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Objective To study the X-ray signs of forearm and leg in skeletal fluorosis and its diagnostic value,aim at finding the easy examination parts.Methods One thousand four hundred and forty subjects were examined using developed shield,darkroom and other portable dedicated device combined with a small X-ray machine.A total of 384 cases were diagnosed skeletal fluorosis.All patients were divided into different groups and the time,degree and range of X-ray to the forearm and calf elbow,knee,and long bone were compared.Results The X-ray change in the forearm elbow was earlier than that of the leg knee,and trabecular bone change was the earliest indicator,197 cases and 157 cases,respectively,and the difference was statistically significant (x2 =28.006,P ＜ 0.01).Membrane ossification of forearm backbone was earlier than that of the leg,and most of them were degree Ⅰ photos,213 cases and 126 cases respectively.The difference was statistically significant (x2 =17.626,P ＜ 0.01).The direction of the interosseous membrane ossification was from the forearm radius to the ulna,then to the fibula and tibia,and was accompanied by changes in the aggravation of forearm.A variety of indicators were observed,especially the membrane ossification in bone and joint trabecular bone and the long bone was the most active,and the forearm was more sensitive,obviously than that of the calf.Conclusion In the X-ray screening or detection of endemic fluorosis,the forearm radiography is a simple,economical,and effective diagnostic method.
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Objective To detect the levels of five trace elements in whole blood of patients with Keshan disease(KSD) and dilated cardiomyopathy(DCM) and explore their role in the pathogenesis of KSD.Methods One hundred and four patients with chronic KSD were selected from Keshan diseased areas in Shandong,Sichuan and Inner Mongolia.Thirty patients with DCM were selected from Qilu Hospital of Shandong University,Jinan Central Hospital,The First People's Hospital.Ninety-one healthy people from KSD endemic areas and 39 healthy people from Jinan were selected as endemic healthy controls and non-endemic healthy controls,respectively.Blood samples were collected to determinate the level of selenium (Se),copper (Cu),zinc (Zn),chromium (Cr) and manganese (Mn) with fluorescence method and atomic absorption spectrometry,according to the principle of informed consent.Results The level of Se,Zn and Cr of KSD group[(36.0 + 4.9)μg/L,(22.73 + 4.62)mg/L,(0.56 + 0.17)mg/L] was significantly lower than that of non-endemic healthy controls [(56.4 ± 6.8)lμg/L,(25.35 ± 4.44)mg/L,(0.71 ± 0.17)mg/L,all P ＜ 0.05],but the level of Cu of KSD group[(0.95 ± 0.24)mg/L] was significantly higher than that of non-endemic healthy controls[(0.73 ± 0.13) mg/L,all P ＜ 0.05].The level of Se and Cr of KSD was significantly lower than that of endemic healthy controls[(54.5 ± 5.4)μg/L,(0.87 ± 0.02)mg/L,P ＜ 0.05],and Cu was significantly higher than that of endemic healthy controls[(0.66 ± 0.02)mg/L,P ＜ 0.05].The level of Cu and Zn of KSD was significantly lower than that of DCM [(1.21 ± 0.23)mg/L,(27.09 ± 7.10)mg/L,all P ＜ 0.01].The level of Se and Cr of DCM group[(39.6 ± 3.5)μg/L,(0.58 ± 0.14)mg/L] was significantly lower than that of non-endemic healthy controls(all P ＜ 0.01),but Cu[(1.21 + 0.23)mg/L] was significantly increased (P ＜ 0.01).Compared with non-endemic healthy controls,the level of Se of endemic healthy control group was significantly decreased (P ＜ 0.01),while Cu was significantly increased (P ＜ 0.01).Se,Zn and Cr level of KSD decreased gradually following elevated heart function level,but the level of Cu gradually increased.Conclusions The metabolism of Se,Cr,Cu and Zn is unbalanced in KSD patients,whose Se level is still lower than that of people in non-endemic areas.The change of Se,Cr,Cu and Mn level between KSD and DCM is consistent.
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ObjectiveTo look into the distribution of “iodine suitable” region in iodine-deficient areas in Shandong province and to provide a scientific basis for guiding the redesignate of iodine-deficient areas and launch scientific supply of iodine.Methods One to 3 copies of water source samples were collected in 105 existing iodine-deficient counties by village.Water iodine content was detected by arsenic-cerium catalytic spectrophotometry.The areas with water iodine content below 10 μg/L was defined as iodine-deficient areas and among 10 - 150 μg/L were “iodine suitable areas” and greater than 150 μg/L were high iodine areas.Results The research was carried out in 14 cities,105 counties,and 1337 towns.We collected 65 716 water samples.Sample recovery efficiency reached 99.8％.The median of water iodine was 5.57 μg/L.In the 1337 towns surveyed,there were 82.05％(1097/1337) of the township with water iodine median ＜ 10 μg/L,17.43％(233/1337) between 10 - 150 μg/L,and 0.52％(7/1337) ＞ 150 μg/L.Conclusions In Shandong province,the water “iodine suitable” regions are distributed scattered with considerable proportion.In iodine-deficient areas,there are areas with high water iodine,and iodine-deficient regions should be redrawn.Emphasis should be put on iodine nutritional status of residents in “high iodine and iodine suitable” regions,and iodine supplementation should be carries out scientifically.
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Objective To learn the iodine nutritional status of the vulnerable population with different iodine level under the current level of iodized salt in Shandong province and to offer prevention and cure measures.Methods Five groups of vulnerable population including school children aged 8 - 10, pregnant, lactation women, infants and women of childbearing age from mountain areas ( Daiyue, Mengyin counties ) , plain ( Luxian,Gaomi counties ) and coastal (Zhaoyuan county ) of five different iodine deficient areas were investigated in 2007.The thyroids of children aged 8 - 10 were checked by palpation and B ultrasound, their edible salt iodine level was detected by direct titration. The lever of urinary iodine of vulnerable population was examined by arsenic and cerium speetrophotometry. Results The goiter rates of 8 - 10 year-old were 1.8%(9/514) and 1.2%(6/514), respectively by palpation and B-ultrasonic. The mean iodine of 501 edible salt samples was 30.95 mg/kg. The coverage rate of iodized salt was 94.6% (474/501). The rate of qualified iodized salt was 90.4% (453/501). The median of urinary iodine was 216.7 μg,/L. The urinary iodine of school children aged 8 - 10, pregnant, lactation women, infants and women of childbearing age were 234.0, 165.5, 162.4, 257.5, 233.0 μg/L, respectively. Conclusions Current iodine nutritional level is basically appropriate in all groups of vulnerable people. The current iodine content of iodized salt could meet the needs of population from different iodine deficient areas of Shandong province.
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Objective To look into the current distribution of iodine deficiency area in Shandong province and to guide the re-defined iodine deficiency area and to supplement iodine scientifically. Methods In 2008, 100 iodine deficiency counties(cities, districts), designated in Shandong province's "to supplement iodized salt to eliminate the hazard of iodine deficiency management regulations", were selected in the study. One to three samples were collected from water source which was used by the majority of local residents in the 100 iodine deficiency places and iodine concentration was tested by As3+-Ce4+ catalyzing spectrophotometry. Results A total of 65 716 water samples were collected. Sample recovery efficiency reached 99.8%(65 572/65 716). The median water iodine was 5.57 μg/L, with 82.05%( 1097/1337 ) of the township(town) met criteria for the classification of iodine deficiency areas(water iodine ＜ 10 μg/L), 17.43%(233/1337) of the township (town) water iodine moderate(water iodine 10 - 150 μg/L), and 0.52%(7/1337)of the township(town) should be defined high iodine areas(water iodine ＞ 150 - 300 μg/L). Conclusions The iodine deficiency areas should be redefined because water iodine concentrations of iodine deficiency areas have changed. We suggest that the smallest place to supply salt with different range of iodine content is set to the township(town).
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Objective To explore the status of iodine nutrition in 8～10 years children after universal salt iodization(USI)in the iodine deficiency area.Methods Probability proportion to size method(PPS)or simple random sampling methods were used to sample children aged 8～10 years in iodine deficiency area in the vear 1995,1997,1999,2002 and 2005, respectively.Goiter were detected by palpation and B-ultrasound, iodine concentration in salt was detected by direct titration method and that in urine by the method of As3+-Ce4+catalytic spectrophotometry.Results After USI has been implemented,the median of salt and urinary iodine tended to mcreaseand the goiter rate tended to decrease year by year.In 2005,the coverage rate of iodinated salt was elevated to 97.2%,qualified iodize salt rate was 97.1%and edible qualified iodinated salt rate was 94.3%in the whole iodine deficiency areas.The median of urinary iodine Was 227.7 μg/L 89.7%(323/360)of the population had a level of the urinary iodine over 100μg/L Goiter rate of 8～10 years children Wag decreased from 22.3%(282/1267)to 4.4%(53/1200) from 1995 to 2005.Conclusion After 10-year USI,the status of iodine nutrition in ShaJldong Province has been promoted obviously and it is in a suitable iodine nutritional status.