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Objective:To investigate and analyze the living conditions of patients with Kaschin-Beck disease in Gansu Province, and to provide scientific basis for accurate treatment of the patients.Methods:From 2018 to 2019, case investigation, clinical examination and X-ray examination of patients with Kaschin-Beck disease were carried out in the Kaschin-Beck disease area of Gansu Province. The contents of the survey included basic information of the patients, clinical diagnosis classification, disease information, surgery and drug treatment, etc.Results:A total of 23 909 patients with Kaschin-Beck disease were diagnosed in 37 counties (districts) of 7 cities (states). The patients with grade Ⅰ, grade Ⅱ and grade Ⅲ accounted for 64.04% (15 312 cases), 26.12% (6 244 cases) and 9.84% (2 353 cases), respectively; 90.74% (21 694 cases) of the patients were over 50 years old, Han nationality was 97.15% (23 228 cases), and peasants were 99.25% (23 729 cases). The patients mainly had multiple joint thickening and deformation (89.30%, 21 350 cases) and pain (87.04%, 20 810 cases). Joint thickening and deformation and pain were more common in finger joint, knee joint and ankle joint. The thickening and deformation of the three joints accounted for 89.97% (21 512 cases), 78.18% (18 692 cases) and 63.81% (15 257 cases), respectively; pain accounted for 80.66% (19 285 cases), 78.75% (18 828 cases) and 64.50% (15 422 cases), respectively; 83.83% (20 044 cases) had joint rest pain, 82.63% (19 757 cases) had joint movement pain and 76.03% (18 177 cases) had joint morning stiffness. Surgical treatment was completed in 1.97% (470 cases). Long-term drug treatment (more than 6 months in the whole year) accounted for 47.78% (11 424 cases); the annual cost of drug treatment was mainly less than 500 yuan, accounting for 57.72% (13 800 cases).Conclusions:The quality of life of patients with Kaschin-Beck disease in Gansu Province is low. We should pay more attention to adult patients with Kaschin-beck disease and strengthen management and treatment.
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Objective:To investigate the iodine nutritional status of population in Gansu Province, and to provide a scientific basis for policy adjustment of relevant departments.Methods:In 2019, a cross-sectional survey was conducted in 87 monitoring units in 86 counties (districts and cities) of 14 cities (prefectures) in Gansu Province for iodine deficiency disorders (IDD). Instant urine samples and salt samples of children aged 8 to 10 years and pregnant women were collected for detection of urinary iodine and salt iodine. B-ultrasound was used to check the thyroid volume of children in 40 monitoring units.Results:A total of 17 772 children aged 8 to 10 years were investigated. The median urinary iodine (MUI) of children was 197.4 μg/L, the MUI of 14 cities (prefectures) ranged from 160.6 to 233.4 μg/L. There were statistically significant differences in MUI among children of different genders and ages ( P < 0.001). Totally 8 269 children were examined by B-ultrasound, the children's goiter rate was 1.4% (118/8 269). There were statistically significant differences in the thyroid volume among children of different genders and ages ( P < 0.05). A total of 8 605 pregnant women were investigated. The MUI of pregnant women was 178.6 μg/L, and the MUI of 14 cities (prefectures) ranged from 156.5 to 275.0 μg/L. There was no statistical significant difference in MUI among pregnant women in different pregnancies ( P > 0.05). A total of 26 377 samples of salt consumed by children and pregnant women were detected. The median salt iodine was 24.71 mg/kg. The coverage rate of iodized salt and the consumption rate of qualified iodized salt were 99.44% and 93.59%, respectively. Twenty-three counties (districts and cities) failed to meet the elimination standard of IDD in the single indicator. Conclusions:IDD is in a state of continuous elimination in Gansu Province; iodized salt supervision needs to be further strengthened; there is an imbalance of control measures between regions.
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Objective:To evaluate the iodine level of drinking water in different ecological regions in Gansu Province, and to provide a basis for preventing iodine deficiency disorders in accordance with local conditions.Methods:In May to July 2017, according to different topography, landforms and climatic conditions, Gansu Province was divided into six ecological regions: desert area, Hexi Corridor gobi area, Loess Plateau hilly area, Qinling Zhongshan gorge area, Gannan Plateau grassland and meadow area, and Loess Plateau gully area. One county was selected from each of the five districts in the east, west, south, north, and central areas in each ecological regions. Drinking water samples were collected in each county based on the township, and the water iodine content was determined by arsenic-cerium catalytic spectrophotometry.Results:A total of 4 037 water samples were collected in 527 townships of six ecological regions, the water iodine range was 0.10 - 97.60 μg/L, with a median of 2.10 μg/L. Among them, the medians water iodine of the six ecological regions were less than 40 μg/L, the difference between different ecological regions was statistically significant ( H = 1 007.440, P < 0.01); the unified centralized, partially centralized and dispersed water supply water samples were 157, 2 263 and 1 617, and the medians water iodine were 1.61, 2.42, and 1.83 μg/L, respectively, and there was statistically significant difference among different water supply methods ( H = 37.164, P < 0.01). Stratified by water supply method, the differences in water iodine between different ecological regions of the same water supply method were statistically significant ( H = 32.628, 580.630, 391.070, P < 0.01); stratified by ecological region type, the differences of different water supply methods in desert area, Hexi Corridor gobi area, Qinling Zhongshan gorge area, Gannan Plateau grassland and meadow area were statistically significant ( Z = - 2.770, H = 6.369, 9.936, 12.666, P < 0.05). Conclusions:The six ecological regions in Gansu Province are all iodine-deficient areas. The water iodine content varies among different ecological region types and different water supply methods. Surveys on water iodine content and the operating status of water supply facilities should be carried out regularly, and measures should be adjusted in time to prevent and control iodine deficiency disorders in accordance with local conditions.
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Objective:To discuss the safety and curative effect of transurethral plasmakinetic enucleation of prostate(TUKEP) in the treatment of large-volume prostate hyperplasia.Methods:From October 2015 to April 2017, the clinical data of 126 patients with large-volume prostate hyperplasia(weight of prostate>80 g) who admitted to Yuncheng Central Hospital were retrospectively analyzed.Different enucleation methods were used according to weight of prostate: ball enucleation for 80~120 g prostate; divided enucleation for more than 120 g prostate.The clinical data were analyzed and summarized.Results:All 126 patients completed operation successfully.The mean enucleation time, cutting time upon harvesting, intraoperative blood loss and intraoperative mean weight of prostate removed of the 126 patients were (19.4±2.4)min, (61.9±16.7)min, (65.3±47.5)mL and (104.5±23.1)g, respectively.Five cases of them had capsule perforation during operation and indwelling catheter for one week after operation, and unobstructed micturition was recovered after removing the urinary catheter, with no repeated hemorrhage or urinary tract infection.Seven cases received intra-operative blood transfusion, with no transurethral resection syndrome(TURS) during and after operation.These patients were followed up for 1~6 months, 23 cases lost to follow up and 14 cases suffered from temporary urinary incontinence.They received health education and levator ani training and were able to completely control urination during follow-up.The IPSS score, QOL score, Qmax and PVR of the patients after operation were (7.6±1.4)points, (1.7±0.6)points, (20.2±3.1)mL/s and (15.0±9.3)mL, respectively, which showed statistically significant differences compared with before operation( t=15.712, 18.331, -21.382 and 16.380, all P<0.001). All of these indicators were obviously improved than before operation, but there was no statistically significant difference in normal ejaculation before and after operation( P=0.252). Conclusion:TUKEP can radically remove prostate tissue and is an effective and safe surgical method in the treatment of large-volume prostate hyperplasia.
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Objective:To analyze the constitution and clinical characteristics of patients with thyroid diseases in Lanzhou, and to provide experience and basis for clinical treatment and prevention of thyroid diseases.Methods:The data of inpatients with thyroid diseases of Anning Branch of General Hospital of Lanzhou Military Region from October 2008 to October 2018 were collected, and the differences of age, gender, occupation, thyroid disease classification and composition, and thyroid hormone levels were analyzed.Results:A total of 375 inpatients data with thyroid diseases were collected, including 114 males and 261 females, accounting for 30.4% and 69.6%, respectively. Thyroid nodules, hypothyroidism, hyperthyroidism, goiter, thyroiditis, thyroid adenoma and thyroid cancer accounted for 12.3% (46/375), 22.9% (86/375), 10.4% (39/375), 7.5% (28/375), 5.9% (22/375), 40.0% (150/375) and 1.1% (4/375), respectively. There were significant differences in hypothyroidism and thyroid adenoma between different genders ( P < 0.05). There were significant differences in hypothyroidism, hyperthyroidism and thyroid adenoma between different age groups( P < 0.05). There were significant differences in hypothyroidism and thyroid adenoma between different occupations ( P < 0.05). The diagnostic coincidence rates of thyroid stimulating hormone (TSH), free triiodothyroine (FT 3) and free thyroine (FT 4) of inpatients with hyperthyroidism were 43.6% (17/39), 79.5% (31/39) and 89.7% (35/39), respectively. The diagnostic coincidence rates of TSH, FT 4 and FT 3 of inpatients with hypothyroidism were 60.5% (52/86), 44.2% (38/86) and 2.3% (2/86), respectively. The patients with thyroid nodules, thyroiditis, goiter and thyroid adenoma mainly had elevated FT 3 and decreased T 3 levels. Conclusions:Thyroid adenoma and hypothyroidism are the main thyroid diseases in Lanzhou. The incidence in women and aged ≥50 years old people is high, and hyperthyroidism tends to be younger. Therefore, it is necessary to strengthen the physical examination and screening of thyroid diseases.
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Objective To investigate the scope and distribution of water iodine in centralized water supply projects,and provide a basis for taking appropriate control measures in Gansu Province.Methods Collected 2 copies of water samples of all the different water supply of centralized water supply project water in the province's 87 counties (cities,districts),the source water iodine of all centralized water supply projects was tested by the method of cerium sulfate catalytic spectrophotometry.The relationship between different water types and different iodine levels in deep well water were analyzed.Results Of the total 1 563 centralized water supply projects,the median of water iodine was 6.38 μg/L,the range was 0.00-182.10 μg/L,the rates were 62.0％ (969/1 563),30.1％ (471/1 563),6.9％ (108/1 563),0.5％ (7/1 563) and 0.5％ (8/1 563) in water iodine level of ＜ 10,10-＜ 50,50-＜ 100,100-＜ 150 and ≥ 150 μg/L.The surface water was 26.7％ (418/1 563),the median of water iodine was 4.42 μg/L,the groundwater was 73.3％(1 145/1 563),the median of water iodine was 8.10 μg/L,the iodine content of surface water was lower than that of the groundwater (Z =-10.089,P ＜ 0.01);in surface water,the rate of river,lake,reservoir and other water source was 55.7％ (233/418),7.7％ (32/418),21.5％ (90/418) and 15.1％ (63/418),and the median was 2.52,31.10,6.65 and 5.40 μg/L,the iodine content between surface water and water sources of different water sources was significant different (x2 =179.976,P ＜ 0.01);in the groundwater,the rate of deep well,shallow well and spring was 55.5％ (635/1 145),41.3％ (473/1 145) and 3.2％ (37/1 145),and the median was 17.90,3.66 and 4.18 μg/L,the iodine content in groundwater from different sources was significant different (x2 =357.346,P ＜ 0.01).Iodine content of different well depth was significantly different (x2 =288.959,P ＜ 0.01),there was a positive correlation between iodine content and well depth (r =0.364,P ＜ 0.01).Conclusions Iodine content of the surface water is generally lower in many water types in Gansu,iodine content is higher in deep well,and there is high iodine deep well water in local areas.It is recommended that water iodine be included in the population iodine nutrition assessment index.
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Objective To master the situation of iodine deficiency disorders (IDD) and the people's iodine nutritional status after implementation of the new salt iodine standard in Gansu Province in 2012.Methods Totally 30 counties (cities) were selected in Gansu Province by population proportionate to size sampling (PPS) method in 2014,and one primary school was selected in each counties (cities).In each selected school,50 children aged 8-10 years old were selected for thyroid examination by B-ultrasound,urine samples were collected for iodine determination,and salt samples were collected for iodine determination from a subset of children included in the study.Totally 20 pregnant women were selected from the towns with the sampled schools and urine samples were collected for iodine determination.Arsenic and cerium catalysis spectrophotometry (WS/T 107-2006) was used to detect urinary iodine content;direct titration (GB/T 13025.7-2012) was used to detect edible salt iodine content.Urinary iodine of children and pregnant women were compared with 2011 (before implementation of the new salt iodine standard).Results The median of salt iodine was 26.6 mg/kg,the iodized salt coverage rate was 99.5％ (1 492/1 500),the qualified rate of iodized salt was 89.3％ (1 333/1 492),and the consumption rate of qualified iodized salt was 88.9％ (1 333/1 500).The thyroid goiter rate of children was 3.2％ (48/1 500);a total of 1 499 urine samples of children were detected,the urinary iodine median was 169.8 μg/L,it was significantly lower than that in 2011 (216.0 μg/L,Z =-6.813,P ＜ 0.05).A total of 600 urine samples of pregnant women were detected,the urinary iodine median was 161.8 μg/L,it was significantly lower than that in 2011 (168.6 μg/L,Z =-3.590,P ＜ 0.05).Conclusion IDD has been controlled after implementation of the new standard of iodized salt and iodine nutrition condition is good.
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Objective To assess iodine nutritional status of lactating women and infants (0-2 years old) in six ecological regions of Gansu Province,and to provide a scientific basis for iodine supplementation of target people.Methods According to different topography and climate conditions,Gansu Province was divided into six ecological regions:the desert region,the Gobi region of Hexi Corridor,the hills and valleys region of Loess Plateau,the Zhongshan Valley of Qinling Mountains,the grassland meadow area of Gannan plateau and the Loess Plateaugully region.Totally 5 counties were selected from each ecological region,and each county was divided into five geographic locations (east,south,west,north and center).In each location,one township was identified and ten samples of lactating women and infants (0-2 years old) were selected randomly and 60 salt samples of residents were collected to determine iodine content.At the same time salt intake of 20 residents was surveyed in three townships as mentioned above.The water samples of all the centralized water supply projects were collected in each county,and one water sample of the decentralized water supply in ten townships with the largest population of each county from east,south,west,north and center locations was collected to determine iodine content.One soil sample was collected to determine iodine content in east,south,west,north and center townships of each county.The urinary iodine and water iodine levels were measured with the method for determination of iodine in urine by As3+-Ce4+ catalytic spectrophotometry (WS/T 107-2006).The direct titration method among thegeneric methods for iodide testing in salt production industry (GB/T 13025.7-2012) was used to determine the salt iodine level,and the arbitration method was adopted for quantitative determination in the case of Sichuan salt or other special salts and the salt intake was estimated based on three day weighed food record.The soil iodine was determined using the amplified colorimetric method.Results Totally 1 476 and 1 461 urine samples of lactating women and infants were collected,and the total urine iodine medians of lactating women and infants (0-2 years old) were 149.05 and 151.34 μg/L,respectively,the urine iodine median of lactating women and infants in each ecological region was at the 100-199 μg/L appropriate level.Not weaning infants urine iodine (155.32 μg/L) was higher than that of the weaning infants (146.30 μg/L),the difference was significant statistically (Z =-2.808,P ＜ 0.05).There was a correlation between urine iodine of not weaning infants aged 0-2 years old and breastfeeding women (r =0.133,P ＜ 0.01),and there was no correlation between weaning infants and breastfeeding women (r =0.045,P ＞ 0.05).About 9 008 salt samples were collected,and the rates of qualified iodized salt intake in the six ecological regions were all higher than 93％.The daily salt intake per person ranged from 4.5 g to 12.6 g,in which the Loess Plateaugully region was the highest with 12.6 g and the grassland meadow area of Gannan plateau was the lowest with 4.5 g.The water iodine median of 1 513 water samples was 3.3 μg/L.The water iodine medians of the rest 4 ecological regions were all less than 5 μg/L except for the desert region (42.4 μg/L) and the Loess Plateau-gully region (30.0 μg/L) of which the median of water iodine was higher than 20 μg/L.The soil iodine median of 155 soil samples was 127 μg/kg,in which the desert region was the lowest with 78 μg/kg and the grassland meadow area of Gannan plateau was the highest with 218 μg/kg.Conclusion Lactating women and infants are in good iodine nutritional status and the present iodized salt concentration can meet the demand of iodine nutrition of lactating women and infants well.
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Objective To build a case database of endemic cretinism,investigate the distribution of existing cretinism,and provide suggestions for prevention of iodine deficiency disorders.Methods In 2011,an existing endemic cretinism case database was established in Gansu Province by verifying and registering the historical cases before 1985,and searching and diagnosing the cases between 1985-2011 in history cretinism areas and IDD high-risk areas according to endemic cretinism and endemic sub-clinical cretinism diagnosis (WS 104-104) and the IDD monitoring program of the central transfer fund at the same time,and analysis the distribution of existing cretinism.Results In 1985 and 2011,cretinism areas were 53 and 41 in Gansu Province,and the endemic cretinism cases werel9 696 and 4 715,respectively;18 cases of endemic cretinism were born between 1985 to1997,7 new cases were born after 1997;nerve cretinism,myxedematous and mixed types among existing cases were 58.8％ (2 766/4 708),9.8％ (461/4 708) and 31.4％ (1 481/4 708),males and females were 69.3％ (3 261/4 708)and 30.7％ (1 481/4 708),respectively.Cases older than 45 accounted for 73.2％ (3 444/4 708);the 7 new cases were all nerve cretinism and 5 cases distributed in ethnic minority areas.Conclusions There are potential dangers of endemic cretinism in the high-risk areas of iodine deficiency disorders due to multiple factors in Gansu Province;the nervous cretinism is the majority which is caused by insufficient iodine intake in early maternal pregnancy.To prevent new endemic cretinism,it is necessary to strengthen measures of emergency iodine supplementation for pregnant women and nursing mothers in the high-risk areas.
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Objective To assess the iodine nutrition and thyroid function of pregnant women during different periods of pregnancy,to provide evidence for guiding iodine supplementation for them.Methods A cross-sectional survey was performed in 215 pregnant women in Yongjing couty from May to June 2013.Samples of blood and random urine were collected,and serum thyrotrophin (TSH),free triiodothyronine (FT3),free thyroxine (FT4),anti-thyroid peroxidase (anti-TPO),antithyroglobulin (anti-TG) and urinary iodine were measured.Results The medians of urinary iodine from the three groups of pregnant women (first,second and third trimester) were 189.8 μg/L,152.5 μg/L and 144.9 μg/L respectively.With the exception of pregnant women in the third trimester,the urinary iodine medians of pregnant women in the first and second trimesters were within the 150-249 μg/L range which was defined as optimal by WHO/UNICEF/ICCIDD.With the increase of gestational age,the level of FT3 decreased (P＜0.05),with the FT3 levels in the first trimester were higher than those in the second or third trimester (P＜0.05).The difference of TSH levels among the three groups of pregnant women was statistically significant (P＜0.01),with a U-shaped curve seen between the iodine TSH levels and the gestational age.The medians of anti-TG and anti-TPO appeared the lowest in the first trimester,and remained at a high level in women at second and third trimesters.Significant diffierence was seen in anti-TG,anti-TPO levels of the three groups of pregnant women (first,second and third trimester) (P＜0.01).The incidence of thyroidfunction disorder was 1.86％,including subclinical hypothyroidism accounted for 1.40％,and hypothyroidism accounted for 0.47％.The incidence of thyroidfunction disorder mainly appeared in the early pregnancy.Abnormal FT3,TSH,positive anti-TG and anti-TPO were mainly seen during early pregnancy.The changes of TSH,FT3,FT4,anti-TG and anti-TPO along with the changes of urine iodine levels were not obvious.Conclusion With the increase of gestational age,the incidence of iodine deficiency also increased among pregnant women.Abnormal thyroid hormones,TSH,positive anti-TG and anti-TPO were mainly existed in the early pregnancy.Programs as monitoring urinary iodine as well as thyroid function targeting all the pregnant women should be carried out.