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Objective:To explore the medical reference values, distribution characteristics and influencing factors of serum iodine in adults with different thyroid health conditions, and to evaluate the importance of serum iodine in evaluating individual iodine nutrition.Methods:From February 2017 to November 2018, multi-stage stratified cluster sampling was used to select one community and one agricultural (fishing) village in the coastal Yingkou City and the inland areas of Shenyang City of Liaoning Province as survey sites. Cluster sampling of adults over 18 years old who had lived for five years were conducted with questionnaire survey, clinical physical examination and thyroid ultrasound examination. Fasting venous blood samples and one random urine sample were collected from all subjects for serum iodine, thyroid hormone, antibody and urine iodine detection. The 95% medical reference value of serum iodine was established by using the percentage quantile method, and the reference value, distribution characteristics and influencing factors of serum iodine in adults with different thyroid health status were analyzed. The diagnostic value of iodine nutritional indicators in thyroid diseases was evaluated by the receiver operating characteristic (ROC) curve.Results:A total of 2 931 adults were surveyed, with serum iodine levels of 62.1 (53.6, 72.2) μg/L, ranging from 5.6 to 642.3 μg/L; urine iodine was 167.6 (111.2, 244.2) μg/L, and the overall iodine level was at an appropriate level. A total of 1 089 patients with thyroid diseases were examined, with a detection rate of 37.2% (1 089/2 931); among them, there were 597 cases of thyroid nodules, 56 cases of endemic goiter, 42 cases of hypothyroidism, 161 cases of subclinical hypothyroidism, 27 cases of hyperthyroidism, 18 cases of subclinical hyperthyroidism, and 474 cases of autoimmune thyroid disease (AITD). There was a statistically significant difference in the detection of thyroid diseases among adults with different levels of serum iodine (χ 2 = 13.80, P < 0.05). The reference values of serum iodine in normal adults, hypothyroidism (without thyroid hormone intervention), hyperthyroidism (without anti thyroid hormone drug treatment), AITD, endemic goiter, and thyroid nodules were 37.2 - 103.0, 12.5 - 52.8, 49.9 - 163.1, 34.3 - 129.3, 27.3 - 92.8, and 37.9 - 119.5 μg/L, respectively. The ROC curve analysis results showed that the serum iodine area under curve(AUC) of patients with hyperthyroidism, subclinical hyperthyroidism, endemic goiter, thyroid nodules, and AITD were 0.94, 0.61, 0.55, 0.53, and 0.52, respectively. The results of univariate analysis showed that there were statistically significant differences in adult serum iodine levels among different positions, regions, age, education level, occupation, iodine intake, blood pressure, and body mass index ( P < 0.05). Conclusions:There are significant differences in serum iodine levels among adults with different thyroid health conditions, and evaluation standards and systems should be developed separately. Serum iodine is an important indicator for evaluating individual iodine nutrition.
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Objective To analyze the iodine nutritional status of children and pregnant women in Liaoning Province,and the iodine content of edible salt suitable for iodine nutrition level,to provide a basis for adjusting the suitable salt iodine content standard of key population.Methods In 2015-2018,a cross-sectional survey method was used to conduct iodine nutritional status surveys in counties (districts) within the jurisdiction of Liaoning Province.One township (community) was selected in each county (district)according to the east,west,south,north,and middle directions.Forty children aged 8-10 (age and gender distribution balanced) and 20 pregnant women were selected in each township (community),urine and household salt samples were collected from children and pregnant women,to test urine and salt iodine levels;and the water samples from all township (community) water supply plants in the province were collected for water iodine detection in 2017;and all respondents were calculated the dietary iodine intake.The multi-order linear curve was used to fit the salt iodine content suitable for children and pregnant women.Results A total of 1 549 townships (communities) were surveyed,including 1 125 centralized water supply townships (communities) with water iodine ＜ 40 μg/L;50 820 children aged 8-10 and 26 707 pregnant women were selected from the centralized water supply towns.The average iodine content of edible salt was 24.0 and 23.9 mg/kg,respectively.The median urinary iodine level of children was 168.5 μg/L,at the appropriate level of iodine;the median urinary iodine level of pregnant women was 137.8 μg/L,at the deficiency level of iodine.The average dietary intake of iodine in children was 228.4 μg/d,which was 3.51 times of the standard iodine requirement (EAR,65 μg/d) and 2.54 times of the recommended intake (RNI,90 μ g/d).The average dietary intake of iodine in pregnant women was 273.4 μg/d,which was 1.71 times of the EAR (160 μg/d) and 1.19 times of the RNI (230 μg/d),and 21.4％ (5 728/26 707) of pregnant women had lower iodine intake than RNI,the iodine intake was insufficient.After multi-level linear curve fitting combined with monitoring data,the iodine content range of edible salt in children's urine was suitable and the iodine intake in RNI-tolerable intake (UL,300 μg/d) was 13-25 mg/kg (20 mg/kg + 20％);the iodine content range of edible salt in pregnant women's urinary iodine was suitable and the iodine intake in RNI-UL (600 μg/d) is 25-37 mg/kg (31 mg/kg + 20％).Conclusions Under the current salt iodine content standard (25 mg/kg) in Liaoning Province,children's iodine nutrition is generally at the level of iodine appropriate;pregnant women's iodine nutrition is generally at the level of iodine deficiency.It is recommended that all regions should revise the iodine content standard for edible salt in due course in combination with the iodine nutritional status of key populations within the jurisdiction.
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Objective To study the status of prevention and control of iodine deficiency disorders (IDD),master the iodine nutritional status of children and pregnant women in Liaoning Province.Methods One hundred counties (districts) of Liaoning Province,34 counties (districts) were randomly selected to carry out a cross-sectional survey on iodine nutritional status of the population according to "National Surveillance Program on IDD" in 2016.Five townships (communities) were randomly selected according to their sub-area positions of east,west,south,north and center,1 primary school was randomly selected in each township (communities),40 non boarding students aged 8-10 (half males half females) were selected from each school.The radial size of the thyroid was measured by Ultra-portable Doppler Diagnostic Ultrasound System and the volume was calculated.Twenty pregnant women were randomly selected in each township (communities).Their salt and random urine samples were collected;salt iodine level and urinary iodine level were tested.Results The mean of salt iodine content of 6 874 children's family salt samples was (24.0 ± 4.7) mg/kg,the iodized salt coverage rate was 98.4％ (6 761/6 874) and the consumption rate of qualified iodized salt was 95.5％ (6 567/6 874).The median urinary iodine (MUI) of 6 874 children's urine samples was 168.0 μg/L,and children's goiter rate was 1.6％ (111/6 874).The mean of salt iodine content of 3 404 pregnant women's family salt samples was (24.1 ± 4.3) mg/kg,the iodized salt coverage rate was 99.0％ (3 369/3 404) and the consumption rate of qualified iodized salt was 84.6％ (2 880/3 404).The MUI 3 404 of pregnant women's urine samples was 135.8 μg/L (＜ 150 μg/L).Conclusions In 2016,8-10 years old children's urinary iodine is at adequate level.But the pregnant women are in iodine deficiency.
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Objective To understand the infection status of human parasites among rural residents in Liaoning Province, and provide scientific basis for control of parasites. Methods From October 2014 to December 2015, in 32 counties of 4 different ecological zones of Liaoning Province, survey sites were determined by stratified sampling according to their economic status. More than 250 people were examined at each survey site, and the rate of resident inspection was no less than 85％. The fecal samples of the subjects were collected, intestinal helminth eggs, intestinal protozoa and the eggs of Enerobius vermicularis in children aged 3 - 6 were examined by modified Kato-Katz thick smear, iodine stain direct smear and adhesive cellophane anal swab, respectively. Results Totally 26520 rural residents were surveyed, their infection rate of parasitic disease was 0.29％ (78/26520). Among them, the infection rate of Ascaris and Trichuris was 0.29％ (76/26520) and 0.02％ (5/26520), respectively; Enerobius vermicularis and Hookworm were not detected. The parasite infection rate in the 60-year-old age group was relatively high (0.49％, 34/6939). Conclusion The infection rate of rural residents in Liaoning Province is at a relatively low level, which is closely related to the improved living standard and the continuous improvement of environmental hygiene in recent years.
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Objective To master the prevalence of drinking-water-borne endemic fluorosis of children in the disease affected areas of Liaoning Province and to understand the effect of water improvement measures in prevention and control of fluorosis.Methods The data of 18 water improvement projects in drinking-water-borne endemic fluorosis areas of Liaoning Province from 2011 to 2016 were collected by retrospective method,and the data of dental fluorosis in children aged 8 to 12 years old were analyzed.The prevalence and detection rate of dental flaorosis in children aged 8 to 12 years old were analyzed.To compare the incidence of dental fluorosis among children from villages with qualified water fluoride and those from villages with unqualified water fluoride.Results From 2011 to 2016,in the annual survey of 18 water engineering projects in 18 monitored villages,normal operating rate was between 94.44％ (17/18)-100.00％ (18/18),water fluoride qualified rate was between 88.89％ (16/18)-100.00％ (18/18).In the monitored village,4 941 children aged 8 to 12 were examined,and the detection rate of dental fluorosis was 9.8％ (484/4 941).The dental fluorosis index was 0.19.The detection rate (14.0％,10.7％,10.7％,8.7％,6.6％,8.1％) of dental fluorosis was decreasing year by year (x2trend =24.3,P ＜ 0.05).The total detection rate of children's dental fluorosis in monitored villages (8.1％,356/4 422) with normal operation of water improvement projects and qualified water fluoride was lower than that in monitored villages with excessive water fluoride (24.7％,128/519,x2 =145.1,P ＜ 0.05).Conclusion After water improvement measures are implemented in drinking water fluorosis areas of Liaoning Province,the dental fluorosis of children in the affected areas is effectively controlled,but the problem of excessive fluoride in water improvement projects still exists,and the management of water improvement projects should be strengthened in the future.
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OBJECTIVE:To explore the clinical efficacy and safety of alfacalcidol in the adjuvant treatment of bronchiolitis in children. METHODS:Data of 156 children with bronchiolitis were retrospectively collected and divided into observation group(78 cases) and control group (78 cases) by different medication. All children received oxygen inhalation,relieving asthma,antiviral and other conventional treatment,then control group inhaled Budesonide suspension 0.5-1.0 mg + Salbutamol aerosol 0.25 mL for atomization,bid,10 min every times,7-d was a course. Observation group additionally given Alfacalcidol soft capsule 0.010-0.015μg/(kg·d),3 times a week,3-month was a course. They were treated for 3 months. Clinical efficacy,improvement time of clinical symptoms and signs,levels of 25-(OH)D3 and serum LEP,IgA,IgG,IgM and IgE before and after treatment,and the incidence of adverse reactions in 2 groups were observed and compared. RESULTS:The total effective rate in observation group was signifi-cantly higher than control group,improvement time of cough,asthma,wheezing and moist rale were significantly shorter than con-trol group with statistical significansce (P<0.05) after 7-d treatment;after 3-month treatment,25-(OH)D3,IgA and IgG levels were significantly higher than before,and observation group was higher than control group,LEP and IgE levels were significantly lower than before,and observation group was lower than control group,with statistical significances(P<0.05). There was no sig-nificantly difference of the level of IgM in 2 groups before and after treatment. And there were no severe adverse reactions in 2 groups. CONCLUSIONS:Based on conventional treatment,alfacalcidol shows good efficacy in the adjuvant treatment of bronchiol-itis in children,which can obviously enhance immune function,reduce serum LEP level,then shorten remission time of clinical symptoms and signs,with less adverse reactions and good safety.
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Objective To investigate the prevalence of adult skeletal fluorosis in drinking-water-borne endemic fluorosis areas in Liaoning Province and to observe the effects of preventive measures.Methods Three water-changed villages were selected from six drinking-water-borne endemic fluorosis counties,Faku County,Liaoyang County,Haicheng City,Linghai City,Fu Mongolia County,and Jianping County.Totally 18 diseased villages were selected as the investigation sites.The operating condition of the improvement projects was investigated and the fluoride level of drinking water was tested.People over the age of 25 and living in the local for more than 5 years in each survey site were selected and divided into five groups according to age groups of 25-,35-,45-,55-,and ≥65 years old.Ten people in each age group were selected,half male and half female,to examine skeletal fluorosis by X-ray.Clinical symptoms and bone change,including sclerotin,bones,and joints changes were also examined.Results The water fluorine values of two villages were 1.32 and 1.69 mg/L,more than the national standard (1.2 mg/L),while other 16 villages were between 0.5-1.0 mg/L.X-ray images were analyzed for diagnosis of skeletal fluorosis in 905 adults,and 46 cases were diagnosed as skeletal fluorosis in the 18 monitored villages.Xray detection rate was 5.08％,of which the X-ray detection rate of adult fluorosis in water fluoride qualified monitoring villages was 4.11％ (33/803).The detection rate of adult skeletal fluorosis was 12.75％ (13/102) in water fluoride unqualified monitoring villages.There was a significant difference of the total detection rates between the two groups of monitored villages (x2 =13.99,P ＜ 0.05).Skeletal fluorosis was mainly happened in the age group over the age of 45,account for 89.13％ (41/46).Peri-bone changes were observed in the 46 cases of patients with skeletal fluorosis.Conclusions The condition of skeletal fluorosis has been effectively alleviated after implementing the improvement measures.Prevention and treatment can effectively control the occurrence of fluorosis.
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Objective:To explore the value of cone beam CT(CBCT) scanning following parotid sialography in the diagnosis of chronic parotitis.Methods:20 cases of suspected chronic parotitis patients underwent parotid gland sialography followed by CBCT scanning.The images were observed by transverse plane,coronal plane,sagittal plane of multiplanar reconstruction (MPR) and 3D reconstruction.Results:The acinus and ducts system of parotid were clearly displayed from any orientation by MPR and 3D-reconstructed images.The images of 6 cases of chronic recurrent parotitis in CBCT sialography were charactered by punctiform dilatation in whole parotid gland,4 of them showed a normal ductal system,while 2 exhibited expression of ductal inflammation.The images of 14 cases of chronic obstructive parotitis showed irregular ductal dilatations and stenosis.Punctiform dilatations were found in 2 cases,and small filling defects (negative salivary calculi) in 3 cases.Conclusion:CBCT sialography is an effective clinical examination for the diagnosis and treatment chronic parotitis.
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From the perspectives of pragmatics , social linguistics and functional linguistics , the author made a detailed literature review on critical discourse analysis on doctor -patient conversations , summing up the character-istics and the similarities and differences of doctor -patient criticism conversational analysis .On this basis in this paper , the dynamic of the power relations in both doctors , discusses how to dialectical view of the power character-istics of between doctor and patient , and points out that the use of critical linguistics in doctor -patient conversa-tions need to be aware of problems , namely must have the dialectical thinking , focus on empirical research , dimen-sional analysis .
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<p><b>OBJECTIVE</b>To evaluate the efficacy of SLIT with Dermatophagoides farinae drops in children with allergic rhinitis and allergic asthma according to its different duration.</p><p><b>METHODS</b>The efficacy of Dermatophagoides farinae SLIT in 100 children (aged 3-14 yr) with allergic rhinitis and allergic asthma induced by house dust mites was retrospectively analyzed. All children were treated with Dermatophagoides farinae drops for 4 years and followed-up at the interval of 3 months. Total nasal symptom scores (TNSS), total rhinitis symptomatic medication scores (TRMS), daytime asthma symptom scores (DASS), nighttime asthma symptom scores (NASS), total asthma symptomatic medication scores (TAMS), visual analog scale scores (VAS) and lung function were assessed during follow-up visit. SPSS 20.0 software was used for data analysis.</p><p><b>RESULTS</b>After 2 years' SLIT, compared with 1-year duration, besides NASS (0.00[0.00;0.00], 0.00[0.00;0.00]; Z = 1.811; P > 0.05), TNSS (2.00[1.00;2.00], 0.00[0.00;0.00]; Z = 7.021, P < 0.01), TRMS (2.00[2.00;2.00], 0.00[0.00;0.00]; Z = 8.855; P < 0.01), VAS scores (3.00[2.00;4.00], 1.00[0.00;1.00]; Z = 4.494, P < 0.01), DASS (1.00[0.00;1.00]; 0.00[0.00;0.00]; Z = 4.383, P < 0.01) and TAMS (0.00[0.00;1.00], 0.00[0.00;0.00]; Z = 8.944; P < 0.01) all showed significant improvement. After 3-year duration, compared with 2-year duration, VAS scores (1.00[0.00;1.00], 0.00[0.00;0.00]; Z = 3.645, P < 0.05) in patients were significantly decreased. Other results showed no significant difference. The comparison of efficacy between 3 and 4-year duration showed no significant difference in global clinical outcomes (all P > 0.05).</p><p><b>CONCLUSIONS</b>Patients receiving 2 year' SLIT achieve more clinical benefits than those who receiving 1-year duration. The higher efficacy of 3-year duration compared with 2-year duration is supported by a significant improvement in VAS. Besides, the comparison between 3 and 4-year duration shows no significant difference in global clinical outcomes. Therefore, 3 years' duration is optimal in this study.</p>
Subject(s)
Adolescent , Animals , Child , Child, Preschool , Humans , Administration, Sublingual , Allergens , Antigens, Dermatophagoides , Asthma , Drug Therapy , Dermatophagoides farinae , Retrospective Studies , Rhinitis, Allergic, Perennial , Drug Therapy , Sublingual Immunotherapy , Time Factors , Treatment OutcomeABSTRACT
Plant alkaloids have anti-tumor activities.In recent years,the anti-tumor mechanisms of plant alkaloid are demonstrated to be related to the block of tumor cell cycle,the induction of tumor cell apoptosis,the inhibition of tumor angiogenesis and multi-drug resistance.In addition,most recently,plant alkaloids are found to inhibit telomerase activity and induce autophagy.Therefore,plant alkaloids may be developed into a sort of potential antitumor drugs.
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Objectives To study the value of cough peak expiratory lfow (CPEF) in predicting extubation outcome of children with acute respiratory failure. Methods A total of 62 children with acute respiratory failure were selected and received mechanical ventilation longer than 72 hours. They were conscious at the time of extubation and successfully got through 30 minutes of spontaneous breathing trial. Children were divided into success group and failure group according to the outcome of extubation. CPEF, pulmonary function parameters, blood gas analysis and pediatric critical illness scores were compared before extubation between two groups. Results Fifty-two cases were successfully extubated but 10 cases failed. CPEF of the success group was signiifcantly higher than that of the failure group (P<0.01). Based on the results of receiver operating characteristic curves, the area under the curve was 0.873. The optimal operating point of CPEF was 40.5L/min, and the sensitivity and speciifcity were 76.9%and 90.0%, respectively (P<0.01). Conclusions It is suggested that CPEF can be used as a predictor of extubation outcome.