: To investigate the association between aflatoxin exposure and primary hepatocellular carcinoma (PHC) development. Methods: From December 2013 to May 2016, we selected 214 patients newly diagnosed with PHC as cases, and 214 patients as controls from three hospitals in Chongqing. Cases were confirmed with PHC diagnosis standard. And cases caused by clear reasons such as drug-induced liver injury, alcoholic liver damage, fatty liver and gallstones etiology, were excluded. Controls were included with no cancer and no digestive system disease, and recruited simultaneously with cases. Cases and controls were frequency-matched (1∶1) by same gender and age (±3 years). Peripheral blood and random urine samples were collected and analyzed for serum HBsAg status by biochemistry analyzer, and serum AFB₁-ALB adduct and urinary AFB₁-N⁷-GUA adduct by ELISA. Basic information, living habits and history of disease for patients were obtained by questionnaires. We used wilcoxon rank sum test to compare the median of serum AFB₁-ALB adduct and urinary AFB₁-N⁷-GUA adduct in cases and controls. Logistic regression analyses were performed to assess risk factors for PHC, and synergism index (S) of aflatoxin with other factors was estimated by the method of Andersson. Results: There was no significant difference in age between PHC cases (50.74±9.67) years and controls (51.15±9.90) years. Logistic regression showed that the odds ratio of HBV infection for PHC development was 46.3 (95% CI: 23.3-88.0). There was a significant difference in median concentrations of serum AFB₁-ALB adduct (cases vs controls: 146.23 vs 74.42 ng/g albumin, P<0.001), but no difference in median concentrations of urinary AFB₁-N⁷-GUA adduct was observed (cases vs controls: 0.17 vs 0.14 ng/mg creatinine, P<0.210). The odd ratios for PHC risk after adjustment were 1.9 (95%CI: 1.1-3.4) for AFB₁-ALB adduct, and 2.1 (95%CI: 1.0-4.2) for AFB₁-N⁷-GUA adduct. Moreover, we observed a positive interaction of aflatoxin exposure with HBV, alcohol drinking, and diabetes. The S was 4.7 (95%CI: 2.8-7.9), 3.5 (95%CI: 1.0-12.0), and 12.4 (95%CI: 1.8-84.2), respectively for serum AFB₁-ALB adduct with each of the three factors mentioned, and was 1.9 (95%CI:1.1-3.1), 2.0 (95%CI: 1.1-3.6), and 2.0 (95%CI: 1.1-3.6), respectively for urinary AFB₁-N⁷-GUA adduct with each of the three factors mentioned. Conclusion HBV was still the main risk factor, and AFB₁ exposure was also an independent risk factor for PHC in Chongqing. There was a positive interaction of aflatoxin with HBV, alcohol drinking, and diabetes.

Objective To explore the lived experience of children with acute leukemia about acupoint therapy during chemotherapy, so as to provide the theoretical and practice evidence for development of more scientific nursing measures. Methods Totally 14 children with acute leukemia participated in half-structured interviews regarding their experience of acupoint therapy.The NVivo 10.0 software was used to supervise, excavate and seek data.The data were analyzed by the Co1aizzi phenomenological methodology. Results Five themes were extracted including benefit sense,a sense of accomplishment of self-fulfilling, a sense of attachment to medical, sigh with emotion the magic of traditional Chinese medicine and bearable mild discomfort. Conclusions The experience of children with acute leukemiais positive feelings for the most part, nursing staff should listen to them and give corresponding nursing according to specific circumstances in order to improve the quality of nursing.