Objective To understand the proficiency level and sources of Traditional Chinese Medicine(TCM)health education among hemodialysis patients,in order to provide the basis for promoting the application of TCM nursing in hemodialysis patients.Methods Utilizing a convenience sampling approach,we conducted a survey from April to May 2023 involving hemodialysis patients from 7 tertiary TCM hospitals across Beijing,Hebei Province,Sichuan Province,and other regions.Custom-made questionnaires were utilized,gathering general information,respons-es conceming the level of mastery on TCM health education,and their primary sources of such knowledge.Results A total of 413 questionnaires were disseminated,and 392 proved valid,yielding a valid response rate of 94.92％.The score of patient's knowledge on TCM health education averaged(8.25±3.73),and an average score rate of 48.53％was obtained.In the patients undergoing hemodialysis,a relatively larger number of people possess knowl-edge of TCM health knowledge about relieving symptoms(50.8％～55.9％)and traditional Chinese daily life routines(56.4％～90.1％).However,fewer people are aware of how to use the five-tone therapy method for emotional inter-vention(40.8％)and principle of taking restorative Traditional Chinese Medicine(24.5％～36.7％),the dietary prin-ciples of"nurturing yang in spring and summer,and nurturing yin in autumn and winter"(14.3％),and theories of TCM kidney functions(9.9％).Approximately 23.0％of the patients sourced their TCM health education knowledge from new media platforms.Compared with new media method alone,patients who utilized only traditional education-al platforms(P=0.020),and those who combined both new media and traditional methods(P=0.018)demonstrated higher proficiency in TCM health education.Conclusion Hemodialysis caregivers are urged to develop a TCM health education framework that emphasizes emotional well-being and traditional wellness concepts,thereby fostering patient-centric TCM health ideologies.Hemodialysis education personnel are encouraged to leverage new media whilst ensuring education quality and effective outcomes.

Objective:To learn about the fasting blood glucose (FBG) level of adults in different water iodine areas in Shanxi Province, and to study the relationship between high iodine intake in drinking water and blood glucose.Methods:The urinary iodine content and FBG of 18-65 years old residents in the high-water iodine area of Gaoche Village, Wenshui County, Shanxi Province in 2016 (iodine content in drinking water > 100 μg/L) and the low-water iodine area of Maxi Village (iodine content in drinking water < 10 μg/L) were retrospectively analyzed, and the urinary iodine content, FBG level and its abnormal rate of adults in different water iodine areas were compared.Results:A total of 598 subjects were included, including 276 in Gaoche Village and 322 in Maxi Village. The difference of median urinary iodine (422.8, 126.5 μg/L) between Gaoche Village and Maxi Village was statistically significant ( Z = 7.81, P < 0.001). The FBG levels of adults in Gaoche Village and Maxi Village [(6.70 ± 1.87), (6.04 ± 1.23) mmol/L] were significantly different ( t = 5.18, P < 0.001). The difference of FBG level in males [(6.82 ± 1.82), (5.99 ± 1.11) mmol/L] between the two regions was statistically significant ( t = 4.45, P < 0.001), the difference of FBG level in females [(6.59 ± 1.91), (6.07 ± 1.30) mmol/L] was statistically significant ( t = 2.96, P = 0.003). In Gaoche Village and Maxi Village, there was no statistically significant difference in FBG level between males and females ( t = 1.04, 0.52, P = 0.308, 0.564). Comparison of FBG levels in 18-< 45 years old group [(6.31 ± 1.57), (5.79 ± 0.89) mmol/L] and 45-65 years old group [(7.00 ± 2.02), (6.18 ± 1.36) mmol/L] between the two regions, the differences were statistically significant ( t = 3.10, 4.60, P = 0.002, P < 0.001). Moreover, in Gaoche Village and Maxi Village, the FBG level of the 45-65 years old group was higher than that of the 18-< 45 years old group in the same area, and the difference was statistically significant ( t = 3.07, 2.74, P = 0.003, 0.006). The abnormal rate of FBG in adults in Gaoche Village and Maxi Village [28.3% (78/276) and 15.5% (50/322)] was statistically significantly different (χ 2 = 14.32, P < 0.001). Conclusion:Long-term intake of high iodine in drinking water may cause abnormal glucose metabolism.

With the widespread use of Internet, the amount of data in the field of traditional Chinese medicine (TCM) is growing exponentially. Consequently, there is much attention on the collection of useful knowledge as well as its effective organization and expression. Knowledge graphs have thus emerged, and knowledge reasoning based on this tool has become one of the hot spots of research. This paper first presents a brief introduction to the development of knowledge graphs and knowledge reasoning, and explores the significance of knowledge reasoning. Secondly, the mainstream knowledge reasoning methods, including knowledge reasoning based on traditional rules, knowledge reasoning based on distributed feature representation, and knowledge reasoning based on neural networks are introduced. Then, using stroke as an example, the knowledge reasoning methods are expounded, the principles and characteristics of commonly used knowledge reasoning methods are summarized, and the research and applications of knowledge reasoning techniques in TCM in recent years are sorted out. Finally, we summarize the problems faced in the development of knowledge reasoning in TCM, and put forward the importance of constructing a knowledge reasoning model suitable for the field of TCM.

Objective:To investigate the prevalence of thyroid disease in adults in different water iodine areas and to explore the association between iodine and thyroid disease.Methods:In May of 2016, using cross-sectional survey, Gaoche Village and Maxi Village of Wenshui County were selected in Shanxi Province as a high-iodine area and a low-iodine area, respectively, Xiwenzhuang Village of Taiyuan City as an appropriate-iodine area. Questionnaire surveys, urinary iodine levels, thyroid ultrasound, determination of thyroid function and autoantibody were conducted for permanent residents aged 18 - 65.Results:A total of 898 people were investigated, including 288 in high-iodine area, 324 in low-iodine area and 286 in appropriate-iodine area. The medians urinary iodine were 417.8, 126.6 and 216.5 μg/L in high, low and appropriate-iodine areas, respectively, and the difference was statistically significant ( H = 288.61, P < 0.05). After age and sex standardization, the detection rates of hyperthyroidism in low, appropriate and high-iodine areas were 0.27%, 1.06% and 1.43%, respectively. The detection rates of sub-clinical hyperthyroidism were 0.57%, 0.31% and 0.30%, respectively. The detection rates of hypothyroidism were 1.45%, 1.15% and 1.85%, respectively. The detection rates of sub-clinical hypothyroidism were 19.34%, 28.50% and 32.76%, respectively. The detection rates of thyroid nodule were 20.51%, 20.17% and 33.78%, respectively. The positive rates of anti-thyroglobulin antibodies (TgAb) were 18.13%, 19.41% and 11.99%, respectively. The positive rates of thyroid peroxidase antibody (TPOAb) were 9.25%, 12.04% and 8.97%, respectively. The appropriate-iodine area was used as control, logistic regression analysis showed that only the detection rate of thyroid nodule in high-iodine area was significantly higher than that in appropriate-iodine area [odds ratio ( OR) = 0.488 5, 95% confidence interval ( CI) = 0.327 2 - 0.729 2 , P < 0.05]. Conclusion:In Shanxi Province, the detection rate of thyroid nodules is different in different areas of water iodine, and the detection rate of thyroid nodule in adults in high-iodine area is higher than that in other areas.

Objective:To detect serum levels of vitamin A (Vit A), vitamin D(Vit D)25-hydroxy vitamin D[25-(OH)D] and vitamin E(Vit E) in children aged 0-6 years in Tibetan Plateau of Garzi Prefecture, thus providing references for physical examinations and prevention of 4 key diseases (rickets, malnutrition anemia, pneumonia and diarrhea) in children in plateau areas by relevant government departments.Methods:A total of 2 122 children who participated in physical examination in 12 townships of Xiangcheng County and 14 townships of Daocheng County, Garzi Tibetan Autonomous Prefecture, Sichuan Province from April 2017 to April 2019 with 0-6 years old were recruited for surveying physical measurements and collection of venous blood.Serum Vit A and Vit E levels were detected by high performance liquid chromatography.Serum levels of 25-(OH)D were detected by high performance liquid chromatography tandem mass spectrometry.The relationship between Vit A, Vit E and 25-(OH)D levels with the gender, age, seasonal change and altitude was analyzed.Results:The serum Vit A level, subclinical Vit A deficiency rate and marginal vitamin A deficiency rate were(1.05±0.27) μmol/L, 8.15%(173/2 122 cases) and 45.99%(976/2 122 cases), respectively in 2 122 children with 0-6 years old.There were significant differences in the serum Vit A level, the subclinical Vit A deficiency rate and the marginal vitamin A deficiency rate in children with different ages, seasons and altitudes (all P<0.05). The serum level of 25-(OH)D and 25-(OH)D deficiency rate insufficient rate were (24.65±6.45) ng/L, 6.03%(128/2 122 cases) and 16.59%(352/2 122 cases), respectively.There were significant differences in the serum level of 25-(OH)D, 25-(OH)D deficiency rate and 25-(OH)D insufficient rate in children with different ages and seasons (all P<0.05). The mean serum Vit E level, Vit E deficiency rate and Vit E insufficient rate were (7.81±1.74) mg/L, 2.78%(59/2 122 cases) and 29.59%(628/2 122 cases), respectively.There were significant differences in serum Vit E level, Vit E deficiency rate and Vit E insufficient rate in children with different ages and seasons (all P<0.05). The mean serum levels of Vit A and Vit D remained the lowest before the age of 1 year, and their deficiencies at this age were the most significant.The mean serum level of Vit E remained the lowest in >1-2 years old, and its deficiency and insufficient at this age were the most significant.Vit A, D and E levels were significantly affected by seasonal changes, which were significantly higher in the summer than in the spring, autumn and winter.In addition, Vit A and 25-(OH)D were significantly affected by the altitude, which were the lowest above 4 km altitude. Conclusions:The overall serum levels of Vit A, 25-(OH) D and E in children with 0-6 years old in Tibetan Plateau areas of Ganzi Prefecture are lower than those in plain areas.Vit A, 25-(OH) D and Vit E levels significantly differed in the age, season and altitude, which are related to the lack of local resources, insufficient maternal nutrition during pregnancy and insufficient intake after birth, as well as temperature and light caused by changes in local seasons and altitude.Therefore, it is necessary to make reasonable supplements during pregnancy to prevent vitamin deficiency.

Objective:To study the relationship between thyroid volume (TV) and thyroid autoantibodies in patients with autoimmune thyroid disease (AITD), and to explore the factors affecting goiter in patients with AITD.Methods:The newly diagnosed AITD adult patients in the Affiliated Hospital of Shanxi Institute for Endemic Disease Prevention and Control from November 2019 to October 2020 were selected for questionnaire survey, physical examination, thyroid function and thyroid autoantibody test, determination of serum iodine content and thyroid ultrasound, and the correlation between thyroid volume and thyroid autoantibody was analyzed.Results:A total of 147 newly diagnosed adult AITD patients were included, including 63 cases of Graves' disease (GD, 30 males and 33 females) and 84 cases of chronic lymphocytic thyroiditis (HT, 29 males and 55 females). The TV of male and female patients with GD was positively correlated with the levels of thyrotropin receptor antibody (TRAb) ( rmen = 0.515, rwomen = 0.412, P < 0.05). The TV of male and female patients with HT was not correlated with the levels of thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb, rmen = - 0.137, 0.168, rwomen = 0.184, - 0.088, P > 0.05). There were no correlation between TPOAb levels and TGAb levels in male and female HT patients ( rmen = 0.153, rwomen = 0.102, P > 0.05). The TV of male and female patients with GD or HT was not correlated with the serum levels of iodine ( rmen = 0.230, 0.013, rwomen = 0.096, 0.069, P > 0.05). Conclusion:TRAb level is positively correlated with the TV in GD patients.

Objective:To master the prevalence of thyroid nodule in adults in different water iodine areas and to explore the association between high iodine intake through drinking water and thyroid nodule prevalence.Methods:Xiwenzhuang Village of Taiyuan City was selected as iodine-adequate area, and Gaoche Village and Maxi Village of Wenshui County as high-iodine area and low-iodine area, respectively, in Shanxi Province. Questionnaire surveys were conducted, thyroid ultrasound was used and urinary iodine levels were determined of residents aged 18 to 65 years. Analysis of the prevalence of thyroid nodules in adults in different wated iodine areas.Results:A total of 868 person were investigated, including 286 in high-iodine area, 270 in iodine-adequate area and 312 in low-iodine area. The medians urinary iodine in high, adequate and low iodine areas were 418.7, 218.5 and 127.1 μg/L, respectively, and the differences were statistically significant ( H = 289.70, P < 0.05). The detection rate of thyroid nodule in adults with high, adequate and low iodine levels were 31.1% (89/286), 27.4% (74/270) and 19.2% (60/312), respectively, the differences were significant statistically among three groups (χ 2 = 11.65, P < 0.05). The detection rates of solitary nodule in adults were 17.8% (51/286), 14.1% (38/270), and 13.1% (41/312), respectively, the differences were not significant statistically among the three groups (χ 2 = 2.83, P > 0.05). The detection rate of multiple nodules in adults were 13.3% (38/286), 13.3% (36/270), and 6.1% (19/312), respectively, the differences were significant statistically among the three groups (χ 2 = 10.89, P < 0.05) high-iodine area and iodine-adequate area have higher detection rates than low-iodine area ( P < 0.05). The thyroid nodules were mainly the cyst nodules in high-iodine area. Conclusions:The detection rate of thyroid nodule in adults is the lowest in adequate iodine nutrition level. More iodine intake is probably a risk factor for thyroid multiple nodules.

Objective To investigate the prevalence of hypertension in adults in different water iodine areas and to explore the epidemiological association between high iodine intake in drinking water and hypertension.Methods In 2016,Xiwenzhuang Village of Taiyuan City as an appropriate-indine area,Gaoche Village and Maxi Village of Wenshui County were selected in Shanxi Province as a high-iodine area and a low-iodine area,respectively,and conducted questionnaire surveys,clinical hypertension examinations,and determination of urinary iodine levels of residents aged 18 to 65 years.Results A total of 853 people were investigated,including 283 in high-iodine area,258 in appropriate-indine area and 312 in low-iodine area.The medians urinary iodine in high,appropriate and low iodine areas were 423.0,218.5 and 126.6 μg/L,respectively,and the difference was statistically significant (H =289.7,P ＜ 0.05).The detection rates of hypertension in adults with high,appropriate and low iodine levels were 38.9％ (110/283),41.9％ (108/258) and 34.0％ (106/312),respectively,the difference was not significant statistically between the three groups (x2 =3.87,P ＞ 0.05).There was no significant difference in the detection rate of hypertension among males [45.9％(62/135),50.0％ (53/106),40.8％ (53/130)] in different areas (x2 =2.04,P ＞0.05),and no significant difference in the detection rate of hypertension among females [32.4％ (48/148),36.2％ (55/152),29.1％ (53/182),x2 =1.89,P ＞ 0.05];The difference between the three groups was not significant statistically in the detection rate of hypertension both among the 18-＜ 45 years group and 45-65 years group (x2 =1.22,5.66,P ＞ 0.05).Conclusion Drinking water with excess iodine might not increase the risk of hypertension in adults in Shanxi Province.

Objective To investigate the clinical effect of mild hypothermia on neonatal bilirubin encephalopathy, and the value of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT and amplitude integrated electroencephalogram (aEEG) for diagnosis and evaluation of curative effect. Methods From May, 2013 to December, 2014, 29 newborns with bilirubin encephalopathy were divided into conventional group (n=15) and mild hypothermia group (n=14). The conventional group received conventional therapy, and the other group received mild hypothermia in addition. The aEEG and neuron-specific enolase (NSE) were measured before and after treatment, as well as the glucose metabolism rate with 18F-FDG PET/CT after treatment. Results The NSE was lower after treatment in both groups (t>9.670, P<0.001), and was lower in the mild hypothermia group than in the conventional group (F=46.146, P<0.001). After treatment, sleep-wake cycle (SWC), epileptiform activity and the degree of abnormality were obviously improved (P<0.05), and were better in the mild hypothermia group than in the conventional group (P<0.05). The cerebral glucose metabolism rate was significantly better in the mild hypo-thermia group than in the conventional group (t>2.943, P<0.01). The cerebral glucose metabolism rate was negatively correlated with aEEG and NSE (r>0.640, P<0.05). Conclusion Mild hypothermia therapy could further promote the energy metabolism of brain cells in neonatal bilirubin encephalopathy. 18F-FDG PET/CT and aEEG can be used for early diagnosis and therapeutic evaluation.

Objective To investigate the prevalence of thyroid nodules in the adults in high water iodine area and to reveal the risk factors of thyroid nodules.Methods Questionnaire investigation,determination of urinary iodine and thyroid ultrasound were carried out for residents aged 18 to 65 years old in Gaoche Village of Wenshui County in Shanxi Province,with the exception of pregnant and lactating women.Possible risk factors for thyroid nodules were analyzed.Results Of the 286 residents,89 cases of thyroid nodule were detected and the prevalence rate was 31.1％.The prevalence rate was 25.7％ (35/136) in male and 36.0％ (54/150) in female,there was no significant difference between sex (x2 =2.49,P ＞ 0.05).The average age of the cases with thyroid nodules was (49.6 ± 11.3) years old and was (43.5 ± 11.6) years old in cases without thyroid nodules,there was significant difference between age groups (t =4.11,P ＜ 0.05).The median of urinary iodine of the cases with thyroid nodules was 453.0 μg/L and was 408.4 μg/L in cases without thyroid nodules,there was no significant difference in the median of urinary iodine (Z =-0.616,P ＞ 0.05).The prevalence rate of solitary nodule was 57.3％ (51/89) and multiple nodules 42.7％ (38/89).As to the property nodule,the cyst nodule,the cyst-solid nodule and the solid nodule was 49.4％ (44/89),29.2％ (26/89) and 21.3％ (19/89),respectively.The results of Logistic regression showed that the prevalence of thyroid nodule increased with age (OR =1.048,95％CI:1.024-1.073,P ＜ 0.05) and the multiple nodule increased with age (OR =1.086,95％CI:1.044-1.129,P ＜ 0.05).The cyst nodule was a more common form in women (OR =2.559,95％CI:1.245-5.262,P ＜ 0.05).The prevalence of cyst-solid nodule increased with age (OR =1.125,95％CI:1.065-1.189,P ＜ 0.05).Conclusions The prevalence of the thyroid nodule in adults is high and the thyroid nodules are mainly the cyst nodules.The prevalence of the thyroid nodule is increased with age,especially the multiple nodules and the cyst-solid nodule in high water iodine area.The cyst nodule is a more common form in women.