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Objective:To understand the iodine content of drinking water and iodine nutrition of key population in Anyang City, Henan Province, and to provide a basis for taking targeted prevention and control measures and scientific adjustment of intervention strategies.Methods:In 2019, stratified sampling method was used to carry out water iodine survey in all townships in Anyang City, and in townships with the median water iodine > 10 μg/L, water iodine survey was carried out in administrative villages, and water iodine content was detected. Two hundred children aged 8 - 10 years and 100 pregnant women were selected from each county (city, district) to test iodine contents of their household salt and urine, respectively.Results:Six hundred and eight water samples were collected in Anyang City, and the median water iodine was 5.98 μg/L. One thousand one hundred and fifty-six samples were collected, and the median water iodine was 34.10 μg/L. A total of 1 605 salt samples were collected in the city, and the median salt iodine was 24.30 mg/kg, the coverage rate of iodized salt was 91.8% (1 473/ 1 605). A total of 1 605 urine samples were collected from children in the city, and the median urinary iodine was 170.10 μg/L. Urine samples of 804 pregnant women were collected, and the median urinary iodine was 190.00 μg/L.Conclusion:Most areas of Anyang City still belong to iodine deficiency area, and the median urinary iodine of children and pregnant women is within the suitable range of iodine.
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Objective:To understand the level of iodine nutrition in the areas with iodine deficiency and high iodine in Anyang City of Henan Province, and to provide a basis for taking targeted prevention and treatment measures and scientific adjustment of intervention strategies.Methods:In 2019, three areas with iodine deficiency (median iodine in water < 10 μg/L) and three areas with high water iodine (median iodine in water > 100 μg/L) were selected from counties (cities and districts) in Anyang City by stratified random sampling. Children aged 8-10 and pregnant women were selected in areas with high iodine and areas with iodine deficiency, respectively. Urine samples and salt samples were collected and tested, and children's thyroids were examined by B-mode ultrasound.Results:A total of 654 salt samples were collected in iodine deficiency areas, among which non-iodized salt accounted for 1.83% (12/654). A total of 628 salt samples were collected from areas with high iodine, among which non-iodized salt accounted for 6.05% (38/628). The difference in non-iodized salt rate between the two areas was statistically significant (χ 2=15.19, P < 0.05). A total of 654 urine samples were collected from children in iodine deficiency areas, with a median of 211.15 μg/L of urinary iodine, and 628 urine samples were collected from high iodine areas, with a median of 390.50 μg/L of urinary iodine. The difference was statistically significant ( U=- 18.34, P < 0.05). A total of 300 urine samples were collected from pregnant women in iodine deficiency areas, with a median of 223.95 μg/L, and 127 urine samples were collected from pregnant women in high iodine areas, with a median of 258.00 μg/L. The difference was statistically significant ( U=- 4.07, P < 0.05). The thyroid volume of 560 children in the iodine deficient areas was detected, and the swelling rate was 1.43% (8/560). The thyroid volume of 628 children in high iodine areas was detected, and the swelling rate was 2.07% (13/628). Conclusion:The iodine nutrition level of the population in the iodine deficiency areas of Anyang City is appropriate, while the iodine nutrition level of the population in the water source high iodine areas is excessive.
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Objective To study the use of preoperative indocyanine green retention test at 15 minutes (ICG R15) in the prediction of liver functional reserve in patients with hilar cholangiocarcinoma (HCCA).Methods The clinical data of 62 patients with HCCA treated in our department from March 2016 to March 2018 was reviewed.The relationship between preoperative ICG R15 and postoperative hepatic insufficiency was analyzed.The relationship between preoperative ICG R15 and Child-Pugh scoring was also studied.Univariate analysis was used to evaluate the risk factors of postoperative liver dysfunction.Logistic regression was used to assess the independent risk factors of postoperative liver dysfunction.The regression equation between independent risk factors and postoperative liver dysfunction was established.Results Among the 62 patients,ICG R15 was less than 10.0％ in 26 patients,between 10.0％ and 19.0％ in 17 patients,between 20.0％ and 29.0％ in 9 patients,between 30.0％ and 39.0％ in 5 patients,and over 40.0％ in 5 patients.There were 29 patients with a Child-Pugh A grading and 33 patients with a Child-Pugh B grading in the preoperative evaluation of liver function.The Wilcoxon W rank sum test was used to compare the preoperative ICG R15 in patients with Child-Pugh grading A and B separately.The ICG R15 in Child-Pugh grading A patients was significantly lower than those in Child-Pugh B grading patients (P ＜0.05).There were no significant differences in age,gender,history of previous liver diseases,duration of operation,and intraoperative blood loss (P ＞ 0.05) between the normal liver function group and the liver dysfunction group.However,there was a significant difference in the preoperative ICG R15 and preoperative bilirubin levels (P ＜ 0.05) between the two groups.The preoperative ICG R15 and preoperative bilirubin levels were significant risk factors of postoperative hepatic insufficiency.Regression analysis suggested that preoperative ICG R15 level was an independent risk factor of postoperative hepatic insufficiency (P ＜ 0.05).A regression equation:logit(P) =0.185 × preoperative ICG R15-3.152 could be constructed.Conclusions ICG R15 is an ideal clinical indicator for evaluation of preoperative liver functional reserve in patients with HCCA.It predicted the recovery of postoperative liver function.
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Objective To investigate the iodine nutritional status of rural residents in Anyang City of Henan Province,and to provide theoretical basis for making policy adjustment on iodine supplement. Methods In 2015, Tangyin County and Anyang County were chosen from Anyang City, one township was selected from each county based on five orientations of east, west, south, north and centre, four villages were chosen from each township,15 households were taken from each village, and kitchen salt samples were collected to detect salt iodine;tap water samples were collected to detect water iodine.In the selected county,one medical institution was selected, 100 women of childbearing age,pregnant women,lactating women and infants aged 0-2 years old were selected to detect urinary iodine; one primary school was selected in the selected township, and 20 children aged 8 - 10 years old were selected to detect urinary iodine. Salt iodine was determined using direct titration (GB/T 13025.7-1999);urinary iodine and water iodine were determined using arsenic cerium catalytic spectrophotometry(WS/T 107-2006). Results A total of 600 salt samples were collected, half from Anyang County and half from Tangyin County, the medians of salt iodine were 27.59,29.15 mg/kg,respectively,the difference was statistically significant(Z = - 4.92, P <0.05).A total of 47 water samples were collected,21 from Anyang County and 26 from Tangyin County,the medians of water iodine were 9.44,5.37 μg/L,respectively,the difference was not statistically significant(Z=-0.30, P > 0.05). A total of 985 key people were surveyed, children, women of childbearing age, pregnant women, lactating women and infants were 200, 205, 197, 187, 196, respectively, the medians of urinary iodine were 253.05, 249.80, 177.10, 266.40, 247.85 μg/L, respectively, the differences were statistically significant (χ2=29.76, P < 0.05). Urinary iodine levels of childbearing age women (226.60,313.85 μg/L),lactating women(230.85,286.20 μg/L) and infants (222.35, 275.35 μg/L) were compared between Anyang County and Tangyin County, the differences were statistically significant (Z=3.33,2.21,3.13,P<0.05).Conclusion The iodine nutritional status of rural residents in Anyang City is basically good,but the urinary iodine levels of general population are high.
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Sphincter of Oddi dysfunction (SDO) is the obstruction of ampulla of Vater,resulting from abnormality of contraction of sphincter of Oddi,which causes the reflux of bile and pancreatic juice and promotes a series of pathophysiological changes in cholangiopancreatic system.Because of lack of typical clinical symptoms and specific diagnostic methods,the standards of diagnosis and therapy are still unclear.Recently,new changes happened in this field with the development of endoscopy and large-scale clinical trials.This review summarized the latest advances on sphincter of Oddi dysfunction in recent years.
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Objective To understand the situation of iodine of Taishan nuclear power station employees,and assess the relationships between iodine nutrition and thyroid nodule of Taishan nuclear power station in Taishan,Guangdong.Methods Totally 300 people were selected from of Taishan nuclear power station through stratifiedrandom sampling method,random urine samples were collected and urinary iodine level was tested in 2014.According to 20 to 29 years old,30 to 39 years old,40 to 59 years old,3 age groups were sampled,and each age group was 100 people.Drinking water and edible salt samples of the of nuclear power station were collected and iodine level was tested.Daily dietary intake of the staff was investigated,and daily iodine intake was calculated.Result of thyroid B ultrasonic of the employees (1 091) were studied,and detection rate of thyroid nodule was calculated.Results Totally 308 urine samples were tested,and the median urinary iodine was 193 μg/L.The difference of urinary iodine between 20-year-old group (201 μg/L) and 30-year-old group (165 μg/L) was statistically significant (P ＜ 0.05).A total of 9 iodized salt samples were collected,with an average iodine value of (24.4 ± 0.5)mg/kg.A total of 9 water samples were collected,the median of water iodine was 20.5 μg/L in 3 centralized water supply samples.The daily iodine intake per capita of the staff was 274.0 μg/d,the highest contribution among all the varieties of food was iodized salt,the second was seafood,which were 45.26 percent and 41.86 percent,respectively.A total of 99 thyroid nodules and suspicious nodules were detected in 1 091,and the prevalence was 9.07 percent (99/1 091).The prevalence of people aged 40-59 [15.6％ (22/141)] was significantly higher than those of people aged 20 to 29 [8.1％ (51/633)] and aged 30 to 39 [8.2％ (26/317)],and the differences were statistically significant (P ＜ 0.05).Conclusions The iodine nutrition of Taishan nuclear power station employees is appropriate as a whole.The detection rate of thyroid nodules is higher in people aged 40 to 59.
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Objective To investigate the iodine nutrition status of school-age children in Anyang,and analyze its related influencing factors.Method Monitoring data on urinary iodine of school-aged children and iodized salt were collected from 2011 to 2015,its general situation was described,and differences in age,sex,residential area type and year were compared.Results Totally 13 371 iodized salt samples were collected in Anyang City from 2011 to 2015,and 12 205 were qualified iodized salt.The median of iodized salt was 26.91 mg/kg.Totally 1 282 urinary iodine samples of school-age children were monitored in Anyang City,and its median of urinary iodine was 237.0 μg/L,the constituent ratio of urinary iodine of children under 100 μg/L and above 300 μg/L was 14.5％(186/ 1 282) and 35.3％ (452/1 282),respectively,the results of urinary iodine were different in different years,and the differences were statistically significant (x2 =36A1,P＜ 0.05);the differences of the residential area type,sex and age had no influence on the urinary iodine of school-age children,and the differences were not statistically significant (Z =-1.07,-0.94,x2 =6.50,P ＞ 0.05).Conclusion The iodine-nutritional status of school-age children is more than adequate,the concentration of urinary iodine is high,and the differences of the residential area type,sex and age have no influence on the urinary iodine of school-age children.
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Objective To compare clinical effects of appendicectomy and conservative treatment of uncomplicated acute appendicitis.Methods Searched The Cochrane library,Medline,Pubmed,Embase,CBM,CNKI,VIP and Wan Fang database in any language.RCTs that compared conservative treatment with appendicectomy in patients with uncomplicated acute appendicitis were included from January 1983 to May 2013 and qualities of the trials were evaluated.Statistic analyses were carried out using RevMan 5.1 soft-ware.Results Four randomized trials met our inclusion criteria (821partiCI:pants).Antibiotics compared with appendicectomy resulted in similar outcomes with regards to the incidence of complicated appendicitis (RR:0.89,95％ CI:0.29-2.68) and intra-abdominal infection(RR:0.54,95％ CI:0.13-2.35).Antibiotics carries a lower risk of complications (RR 0.46,95％ CI:0.32-0.67),but requires more length of hospital stay (Mean Difference 0.52,95％ CI:0.16-0.88).Conclusions The effect of conservative treatment is safe and effective.But the recurrent uncomplicated appendicitis recommends operation.
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Objective To compare the pros and cons of endoscopic papillary balloon dilation (EPBD) with those of endoscopic sphincterotomy (EST) in the treatment of common bile duct stones.Methods We searched The Cochrane library,Medline,Pubmed,Embase,CBM,CNKI,VIP and Wan Fang database in any language.RCTs that compared EPBD with EST for the removal of common bile duct stones were included from January 1983 to September 2012 and qualities of the trials were evaluated.Statistic analyses were carried out using RevMan 5.1 software.Results A total of 18 randomized trials with 2385 participants met our inclusion criteria.EPBD compared with EST resulted in similar outcomes with regards to stone removal on 1 st attempt,overall stone removal,perforation,total short-term complication,long-term cholangitis or mortality.EPBD carries a higher risk of pancreatitis (RR =1.99,95％ CI:1.41-2.81) and severe pancreatitis (RR =4.68,95 ％ CI:1.36-16.11),and requires higher rates of mechanical lithotripsy (RR =1.31,95％ CI:1.14-1.50).Conversely,EPBD not only has statistically significant lower rates of bleeding (RR =0.14,95％ CI:0.06-0.34),but also leads to significantly less long-term cholecystitis (RR =0.38,95％ CI:0.19-0.76),long-term stone recurrence (RR =0.67,95％ CI:0.47-0.96) and total longterm complications (RR =0.52,95 ％ CI:0.40-0.67).Conclusion On the basis of lower rates of bleeding or long-term complications,EPBD should be the preferred strategy over EST for endoscopic management of common bile duct stones,however,the rate of pancreatitis,especially the severe pancreatitis is higher with EPBD.
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Efforts have been directed at the development of efficient protocols for the differentiation of pluripotent stem cells into pancreatic β-cells.This review focuses on the mechanism of RA,BMP,FGFs,IDE1,IDE2,ALK-i 1 and ALKI-2 during the process in which pluripotent stem cells differentiate to pancreatie β-cells and the relationship between the differentiation and the expression of the surface markers including CD14,CD49e,CD238,CD24,EpCAM,SSEA3 and SSEA1 in the different stage of this process.
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Type 1 diabetes mellitus is caused by the autoimmune destruction of beta cells within the islets. In recent years, innate immunity has been proposed to play a key role in this process. High-mobility group box 1 (HMGB1), an inflammatory trigger in a number of autoimmune diseases, activates proinflammatory responses following its release from necrotic cells. Our aim was to determine the significance of HMGB1 in the natural history of diabetes in non-obese diabetic (NOD) mice. We observed that the rate of HMGB1 expression in the cytoplasm of islets was much greater in diabetic mice compared with non-diabetic mice. The majority of cells positively stained for toll-like receptor 4 (TLR4) were beta cells; few alpha cells were stained for TLR4. Thus, we examined the effects of anti-TLR4 antibodies on HMGB1 cell surface binding, which confirmed that HMGB1 interacts with TLR4 in isolated islets. Expression changes in HMGB1 and TLR4 were detected throughout the course of diabetes. Our findings indicate that TLR4 is the main receptor on beta cells and that HMGB1 may signal via TLR4 to selectively damage beta cells rather than alpha cells during the development of type 1 diabetes mellitus.