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Objective:To compare the coverage rate of non-iodized salts, children's iodine nutrition and the change trend of goiter rate between the original water source high iodine areas in Henan Province in 2017 and the newly designated water source high iodine areas in 2019.Methods:Using a cross-sectional survey method, household edible salt monitoring was conducted in all 20 counties (cities, districts) with high iodine content in Henan Province in 2017. Ten counties (cities, districts) were selected to monitor water iodine, urinary iodine and thyroid volume of children aged 8 to 10 years. A total of 4 430 salt samples and 1 012 urine samples were collected, and thyroid volume of 1 012 children were measured. In 2019, monitoring of household edible salt, water iodine, urinary iodine, and thyroid volume was carried out in all 55 newly designated counties (cities, districts) with high iodine village. A total of 9 835 salt samples and 9 830 urine samples were collected, and the thyroid volume of 8 896 children was measured. The monitoring results of two years were compared, and the relationship between children's urinary iodine and goiter rate was analyzed by univariate logistic regression.Results:In 2019, the water iodine content in newly designated high iodine areas decreased compared to the original high iodine areas in 2017 (119.8 to 191.0 μg/L), and the difference was statistically significant ( Z = - 2.48, P = 0.013). The rate of non-iodized salts in 2019 was only 35.5% (3 494/9 835), significantly lower than that in 2017 (96.2%, 4 263/4 430, χ 2 = 4 536.74, P < 0.001). The median urinary iodine of children in 2017 and 2019 were 338.2 and 317.8 μg/L, respectively, the difference between the two years was statistically significant ( Z = - 2.46, P = 0.014). In 2017 and 2019, the goiter rate of children aged 8 to 10 years was 1.5% (15/1 012) and 2.1% (187/8 896), respectively, and there was no significant difference between the two years (χ 2 = 1.76, P = 0.185). The results of univariate logistic regression analysis showed that, compared with the control group with urinary iodine < 100 μg/L, the risk of goiter rate (but the enlargement rate did not exceed 5%) increased with the increase of urinary iodine level (100 - 199, 200 - 299 and ≥300 μg/L groups), and the differences were statistically significant [odds ratio ( OR) = 8.64, 7.68, 10.69, P < 0.05]. Conclusion:After the implementation of the new demarcation standard for areas with excessive iodine in water sources, the supply of non-iodized salts in Henan Province is relatively lagging behind, and the iodine nutrition level of children is still high, but the goiter rate is relatively stable.
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Objective:To learn about the progress of prevention and control of drinking-water-borne endemic arsenic poisoning in Henan Province, and provide scientific basis for achieving the goal of eliminating high arsenic hazards as scheduled.Methods:From July to August 2019, in accordance with the requirements of the National Monitoring Program for Drinking-water-borne Endemic Arsenic Poisoning, a general survey was carried out in 26 high-arsenic villages in 6 counties of Henan Province to investigate the water improvement situation and the operation of water improvement projects, and the arsenic content in drinking water of households was measured, meanwhile, the arsenic poisoning status of permanent residents in high-arsenic villages was investigated.Results:All 26 villages with high arsenic content in the province had undergone water improvement, with a water improvement rate of 100.00%. A total of 18 water improvement projects were investigated in 26 high-arsenic villages, all of which were operating normally. Twenty-six water samples were collected, and the arsenic content in the household water was < 0.01 mg/L, which met the sanitary standards for drinking water. No patient of endemic arsenic poisoning was found during the survey.Conclusion:In Henan Province, the drinking-water-borne endemic arsenic poisoning has been effectively controlled, and the prevention and control achievements should continue to be consolidated in the future.
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Objective:To investigate the iodine nutritional level of residents in iodine adequate areas in Henan Province, and provide basis for making policy of targeted guidance and rational iodine supplementation.Methods:In the 156 counties of Henan Province in 2020, one township was selected from each location (east, west, south, north and middle) in each county; one school was selected from each township; 40 children aged 8-10 years in the school and 20 pregnant women in the township were selected to collect their urine and salt samples to test urine and salt iodine levels. One third of the counties were selected to examine the thyroid gland of children. Individuals lived in villages with water iodine between 40 and 100 μg/L were included in the study.Results:In iodine adequate areas, a total of 2 097 salt samples were collected from children and tested, the consumption rate of qualified iodized salt was 93.6% (1 962/2 097). A total of 2 096 urine samples were collected from children and tested, and the median urinary iodine was 288.0 μg/L. The goiter rate of children was 0.7% (5/723). A total of 1 068 salt samples from pregnant women were tested, and the consumption rate of qualified iodized salt was 93.0% (993/1 068). A total of 1 068 urine samples from pregnant women were tested, with a median urinary iodine 232.7 μg/L. Stratified by water iodine (40-59, 60-79, 80-100 μg/L), the median urinary iodine of children was 273.8, 288.6, and 305.9 μg/L, respectively, statistically significantly different between groups ( H = 15.79, P < 0.001); the goiter rate of children was ≤2%, and the difference between groups was statistically significant (χ 2 = 7.31, P = 0.026); but the median urinary iodine of pregnant women was not significantly different ( H = 1.82, P = 0.402). Under different water iodine conditions, there was no significant difference in urinary iodine levels in children and pregnant women between the high salt iodine concentration group (≥21 mg/kg) and the low salt iodine concentration group (< 21 mg/kg, P > 0.05). Conclusions:The iodine nutrition level of children in iodine adequate areas in Henan Province is relatively high, and the iodine nutrition of pregnant women is appropriate. The goiter rate of children is at a relatively low level. Continuous surveillance should be conducted to comprehensively evaluate the iodine nutrition level. Various measures will be taken by regions and populations.
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Objective:To investigate the iodine content in drinking water of residents in Henan Province, and clarify the distribution characteristics of water iodine in Henan Province.Methods:In 2017, in all counties (cities and districts, hereinafter referred to as counties) of Henan Province, taking township (town, subdistrict office, hereinafter referred to as township) as the unit to carry out an investigation of iodine content in drinking water; and in the township with water iodine content of 10 μg/L or more, taking administrative village (neighborhood committee, hereinafter referred to as the administrative village) as the unit to carry out the drinking water iodine content investigation. Supplementary investigation was conducted from 2018 to 2020 in administrative villages where water iodine levels had never been tested or had not been tested after replacing water sources. At least 25 ml water samples were collected at each sampling site, and the water iodine content was determined by cerous sulfate catalytic spectrophotometry.Results:From 2017 to 2020, the median water iodine in Henan Province was 8.20 μg/L. A total of 50 124 administrative villages in 2 465 townships, 160 counties and 18 provincial-level cities were investigated for iodine content in drinking water, of which 65.5% (32 807/50 124) of the administrative villages had a median water iodine < 40 μg/L, belonging to iodine deficiency area; 16.9% (8 473/50 124) of the administrative villages had a median water iodine of 40-100 μg/L, suitable for iodine; and 17.6% (8 844/50 124) of the administrative villages had a median water iodine > 100 μg/L, belonging to water source high iodine area.Conclusions:Henan Province as a whole is at the state of iodine deficiency in the external environment. Most administrative villages are iodine deficiency areas. There are certain proportion of water source areas with high iodine and areas with suitable iodine.
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Objective:To master the provincial-level quality assessment of the self-inspection projects for control and evaluation of drinking water-borne endemic fluorosis in the counties (cities, districts) of Henan Province, so as to ensure the quality of self-inspection.Methods:Totally 30 counties (cities, districts) with drinking water-borne endemic fluorosis in Henan Province were selected as project counties (cities, districts), using consulting and checking data, on-site investigation and review, the implementation of self-inspection projects were audited. The water improvement and the water fluorine content, and the prevalence of dental fluorosis in children aged 8-12 were investigated in villages with drinking water-borne endemic fluorosis, and the provincial-level quality assessment of the self-inspection projects was carried out.Results:A total of 99 villages with drinking water-borne endemic fluorosis in 30 counties (cities, districts) were investigated, and all 30 counties (cities, districts) completed the investigation task of self-inspection projects. A total of 99 water samples were collected, and there were 23 counties (cities, districts) with the same results of county (city, district) self-inspection and provincial-level review of water fluorine, accounting for 76.67%; a total of 5 815 children aged 8-12 were investigated, there were 18 counties (cities, districts) with the same results of county (city, district) self-inspection and provincial-level review of dental fluorosis detection rate, accounting for 60.00%.Conclusions:The self-inspection projects of control and evaluation of drinking water-borne endemic fluorosis at the county (city, district) level in Henan Province are completed well. Most of the self-inspection projects are consistent with the provincial-level review results, but the disease diagnosis ability of grass-roots professional personnel and the detection technical level of laboratory technician in some counties (cities, districts) need to be improved.
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Objective:To understand the prevention and control progress of drinking water-borne endemic fluorosis in Henan Province, to evaluate the effects of prevention and control measures, and provide a basis for adjusting prevention and control strategies.Methods:In 2019, a general survey was conducted in all registered drinking water-borne endemic fluorosis villages in Henan Province to monitor the basic conditions of water improvement, the fluoride content of drinking water and the prevalence of dental fluorosis in children aged 8-12 years. The control compliance (water fluoride content qualified and the detection rate of dental fluorosis of children ≤30%) status of the villages was analyzed, and calculate the compliance rate.Results:A total of 17 504 drinking water-borne endemic fluorosis villages were monitored, among them, 17 352 villages with water improvement and 152 villages without water improvement, with a water improvement rate of 99.1%. Among the 3 685 water improvement projects constructed, 3 448 were in normal operation, and the normal operation rate was 93.6%. There were 13 526 villages with qualified drinking water fluoride content, and the qualified rate of water fluorine was 77.3%; the actual beneficiary population was 11 011 000, and the population benefit rate was 90.1%. The qualified rate of water fluoride in the villages with and without water improvement was 77.9% (13 512/17 352) and 9.2% (14/152), respectively; the qualified rate of water fluoride in the villages with water improvement was significantly higher than that in the villages without water improvement (χ 2=400.58, P < 0.05). A total of 498 527 children of 8 to 12 years old were examined, 68 972 cases of dental fluorosis were detected, the detection rate of dental fluorosis was 13.84%, and the dental fluorosis index was 0.3. The number of villages meeting the control standard was 12 488, and the compliance rate was 71.3%. Conclusions:In Henan Province, the water improvement projects in the drinking water-borne endemic fluorosis areas have been basically implemented, and the disease has been effectively controlled. However, there is still a certain gap with the target of the "13th Five-Year Plan on National Prevention and Control of Endemic Diseases", and timely rectification is needed to ensure the effectiveness of the water improvement projects.
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Objective:To explore the effect of health education on drinking-water-borne endemic fluorosis in Henan Province.Methods:From 2008 to 2015, using prospective method and combining with the distribution of drinking-water-borne endemic fluorosis in Henan Province, 20-30 drinking-water-borne endemic fluorosis counties (cities, districts, referred to as counties) were selected as project counties in Henan Province each year, and 3 townships (towns) were selected in each project county. School health educational activities on prevention and treatment of drinking-water-borne endemic fluorosis were carried out in the classes of grade 4-6 in one central primary school in each township (town); 3 administrative villages were selected in each township (town) to carry out community health education activities. Before and after the health education activities, questionnaire surveys on health education of drinking-water-borne endemic fluorosis prevention knowledge were conducted among 30-50 primary school students of grade 5 in the central primary school and 15-30 housewives in the school location in each township (town), to evaluate the effect of health education.Results:The baseline survey included 29 085 primary school students and 14 361 housewives. After the health intervention, 25 671 primary school students and 12 821 housewives were surveyed. The awareness rate of primary school students increased from 56.12% before the intervention to 92.40% after the intervention (χ 2=27 395.3, P < 0.01), and that of housewives increased from 62.62% before the intervention to 91.76% after the intervention (χ 2=9 560.8, P < 0.01). Conclusions:After implementation of drinking-water-borne endemic fluorosis health education intervention, the awareness rates of prevention and treatment knowledge in primary school students and housewives in Henan Province are significantly increased. It is suggested that the scope of health education should be further expanded.
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Objective:To evaluate the effect of health education project on prevention and control of endemic diseases in Henan Province.Methods:According to the distribution and condition of endemic diseases in Henan Province, from 2008 to 2015, five project counties (cities, districts, referred to as counties) were selected in each provincial city. Three townships (towns) were selected from each project county as project townships (towns), and one central primary school and the village where the school was located were selected from each township (town) as health education survey sites. The prospective study method was adopted. Firstly, the students in the primary school of the project township (town) and the housewives in the project village were investigated with questionnaire. The intervention activities of health education were carried out in the county, township (town), village and school of the project. The intervention effect of health education was evaluated by questionnaire survey two months later.Results:There were 111 870 people investigated in Henan Province, including 74 580 students and 37 290 housewives. A total of 99 671 people were surveyed after the intervention, including 66 249 students and 33 422 housewives. Elementary student's awareness rate of endemic diseases prevention and control knowledge increased from 59.74% before intervention to 92.89% after intervention, the housewives' awareness rate increased from 65.62% before intervention to 91.82% after intervention. The awareness rate of the target population increased from 61.70% before intervention to 92.53% after intervention ( P < 0.01); among them, the awareness rates of iodine deficiency disorders, drinking water type fluorosis, coal-burning type fluorosis, drinking water type arsenic poisoning, Kashin-Beck disease and Keshan disease were significantly increased ( P < 0.01). Conclusion:With the implementation of health education project, the awareness rate of knowledge on endemic diseases has increased distinctly.
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Objective:To understand the status of drinking water-borne endemic fluorosis in Henan Province, so as to provide scientific basis for improving prevention and control strategies.Methods:Ten counties (districts, referred to as counties) were selected from drinking water-borne endemic fluorosis areas of Henan Province in 2018. Three villages in each project county were selected according to the disease status of mild, moderate and severe conditions, and the operation status of water improvement projects, water fluoride content and dental fluorosis among children aged 8 to 12 years in each diseased village were monitored.Results:Totally 30 villages were surveyed, all of which were in the water improvement projects; a total of 25 water improvement projects were monitored, all of them were in normal operation, and the water fluoride exceeding standard rate was 28.00% (7/25), the qualified rate of water fluoride in the water improvement projects was 72.00% (18/25). Among them, 21 villages were in normal operation and the water fluoride in the water improvement projects met national standard. In which the detection rate of dental fluorosis among children aged 8 to 12 years was 36.71% (606/1 651), the index of dental fluorosis was 0.74, and the epidemic intensity was extremely mild. Water fluoride of water improvement projects in 9 villages exceeded the national standard, where the detection rate of dental fluorosis among children aged 8 to 12 years was 43.57% (261/599), the index of dental fluorosis was 0.78, and the epidemic intensity was extremely mild. The detection rate of dental fluorosis among children in the villages where the water fluoride of water improvement projects exceeded the national standard was higher than that in the villages where the water fluoride of water improvement projects met the national standard (χ 2=8.752, P < 0.01). Conclusions:The excessive fluorine content in the water of water improvement projects is still serious, and the epidemic is still severe. It is necessary to strengthen the scientific demonstration of the water improvement project construction and the project acceptance upon completion, so as to prevent unqualified projects from being put into use. We will carry out regular water quality monitoring and promptly rectify projects with water quality exceeding the standards.
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Objective:To investigate the iodine nutritional status of pregnant women in Henan Province after implementation of new standard of iodized salt, and to provide evidence for scientific adjustment of control strategy.Methods:In 2018, according to "Henan Surveillance Program on Iodine Deficiency Disorders", 5 townships were randomly picked out based on their sub area positions of east, west, south, north and middle in each county in the non-high iodine areas of 156 non-high iodine and high iodine counties (cities, districts). Then 20 pregnant women were sampled in each chosen township to collect and determine their salt and urinary iodine contents. The iodine level in salt was determined by direction titration; the salt samples from Sichuan and other enhanced salt samples were detected by arbitration; iodine content in urine was tested by arsenic cerium catalytic spectrophometry.Results:In total, 15 430 household salt samples of pregnant women were collected and determined; the coverage rate of iodized salt was 95.4% (14 721/15 430) and the consumption rate of qualified iodized salt was 87.0% (13 426/15 430); the median of salt iodine was 25.8 mg/kg. Totally 15 378 urine samples were collected and the median urinary iodine was 188.0 μg/L. The medians of urinary iodine of early, middle and late pregnant were 190.2, 188.9 and 186.0 μg/L, respectively.Conclusions:After the implementation of new standard of iodized salt, the iodine nutritional status of pregnant women in Henan Provence is totally appropriate. The surveillance of iodine status and the universal salt prevention and control strategies among pregnant women should be continuously presented to ensure the moderate amount of iodine intake.
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Iodine nutrition surveillance of vulnerable population was conducted in 18 cities of Henan Province in 2015. The medians and quartiles of urinary iodine concentration in women of reproductive-age (n=3 318), pregnant women (n=36 366), lactating women (n=4 153), infants <2 years of age (n=1 017), and children aged 8-10 years (n=4 806) were 202.1(124.0, 310.0), 192.4(133.6, 262.4), 168.3(119.1, 248.3), 214.2(156.1, 272.3) and 90.0 (121.8, 285.6) μg/L, respectively. Iodine status of the vulnerable populations was generally regarded as adequate in Henan Province. But the median of urinary iodine concentration of reproductive-age women were slightly above the adequate level. The proportions above iodine adequate level were 26.7% in reproductive-age women, 29.4% in pregnant women and 22.5% in children aged 8-10 years.
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Objective To investigate the iodine nutritional status among children aged 8-10 years old in Henan Province after five years of implementation of new standard iodized salt,and to provide evidence for scientific adjustment of control strategy.Methods In 2017,according to "Henan Surveillance Program on Iodine Deficiency Disorders",children aged 8-10 years old (half males and half females) were chosen as research targets.In nonhigh iodine areas of 156 non-high iodine counties (cities,districts) and high iodine counties (cities,districts) in Henan Province,household salt samples were collected;in 113 counties (cities,districts),urine samples were collected;in 67 counties (cities,districts),thyroid volume was measured.Salt iodine was tested by direction titration,the salt samples from Sichuan and other enhanced salt samples were tested by the arbitration method;urinary iodine was tested by arsenic cerium catalytic spectrophometry;thyroid volume was measured by ultrasound method.Results In 2017,totally 31 174 household salt samples of 8-10 years old children were collected and tested,the median of salt iodine was 25.8 mg/kg;the coverage rate of iodized salt was 95.0％ (29 613/31 174) and the consumption rate of qualified iodized salt was 85.6％ (26 673/31 174).Totally 22 442 urine samples were collected and the median of urinary iodine content was 208.0 μg/L.Totally 13 439 school children were examined thyroid volume and the goiter rate.was 1.5％ (196/13 439).Conclusions After the promotion of new standard iodized salt,the iodine nutritional status of children aged 8-10 years old in Henan Province is appropriate.However,the consumption rate of qualified iodized salt is lower,so the universal salt iodization prevention and control strategies should be performed for a long time.At the same time,health education of iodine deficiency knowledge should be strengthened.
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Objective To investigate the consumption rate of non-iodized salt,and evaluate the iodine status and goiter prevalence among school children in high water iodine areas of Henan Province from 2014 to 2015.Methods In the 20 counties with high water iodine,one township was randomly selected from each location (east,west,south,north and middle) in each county;secondly,4 villages were selected from each chosen township;thirdly,15 households were selected to collect salt samples from each chosen village.In the 10 chosen counties,one village with high water iodine was selected and water samples were collected;one school was sequentially selected from the chosen village and 100 school children aged 8-10 were chosen to collect their urine samples and measure their thyroid volume.Salt iodine was tested by semi-quantitative method;iodine contents of urine and water were tested by arsenic cerium catalytic spectrophometry;thyroid volume was measured by ultrasound method.Results In the 20 counties with high water iodine,4 440 salt samples were collected and tested both in 2014 and 2015;the rates of non-iodized salt were 98.2％ (4 363/4 440) in 2014 and 98.3％ (4 366/4 440) in 2015.In the 10 chosen counties,the median water iodine contents from the chosen villages were 202.0 μg/L in 2014 and 235.0 μg/L in 2015;970and 999 urine samples of the students from the chosen villages were collected and tested in 2014 and 2015,and the median urinary iodine contents were 251.9 μg/L in 2014 and 290.6 μg/L in 2015;937 and 948 students were examined in 2014 and 2015,the goiter rates were 3.4％ (32/937) in 2014 and 7.8％ (74/948) in 2015.Stratified by water iodine,the urinary iodine contents and goiter rates of school children increased with the rise of water iodine content.When the water iodine content exceeded 300 μg/L,goiter rate of school children was 8.4％,which was higher than other groups (P ＜ 0.05).Conclusions After stopping the supple of iodized salt in high water iodine areas,the current iodine status and goiter rate of school children are still higher than normal levels.Both noniodized salt supply and water improvement to reduce water iodine content should be taken in the areas with water iodine higher than 150 μg/L.
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Objective To characterize the gestational changes of iodine nutrition and thyroid function and to explore the factors associated with the thyroid function in pregnant women.Methods A longitudinal survey was conducted in 130 pregnant women in Luohe city of Henan province from October 2012 to May 2013.Samples of fasting blood and urine were collected in each trimester to test on thyroid function and urinary iodine.Data regarding social demography and lifestyle behavior were collected through questionnaire in the first trimester.Results The medians of urinary iodine (MUI) for pregnant women were 238.9,150.8 and 306.4 μg/L in the first,second and third trimesters,respectively (P＜0.05).With the increase of gestational age,the level of free triiodothyronine (FT3) showed no significant change (P＞0.05) but the level of free thyroxine(FT4) decreased (P＜0.05),with the level of thyroid stimulating hormone (TSH) increased and then declined (P＜0.05).A U-shaped curve were seen between iodine nutrition and thyroid function.With the increase of iodine level,the level of TSH first increased and then decreased while the levels of FT3 and FT4 showed the opposite trend.The level of TSH was influenced by factors as education level,history of chronic diseases,history of CT and X-ray examination,and intake of pickled food etc.The level of FT4 was associated with residence (urban or rural),stressful events in the previous year,daily means of transportation,and the hours of sedentariness,working and sleeping.Conclusion Significant differences were noticed in iodine nutrition and thyroid function of pregnant women during the three trimesters.It was essential to establish specific reference ranges for different trimesters.Thyroid functions of pregnant women seemed to be associated with iodine level and lifestyle.
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Objective To know the rural doctors' knowledge,belief and practice on iodine deficiency disorders(IDD),as well as their capability on health education communication in Ye County,Henan Province.Methods Semi-structured interviews were conducted among 50 rural doctors in Ye County,Henan Province.Topics covered include:sales of salt purchases,daily supervision and monitoring activities of salt,the health effects of salt,the situation of rural doctors trained,the situation of rural doctors participated in health education and related recommendations.Results ①Twenty-nine of the rural doctors knew exactly the advantage of salt iodization.②Thirty-nine of the rural doctors had taken part in the half quantitative detection of salt once or twice a year and 15 of them knew the supervision activities of salt industry department.③Forty-nine of the rural doctors believed salt iodization was beneficial to health and 48 of them were willing to participate in health education on IDD.④The major ways of their acquiring health knowledge were promotional materials [54.0％ (27/50)],TV [50.0％ (25/50)],and lecture/training [24.0％ (12/50)].⑤Thirty-seven of the rural doctors had taken part in health education on IDD.They were used to use booklets [68.0％ (34/50)],promotional slogan [36.0％ (18/50)],broadcast [24.0％ (12/50)],and doctor consultation [24.0％ (12/50)].⑥Twenty-eight of the rural doctors thought the current health education on IDD was better.They hoped to reduce the price of salt,strengthen supervision,receive more training and health education on IDD.Conclusions The rural doctors remain relatively lack of knowledge on IDD.Rural doctors have the initiative and responsibility to conduct health education on IDD,but their pattern is still a one-way propagation.
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Objective To understand the fairness of health resources of endemic diseases institutions in Henan Province,to provide evidence for endemic allocation of health resources for the government.Methods Health-related data resources in endemic disease prevention and control institutions were collected in Henan Province,including personnel,business space area,the value of equipment,and health funding,etc.The percentages of population distribution and geographical distribution of health resources were calculated; Lorenz curves of demographic fairness and geographic fairness were drawn.According to Lorenz curve (Gini coefficients of the population and the geographical distribution were calculated based on Lorenz curve),Gini coefficients were used to evaluate the fairness of the endemic disease prevention institutions for health resource allocation.Results As can be seen from Lorenz curve,the population fairness of endemic disease prevention and health personnel was the best,but the number of senior officers was less and the total value of equipment owned was low.The geographical fairness of all the indicators of health resources was poorer,and geographic fairness among senior officers was the worst.The Gini coefficient of health technical personnel,senior personnel,undergraduate or above personnel,value of equipments,area of business room and health funding allocation determined by the population distribution was less than 0.4.The health resources were relatively fair and reasonable according to the distribution of population.The Gini coefficients of all the indicators determined by the distribution of geography were higher than those determined by the distribution of population.Furthermore,the geographic Gini coefficient of senior personnel was above 0.4 which was in the vigilance state.Conclusions The equality of health resources determined by population distribution in the institutions for endemic diseases control in Henan is superior to those determined by geographic distribution.The allocations of health resources of endemic diseases control in different areas are unbalanced.
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Objective To summarize our experience in the prevention and treatment of right accessory hepatic duct and right hepatic duct injury during laparoscopic cholecystectomy. Methods The clinical data of 21 cases with right accessory hepatic duct or right hepatic duct during laparoscopic cholecystectomy were reviewed retrospectively. Result According to anatomy identified by preoperative work-up and selective cholangiography during the operation, 18 cases had the right accessory hepatic duct,eleven of them were confirmed intraoperatively. The accessory hepatic ducts were conserved in 3 cases and clipped without biliary leaks postoperativly in 7 cases; One case had biliary leaks postoperatively with the duct sutured intraoperatively, and recovered well conservative therapy. Accessory hepatic ducts were accidentally injuried in 7 cases, two patients were transferred to open surgery; three cases were confirmed to be injuried and clipped by second laparoscopic exploration because of biliary leaks postoperatively. Three cases had a low confluence of the right and left hepatic duct with the gallbladder duct joining the right bile duct, the ducts were conserved in 2 cases and injuried in one. Postoperatively all these 21 cases were followed up for 2 years, without jaundice or liver dysfunction. Conclusions To prevent injury of right accessory hepatic duct and right hepatic duct. High vigilance and familiarity with the anatomic variants of the biliary tree and intraoperative cholangiography in selective cases are fundmental.
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Objective:Establishing the hepatic stem cell(WB-F344)line that expresses human interleukin-2 stably and effectively.Methods: We constructed the retroviral vector Plpcx-il-2 containing human interleukin-2 gene, and transfected it into PT67 packaging cells.The infectious viruses were used to infect the hepatic stem cell WB-F344,then the puromycin resistant clones were acquired after puromycin selection.The expression of IL-2 was detected using RT-PCR,immunocytochemistry, Western blot and indirect immunofluorescence, respectively.Results: The retroviral vector containing human IL-2 gene was constructed.The titer of virus in the supernatant reached 10~5 CFU/ml after transfecting PT67 packeting cells.The puromycin resistant clones were acquired after infection of WB-F344 and the cell line WB-F344/Plpcx-IL-2 expressing human interleukin-2 stably was established.Conclusion: By retroviral-mediated transfecting human interleukin-2 gene, the hepatic stem cell stably and effectively expressing interleukin-2 are obtained.This provides a good basis for further research on immuno-gene therapy of liver cancer.