Objective:To understand the epidemiological and etiological characteristics of hand-foot-mouth disease (HFMD) in the Nanshan District of Shenzhen City from 2019 to 2022 and to provide a scientific basis for HFMD prevention in the area.Methods:Epidemiological data on HFMD in Shenzhen Nanshan District from 2019 to 2022 in the China Information System for Disease Control and Prevention were analyzed using descriptive research methods.Real-time reverse transcription polymerase chain reaction (RT-PCR) was used to analyze the etiology characteristics of clinical specimens from HFMD patients. The VP1 gene of the dominant pathogen coxsackievirus A6 (CV-A6) was amplified and sequenced. SepMan Pro of DNASTAR software was used for sequence assembly and MegAlign was used for nucleotide homology analysis.Results:A total of 13 195 HFMD cases were reported in Shenzhen Nanshan District from 2019 to 2022, with an average annual incidence rate of 186.18/100, 000. Summer and autumn are the main onset seasons and children under 7 years old were the main population, accounting for 93.1%. The male-to-female ratio is 1.44∶1. A total of 451 clinical HFMD specimens were detected in the laboratory, including 403 positive (87.36%) and 48 negative (10.64%). The main pathogens were CV-A6 (63.03%), coxsackievirus A16 (CV-A16) (27.79%), coxsackievirus A4 (CV-A4) (4.71%), coxsackievirus A10 (CV-A10) (1.99%), Echovirus 11 (Echo-11) (0.25%), and uncertain type accounted for 2.23%, with no detection for enterovirus71 (EV71) type. The nucleotide homology of the 13 CV-A6 strains ranged from 94.0%?99.6%, and the nucleotide homology with the prototype strain Gdula ranged 84.1%?85.8%. The results of phylogenetic tree showed that all 13 CV-A6 strains in Nanshan District were of the D3a genotype.Conclusions:FHFMD in Nanshan District of Shenzhen City in 2019-2022 shows obvious differences in population and time distribution. Therefore, it is necessary to strengthen publicity and education on HFMD prevention and control in the summer and fall seasons and among key populations. CV-A6 and CV-A16 are the dominant strains of HFMD in Nanshan District, Shenzhen in recent years, so the monitoring of the dominant strains should be improved.

Objective:To establish a medical reference range of serum iodine in adults with normal thyroid function in Fujian Province.Methods:Permanent residents aged 16 - 60 years old and living in the local area for 5 years and more were selected as survey subjects in three areas with appropriate iodine nutrition in Fujian Province from September 2019 to January 2020. Urine and blood samples were collected to detect urinary iodine, serum iodine and thyroid function indexes [thyroid stimulating hormone (TSH), thyroglobulin (Tg), free triiodothyronine (FT 3), free thyroxine (FT 4), total triiodothyronine (TT 3), total thyroxine (TT 4), thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb)] levels. The percentile method was used to establish the 95% medical reference range of serum iodine in adults with normal thyroid function, and Pearson correlation analysis was used to analyze the correlation between serum iodine and thyroid function indexes in adults with normal thyroid function. Results:A total of 149 adults with normal thyroid function were examined, and the median urinary iodine was 119.45 μg/L, which was at the appropriate level (100 - 199 μg/L); serum iodine was (61.35 ± 16.20) μg/L, and the 95% medical reference range of serum iodine in adults with normal thyroid function was preliminarily formulated as 34.36 - 97.17 μg/L. Correlation analysis showed that serum iodine was positively correlated with FT 4 level ( r = 0.17, P = 0.035), but was not correlated with other thyroid function indexes ( P > 0.05). Conclusion:The medical reference range of serum iodine in adults with normal thyroid function in Fujian Province is successfully established, which provides a basis for judgment of individual iodine nutrition in adults.

Objective:To understand the correlation between urinary iodine, salt iodine and thyroid nodules in children aged 8 - 10 years and pregnant women in different regions of Fujian Province, and to explore the influencing factors of thyroid diseases.Methods:A cross-sectional study was conducted in Dongshan County and Pingtan County of Fujian Province from September to November 2019. According to the inclusion criteria, 140 pregnant women and 270 children aged 8 - 10 years were selected in Dongshan County, and 189 pregnant women and 368 children aged 8 - 10 years were selected in Pingtan County. Random urine and edible salt samples were collected to determine iodine content, and iodine nutrition was evaluated in each population. Thyroid was examined by B ultrasound and questionnaire survey of thyroid diseases was carried out. The correlation between urinary iodine, salt iodine and thyroid nodules in children aged 8 - 10 years and pregnant women in different regions was analyzed.Results:There were statistically significant differences in the median urinary iodine among children in different genders (male: 151.30 μg/L, female: 130.30 μg/L) and regions (Dongshan County: 160.30 μg/L, Pingtan County: 129.70 μg/L, P < 0.05); there was no significant difference in the median urinary iodine among children of different ages (8, 9, 10 years old: 141.60, 128.05, 150.30 μg/L, P > 0.05). The median urinary iodine among pregnant women was 119.30 μg/L, and there was no significant difference in median urinary iodine among pregnant women in different stages and regions ( P > 0.05). The medians of salt iodine from children and pregnant women were 20.30 and 23.65 mg/kg, respectively. Urinary iodine in children was positively correlated with salt iodine ( r = 0.13, P < 0.05). However, there was no correlation between urinary iodine and salt iodine in pregnant women ( P > 0.05). The detection rate of thyroid nodules in children was 21.79% (139/638). There was significant difference in the detection rate of thyroid nodules in children of different ages ( P < 0.05). The detection rate of thyroid nodules in pregnant women was 4.26% (14/329). There was no correlation between detection rate of thyroid nodules and urinary iodine or salt iodine in children and pregnant women ( P > 0.05). Thyroid volume of children in the two counties was within the normal range, and there was no correlation between thyroid volume and urinary iodine or salt iodine ( P > 0.05). Conclusions:The iodine nutrition of children in Dongshan County and Pingtan County is suitable (100 - 199 μg/L), while iodine deficiency (< 150 μg/L) exists in pregnant women. Urinary iodine in children is related to salt iodine, and urinary iodine increased with increase of salt iodine. The prevalence of thyroid nodules in children of different ages is different, which requires further study. The detection rate of thyroid nodules in children and pregnant women is not correlated with urinary iodine and salt iodine.

Objective:The iodine excretion of adult individuals was calculated by two creatinine correction methods of urinary iodine, and the significance and value of the methods to measure individual iodine nutrition levels were assessed to provide a reference basis for further epidemiological investigation and study of iodine deficiency disorders.Methods:Healthy adults aged 18 - 59 years from Fujian Province were recruited and their 24 h urine, fasting urine, and morning spot urine (8:00 - 12:30) were collected and the corresponding urinary iodine and creatinine concentrations were measured. The estimated 24 h urinary iodine excretion was calculated using two different creatinine correction and creatinine estimation formulas were compared with the measured 24 h urinary iodine excretion.Results:There were no significant differences in measured 24 h urinary iodine excretion value, estimated 24 h urinary iodine excretion value 1 of fasting urine and morning spot urine, and estimated 24 h urinary iodine excretion 2 of fasting urine and morning spot urine between genders (μg/d: 195.5 vs 190.9, 190.0 vs 181.7, 160.2 vs 144.2, 174.8 vs 179.2, 148.3 vs 131.5); there were no significant differences in measured 24 h urinary iodine excretion and fasting urinary estimated 24 h urinary iodine excretion 1, estimated 24 h urinary iodine excretion 2 ( P > 0.05), and there were significant differences in measured 24 h urinary iodine excretion and morning spot urinary estimated 24 h urinary iodine excretion 1, estimated 24 h urinary iodine excretion 2 ( P < 0.01). And there were significant linear correlations between measured 24 h urinary iodine excretion and estimated 24 h urinary iodine excretion 1 of fasting urine and morning spot urine, estimated 24 h urinary iodine excretion 2 of fasting urine and morning spot urine ( r = 0.772, 0.266, 0.828, 0.391, P < 0.01). Conclusions:It is feasible to estimate 24 h urinary iodine excretion in adults with creatinine-corrected fasting urinary iodine concentration. Creatinine-corrected fasting urinary iodine concentration can be used as an individual iodine nutrition level evaluation index, but whether it is applicable to children and pregnant women remains to be further studied.

Objective:To investigate the iodine nutritional status among children aged from 8 - 10 and pregnant women in Xiamen City before and after adjustment of salt iodine concentration, and scientifically evaluate the suitability of the new standard iodized salt adjustment policy for Xiamen City.Methods:In the pre-adjustment period (2011) and the post-adjustment period (2018), cross-sectional research methods and stratified cluster sampling methods were adopted in six districts of Xiamen City. The salt samples of residents and pregnant women, urine samples of children aged from 8 - 10 and pregnant women were collected to determine the iodine level; thyroid of children aged from 8 - 10 was examined. Changes in salt iodine, urine iodine and goiter prevalence before and after adjusting iodine content of salt were compared.Results:The median of salt iodine in residents after the adjustment (23.5 mg/kg) was significantly lower than that of before (28.9 mg/kg, Z = - 10.512, P < 0.05), the median of salt iodine in pregnant women after the adjustment (23.7 mg/kg) was significantly lower than that of before (29.2 mg/kg, Z = - 12.622, P < 0.05); the consumption rate of qualified iodized salt in residents after the adjustment (95.7%, 1 196/1 250) was significantly lower than that of before (97.1%, 1 608/1 656; χ 2 = 4.250, P < 0.05); before and after adjustment of salt iodine concentration, the consumption rate of qualified iodized salt in pregnant women was 94.7% (124/131) and 95.9% (579/604), respectively. No significant difference was found when comparing the consumption rate of qualified iodized salt in pregnant women (χ 2 = 0.015, P > 0.05). There was significant difference in median urinary iodine (from 204.2 to 183.9 μg/L, detected in 652, 1 250 urine samples, respectively) of children aged 8 - 10 years ( Z = - 3.583, P < 0.05); the difference of iodine nutritional status in pregnant women before and after adjustment of salt iodine concentration(130.2, 130.8 μg/L, detected in 132, 604 urine samples, respectively) was not significant ( Z = - 1.715, P > 0.05). The thyroid goiter rate of children aged 8 - 10 years had reduced from 1.1% (14/1 239) to 0.2% (2/1 253), the difference was statistically significant (χ 2 = 9.195, P < 0.05). Conclusions:As a whole, the measure of control and prevention of iodine deficiency disorders through iodized salt is implemented well in Xiamen City. After adjustment of salt iodine concentration, the iodine status of children aged from 8 to 10 is adequate, but the pregnant women has showed iodine deficiency.

Objective:To analyze the disease burden of iodine deficiency disorders (IDD) and its changes in China in 1990 and 2016.Methods:Based on the data of Global Burden of Disease Study 2016 (GBD 2016), a descriptive statistical method was used to compare and analyze the changes of deaths number, mortality, disability adjusted life year [DALY, including years of life lost (YLL) and years lived with disability (YLD)], DALY rate and other disease burden indicators caused by IDD in China in 1990 and 2016.Results:The GBD 2016 data showed that the deaths number from IDD in China decreased from 259.31 in 1990 to 116.41 in 2016, the mortality decreased from 0.022 827/100 000 in 1990 to 0.008 515/100 000 in 2016; and the mortality in different age groups had decreased, the children mortality in the < 5 years old group had decreased from 0.088 639/100 000 to 0.009 875/100 000. The DALY and YLD due to IDD in China increased from 406.13 thousand person-years and 391.68 thousand person-years in 1990 to 455.05 thousand person-years and 451.95 thousand person-years in 2016, while YLL decreased from 14.45 thousand person-years to 3.10 thousand person-years; the DALY rate, YLL rate, and YLD rate decreased from 35.75 person-years per 100 000, 1.27 person-years per 100 000 and 34.48 person-years per 100 000 in 1990 to 33.29 person-years per 100 000, 0.23 person-years per 100 000 and 33.06 person-years per 100 000 in 2016. The main component of DALY for IDD was YLD, and the proportion increased from 96.44% in 1990 to 99.32% in 2016.Conclusions:The mortality of IDD in China has decreased, and IDD in the younger age group has been effectively controlled; however, the disease burden, especially the burden caused by disability has increased, and the disability of the population due to IDD should be given special attention.

Objective To understand the iodine nutritional status of children aged 8 to 10 years old and pregnant women in the new standard iodized salt pilot areas of Fujian Province,and to analyze the rationality of urine specific gravity correction for urinary iodine.Methods In the 3rd,6th,9th,12th,15th and 21th months after supplying of new standard iodized salt in March 2012,the first to sixth phases' assessment were conducted in Xindian Town of Xiang'an District,Xiamen City and Yongfu Town,Xinqiao Town of Zhangping City,Longyan City.Totally 200 children aged 8 to 10 years old and 50 pregnant women were selected from each town,home salt samples and urine samples were collected,salt iodine,urinary iodine and urine specific gravity were tested.Salt iodine was detected by "General Test Method in Salt Industry-Determination of Iodine" (GB/T 13025.7-2012);urinary iodine was detected by "Method for Determination of Iodine in Urine by As3+-Ce4+ Catalytic Spectrophotometry" (WS/T 107-2006);urine specific gravity was detected by digital refractometer.Results From the first to sixth phases' assessment,the iodized salt coverage rates of children aged 8 to 10 years old and pregnant women were ＞ 95％,the edible rates of qualified iodized salt were ＞ 90％.The measured medians of urinary iodine of children aged 8 to 10 years old were 216.7,219.5,188.1,206.7,209.2,and 201.0 μg/L,respectively;except the third phase's assessment,which was in the iodine appropriate level (100-199 μg/L),the other five phases/ assessment were all higher than the iodine appropriate level (200-299 μg/L);the medians of urinary iodine of children aged 8 to 10 yearsold after urine specific gravity correction were 215.0,213.6,197.3,202.9,204.3,and 197.7 μg/L,respectively;there were no significant differences in urinary iodine between the measured and urine specific gravity correction (Z =-0.131,-0.183,-1.052,-1.180,-0.311,-0.368,P ＞ 0.05).The measured medians of urinary iodine of pregnant women were 134.0,132.2,120.9,115.6,113.3,and 123.3 μg/L,respectively,which were in the iodine deficiency level (＜ 150 μg/L);the medians of urinary iodine of pregnant women after urine specific gravity correction were 207.3,197.1,168.8,158.3,171.8,and 181.7 μg/L,respectively;there were significant differences in urinary iodine between the measured and urine specific gravity correction (Z =-6.419,-6.406,-5.990,-6.648,-7.008,-8.034,P ＜ 0.01).Conclusions The iodine nutrition of children aged 8 to 10 years old is appropriate in the new standard iodized salt pilot areas of Fujian Province,while that of pregnant women is mild iodine deficiency.Further research is needed to use urine specific gravity to calibrate the concentration of urinary iodine to assess the iodine nutritional level of the focused populations in the regions.

Objective To evaluate the efficacy and safety of Willis covered stent in the treatment of traumatic carotid cavernous fistulae (tCCF).Methods The imaging and clinical data of 7 patients with tCCF treated with Willis covered stent in Shanghai Punan Hospital from November 2015 to June 2018 were analyzed retrospectively.Results Seven Willis covered stent were used in 7 patients.Immediately after stent release,angiography showed that the fistulae completely disappeared in 6 cases.One patient had a small amount of endoleak,and there was still a small amount of endoleaks after balloon dilatation.It was not further treated.There were no operative complications.During 3-12 months follow-up,no new neurological deficits were found in all patients.Angiographic follow-up of 2 patients showed that the fistulae completely disappeared without recurrence.The internal carotid arteries were patent,no in-stent stenosis and stent displacement.Conclusions Wills covered stent can be used as a treatment for tCCF.Its efficacy is satisfactory and the safety is good.

Objective: To investigate the breakthrough points and methods of pharmaceutical care performed by clinical pharmacists for chemotherapy-induced Ⅳ degree myelosuppression.Methods: One advanced lung adenocarcinoma patient suffering from chemotherapy-induced Ⅳ degree myolosuppression was selected as the example, clinical pharmacists provided suggestions on the chemotherapy regimen, assisted physicians in making reasonable treatment plan and implemented comprehensive pharmaceutical care for the patient.Results: Clinical pharmacists played a positive role in the clinical treatment through the comprehensive pharmaceutical care in oncology department.Conclusion: With the professional knowledge of pharmacy, clinical pharmacists can improve the level of clinical rational drug use.

Heavy metal residue in vegetables is a big concern in the whole world.The aim of this work is to explore the effect of multivariable selection on analyzing Cd in Chinese cabbage polluted in lab by collecting the spectra of laser induced breakdown spectroscopy (LIBS) from the samples.At the same time,the actual Cd content in samples was obtained by anodic stripping voltammetry (ASV).The LIBS spectral range in partial least square (PLS) model was screened by standard normal variable transformation (SNV),first derivative (FD),second derivative (SD) and center treatment (CT) for preprocessing spectra and the optimized method was used for the analysis of interval partial least square (iPLS) and synergy interval partial least square (SiPLS).The results indicated that the method of CT was the best as a comparison with PLS,iPLS and SiPLS.And the intervals of wavelength were 214.72-215.82 nm,215.88-216.97 nm and 225.08 -226.35 nm by utilizing the optimized SiPLS.Here the root mean square error of cross validation (RMSECV) between real content and predicted ones was 1.487,the root mean squared error of prediction (RMSEP) was 1.094,the correlation coefficient (R) was 0.9942,and the average relative error (ARE) was 11.60％.The results displayed that LIBS could predict Cd in vegetables by multivariable selection of SiPLS and the accuracy could meet the requirement of rapid and green analysis of Cd in vegetables.