Achievements, main experiences, challenges and suggestions on control of endemic diseases in China in the last decade / 中华地方病学杂志

Since the 18th National Congress of the Communist Party of China (CPC), the CPC Central Committee and the State Council have paid great attention to the prevention and control of endemic diseases. Through the implementation of the prevention and control measures of endemic diseases, especially the implementation of the "Six Major Actions" to tackle key problems in "three years' project", all kinds of diseases have met the relevant requirements. The prevention and control of endemic diseases in China has achieved remarkable results and made historic achievements. However, risk challenges remain. At present, there are still some problems in the management and treatment of patients with iodine deficiency disorders, water-borne iodine excess goiter, drinking water-borne endemic fluorosis and drinking tea-borne endemic fluorosis in China, which need to be solved by strengthening the prevention and control efforts.

IL-6 and IL-10 gene polymorphisms and susceptibility to autoimmune thyroid disease: a Meta analysis / 中华地方病学杂志

Objective:To clarify the relationship between interleukin (IL)-6, IL-10 gene polymorphisms and autoimmune thyroid disease (AITD).Methods:Literature search was conducted through databases such as PubMed, Web of Science, CNKI, Embase, Wanfang Database and VIP.com, and domestic and foreign literatures related to IL-6, IL-10 gene polymorphisms and AITD were included in the study. The time limit was from the self-built of the databases to July 2021. Meta-analysis was performed with STATA 16.0 software, the odds ratio ( OR) and 95% confidence interval ( CI) were used as effect indicators, random-effect or fixed-effect model was selected according to the heterogeneity results, and the source of heterogeneity was explored through subgroup analysis. Publication bias was assessed using funnel plots and Egger's test. Results:Finally, 19 literatures were included, all in English. There were 12 studies on IL-6 genes and 11 studies on IL-10 genes, including 4 studies on both IL-6 and IL-10 genes. In the whole population, the loci associated with AITD were IL-6 -174 G/C site (GG vs CC + GC: OR =1.94, 95% CI = 1.01 - 3.76), IL-6 -572 G/C site (GG + GC vs CC: OR = 0.49, 95% CI = 0.29 - 0.84; GG vs CC + GC: OR = 0.76, 95% CI = 0.60 - 0.96; GG + CC vs GC: OR = 0.63, 95% CI = 0.49 - 0.81), IL-10 -819 T/C site (TT + TC vs CC: OR = 1.84, 95% CI = 1.01 - 3.34; T vs C: OR = 1.59, 95% CI = 1.00 - 2.51), and IL-10 -1 082 A/G site (AA + AG vs GG: OR = 0.77, 95% CI = 0.64 - 0.92; AA vs GG + AG: OR = 2.03, 95% CI = 1.16 - 3.58; A vs G: OR = 0.76, 95% CI = 0.61 - 0.94). The results of subgroup analysis showed that in Asian population, the loci associated with AITD were IL-6 -174 G/C site (GG vs CC + GC: OR = 4.61, 95% CI = 1.11 - 19.23; G vs C: OR = 0.65, 95% CI = 0.44 - 0.97); IL-6 -572 G/C site (GG vs CC + GC: OR = 0.64, 95% CI = 0.41 - 0.99; GG + CC vs GC: OR = 0.60, 95% CI = 0.38 - 0.94); IL-10 -819 T/C site (TT + TC vs CC: OR = 2.51, 95% CI = 1.48 - 4.25; T vs C: OR = 1.91, 95% CI = 1.05 - 3.46); and IL-10 -1 082 A/G site (AA + AG vs GG: OR = 0.66, 95% CI = 0.52 - 0.84; AA vs GG + AG: OR = 2.83, 95% CI = 1.54 - 5.21; A vs G: OR = 0.66, 95% CI = 0.53 - 0.82). Conclusion:IL-6 -174 G/C, IL-6 -572 G/C, IL-10 -819 T/C and IL-10 -1 082 A/G polymorphisms are associated with the susceptibility to AITD, especially in Asians.

Achievement during the 13th Five-Year Plan and analysis of the 14th Five-Year Plan on prevention and control of endemic diseases in China / 中华地方病学杂志

During the 13th Five-Year Plan period, remarkable progress has been made in prevention and control of endemic diseases in China through implementation of the national plan for prevention and control of endemic diseases and the special three-year action plan for prevention and control of endemic diseases. This paper reviewed the achievements made in prevention and control of endemic diseases in China during the 13th Five-Year Plan period, discussed the current problems we are facing on prevention and control of endemic diseases. The key tasks of prevention and control of endemic diseases during the 14th Five-Year Plan period are indicated in order to carry out scientific and accurate prevention and control of endemic diseases.

The role of TSH-THSR-cAMP-PKA signal pathway in the process of iodine uptake in lactating rat mammary gland / 中华地方病学杂志

Objective:To observe the mRNA and protein expression levels of thyroid stimulating hormone receptor (TSHR), protein kinase A (PKA) and sodium iodine transporter (NIS) in mammary gland tissue of lactating rats with different iodine nutrition levels, and to explore the role of thyroid stimulating hormone (TSH)-THSR-cyclic adenosine monophosphate (cAMP)-PKA signal pathway in the process of mammary iodine uptake during lactation.Methods:Using a group design, according to body weight (80 - 100 g), 110 Wistar female rats were randomly divided into normal iodine (NI) group, severe iodine deficiency (SID) group, moderately iodine deficiency (MID) group, moderately iodine excess (MIE) group and severe iodine excess (SIE) group, with 22 rats in each group. Another 22 Wistar male rats were selected, and the feeding situation was consistent with that of NI group. After 3 months of feeding, 24-hour urine samples of female rats were collected, and the female rats were caged with the male rats (5 ∶ 1). After mating, each female rat was fed separately. At 10 days of childbirth, the lactating rats were sacrificed and thyroid and mammary gland tissues were taken. The urinary iodine was determined by arsenic cerium catalytic spectrophotometry. The morphological changes of thyroid and mammary gland tissues were observed by HE staining. The mRNA expression levels of TSHR, PKA and NIS in thyroid and mammary gland tissues were measured by real-time PCR; the protein expression levels of TSHR, PKA, phosphorylated PKA (p-PKA), and NIS in mammary gland tissue were measured by Western blotting.Results:Compared with NI group (162.59 μg/L), the median urinary iodine of female rats in SID and MID groups (3.16, 6.36 μg/L) was lower, and the median urinary iodine of female rats in MIE and SIE groups (2 356.27, 11 507.29 μg/L) was higher ( P < 0.01). HE staining showed that different levels of iodine uptake had different effects on thyroid follicles: most of the follicles in NI group were uniform round or oval; in MID group, the number of small follicles increased, the epithelial cells were monolayer columnar or cubic, the follicular cavity became smaller, and the glia decreased; the follicles in SID group became smaller, and the epithelial cells were columnar or high columnar, with reduced or absent glia in the follicular cavity; pleomorphic changes were found in thyroid follicles in SIE and MIE groups, with some follicles significantly enlarged and some small follicles hyperplasia. Different levels of iodine intake had different effects on mammary duct: compared with NI group, the connective tissue around the mammary duct in SID and MID groups showed obvious fibrosis, while the fibrosis in MIE and SIE groups was significantly reduced. The results of real-time PCR showed that there were significant differences in the mRNA expression levels of TSHR, PKA and NIS in thyroid tissues of lactating rats with different levels of iodine nutrition ( F = 10.73, 92.37, 115.75, P < 0.01). There were statistically differences in the mRNA expression levels of TSHR, PKA and NIS in mammary gland tissues of lactating rats with different levels of iodine nutrition ( F = 40.25, 39.63, 14.92, P < 0.05). Western blotting results showed that there were significant differences in the protein expression levels of TSHR, PKA, p-PKA and NIS in mammary gland tissues of lactating rats with different levels of iodine nutrition ( F = 4.14, 6.73, 8.48, 4.51, P < 0.05). Among them, the protein expression level of TSHR in MIE and SIE groups was lower than that in NI group ( P < 0.05); the protein expression level of PKA in SID and MID groups was higher than that in NI group ( P < 0.05); the protein expression level of p-PKA in SID group was higher than that in NI group, but that in SIE group was lower than that in NI group ( P < 0.05), the protein expression level of NIS in SID group was higher than that in NI group ( P < 0.05). Conclusions:The mRNA and protein expression levels of TSHR are decreased in mammary gland tissues of lactating rats with high iodine intake, while the mRNA and protein expression levels of PKA and NIS are increased in low iodine intake. TSH-TSHR-cAMP-PKA signal pathway may be involved in the regulation of iodine intake in mammary gland tissue of lactating rats, which may protect itself and its offspring.

Determination of iodine in serum: verification of inductively coupled plasma mass spectrometry / 中华地方病学杂志

Objective:To verify the determination method of iodine in serum by inductively coupled plasma mass spectrometry (ICP-MS) and to evaluate the consistency between ICP-MS and As 3+-Ce 4+ catalytic spectrophotometry in determination of serum iodine. Methods:Serum iodine concentration was determined by ICP-MS, 187Re was used as an internal standard, and ralated parameters were optimized. Eighty-eight serum samples were simultaneously determined by ICP-MS and As 3+-Ce 4+ catalytic spectrophotometry, and the evaluation indexes included determination range of standard curve, detection limit, precision, accuracy. In addition, we also evaluated the consistency of the two methods through inter-group correlation analysis, intra-group correlation coefficient analysis, Passing-Bablok regression and Bland-Altman analysis. Results:The linear range of ICP-MS standard curve was 0 - 300 μg/L. There was a good linear correlation between iodine concentration value and iodine response value, and the correlation coefficient range was 0.999 8 to 0.999 9. The detection limit of the ICP-MS method was 1.96 μg/L. The relative standard deviation ( RSD) ranged from 0.2% to 1.4% and from 0.4% to 1.8% for intra and inter-batch precision tests of serum samples. The recovery rate ranged from 90.44% to 108.71%. The correlation analysis of 88 serum samples showed that there was a good correlation between the two methods ( r = 0.934, P < 0.05), and the intra-class correlation coefficient was 0.932. The results of Passing-Bablok regression showed that there was no significant difference between the two methods ( P > 0.05). Bland-Altman diagram suggested that the results of the two methods were consistent. Conclusions:ICP-MS method has low detection limit, high precision and accuracy. ICP-MS method is simple, rapid, easy and suitable for determination of iodine in large quantities of serum samples. The results of the two methods for determining serum iodine are consistent.

Reuse process of positive pressure powered air-filter protective hoods / 浙江大学学报·医学版

OBJECTIVE@#To establish reuse process of positive pressure powered air-filter protective hoods during coronavirus disease 2019 (COVID-19) epidemic.@*METHODS@#The procedure of pretreatment, storage, recovery, cleaning, disinfection and sterilization process of positive pressure powered air-filter protective hoods, which were used in the treatment of COVID-19 infection patients was established in Central Sterile Supply Department of the hospital. The cleaning and disinfection effects of the protective hoods after treatment were examined by magnifying glass method, residual protein detection method, real-time PCR, and agar pour plate method.@*RESULTS@#Twenty five used protective hoods underwent totally 135 times of washing, disinfecting and sterilizing procedures. After washing, all the protein residue tests and COVID-19 nucleic acid tests showed negative results. After sterilizing, all the protective hoods met sterility requirement. All the tested protective hoods were undamaged after reprocessing.@*CONCLUSIONS@#The established reuse procedures for used positive pressure powered air-filter protective hoods are safe.

Effects of different iodine levels on brain development and ethology in offspring of EAT rats / 中华地方病学杂志

Objective:By establishing a rat model of experimental autoimmune thyroiditis(EAT), to investigate the effects of different iodine intake on the hippocampal morphology, monoamine neurotransmitters and ethology of the offspring of EAT rats.Methods:A total of 60 female and 20 male Lewis rats with a body weight of 50 - 60 g were selected. Female rats were divided into 4 groups (15 rats in each group) with random number table method according to their body weight: control group (NI group), thyroglobulin group (Tg group), Tg + high iodine Ⅰ group (Tg + HⅠ group), and Tg + high iodine Ⅱ group (Tg + HⅡ group), and the latter three groups were model groups. The contents of iodine in drinking water of the 4 groups were 100 μg/L, 100 μg/L, 20 mg/L and 200 mg/L, respectively. Rats in the model groups were immunized with porcine thyroglobulin (PTg) subcutaneously at multiple sites, and the NI group was injected with normal saline, once every 2 weeks, 3 times in total. The rats in each group were mated in cages according to the ratio of 3 : 1 between female and male. After experiment of the offspring, the urine samples of mother rats were collected within the previous week, urinary iodine concentration was determined by As 3+-Ce 4+ catalytic spectrophotometry; then the mother rats were killed, HE staining was used to observe the changes of thyroid histomorphology and the infiltration of inflammatory cells; serum thyroglobulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) of mother rats were determined by radioimmunoassay. Brain tissues were collected from 7 days old offspring, hippocampal morphology of 7 days old offspring was observed by toluidine blue staining; the contents of norepinephrine (NE), dopamine (DA) and 5-hydroxytryptamine (5-HT) in brain tissues of 7 days old offspring were measured by enzyme-linked immunosorbent assay (ELISA); 30 and 60 days old offspring were used for water maze-location navigation test and open field test. Results:The levels of urinary iodine increased significantly of mother rats in Tg + HⅠ and Tg + HⅡ groups than that in NI group (median, μg/L: 35 380.18, 236 847.16 vs 221.43, P < 0.05). HE staining showed that the thyroid tissue of mother rats in Tg, Tg + HⅠ and Tg + HⅡ groups had different degrees of destruction and inflammatory cells infiltration, and the degree of destruction and infiltration increased with the increase of iodine intake. Compared with NI group, the contents of TgAb and TPOAb in serum of mother rats in Tg, Tg + HⅠ and Tg + HⅡ groups were significantly increased(2.118 4 ± 0.675 1, 2.103 0 ± 0.714 1, 2.783 6 ± 1.084 3 vs 0.790 1 ± 0.101 0, P < 0.05; 1.015 8 ± 0.252 8, 1.019 5 ± 0.202 0, 0.936 6 ± 0.183 4 vs 0.692 2 ± 0.111 9, P < 0.05), and the content of TgAb in Tg + HⅡ group was significantly higher than that in Tg and Tg + HⅠ groups ( P < 0.05). Compared with NI group, the number of hippocampal neurons decreased and relative damage occurred in Tg, Tg + HⅠ and Tg + HⅡ groups of the offspring. Compared with NI group, the NE contents in brain tissues of the offspring in Tg, Tg + HⅠ and Tg + HⅡ groups decreased (pg/ml: 1 232.01 ± 253.45, 1 197.64 ± 222.46, 1 074.40 ± 366.38 vs 1 733.67 ± 158.12, P < 0.05); there were no significant differences in DA and 5-HT contents in brain tissues of offspring in each group ( P > 0.05). In the water maze-location navigation test, the latency of the Tg + HⅡ group on the 4th day of the 30 days old offspring reaching the platform was significantly longer than that of the NI and Tg groups ( P < 0.05). In the open field test, there was no significant difference in 30 and 60 days old offspring in the latency of moving the original quadrant ( P > 0.05). Conclusions:With the increase of iodine intake, the degrees of thyroid tissue destruction and inflammatory cells infiltration in EAT rats increase, and the levels of TgAb in serum increase significantly. Iodine has certain effects on the hippocampal morphology and the level of monoamine neurotransmitters in the brains of the offspring of EAT rats. The effects of different iodine-induced EAT rats on their offspring's learning, memory and spatial exploration are mainly shown in childhood.

The effects of iodine excess on thyroid function, antibody and TSHR gene expression in experimental autoimmune thyroiditis rats / 中华地方病学杂志

Objective:Experimental autoimmune thyroiditis (EAT) rat model was establish to observe the effects of iodine excess on thyroid function, antibody and thyrotropin receptor (TSHR) gene expression in EAT rats, and to explore the role of TSHR gene in autoimmune thyroiditis.Methods:According to body weight (80 - 180 g), 48 rats (4-week-old female Lewis) were randomly divided into control group, thyroglobulin (TG) group, TG + high iodine Ⅰ(TG + HⅠ) group, and TG + high iodine Ⅱ (TG + HⅡ) group, 12 rats per group. The iodine concentration in drinking water given to each group was 50 μg/L, 50 μg/L, 20 mg/L and 200 mg/L, respectively. At the same time, rats in TG, TG + HⅠ and TG + HⅡ groups were immunized once every two weeks for three times using pTg and CFA as immunoreagent. Paraffin embedded sections of thyroid tissues were used to observe the pathological changes of rats. The serum levels of thyroglobulin antibody (TgAb), thyroperoxidase autoantibody (TPOAb), free triiodothyronine (FT 3) and free thyroxine (FT 4) in rats were determined by radioimmunoassay. Serum TSHR content in rats was determined by enzyme linked immunosorbent assay (ELISA). The expression of TSHR mRNA in whole blood and thyroid tissue of rats was determined by RT-PCR. The expression of TSHR protein in thyroid tissue of rats was determined by immunohistochemistry (IHC). Results:Hematoxylin-eosin (HE) showed that the thyroid follicles in control group were complete in structure and regular in shape, and no lymphocyte infiltration was observed. A small number of lymphocytes were observed in TG group and scattered in distribution. Follicular structure destruction, fusion and interfollicular infiltration were observed in TG + HⅠ group and TG + HⅡ group. There were significant differences in serum TgAb, TPOAb, FT 3 and FT 4 levels among all groups ( H = 30.28, 21.99, 12.87, 26.69, P < 0.05). Compared to the control group [6.89 (6.32, 7.27), 11.02 (7.60, 12.53), 5.05 (2.71, 7.99), 7.51 (6.50, 9.24) pmol/L], the levels of TgAb [34.99 (25.39, 41.35), 37.70 (29.06, 43.99), 46.41 (38.52, 55.26)], TPOAb [22.87 (13.65, 31.82), 22.22 (14.82, 28.33), 14.61 (12.95, 19.34)], FT 3 [57.74 (24.56, 64.27), 43.64 (5.69, 80.03), 38.56 (17.73, 47.59) pmol/L], and FT 4 [62.16 (41.22, 91.57), 60.61 (35.52, 103.31), 47.96 (31.84, 112.71) pmol/L] were significantly higher in TG group, TG + HⅠ group, and TG + HⅡ group ( P < 0.05). Compared with the control group [(249.37 ± 38.12) μU/L], TG group [(225.33 ± 41.28) μU/L], and TG + HⅠ group [(218.15 ± 65.51) μU/L], TSHR expression level in TG + HⅡ group [(154.26 ± 25.95) μU/L] were significantly decreased ( P < 0.05). The mRNA expression levels of TSHR gene in the whole blood (0.89 ± 0.19, 0.89 ± 0.30, 0.85 ± 0.24) and thyroid tissue(0.63 ± 0.25, 0.46 ± 0.16, 0.51 ± 0.25) of TG group, TG + HⅠ group and TG + HⅡ group were significantly lower than that of control group (1.00 ± 0.05, 1.13 ± 0.21, P < 0.05). IHC showed that the positive intensity of TSHR protein in control group was significantly higher than that in TG group, TG + HⅠ group and TG + HⅡ group. Conclusions:Long-term exposure to high iodine will eventually lead to the damage of iodine-uptake function in thyroid gland and thyroid diseases. Abnormal expression of TSHR gene may lead to antigenicity of thyrotropin binding site in extracellular receptor region and autoimmune thyroid disease.

Relationship between gene copy number variation of PI3K/AKT signaling pathway and thyroid cancer: a recent advance / 中华地方病学杂志

At present,more and more studies have shown that gene copy number variation can be involved in the occurrence,development and outcome of thyroid cancer.The studies on the copy number variation of genes related to phosphatidylinositol-3 kinase/protein kinase B (PI3K/AKT) signaling pathways can serve as molecular bases for further understanding the gene map of thyroid cancer subtypes,as well as the accurate diagnosis of thyroid cancer and the development of precise molecular targeted therapy.This review summarizes recent advances on correlation between PI3K/AKT pathway-related gene copy number variation and thyroid cancer.

Effects of different water iodine level on iodine nutrition and thyroid function in pregnant women / 中华地方病学杂志

Objective To understand the effects of different water iodine level on iodine nutrition and thyroid function in pregnant women,and provide a reference for prevention and treatment of iodine deficiency disorders in the future.Methods According to the background material of water iodine in provinces given non-iodized salt,the administrative villages with water iodine content ＜ 10,10-49,50-99,100-299 and ≥ 300 μg/L were selected as survey sites in Shandong,Shanxi,Hebei,Henan,Jiangsu and Anhui provinces.Urine,blood,drinking water and salt samples were collected from pregnant women at the site of investigation,and urinary iodine,serum iodine,thyroid function and antibody index,water iodine,and salt iodine were measured;thyroid volume was also examined.Results A total of 575 pregnant women were investigated.The medians urinary iodine of pregnant women with water iodine ＜ 10,10-49,50-99,100-299 and ≥300 μg/L groups were 175.55,180.90,139.70,330.15 and 817.70 μg/L,respectively,and the differences were statistically significant in different water iodine groups (H =152.593,P ＜ 0.01).The levels of serum iodine and free thyroxine (FT4) were significantly different among pregnant women in different water iodine groups (H =82.843,F =3.070,P ＜ 0.01 or ＜ 0.05).However,there was no significant difference in serum thyroid stimulating hormone (TSH) levels (H =1.774,P ＞ 0.05).And with the increase of water iodine levels,the abnormal rate of TSH showed the phenomenon of middle low and both ends high ("U" type,x2 =16.729,P ＜ 0.01).There were no significant differences in the positive rates of serum thyroid peroxidase antibody (TPOAb),thyroglobulin antibody (TgAb),any antibody and double antibodies in pregnant women among different water iodine groups (P ＞ 0.05).And there was a statistically significant difference in the detection rate of subclinical hypothyroidism (x2 =11.869,P ＜ 0.05).The rates of goiter in pregnant women among different water iodine groups were less than 5％.The difference in detection rates of thyroid nodules was statistically significant (x2 =13.591,P ＜ 0.05),and the rate was the highest in water iodine ≥300 μg/L group (21.33％,16/75).Conclusions In water iodine ≥300 μg/L group,urinary iodine level of pregnant women is in the level of iodine excess,and serum iodine level,FT4 level,thyroid nodules detection rate are higher.The abnormal rate of serum TSH and the detection rate of hypothyroidism show a "U" curve that increases at iodine deficiency and iodine excess.

Prevalence, etiology and harm of subclinical hypothyroidism / 中华地方病学杂志

The incidence of subclinical hypothyroidism (SCH) is increasing year by year.Older people,women and people with excess iodine intake are more likely to develop the disease.SCH is caused by autoimmune thyroiditis,environmental and iatrogenic factors.Patients are prone to adverse outcomes in pregnant women and offspring,cardiovascular diseases,and abnormal lipid metabolism.Therefore,it is of great clinical and public health significance to understand and actively prevent SCH.

Observation of prolactin and estradiol levels in lactating women in different iodine nutrition areas / 中华地方病学杂志

Objective To observe prolactin (PRL) and estradiol (E2) levels in lactating women in different iodine nutrition areas.Methods According to the recent national water-borne high iodine area survey and the monitoring results of iodine deficiency disorders,the following places were selected,including Nankang,Xinggang and Yingpan towns of Beihai City,Guangxi (water iodine ≤ 10 μg/L,low iodine areas),Yangcheng Township and Jiajiazhuang Township of Fenyang City,Shanxi (water iodine 50-100 μg/L,adaptive iodine areas),Pingyao County and Jicun Town of Fenyang City,Shanxi (water iodine ≥300 μg/L,high iodine areas),and urinary and blood samples were collected in lactating women (n =100,97,123) from the three regions.The urinary iodine concentration was tested by arsenic cerium catalytic spectrophotometry.Serum levels of PRL and E2 were determined by chemiluminescence immunoassay.Results The urinary iodine medians of lactating women were 51.42,283.62,842.31 μg/L,respectively,in the three regions,the difference between the regions was statistically significant (x2 =241.09,P ＜ 0.05);the iodine levels of lactating women in low iodine areas,adaptive iodine areas and high iodine areas were in the state of iodine deficiency (＜ 100 μg/L),sufficient or adequate (200-299 μg/L) and iodine excess status (≥ 300 μg/L),respectively.Serum PRL and E2 levels of lactating women in the three types of areas were 38.81,20.98,16.41 μg/L and 29.57,43.70,45.51 ng/L,respectively.The differences between the regions were statistically significant (x2 =41.54,24.03,P ＜ 0.05).Conclusion With the increase of iodine nutrition level,PRL in lactating women has presented a gradually decreasing trend,E2 is increased.

Interpretation of "Guidelines for Monitoring of Salt Iodization Programmes and Assessment of Iodine Nutrition in the Population" of United Nations International Children's Emergency Fund / 中华地方病学杂志

Building on the results of a United Nations International Children's Emergency Fund (UNICEF)-Iodine Global Network (IGN) Technical Working Group Meeting,a new UNICEF "Guidelines for Monitoring of Salt Iodization Programmes and Assessment of Iodine Nutrition in the Population" has been formulated.This document aims to guide program managers to improve the effectiveness of national salt iodization programs.The main content of the guide is interpreted in this paper.

Methodological validation: a method for Determination of Iodine in Serum-As3+-Ce4+ Catalytic Spectrophotometry / 中华地方病学杂志

Objective To carry out a methodological validation of a new standard method "Determination of Iodine in Serum-As3+-Ce4+ Catalytic Spectrophotometry".Methods In accordance with the requirements of "Guide for Establishing Occupational Health Standards-Part 5:Determination Methods of Chemicals in Biological Materials (GB/T 210.5-2008)",the methodological validation was tested in 3 standard development and 3 verification laboratories,calculated the linear relation and range of standard curve and the lowest linmit of detection,precision,accuracy and anti-interference ability,sample stability of sample determination.Results The linear range of iodine mass concentration of the standard curve was 0 to 300 μg/L in 6 laboratories.The linear correlation coefficients of the standard curve obtained from each laboratory were 0.999 1 to 1.000 0.The detection limits of serum iodine were 1.8 to 6.9 μg/L (the.sample amount was 0.10 ml) in 5 laboratories.Precision:15 different serum samples from 5 laboratories with a total iodine concentration range of 48.8 to 273.2 μg/L were repeatedly tested for six times,the relative standard deviations (RSD) were 0.7％ to 3.8％ (the average was 1.7％).Accuracy:a total recovery of samples with iodine concentrations ranging from 26.3 to 253.3 μg/L were performed in 5 laboratories,the recoveries were 96.2％ to 105.2％ (the average was 99.8％).One laboratory carried out the standard method and the inductively coupled plasma mass spectrometry (ICP-MS) method for serum iodine determination.The recovery rates of the two methods were 96.4％ ～ 107.8％,which met the measurement requirements.Anti-interference:15 kinds of chemical reagents were added for interference test in 3 laboratories,and the results showed no deviation,indicating that the standard method had strong anti-interference.Stability:The samples could be stored for 7 days at room temperature,for 2 months at 4 ℃,and for 3 months after freezing when the assay results were not affected.Reaction temperature and time:the appropriate pairing budget for temperature and time was consistent with the standard method.Conclusion The verification of the standard method for serum iodine determination further proves that the standard method has the advantages of simple reagents preparation,wide linear range,better correlation coefficient,lower detection limit,higher precision and accuracy,stronger antiinterference ability,convenient batch testing,and wide applicability.

Advances in the relationship between iodine and thyroid carcinoma / 中华地方病学杂志

In recent years,the incidence rates of thyroid carcinoma (TC) in many countries have been increasing rapidly,especially papillary TC.But the reasons are not yet unified.The main influencing factors include improved diagnosis methods,increased screening,radiation exposure,mental stress,body mass index (BMI) and obesity.The role of iodine intaken in TC remains uncertain.It is generally believed that iodine deficiency is a risk factor for follicular TC;and excessive iodine intake can rise the constituent ratio of papillary TC.

"An interpretation of ""The Consensus of 2016 Conference on Iodine and Thyroid Disease""" / 中华地方病学杂志

The 2016 conference on iodine and thyroid disease is aimed to establish a platform for sharing the achievement on fundamental,preventive and clinical research of iodine and thyroid disease,for exchanging information between producer and consumer on iodized salt,iodine additive and iodine determination,for communication on policy and measures concerning iodine deficiency disorders (IDD) prevention and control,for promoting the exchange of experience between international and domestic scholars in IDD prevention and control and the clinical,fundamental research update and achievement,and for discussing the key and difficult problems.After communication and discussion,the participants at the 2016 conference drafted a consensus on iodine and thyroid disease.Through incorporating the current IDD prevention and control schedule and task,this article describes,elaborates and explains the key items of the consensus with expectation of a better utilization and application of the consensus in the future in IDD prevention and control.

"Review of the ""12th Five-Year Plan"" and prospect of the ""13th Five-Year Plan"" on prevention and control of endemic diseases in China" / 中华地方病学杂志

In 2012,General Office of the State Council forwarded the'12th Five-Year Plan'on National Prevention and Control of Endemic Diseases,which was jointly developed by the Former Ministry of Health,Development and Reform Commission,and Ministry of Finance.During the 12th Five-Year Plan period,the national prevention and control of endemic diseases had made steady progress.This article mainly summarized the progress made in prevention and control of endemic diseases in China during the 12th Five-Year Plan period.The main problems encountered in prevention and control of endemic diseases in China were discussed.The prevention and key research tasks of the 13th Five-Year Plan on national prevention and control of endemic diseases were introduced.In the 13th Five-Year Plan,key issues in prevention and control of endemic diseases will be the existing main problems,to carry out targeted prevention and control,and to develop scientific and accurate prevention and control plan according to law.

Iodine-rich diet and thyroid cancer: a Meta-analysis / 中华地方病学杂志

Objective To explore the relationship between iodine-rich diet and thyroid cancer.Methods PubMed,Excerpt Medica Database (EMbase),China National Knowledge Infrastructure (CNKI),WanFang,WeiPu,and China Biology Medicine disc (CBM) were searched through computer,for relevant articles published before June 2016,to find case-control studies concerning the relationship between iodine-rich diet and thyroid cancer.According to the inclusion and exclusion criteria for data extraction and quality evaluation,Meta-analysis was performed using Stata 12.0.Results Totally 19 case-control studies were included in this study.Cases and controls were 47 316 people (case 6 662,control 40 654).The quality of the literature was reliable (the score was 6 points and more).Meta analysis results showed a total of 13 articles studied fish,more frequent intake (3 times per week and more) of fish can reduce the risk of thyroid cancer [odds ratio (OR) =0.87,95％ confidence interval (CI):0.77-0.98,P ＜ 0.05];except saltwater fish,a total of 16 articles studied seafood,more frequent intake of seafood (3 times per week and more) increases the risk of thyroid cancer (OR =1.48,95％CI:1.11-1.99,P＜ 0.05).Study factors subgroup analysis showed that seafood (OR =2.23,95％CI:1.45-3.45,P ＜ 0.05),marine animal food (OR =9.48,95％CI:5.03-17.88,P ＜ 0.05) and seaweed (OR =1.93,95％CI:1.39-2.69,P ＜ 0.05) can increase the risk of thyroid cancer,shellfish (OR =1.21,95％CI:0.94-1.56,P ＞ 0.05),saltwater fish (OR =0.94,95％CI:0.50-1.77,P ＞ 0.05)and freshwater fish (OR =0.90,95％CI:0.66-1.21,P ＞ 0.05) had no effect on the prevalence of thyroid cancer.Conclusion Seafood,marine animal foods and seaweed will increase the risk of thyroid cancer.

The prevalence of hypothyroidism among adults in China: A systematic review / 中华地方病学杂志

Objective To systematically review the prevalence of hypothyroidism from 2000 to 2016 in China.Methods Twenty-five researches were selected from the database of Wanfang,CNKI,CBM,PubMed and Embass according to the inclusion and exclusion criteria and reviewed systematically.Overall prevalence and 95％CI were calculated and forest plots were drawn by Stata 12.0.Results Based on the results from the existing data,the prevalence of hypothyroidism was 9.3％ (7.1％ for male and 12.2％ for female),compared with the group of 60 and over (11.8％),other age groups had lower prevalence of hypothyroidism (the groups of 18-＜ 40 and 40-＜ 60 was 7.4％ and 9.1％,respectively).The prevalence of clinical hypothyroidism and subclinical hypothyroidism was 1.1％ and 8.7％,respectively.In northwest area,the prevalence of hypothyroidism (14.9％) was significantly higher than those of other regions (the east area was 7.7％,north area was 8.0％,southwest area was 13.4％).The prevalence of hypothyroidism from 2011 to 2016 (10.8％) was higher than those of 2002 to 2010 (5.0％).The prevalence of iodine excess group (15.3％) was higher than that of iodine adequate group (8.9％) and that of iodine deficiency group (3.0％).Conclusion The prevalence of hypothyroidism in China has a tendency to increase in recent years,and the preventive and curative strategies to control hypothyroidism need to be further studied.

National monitoring results in high water iodine areas in 2015 / 中华地方病学杂志

Objective To observe the high iodine induced thyroid goiter condition,iodine nutritional status and coverage rate of non-iodized salt in high water iodine areas.Methods The household non-iodized salt was monitored in counties (cities,regions) of high water iodine areas and high iodine diseased areas in Tianjin,Hebei,Shanxi,Jiangsu,Anhui,Shandong,Henan and Shaanxi provinces.Among the monitoring sites,where the water iodine were 150-300 μg/L or higher than 300 μg/L,50％ of the them were selected to investigate the water iodine,children urinary iodine and thyroid volume of children in high iodine counties.Results Household edible salt was monitored in 110 counties of 8 provinces,with a total of 25 597 salt samples.The number of non-iodized salt was 24 640,and the coverage rate of non-iodized salt was 96.3％.After being weighted based on the population of counties,the coverage rate of non-iodized salt was 96.9％.In all,73 survey areas include 183 663 people,64 monitoring sites (87.7％) where the water iodine level were higher or equal to 150 μg/L and the median of water iodine was 250.8 μg/L.Totally 5 991 children aged 6-12 were measured thyroid volume,the total goiter rate was 6.2％,the children thyroid goiter rate was higher than 5％ in Hebei,Shanxi,Henan,Tianjin and Shandong provinces.Totally 4 618 children were detected urinary iodine,the median urinary iodine concentration was 373.0 μg/L,and the children median urinary iodine concentration was exceeded 300 μg/L in Tianjin,Hebei,Shanxi,Jiangsu and Shandong provinces.The children urinary iodine concentration and goiter rate increased gradually with increasing of water iodine content.Conclusions The non-iodized salt coverage rate is high in high water iodine areas,most monitored areas have changed drinking water sources,but the median water iodine concentration is still higher than 150 μg/L.Children median urinary iodine concentration is higher than 300 μg/L,iodine is in a excessive status.The children total goiter rate is higher than 5％.Some countermeasures are proposed to search low iodine water,change water sources,do health education,and add other surveillance measures,such as thyroid function detection on target groups,and so on.