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 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 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.

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 provide evidence-based references for maintaining and enhancing the health level of military helicopter flying personnel and formulating medical support measures by systematically evaluating the disease spectrum of Chinese military helicopter flying personnel and understanding the disease characteristics.Methods:The literatures about disease investigation of Chinese helicopter flying personnel was extracted from China National Knowledge Infrastructure Database, VIP database, Wanfang database and PubMed database. The retrieval time span was from the establishment of the database to September 26, 2022. Two researchers independently screened the literature, extracted the data and evaluated the bias risk included in the study. RevMan 5.4 software was used to systematically evaluate the detection ratio of single disease.Results:Twelve research articles were included, published in 2009—2020, with 7 034 subjects aged 20-56 years. Meta-analysis results showed that the top 5 detected diseases were hepatobiliary diseases (22.4%, 95% CI: 14.0%-30.7%, I2=99%, P<0.001), metabolic diseases (17.5%, 95% CI: 11.7%-23.3%, I2=97%, P<0.001), headache (10.3%, 95% CI: 4.8%-15.8%, I2=75%, P=0.007), spinal and joint diseases (10.0%, 95% CI: 7.4%-12.6%, I2=96%, P<0.001), and occupational aviation diseases (7.8%, 95% CI: 3.1%-12.5%, I2=76%, P=0.006). Although the detection rate of oral diseases was relatively high (24.9%), it was not significant due to the limited number of included literatures. Conclusions:Diseases with a high detection rate among Chinese military helicopter flying personnel are mainly hepatobiliary diseases, metabolic diseases, headache and spinal and joint diseases, and occupational aviation diseases. Rational health maintenance strategies for military helicopter flying personnel should be implemented on an evidence-based basis to better maintain and promote their health levels.

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 provide evidence-based references for maintaining and enhancing the health level of military helicopter flying personnel and formulating medical support measures by systematically evaluating the disease spectrum of Chinese military helicopter flying personnel and understanding the disease characteristics.Methods:The literatures about disease investigation of Chinese helicopter flying personnel was extracted from China National Knowledge Infrastructure Database, VIP database, Wanfang database and PubMed database. The retrieval time span was from the establishment of the database to September 26, 2022. Two researchers independently screened the literature, extracted the data and evaluated the bias risk included in the study. RevMan 5.4 software was used to systematically evaluate the detection ratio of single disease.Results:Twelve research articles were included, published in 2009—2020, with 7 034 subjects aged 20-56 years. Meta-analysis results showed that the top 5 detected diseases were hepatobiliary diseases (22.4%, 95% CI: 14.0%-30.7%, I2=99%, P<0.001), metabolic diseases (17.5%, 95% CI: 11.7%-23.3%, I2=97%, P<0.001), headache (10.3%, 95% CI: 4.8%-15.8%, I2=75%, P=0.007), spinal and joint diseases (10.0%, 95% CI: 7.4%-12.6%, I2=96%, P<0.001), and occupational aviation diseases (7.8%, 95% CI: 3.1%-12.5%, I2=76%, P=0.006). Although the detection rate of oral diseases was relatively high (24.9%), it was not significant due to the limited number of included literatures. Conclusions:Diseases with a high detection rate among Chinese military helicopter flying personnel are mainly hepatobiliary diseases, metabolic diseases, headache and spinal and joint diseases, and occupational aviation diseases. Rational health maintenance strategies for military helicopter flying personnel should be implemented on an evidence-based basis to better maintain and promote their health levels.

Objective:To investigate the iodine nutritional status of population in Gansu Province, and to provide a scientific basis for policy adjustment of relevant departments.Methods:In 2019, a cross-sectional survey was conducted in 87 monitoring units in 86 counties (districts and cities) of 14 cities (prefectures) in Gansu Province for iodine deficiency disorders (IDD). Instant urine samples and salt samples of children aged 8 to 10 years and pregnant women were collected for detection of urinary iodine and salt iodine. B-ultrasound was used to check the thyroid volume of children in 40 monitoring units.Results:A total of 17 772 children aged 8 to 10 years were investigated. The median urinary iodine (MUI) of children was 197.4 μg/L, the MUI of 14 cities (prefectures) ranged from 160.6 to 233.4 μg/L. There were statistically significant differences in MUI among children of different genders and ages ( P < 0.001). Totally 8 269 children were examined by B-ultrasound, the children's goiter rate was 1.4% (118/8 269). There were statistically significant differences in the thyroid volume among children of different genders and ages ( P < 0.05). A total of 8 605 pregnant women were investigated. The MUI of pregnant women was 178.6 μg/L, and the MUI of 14 cities (prefectures) ranged from 156.5 to 275.0 μg/L. There was no statistical significant difference in MUI among pregnant women in different pregnancies ( P > 0.05). A total of 26 377 samples of salt consumed by children and pregnant women were detected. The median salt iodine was 24.71 mg/kg. The coverage rate of iodized salt and the consumption rate of qualified iodized salt were 99.44% and 93.59%, respectively. Twenty-three counties (districts and cities) failed to meet the elimination standard of IDD in the single indicator. Conclusions:IDD is in a state of continuous elimination in Gansu Province; iodized salt supervision needs to be further strengthened; there is an imbalance of control measures between regions.

Objective:To study the iodine nutritional status and thyroid function of adult males in iodine nutrition appropriate rural areas of Gansu Province.Methods:In 2017, Liangzhou District and Linze County of Gansu Province with suitable children iodine nutrition were selected as the study areas and 52 males aged 20 - 49 years old were investigated in each study area. One random urine sample was collected to determine urinary iodine. Fasting blood samples were collected to determine serum thyroid-stimulating hormone (TSH), free triiodothyronine (FT 3), free thyroxin (FT 4), thyroglobulin antibody (TgAb) and thyroid microsomal antibody (TMAb). At the same time, thyroid examination was performed by B-ultrasound. Results:The median urinary iodine of adult males in Liangzhou District and Linze County was 180.2 and 161.0 μg/L, respectively, and the difference was statistically significant ( P < 0.05). There was no goiter in adult males in Liangzhou District and Linze County. The serum TSH (median), FT 3 and FT 4 (mean value) of adult males in Liangzhou District and Linze County were 1.85, 1.61 mU/L, 5.19, 5.16 pmol/L and 16.58, 16.30 pmol/L, respectively. There were no significant differences between the two areas ( P > 0.05). The overall abnormal rate of thyroid function in the two areas was 6.7% (7/104), mainly subclinical hypothyroidism (6/7). The incidences of thyroid dysfunction in Liangzhou District and Linze County were 5.8% (3/52) and 7.7% (4/52), respectively, with no statistical difference between the two areas ( P > 0.05). The total positive rate of antibody was 12.5% (13/104). The positive rates of antibody in Liangzhou District and Linze County were 13.5% (7/52) and 11.5% (6/52), respectively, with no statistical difference between the two areas ( P > 0.05). Both TgAb and TMAb were positive in 9/13 of antibody positive persons, of which the proportion of antibody positive persons in Liangzhou District and Linze County were 7/7 and 2/6, respectively. The 11/13 of the total antibody positive persons were simple antibody positive without thyroid hormone and TSH abnormalities. Conclusion:The iodine nutrition of adult males in iodine nutrition appropriate rural areas of Gansu Province is suitable, but there is a potential risk of thyroid disease in this population, which should be paid attention to and checked regularly.

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.