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Objective To understand the situation of iodine deficiency disorders and iodine nutrition of children in Yunnan Province after the implementation of new standard of salt iodine,and provide the basic data for prevention and control of iodine deficiency disorders.Methods Using multistage sampling method,Yunnan provincial evaluations for iodine deficiency disorders elimination were carried out.According to the comparative analysis of 2010 (pre-adjustment) and 2015 (post-adjustment) evaluation results,the changes of the median of salt iodine,the coverage rate of iodized salt,the qualified rate of iodized salt,the rate of qualified iodized salt consumption,goiter rate of school children aged 8-10 and the median of urinary iodine were evaluated.Salt iodine was tested using the "Salt Industry General Test Method for Determination of Iodine" (GB/T 13025.7-1999);thyroid volume examination of children using B-scan ultrasonography,thyroid volume calculation and enlargement judgment using "Diagnostic Criteria for Endemic Goiter" (WS 276-2007);and urinary iodine detection using "Urinary Iodine Arsenic Cerium Catalytic Spectrophotometry" (WS/T 107-2006).Results The medians of salt iodine in 2010 and 2015 were 30.6 and 22.4 mg/kg,respectively,the difference was statistically significant (U =317 503.50,P ＜ 0.01).The coverage rates of iodized salt in 2010 and 2015 were 99.6％ (1 681/1 688) and 98.9％ (2 592/2 622),the qualified rates of iodized salt were 98.6％ (1 657/1 681) and 89.7％ (2 325/2 592),and the rates of qualified iodized salt consumption were 98.2％ (1 657/1 688) and 88.7％ (2 325/2 622),and the differences were statistically significant (x2 =6.42,125.11,130.18,P ＜ 0.01);the rates of children goiter in 2010 and 2015 were 0.8％ (25/3 272) and 1.4％(44/3 245),respectively;the medians of urinary iodine of children were 289.0 and 157.3 μg/L,respectively,the difference was statistically significant (U =1 121 669.50,P ＜ 0.01).Conclusion After decreasing of salt iodine level starting from 2012 in Yunnan Province,the children iodine nutrition condition is in a more proper level.
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Objective To analyze the characteristic of Yunnan unexpected sudden death (YUSD) cases by pathological diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC),in order to offer clue for ARVC etiologic research of YUSD.Methods The pathological diagnosis results of 9 cases of sudden death of ARVC in Yunnan,as well as epidemiological investigation data,were used to comprehensively analyze the pathological features of the pathological diagnosis of ARVC in Yunnan.Results The 9 cases including 8 females and 1 male,aged 16-47 years.The sudden death time was from June to August,mainly distributed in 8 families from the disease seriously ridden 7 villages.Three of them had a genetic history of family YUSD,2 cases had a history of mental stimulation,1 case had eaten Trogia venenata;and acute symptoms and signs were palpitation,chest tightness,shortness of breath,and loss of consciousness.Pathological observations were the typical ARVC change,mainly right ventricular lesions,with different degrees of cardiac enlargement and extensive adipose tissue infiltration in the ventricular wall.Among them,6 cases of fat infiltration almost reached the full thickness of the heart wall.In addition to the pathological changes of ARVC,8 cases were accompanied by one or several pathological changes in myocarditis,cardiac dysplasia,nephropathy,pulmonary edema,pneumonia and pancreatitis.Of the 9 cases,5 cases were diagnosed with ARVC,2 cases with ARVC and pulmonary edema,1 case with ARVC and acute hemorrhagic necrotizing pancreatitis,and 1 case with ARVC and Trogia venenata poisoning.The clinical examination abnormalities of the family members of the cases mainly showed arrhythmogenic electrocardiography changes and abnormal myocardial enzymes.Conclusions The nine cases have showed typical epidemiology characteristics of YUSD,and cardiachistological changes are consistent with the ARVC pathological diagnostic criteria.A part of YUSD cases may be caused by ARVC,and the inference will be proved by cadaveric pathologic examination and related pathogenic gene detection.
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Objective In order to master the current prevalence situation of dilated cardiomyopathy in Yunnan Province.Methods An investigation of dilated cardiomyopathy was carried out in 17 counties from August to December in 2011 in non-Keshan disease areas.Two townships (towns) that similar to Keshan disease areas in natural environment,pattern of production and lifestyle in non-Keshan disease areas were selected in each project county,and 1 village was selected as surveillance site in each selected township(town).The number of resident in each village no less than 500 people was appropriate and deficiency was supplemented from neighboring villages.The sampling rate was no less than 80％.Clinical examination and electrocardiographic tracings were carried out.The patients with suspected dilated cardiomyopathy and latent Keshan disease were taken anteroposterior chest X-ray in accordance with the National Non-Keshan Disease Area Dilated Cardiomyopathy Condition Survey Program.The surveillance was carried out based on The National Investigation Scheme of Dilated Cardiomyopathy in Non-Keshan Disease Areas.Cases were diagnosed based on the diagnostic standard of dilated cardiomyopathy and suspected latent Keshan disease.Results In the 34 villages of 17 selected counties,14 545 people were investigated.Twenty-six cases of latent dilated cardiomyopathy and suspected latent Keshan disease were detected,and the total detection rate was 17.88/million.One case was dilated cardiomyopathy,and 25 cases were suspected latent Keshan disease,detection rates were 0.69/million and 17.19/million,respectively.Male and female cases were 15 and 11,respectively.The ratio of people aged 65 and older accounted for 42.31％(11/26),among them suspected latent Keshan disease accounted for 44.00％(11/25),and 1 case of dilated cardiomyopathy was in the 45 to 54 years old group.Electrocardiographic examination of 14 519 people,the abnormal rate was 8.13％(1 180/14 519).Among 112 chest X-ray films,104 cases had a cardiothoracic ratio less than or equal to 0.50,4 cases from 0.51 to 0.55,3 cases from 0.56 to 0.60,and 1 case more than or equal to 0.61.Conclusion The detection rate of dilated cardiomyopathy cases is lower in non-Keshan disease area of Yunnan Province,but suspected latent Keshan disease is detected.
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Objective To master the current situation of Keshan disease(KD) and its trend in Yunnan Province,and scientifically evaluate the control and prevention measures.Methods According to the 2011 Endemic Disease Prevention and Control Project Implementation Plan and National Keshan Disease Mornitoring Program,choose Eryuang,Dali,Xiangyun,Wuding,Nanhua,Chuxiong and Mouding Counties(Cities)in Yunnan Province,that were seriously affected by Keshan disease,monitoring was carried out; 2 towns were selected in each county,and 1 village was selected as surveillance site in each selected town.All the residents were clinically examined and Electrocardiography tracing was taken.Suspected cases were given filmed chest X-ray and color echocardiography.KD cases were correctly diagnosed according to the diagnostic criteria.Results A total of 6 022 residents were investigated in the 14 investigation sites; 25 cases of KD were found,and the total incidence rate was 0.42％.Among the 25 KD cases,22 cases were latent KD,and the incidence rate was 0.37％; women(15 cases) were more than men (10 cases),and 10 patients were 3-14 years old,accounted for 40.00％(10/25).Potential KD 22 cases,including 10 cases of 3-14 years old; slow type of KD 3 cases,including 2 cases 45-54 years old.Electrocardiographic examination 6 022 residents,the abnormal rate was 20.44％.Among 32 X-ray films,28 cases had a cardiothoracic ratio less than or equal to 0.50,2 cases from 0.51 to 0.55,1 case from 0.56 to 0.60,and 1 case more than or equal to 0.61.Conclusions The results of KD surveillance have presented a downward trend in Yunnan Province,and the incidence rate of KD is lower.But the pathogenic factors are still active,which is harmful to children health in KD areas.In future,surveillance of children KD should be strengthened,control measures should be implemented,in order to guarantee the health of people who lived in KD areas.