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Objective:To understand the correlation between urinary iodine, salt iodine and thyroid nodules in children aged 8 - 10 years and pregnant women in different regions of Fujian Province, and to explore the influencing factors of thyroid diseases.Methods:A cross-sectional study was conducted in Dongshan County and Pingtan County of Fujian Province from September to November 2019. According to the inclusion criteria, 140 pregnant women and 270 children aged 8 - 10 years were selected in Dongshan County, and 189 pregnant women and 368 children aged 8 - 10 years were selected in Pingtan County. Random urine and edible salt samples were collected to determine iodine content, and iodine nutrition was evaluated in each population. Thyroid was examined by B ultrasound and questionnaire survey of thyroid diseases was carried out. The correlation between urinary iodine, salt iodine and thyroid nodules in children aged 8 - 10 years and pregnant women in different regions was analyzed.Results:There were statistically significant differences in the median urinary iodine among children in different genders (male: 151.30 μg/L, female: 130.30 μg/L) and regions (Dongshan County: 160.30 μg/L, Pingtan County: 129.70 μg/L, P < 0.05); there was no significant difference in the median urinary iodine among children of different ages (8, 9, 10 years old: 141.60, 128.05, 150.30 μg/L, P > 0.05). The median urinary iodine among pregnant women was 119.30 μg/L, and there was no significant difference in median urinary iodine among pregnant women in different stages and regions ( P > 0.05). The medians of salt iodine from children and pregnant women were 20.30 and 23.65 mg/kg, respectively. Urinary iodine in children was positively correlated with salt iodine ( r = 0.13, P < 0.05). However, there was no correlation between urinary iodine and salt iodine in pregnant women ( P > 0.05). The detection rate of thyroid nodules in children was 21.79% (139/638). There was significant difference in the detection rate of thyroid nodules in children of different ages ( P < 0.05). The detection rate of thyroid nodules in pregnant women was 4.26% (14/329). There was no correlation between detection rate of thyroid nodules and urinary iodine or salt iodine in children and pregnant women ( P > 0.05). Thyroid volume of children in the two counties was within the normal range, and there was no correlation between thyroid volume and urinary iodine or salt iodine ( P > 0.05). Conclusions:The iodine nutrition of children in Dongshan County and Pingtan County is suitable (100 - 199 μg/L), while iodine deficiency (< 150 μg/L) exists in pregnant women. Urinary iodine in children is related to salt iodine, and urinary iodine increased with increase of salt iodine. The prevalence of thyroid nodules in children of different ages is different, which requires further study. The detection rate of thyroid nodules in children and pregnant women is not correlated with urinary iodine and salt iodine.
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Objective:To establish a medical reference range of serum iodine in adults with normal thyroid function in Fujian Province.Methods:Permanent residents aged 16 - 60 years old and living in the local area for 5 years and more were selected as survey subjects in three areas with appropriate iodine nutrition in Fujian Province from September 2019 to January 2020. Urine and blood samples were collected to detect urinary iodine, serum iodine and thyroid function indexes [thyroid stimulating hormone (TSH), thyroglobulin (Tg), free triiodothyronine (FT 3), free thyroxine (FT 4), total triiodothyronine (TT 3), total thyroxine (TT 4), thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb)] levels. The percentile method was used to establish the 95% medical reference range of serum iodine in adults with normal thyroid function, and Pearson correlation analysis was used to analyze the correlation between serum iodine and thyroid function indexes in adults with normal thyroid function. Results:A total of 149 adults with normal thyroid function were examined, and the median urinary iodine was 119.45 μg/L, which was at the appropriate level (100 - 199 μg/L); serum iodine was (61.35 ± 16.20) μg/L, and the 95% medical reference range of serum iodine in adults with normal thyroid function was preliminarily formulated as 34.36 - 97.17 μg/L. Correlation analysis showed that serum iodine was positively correlated with FT 4 level ( r = 0.17, P = 0.035), but was not correlated with other thyroid function indexes ( P > 0.05). Conclusion:The medical reference range of serum iodine in adults with normal thyroid function in Fujian Province is successfully established, which provides a basis for judgment of individual iodine nutrition in adults.
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Objective:The iodine excretion of adult individuals was calculated by two creatinine correction methods of urinary iodine, and the significance and value of the methods to measure individual iodine nutrition levels were assessed to provide a reference basis for further epidemiological investigation and study of iodine deficiency disorders.Methods:Healthy adults aged 18 - 59 years from Fujian Province were recruited and their 24 h urine, fasting urine, and morning spot urine (8:00 - 12:30) were collected and the corresponding urinary iodine and creatinine concentrations were measured. The estimated 24 h urinary iodine excretion was calculated using two different creatinine correction and creatinine estimation formulas were compared with the measured 24 h urinary iodine excretion.Results:There were no significant differences in measured 24 h urinary iodine excretion value, estimated 24 h urinary iodine excretion value 1 of fasting urine and morning spot urine, and estimated 24 h urinary iodine excretion 2 of fasting urine and morning spot urine between genders (μg/d: 195.5 vs 190.9, 190.0 vs 181.7, 160.2 vs 144.2, 174.8 vs 179.2, 148.3 vs 131.5); there were no significant differences in measured 24 h urinary iodine excretion and fasting urinary estimated 24 h urinary iodine excretion 1, estimated 24 h urinary iodine excretion 2 ( P > 0.05), and there were significant differences in measured 24 h urinary iodine excretion and morning spot urinary estimated 24 h urinary iodine excretion 1, estimated 24 h urinary iodine excretion 2 ( P < 0.01). And there were significant linear correlations between measured 24 h urinary iodine excretion and estimated 24 h urinary iodine excretion 1 of fasting urine and morning spot urine, estimated 24 h urinary iodine excretion 2 of fasting urine and morning spot urine ( r = 0.772, 0.266, 0.828, 0.391, P < 0.01). Conclusions:It is feasible to estimate 24 h urinary iodine excretion in adults with creatinine-corrected fasting urinary iodine concentration. Creatinine-corrected fasting urinary iodine concentration can be used as an individual iodine nutrition level evaluation index, but whether it is applicable to children and pregnant women remains to be further studied.
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Objective:To analyze the disease burden of iodine deficiency disorders (IDD) and its changes in China in 1990 and 2016.Methods:Based on the data of Global Burden of Disease Study 2016 (GBD 2016), a descriptive statistical method was used to compare and analyze the changes of deaths number, mortality, disability adjusted life year [DALY, including years of life lost (YLL) and years lived with disability (YLD)], DALY rate and other disease burden indicators caused by IDD in China in 1990 and 2016.Results:The GBD 2016 data showed that the deaths number from IDD in China decreased from 259.31 in 1990 to 116.41 in 2016, the mortality decreased from 0.022 827/100 000 in 1990 to 0.008 515/100 000 in 2016; and the mortality in different age groups had decreased, the children mortality in the < 5 years old group had decreased from 0.088 639/100 000 to 0.009 875/100 000. The DALY and YLD due to IDD in China increased from 406.13 thousand person-years and 391.68 thousand person-years in 1990 to 455.05 thousand person-years and 451.95 thousand person-years in 2016, while YLL decreased from 14.45 thousand person-years to 3.10 thousand person-years; the DALY rate, YLL rate, and YLD rate decreased from 35.75 person-years per 100 000, 1.27 person-years per 100 000 and 34.48 person-years per 100 000 in 1990 to 33.29 person-years per 100 000, 0.23 person-years per 100 000 and 33.06 person-years per 100 000 in 2016. The main component of DALY for IDD was YLD, and the proportion increased from 96.44% in 1990 to 99.32% in 2016.Conclusions:The mortality of IDD in China has decreased, and IDD in the younger age group has been effectively controlled; however, the disease burden, especially the burden caused by disability has increased, and the disability of the population due to IDD should be given special attention.
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Objective:To investigate the iodine nutritional status among children aged from 8 - 10 and pregnant women in Xiamen City before and after adjustment of salt iodine concentration, and scientifically evaluate the suitability of the new standard iodized salt adjustment policy for Xiamen City.Methods:In the pre-adjustment period (2011) and the post-adjustment period (2018), cross-sectional research methods and stratified cluster sampling methods were adopted in six districts of Xiamen City. The salt samples of residents and pregnant women, urine samples of children aged from 8 - 10 and pregnant women were collected to determine the iodine level; thyroid of children aged from 8 - 10 was examined. Changes in salt iodine, urine iodine and goiter prevalence before and after adjusting iodine content of salt were compared.Results:The median of salt iodine in residents after the adjustment (23.5 mg/kg) was significantly lower than that of before (28.9 mg/kg, Z = - 10.512, P < 0.05), the median of salt iodine in pregnant women after the adjustment (23.7 mg/kg) was significantly lower than that of before (29.2 mg/kg, Z = - 12.622, P < 0.05); the consumption rate of qualified iodized salt in residents after the adjustment (95.7%, 1 196/1 250) was significantly lower than that of before (97.1%, 1 608/1 656; χ 2 = 4.250, P < 0.05); before and after adjustment of salt iodine concentration, the consumption rate of qualified iodized salt in pregnant women was 94.7% (124/131) and 95.9% (579/604), respectively. No significant difference was found when comparing the consumption rate of qualified iodized salt in pregnant women (χ 2 = 0.015, P > 0.05). There was significant difference in median urinary iodine (from 204.2 to 183.9 μg/L, detected in 652, 1 250 urine samples, respectively) of children aged 8 - 10 years ( Z = - 3.583, P < 0.05); the difference of iodine nutritional status in pregnant women before and after adjustment of salt iodine concentration(130.2, 130.8 μg/L, detected in 132, 604 urine samples, respectively) was not significant ( Z = - 1.715, P > 0.05). The thyroid goiter rate of children aged 8 - 10 years had reduced from 1.1% (14/1 239) to 0.2% (2/1 253), the difference was statistically significant (χ 2 = 9.195, P < 0.05). Conclusions:As a whole, the measure of control and prevention of iodine deficiency disorders through iodized salt is implemented well in Xiamen City. After adjustment of salt iodine concentration, the iodine status of children aged from 8 to 10 is adequate, but the pregnant women has showed iodine deficiency.
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Objective To understand the iodine nutritional status of children aged 8 to 10 years old and pregnant women in the new standard iodized salt pilot areas of Fujian Province,and to analyze the rationality of urine specific gravity correction for urinary iodine.Methods In the 3rd,6th,9th,12th,15th and 21th months after supplying of new standard iodized salt in March 2012,the first to sixth phases' assessment were conducted in Xindian Town of Xiang'an District,Xiamen City and Yongfu Town,Xinqiao Town of Zhangping City,Longyan City.Totally 200 children aged 8 to 10 years old and 50 pregnant women were selected from each town,home salt samples and urine samples were collected,salt iodine,urinary iodine and urine specific gravity were tested.Salt iodine was detected by "General Test Method in Salt Industry-Determination of Iodine" (GB/T 13025.7-2012);urinary iodine was detected by "Method for Determination of Iodine in Urine by As3+-Ce4+ Catalytic Spectrophotometry" (WS/T 107-2006);urine specific gravity was detected by digital refractometer.Results From the first to sixth phases' assessment,the iodized salt coverage rates of children aged 8 to 10 years old and pregnant women were ＞ 95％,the edible rates of qualified iodized salt were ＞ 90％.The measured medians of urinary iodine of children aged 8 to 10 years old were 216.7,219.5,188.1,206.7,209.2,and 201.0 μg/L,respectively;except the third phase's assessment,which was in the iodine appropriate level (100-199 μg/L),the other five phases/ assessment were all higher than the iodine appropriate level (200-299 μg/L);the medians of urinary iodine of children aged 8 to 10 yearsold after urine specific gravity correction were 215.0,213.6,197.3,202.9,204.3,and 197.7 μg/L,respectively;there were no significant differences in urinary iodine between the measured and urine specific gravity correction (Z =-0.131,-0.183,-1.052,-1.180,-0.311,-0.368,P ＞ 0.05).The measured medians of urinary iodine of pregnant women were 134.0,132.2,120.9,115.6,113.3,and 123.3 μg/L,respectively,which were in the iodine deficiency level (＜ 150 μg/L);the medians of urinary iodine of pregnant women after urine specific gravity correction were 207.3,197.1,168.8,158.3,171.8,and 181.7 μg/L,respectively;there were significant differences in urinary iodine between the measured and urine specific gravity correction (Z =-6.419,-6.406,-5.990,-6.648,-7.008,-8.034,P ＜ 0.01).Conclusions The iodine nutrition of children aged 8 to 10 years old is appropriate in the new standard iodized salt pilot areas of Fujian Province,while that of pregnant women is mild iodine deficiency.Further research is needed to use urine specific gravity to calibrate the concentration of urinary iodine to assess the iodine nutritional level of the focused populations in the regions.
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Objective: To investigate the breakthrough points and methods of pharmaceutical care performed by clinical pharmacists for chemotherapy-induced Ⅳ degree myelosuppression.Methods: One advanced lung adenocarcinoma patient suffering from chemotherapy-induced Ⅳ degree myolosuppression was selected as the example, clinical pharmacists provided suggestions on the chemotherapy regimen, assisted physicians in making reasonable treatment plan and implemented comprehensive pharmaceutical care for the patient.Results: Clinical pharmacists played a positive role in the clinical treatment through the comprehensive pharmaceutical care in oncology department.Conclusion: With the professional knowledge of pharmacy, clinical pharmacists can improve the level of clinical rational drug use.
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Objective To investigate the coverage of iodized salt and the iodine status among children aged from 8-10 years in both urban and rural areas of Xiamen after promotion of new standard iodized salt,and to provide scientific evidence for adjustment of control strategy.Methods After 3 year promotion of new standard iodized salt,Huli and Xiang'an were selected as the urban and rural investigation sites,respectively in 2015.Each investigation site was further divided into five sampling areas,namely east,west,south,north and central.In each sampling area,one town was randomly selected and 2 tapping water samples were collected to determine the iodine level;in each town,4 villages were randomly selected and 15 residents were selected and edible salt samples were collected to determine the iodine level.Moreover,one primary school was selected in each town,and 40 children aged from 8-10 years old were randomly selected to perform thyroid examination and urinary iodine level determination.The water iodine was detected by arsenic cerium catalytic spectrophotometry;salt iodine was detected by direct titration;urinary iodine was detected by arsenic cerium catalytic spectrophotometry;thyroid was examined by B ultrasound.Results The iodine concentration was lower than 10 μg/L in drinking water in both urban and rural areas.The coverage rate of iodized salt in urban and rural areas was 99.3％ (298/300) and 94.0％ (282/300),respectively.The consumption rate of qualified iodized salt was 93.7％ (281/300) and 90.7％ (272/300),respectively.The prevalence of goiter was 3.8％ (8/210) both in urban and rural areas.The prevalence of thyroid nodule was 17.6％ (37/210) and 19.5％ (41/210),respectively.No significance was found when comparing the prevalence of goiter and the prevalence of thyroid nodule (x2 =0.000,0.252,all P ＞ 0.05).The median of urinary iodine was 208.9 and 167.2 μg/L,respectively.The statistical analysis found that the urban children had higher iodine level when comparing with rural counterparts (Z =4.030,P ＜ 0.01).The prevalence of goiter in male and female was 2.4％ (5/208) and 5.2％ (11/212),respectively,and no significant difference was detected (x2=2.222,P＞ 0.05).The prevalence of thyroid nodule in male and female children was 13.5％ (28/208) and 23.6％ (50/212),respectively,the analysis showed that the female children had higher prevalence of thyroid nodule (x2 =7.115,P ＜ 0.01).The median of urinary iodine in male and female children was 197.8 and 169.6 μg/L,respectively,and the urinary iodine level was significantly higher in male when comparing with female children (Z =2.218,P ＜ 0.05).Conclusions After promotion of new standard iodized salt,the iodine nutrition of children aged from 8-10 years in both urban and rural areas of Xiamen were good.The goal of eliminating iodine deficiency disorders was achieved.The iodine supplement measure should be further promoted to ensure the adequate level of iodine in residents,adhere to the iodine supplement measure,promote a healthy lifestyle,ensure the amount of iodine intake.
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Objective:To provide reference for clinical pharmacists participating in the therapy and pharmaceutical care for ad-vanced breast cancer. Methods:By participating in the drug therapy for a case of advanced breast cancer with bone metastases pain, clinical pharmacists provided the medication analysis and the real-time pharmaceutical care according to the disease conditions during the treatment process. Results:Clinical pharmacists made full use of pharmacological knowledge to analyze and offer proposals on re-lieving pain, chemotherapy and bisphosphonates therapy,which guaranteed the safety of drug use. Conclusion: Medication analysis and pharmaceutical care performed by clinical pharmacists can ensure the safety and effectiveness of drug use for the patients with drug treatment.
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Objective:To provide reference for clinical pharmacists participating in the therapy and pharmaceutical care for ad-vanced breast cancer. Methods:By participating in the drug therapy for a case of advanced breast cancer with bone metastases pain, clinical pharmacists provided the medication analysis and the real-time pharmaceutical care according to the disease conditions during the treatment process. Results:Clinical pharmacists made full use of pharmacological knowledge to analyze and offer proposals on re-lieving pain, chemotherapy and bisphosphonates therapy,which guaranteed the safety of drug use. Conclusion: Medication analysis and pharmaceutical care performed by clinical pharmacists can ensure the safety and effectiveness of drug use for the patients with drug treatment.
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Objective To evaluate the safety and efficacy of bipolar plasmakinetic system in exfoliative tran-surethral resection of bladder tumors .Methods Clinical data of 72 patients with non muscle invasive bladder cancer (NMIBC) were retrospectively analyzed.Transurethral bipolar plasmakinetic system was used ,30°viewer,F27 outer sheath was pushed off and bladder tumor was cut .When the bladder filling state ,pushed off bladder mucosa distance from tumor basal 2cm,then electricity cut the exfoliative bladder tumor .When bladder half filling state electricity cut the base of the bladder muscle layer of bladder tumor .Results This group of 72 cases were successfully completed surgery,surgery time 37~93 min,without intraoperative bladder perforation ,slight obturator nerve reflex in 5 cases. The keeping intact pathologic specimens was good for pathological staging .Conclusion Exfoliative transurethral resection of bladder tumors with bipolar plasma is a safe , practical and effective way of operation , which can avoid severe obturator reflex occurred in the operation , and greatly reduce the occurrence of bladder perforation , without TURS,surgical removal of the pathological specimens is specification .
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A new analytical method has been developed for the simultaneous determination of CrⅢand CrⅥusing on-line sample pretreatment valve-switching ion chromatography. The organic matrix in leather was removed by using a reverse-phase column as the pretreatment column. Before injection, EDTA was added into sample solution to react with the CrⅢto form anion which could absorb visible light strongly. After injection, the ions separated by the pretreatment column were received in a collection loop. Then the ions were delivered into an analytical column and separated. CrⅥ then was derived with the derivatization reagent 1, 5-diphenylcarbazide ( DPC) , and detected together with CrⅢ-EDTA complex by a UV-Vis detector. Under the optimum conditions, the linear range of the method for CrⅢ and CrⅥ was 0. 3-10 mg/L (r=0. 9991) and 0. 05-2 mg/L ( r = 0. 9992 ), whereas detection limits ( S/N = 3 ) were 80. 78 μg/L and 6. 67 μg/L, respectively. The recoveries were in the range of 88. 7%-108. 5% with the relative standard deviations for retention time and peak area less than 3%. The method could be applied to determine CrⅢ and CrⅥ in leather and cloth effectively and quickly.
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Objective To survey the dietary iodine intake among residents in the coastal province of Fujian after universal salt iodization. Methods Using multi-stage stratified random sampling method, four different geographic areas of coastal cities, inland cities, coastal rural and inland rural areas were selected; 3 counties (cities, districts) were selected from each area; 30 families were selected from each of those counties (cities, districts). Total dietary study method was applied to investigate the basic information, all food and water intake during the investigation, the spice variety, quantity and cooking methods, and recipes. All foods consumed were divided into 13 classes:grains and their products, beans(including nuts) and their products, potato and its products, meat and its products, eggs and their products, aquatic products, milk and dairy products, vegetables, fruits and their products, sugar and sugar products, beverage and water, alcohol and seaweeds. Food samples were collected and iodine contents of different types of food were measured, and daily food consumption of the reference man(adult male) in the four areas was calculated. Then the male adult dietary iodine intake in the four areas and Fujian Province was estimated. Results A total of 69 families(accounting for 19.2% of the 359 families surveyed) ate seaweed foods during the three days survey period. The average salt intakes per reference man were 4.5, 5.8, 7.5, 12.3 g, respectively, in coastal cities, inland cities, coastal rural and inland rural. The adult male dietary iodine intake in Fujian Province was 343.8μg/d, and the values were 234.4, 347.1, 328.4, 465.3μg/d, respectively, in coastal cities, coastal rural, inland cities and inland rural. If people did not eat seaweed foods, the results would be 239.7, 137.5, 253.6, 200.3, 367.4μg/d. The main sources of dietary iodine intake were vegetables (33.2%), seaweeds(30.3%), meat(13.4%) and aquatic products(13.0%). If people did not eat seaweed foods, the results would be vegetables(47.6%), meat(19.1%) and aquatic products(18.7%), and iodine contribution rate of the 3 types of food was 85.4%. Conclusions Under the conditions of eating iodized salt, male adult dietary iodine intake is appropriate in different areas of Fujian Province. There is no such problem as iodine excessive. Iodized salt is the main source of dietary iodine. Residents in coastal city, if not eating seaweed foods, will be at risk of iodine deficiency, even if they eat iodized salt.
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A new method has been established for simultaneous determination of anions and cations in fertilizer sample by multimodal liquid chromatography with direct conductivity detection. An Acclaim Trinity P1 column based on nanopolymer silica hybrid technology with multimodal separation functional groups reversed-phase/anion-exchange/cation-exchange was used for the analysis. The chromatographic conditions were optimized and the effect ion of eluent on retention was discussed. Eight ions ( Li+, NH+4 , K+, HCOO-, NO-2 , Cl-, NO-3 and Br-) were separated and determined simultaneously by using 25 mmol/L CH3 COONa solution containing 50% acetonitrile at pH=5. 0 as mobile phase. The flow rate was 0. 50 mL/min and the temperature was 30 ℃. Under the optimum conditions, the linear ranges of the method were in the range of 0 . 5-200 mg/L for all the ions with correlation coefficient of 0 . 9997-0 . 9999 . Whereas the detection limits (S/N=3) were in the range of 0. 16-1. 72 mg/L and the relative standard deviations (RSD, n=9) were in the range of 1 . 3-2 . 5%. The method was applied to the determination of anions and cations in the fertilizer samples with satisfied results and the recoveries were in the range of 95 . 8%-103 . 8%.