Objective:To analyze the iodine nutrition status and its related factors among adults aged 18 years and above in Zhejiang Province in 2022.Methods:A multistage stratified sampling method was used to select 4 320 adults aged 18 years and above from 16 on-site survey sites in Zhejiang Province for the study. A questionnaire was used to investigate the general demographic information and personal dietary characteristics of the study participants. Household edible salt and urine samples were collected to detect salt iodine content and urinary iodine level by using direct titration and cerium arsenate-catalyzed spectrophotometry, respectively, to evaluate the iodine nutritional status according to the standard. The multiple-ordered logistic regression model was used to analyze the factors influencing the urinary iodine concentration.Results:The age of the 4 320 study participants was (51.19±15.33) years, with males accounting for 44.44% (1 920). About 40.16% of adults (1 735) were from coastal areas and 56.37% (2 435) from urban areas. The salt iodine content, M ( Q1, Q3), of the 4 320 household edible salt samples was 21.10 (0.00, 24.16) mg/kg, including 1 662 non-iodized salt samples, 182 unqualified iodized salt samples and 2 476 qualified iodized salt samples. The rate of iodized salt coverage was 61.53%, and the rate of qualified iodized salt consumption was 57.31%. There was a statistically significant difference in the proportion of qualified iodized salt in adult households among different regions ( P<0.001), with the proportion of non-iodized salt gradually decreasing from coastal to inland areas ( χ 2trend=618.458, P<0.001). The urinary iodine concentration M ( Q1, Q3) was 137.60 (86.85, 210.60) μg/L in 4 320 adult urine samples, with the urinary iodine levels of<100, 100-199, 200-299, and≥300 μg/L accounting for 31.64% (1 367), 40.56% (1 752), 17.66% (763), and 10.14% (438), respectively. There was a nonlinear positive correlation between household salt iodine content and urinary iodine level in adults aged 18 years and above by using the χ 2 test for trend ( χ 2regression=231.10, P<0.001 and χ 2skew=28.81, P<0.001). Urinary iodine concentrations were higher in men than in women ( P=0.029) and higher in adults in rural areas than in urban areas ( P<0.001). There were statistically significant differences in the distribution of iodine nutritional status among adults of different ages, regions, and urban and rural areas (all P<0.001). The proportion of those with urinary iodine levels<100 μg/L gradually increased with age ( χ 2trend=37.493, P<0.001), and gradually decreased from coastal areas to inland areas ( χ 2trend=71.381, P<0.001). The results of the multiple-ordered logistic regression model analysis showed that compared with adults aged 18 to 44 years and male adults, those aged 45 to 59 years and female adults had lower urinary iodine levels, with OR (95% CI) of 0.75 (0.68-0.83) and 0.85 (0.76-0.95), respectively. Compared with adults in coastal and urban adults, those in sub-coastal, inland and rural adults had higher levels of urinary iodine, with OR (95% CI) of 1.89 (1.63-2.19), 2.02 (1.72-2.37) and 1.46 (1.28-1.66), respectively. Conclusion:The overall iodine nutrition level of adults aged 18 years and above in Zhejiang Province in 2022 is generally appropriate. However, there is a potential risk of iodine deficiency among adults in coastal areas.

Objective To study the root canal morphology of permanent mandibular anterior teeth and explore its correlation with the occurrence of three-rooted mandibular molars using cone beam computed tomographic(CBCT)imaging.Methods CBCT image data of 200 subjects were randomly collected from dental clinics.The root canal morphology of the mandibular anterior teeth was identified and classified by Vertucci's classification,and the root length and labio-lingual dimension at the tooth neck level were measured.The occurrence of three-rooted mandibular first molars was examined as well.The concurrence rates of double-canaled anterior teeth and three-rooted mandibular first molars at each side,and concurrence rates of bilateral double-canaled anterior teeth and three-rooted man-dibular first molars were calculated.Spearman correlation tests were applied to analyze the correlation between the double-canaled ante-rior teeth and three-rooted mandibular first molars,as well as the bilateral antimetric teeth.Results The incidence of double-canaled system was 10.4％,18.6％and 6.5％in mandibular central incisors,lateral incisors and canines,respectively;the bilateral concur-rence rates were 5.7％,11.1％and 3.0％,respectively,and Spearman correlation coefficients(rho)were 0.487,0.505 and 0.440(P＜0.01),respectively;gender difference and side difference were not detected(P＞0.05).The frequency of three-rooted mandibular first molars was 24.6％;gender difference was not detected(P＞0.05),while the incidence was significantly higher at the right side(29.0％)than the left side(20.3％)(P＜0.05).The bilateral concurrence rate was 17.4％,and a moderate correlation was detected(rho=0.666,P＜0.01).The concurrence rates between the double-canaled anterior teeth and three-rooted mandibular first molars at each side were very low(2.6％-7.6％),and Spearman correlation tests demonstrated that no correlation(P＞0.05)could be detected between them.Conclusion The lateral incisors exhibited the highest incidence of two root canals among the mandibular anterior teeth.Ad-ditionally,there was no significant corr-elation between three-rooted mandibular first molars and double-canaled mandibular anterior teeth.

Objective To evaluate the diagnostic value of positron emission tomography(PET)/computed tomography(CT)and bone marrow biopsy(BMB)for bone marrow infiltration in common non-Hodgkin lymphoma(NHL).Methods We retrospectively analyzed data from 197 patients with NHL and compared the diagnostic value of PET/CT and BMB for bone marrow infiltration.Differences in PET/CT parameters and serological test results were compared between PET/CT-positive and PET/CT-negative patients as well as between BMB-positive and BMB-negative patients.Results In patients with diffuse large B-cell lymphoma(DLBCL),the sensitivities of PET/CT and BMB for detecting bone marrow infiltration were 90.5%and 66.7%,and the specificities were 95.1%and 100.0%,respectively.In patients with follicular lymphoma(FL),the sensitivities were 63.6%and 81.8%,and the specificities were 98.1%and 100.0%,respec-tively.In patients with T-cell lymphoma(TCL),the sensitivities were 60.0%and 80.0%,and the specificities were 88.0%and 100.0%,respectively.Among patients with DLBCL and TCL,significant differences were observed in platelet count and lactate dehydrogenase levels between PET/CT-positive and PET/CT-negative patients(P<0.05).Conclusion PET/CT showed excellent diagnostic perfor-mance for evaluating bone marrow infiltration in DLBCL.PET/CT had limited sensitivity for FL and TCL and might serve as a supplemen-tary tool for BMB.Platelet count and lactate dehydrogenase levels may aid in the diagnosis of bone marrow infiltration in DLBCL and TCL.

This paper reports the clinical data and the diagnosis and treatment of a patient with exogenous insulin autoimmune syndrome(EIAS)induced by long-term use of exogenous insulin(Eucrin 50).For diabetes patients with hyperinsulin-induced hypoglycemia,detection of IAA is helpful for diagnosis EIAS.Due to different test methods affect IAA results,if negative,EIAS cannot be completely excluded.The polyethylene glycol precipitation method can assist in early diagnosis.

Objective:To analyze the iodine nutrition status of children and adolescents and influencing factors in Zhejiang Province, providing scientific basis for optimizing iodine deficiency disorders (IDD) prevention and control strategies.Methods:In June 2022, a multistage stratified sampling method was used to divide 16 counties (cities, districts, abbreviated as counties) in Zhejiang Province into three categories based on their geographical locations (average distance from the coastline): coastal areas (including Dinghai District, Jiaojiang District, Sanmen County, Cixi City and Lucheng District), sub-coastal areas (including Wuxing District, Haining City, Linping District, Fuyang District and Fenghua District), and inland areas(including Suichang County, Changshan County, Shengzhou City, Jindong District, Dongyang City and Yongjia County). One county was selected from each category, and one township (street) was selected from each county. Two administrative villages (neighborhood committees) were selected from each township (street). Ten households including all children and adolescents aged 6-17 in each household were selected from each administrative village (neighborhood committee). Demographic information and personal dietary characteristics were collected via questionnaires, while household salt and a random urine sample were tested for iodine level. Trend analysis was conducted using a χ 2trend test, and a multivariate logistic stepwise regression model was used to analyze the influencing factors of urinary iodine levels. Results:A total of 755 children and adolescents aged 6-17 were selected, including 387 males (51.26%) and 368 females (48.74%), with an age of (11.24 ± 3.32) years. There were 269 children and adolescents in coastal areas (35.63%) and 409 children and adolescents in urban areas (54.17%). A total of 755 household salt samples were collected, with a median salt iodine concentration of 21.80 mg/kg. These included 263 non-iodized salt samples, 38 unqualified iodized salt samples, and 454 qualified iodized salt samples. The coverage rate of iodized salt was 65.17% (492/755), and the consumption rate of qualified iodized salt was 60.13% (454/755). The distribution of salt iodine quality among children and adolescents in different geographical locations showed statistically significant differences (χ 2 = 111.95, P < 0.001), with the proportion of non-iodized salt gradually decreasing from coastal areas to inland areas (χ 2trend = 90.17, P < 0.001). A total of 755 urine samples were collected, with a median urinary iodine concentration of 186.60 μg/L. The proportions of urinary iodine < 100, 100-199, 200-299, and ≥300 μg/L were 16.95% (128/755), 37.62% (284/755), 24.37% (184/755), and 21.06% (159/755), respectively. The χ 2trend test revealed a nonlinear positive correlation between salt iodine level and urinary iodine level (χ 2regression = 21.98, P < 0.001; χ 2partial = 6.96, P < 0.001). The frequency distribution of urinary iodine in children and adolescents from different geographical locations and between urban and rural areas showed statistically significant differences (χ 2 = 29.63, 16.56, P < 0.001). Among them, the proportion of children and adolescents with urinary iodine < 100 μg/L gradually decreasing from coastal areas to inland areas (χ 2trend = 6.15, P = 0.013). The results of multivariate logistic regression analysis revealed that sub-coastal regions, inland regions, and urban-rural regions ( OR = 1.57, 1.53, 1.64, 95% CI: 1.11-2.24, 1.03-2.27, 1.17-2.32, P < 0.05) were significantly associated with urinary iodine levels in children and adolescents aged 6-17. Conclusions:In 2022, the iodine nutrition of children and adolescents in Zhejiang Province is generally suitable, but there is a risk of iodine deficiency among coastal children and adolescents. Geographic location and urban/rural areas are influencing factors on iodine nutrition status of children and adolescents in Zhejiang Province.

Objective To investigate the clinical value of baseline 18F-fluorodeoxyglucose(18F-FDG)PET/CT metabolic parame-ters and certain clinical indicators in predicting the prognosis of patients with diffuse large B-cell lymphoma(DLBCL).Methods A retrospec-tive analysis was conducted on the baseline 18 F-FDG PET/CT data of 73 DLBCL patients who received R-CHOP treatment.Patients were divided into progression group(24 cases)and non-progression group(49 cases)based on disease progression within 2 years post-treatment.The lesion maximum standardized uptake value(SUVmax),tumour-to-liver blood pool SUVmax ratio(LLR)and tumour-to-mediastinal blood pool SUVmax ratio(L-BPR)were analyzed using receiver operating characteristic(ROC)curves.Kaplan-Meier(K-M)survival curves analysis were performed based on the optimal thresholds of SUVmax,LLR and L-BPR.x2 tests were used to analyze and compare the relationship between each parameter and disease progression.Indicators that were significant in the x2 tests were included in the multivariate Cox regression analysis.Results The area under the curve(AUC)for LLR,L-BPR,and SUVmax were 0.920,0.914,and 0.848,respectively,with optimal thresholds of 7.41,10.67,and 14.70.Based on these thresholds,K-M survival curves analysis showed that the 2-year progression-free survival(PFS)rates for DLBCL patients were 79.2％vs 30.8％(P＜0.001),74.3％vs 22.0％(P=0.009),and 79.5％vs 51.6％(P=0.002),respectively.Significant differences were observed between the progression and non-progression groups in terms of LLR,L-BPR,SUVmax,extranodal involvement,international prognostic index(IPI)score,lactate dehydrogenase(LDH)level,Eastern Cooperative Oncology Group(ECOG)score,and β2-microglobulin(β2-MG)levels(P＜0.05).Multivariate Cox regression analysis revealed that the IPI score and LLR were independent predictors affecting the 2-year PFS of DLBCL patients(P＜0.05).Conclusion Baseline 18F-FDG PET/CT metabolic parameter LLR and IPI score are inde-pendent factors for predicting the prognosis of DLBCL patients.

Objective To analyze the 18F-fluorodeoxyglucose(18F-FDG)PET/CT manifestations of autoimmune pancreatitis(AIP)and to explore the diagnostic value of 18F-FDG PET/CT in AIP.Methods Twenty-three patients with suspected AIP who underwent 18F-FDG PET/CT were retrospectively analyzed.Eleven patients were diagnosed with AIP based on the International Consensus Diagnostic Criteria(ICDC)of AIP published by the International Pancreatic Disease Association.The detection rate and diagnostic sensitivity of 18F-FDG PET/CT for pancreatic enlargement,duct stenosis,duct dilation,pseudocapsules,and extrapancreatic involvement were analyzed,along with the 18F-FDG PET/CT manifestations of AIP.Results The 18F-FDG PET/CT manifestations of 11 patients with AIP:9 patients(81.82%)showed diffuse pancreatic enlargement,and 2 patients(18.18%)had local pancreatic head enlargement.And metabolism showed diffuse or localized increase.The maximum standardized uptake value(SUVmax)for the early PET/CT was 1.7-9.1(4.52±1.92),and for the delayed PET/CT,it was 2.6-9.8(5.25±1.98),with a statistically signifi-cant difference between the two phases SUVmax(t=-7.627,P<0.001).Two patients showed duct stenosis,six had distal duct dilation,and three exhibited pseudocapsule formation.Extrapancreatic involvement occurred in ten patients(90.91%),including sclerosing cholangitis,bile duct dilation inside and outside the liver,gallbladder changes,lymph node involvement,salivary gland involvement,prostate involvement,retroperitoneal fibrosis,pulmonary lesions,arteritis,and granulomatous tissue formation,etc.Among them,the same patient may present with multiple manifestations of extrapancreatic involvement.Among the 11 patients,eight were diagnosed as AIP,two as pancreatic cancer,and one as acute pancreatitis by 18F-FDG PET/CT.The diagnostic sensitivity was 72.73%.Conclusion The 18F-FDG PET/CT of AIP demonstrates specificity in anatomical morphology and metabolic changes and can better display extrapancreatic involvement,which has unique clinical value in AIP imaging diagnosis.

Objective:To investigate the iodine nutrition status of pregnant women in Zhejiang Province, explore the impact of salt industry system reform on iodine nutrition level of pregnant women, and provide scientific basis for prevention and treatment of iodine deficiency disorders.Methods:From 2016 to 2021, a multi-stage stratified sampling method was used to select 100 pregnant women from 90 counties (cities, districts) in Zhejiang Province each year as survey subjects. Salt samples were collected from pregnant women's families, and one random urine sample was taken for salt iodine and urinary iodine level testing, respectively.Results:A total of 56 581 samples of household edible salt were collected from pregnant women, with a median salt iodine level of 23.20 mg/kg. Among them, 7 961 were non iodized salt, 45 803 were qualified iodized salt, and 2 817 were unqualified iodized salt. The iodized salt coverage rate was 85.93% (48 620/56 581), and the qualified iodized salt consumption rate was 80.95% (45 803/56 581). The proportion of non iodized salt increased from 10.05% (897/8 928) in 2016 to 15.09% (1 461/9 679) in 2021 (χ 2trend = 95.16, P < 0.001). A total of 56 581 urine samples were collected from pregnant women, with a median urinary iodine level of 130.50 μg/L. Among them, the proportions of urinary iodine levels < 150, 150 - 249, 250 - 499, and ≥500 μg/L were 58.32% (32 996/56 581), 27.24% (15 410/56 581), 12.24% (6 926/56 581), and 2.21% (1 249/56 581), respectively. The median urinary iodine level of pregnant women in inland areas was significantly higher than that in coastal areas ( Z = 19.15, P < 0.001). Furthermore, urinary iodine levels exhibited a non-linear decline as age increased (χ 2regression = 12.65, P < 0.001; χ 2partial = 22.65, P < 0.001) and as pregnancy progressed (χ 2regression = 37.28, P < 0.001; χ 2partial = 18.89, P < 0.001). Conclusions:The overall iodine nutrition status of pregnant women in Zhejiang Province is in a state of iodine deficiency (< 150 μg/L), and there is a greater risk in coastal areas compared to inland areas. However, in the context of the reform of the salt industry system, it is still necessary to strengthen the quality supervision of iodized salt, provide scientific iodine supplementation education, promote specialized iodized salt for pregnant women, and strengthen interventions for prevention and control of iodine deficiency disorders.

Objective To evaluate the diagnostic value of positron emission tomography(PET)/computed tomography(CT)and bone marrow biopsy(BMB)for bone marrow infiltration in common non-Hodgkin lymphoma(NHL).Methods We retrospectively analyzed data from 197 patients with NHL and compared the diagnostic value of PET/CT and BMB for bone marrow infiltration.Differences in PET/CT parameters and serological test results were compared between PET/CT-positive and PET/CT-negative patients as well as between BMB-positive and BMB-negative patients.Results In patients with diffuse large B-cell lymphoma(DLBCL),the sensitivities of PET/CT and BMB for detecting bone marrow infiltration were 90.5%and 66.7%,and the specificities were 95.1%and 100.0%,respectively.In patients with follicular lymphoma(FL),the sensitivities were 63.6%and 81.8%,and the specificities were 98.1%and 100.0%,respec-tively.In patients with T-cell lymphoma(TCL),the sensitivities were 60.0%and 80.0%,and the specificities were 88.0%and 100.0%,respectively.Among patients with DLBCL and TCL,significant differences were observed in platelet count and lactate dehydrogenase levels between PET/CT-positive and PET/CT-negative patients(P<0.05).Conclusion PET/CT showed excellent diagnostic perfor-mance for evaluating bone marrow infiltration in DLBCL.PET/CT had limited sensitivity for FL and TCL and might serve as a supplemen-tary tool for BMB.Platelet count and lactate dehydrogenase levels may aid in the diagnosis of bone marrow infiltration in DLBCL and TCL.

Objective:To analyze the iodine nutrition status and its related factors among adults aged 18 years and above in Zhejiang Province in 2022.Methods:A multistage stratified sampling method was used to select 4 320 adults aged 18 years and above from 16 on-site survey sites in Zhejiang Province for the study. A questionnaire was used to investigate the general demographic information and personal dietary characteristics of the study participants. Household edible salt and urine samples were collected to detect salt iodine content and urinary iodine level by using direct titration and cerium arsenate-catalyzed spectrophotometry, respectively, to evaluate the iodine nutritional status according to the standard. The multiple-ordered logistic regression model was used to analyze the factors influencing the urinary iodine concentration.Results:The age of the 4 320 study participants was (51.19±15.33) years, with males accounting for 44.44% (1 920). About 40.16% of adults (1 735) were from coastal areas and 56.37% (2 435) from urban areas. The salt iodine content, M ( Q1, Q3), of the 4 320 household edible salt samples was 21.10 (0.00, 24.16) mg/kg, including 1 662 non-iodized salt samples, 182 unqualified iodized salt samples and 2 476 qualified iodized salt samples. The rate of iodized salt coverage was 61.53%, and the rate of qualified iodized salt consumption was 57.31%. There was a statistically significant difference in the proportion of qualified iodized salt in adult households among different regions ( P<0.001), with the proportion of non-iodized salt gradually decreasing from coastal to inland areas ( χ 2trend=618.458, P<0.001). The urinary iodine concentration M ( Q1, Q3) was 137.60 (86.85, 210.60) μg/L in 4 320 adult urine samples, with the urinary iodine levels of<100, 100-199, 200-299, and≥300 μg/L accounting for 31.64% (1 367), 40.56% (1 752), 17.66% (763), and 10.14% (438), respectively. There was a nonlinear positive correlation between household salt iodine content and urinary iodine level in adults aged 18 years and above by using the χ 2 test for trend ( χ 2regression=231.10, P<0.001 and χ 2skew=28.81, P<0.001). Urinary iodine concentrations were higher in men than in women ( P=0.029) and higher in adults in rural areas than in urban areas ( P<0.001). There were statistically significant differences in the distribution of iodine nutritional status among adults of different ages, regions, and urban and rural areas (all P<0.001). The proportion of those with urinary iodine levels<100 μg/L gradually increased with age ( χ 2trend=37.493, P<0.001), and gradually decreased from coastal areas to inland areas ( χ 2trend=71.381, P<0.001). The results of the multiple-ordered logistic regression model analysis showed that compared with adults aged 18 to 44 years and male adults, those aged 45 to 59 years and female adults had lower urinary iodine levels, with OR (95% CI) of 0.75 (0.68-0.83) and 0.85 (0.76-0.95), respectively. Compared with adults in coastal and urban adults, those in sub-coastal, inland and rural adults had higher levels of urinary iodine, with OR (95% CI) of 1.89 (1.63-2.19), 2.02 (1.72-2.37) and 1.46 (1.28-1.66), respectively. Conclusion:The overall iodine nutrition level of adults aged 18 years and above in Zhejiang Province in 2022 is generally appropriate. However, there is a potential risk of iodine deficiency among adults in coastal areas.