The prevalence and related influencing factors of adult thyroid nodules in Wuhan City from 2019 to 2021 / 中华地方病学杂志

Objective:To study the prevalence and epidemiological characteristics of adult thyroid nodules in Wuhan City, and to analyze the influencing factors of thyroid nodules, so as to provide basis for prevention and treatment of adult thyroid nodules in Wuhan City.Methods:From 2019 to 2021, two communities or towns were selected from each of the 13 districts in Wuhan City using multi-stage cluster random sampling method. One hundred permanent residents over the age of 16 were selected from each community or town according to the inclusion and exclusion criteria (age and sex ratio balanced), for questionnaire survey, physical examination, urinary iodine test and thyroid ultrasound examination. The influencing factors of thyroid nodules was analyzed using logistic regession and Spearman correlation.Results:A total of 2 578 adults were investigated, including 1 168 men and 1 410 women. The age was (41.79 ± 13.01) years. The prevalence of thyroid nodules was 35.49% (915/2 578). The prevalence of single nodules was 19.16% (494/2 578), which was higher than that of multiple nodules [16.33% (421/2 578), χ 2 = 2 577.00, P < 0.001]. Multivariate logistic regression analysis showed that female ( OR = 2.033, 95% CI: 1.631 - 2.535), older ( OR = 1.404, 95% CI: 1.290 - 1.528), history of thyroid disease ( OR = 1.351, 95% CI: 1.211 - 1.506) and diabetes ( OR = 1.449, 95% CI: 1.083 - 1.938) were independent risk factors for adult thyroid nodules ( P < 0.05). The median urinary iodine of residents in Wuhan City was 185.32 μg/L, at an appropriate level of iodine nutrition, there was no correlation between urinary iodine and thyroid nodules ( r = 0.02, P = 0.391). Conclusions:The prevalence of thyroid nodules of adults in Wuhan City is high. Women, older, a history of thyroid diseases and diabetes are all risk factors for thyroid nodules. No correlation is found between urinary iodine level and thyroid nodules.

Residual coronary artery tree description and lesion EvaluaTion (CatLet) score, clinical variables, and their associations with outcome predictions in patients with acute myocardial infarction / 中华医学杂志(英文版)

BACKGROUND@#We have recently developed a new Coronary Artery Tree description and Lesion EvaluaTion (CatLet) angiographic scoring system. Our preliminary studies have demonstrated its superiority over the the Synergy between percutaneous coronary intervention (PCI) with Taxus and Cardiac Surgery (SYNTAX) score with respect to outcome predictions for acute myocardial infarction (AMI) patients. The current study hypothesized that the residual CatLet (rCatLet) score predicts clinical outcomes for AMI patients and that a combination with the three clinical variables (CVs)-age, creatinine, and ejection fraction, will enhance its predicting values.@*METHODS@#The rCatLet score was calculated retrospectively in 308 consecutively enrolled patients with AMI. Primary endpoint, major adverse cardiac or cerebrovascular events (MACCE) including all-cause mortality, non-fatal AMI, transient ischemic attack/stroke, and ischemia-driven repeat revascularization, was stratified according to rCatLet score tertiles: rCatLet_low ≤3, rCatLet_mid 4-11, and rCatLet_top ≥12, respectively. Cross-validation confirmed a reasonably good agreement between the observed and predicted risks.@*RESULTS@#Of 308 patients analyzed, the rates of MACCE, all-cause death, and cardiac death were 20.8%, 18.2%, and 15.3%, respectively. Kaplan-Meier curves for all endpoints showed increasing outcome events with the increasing tertiles of the rCatLet score, with P values <0.001 on trend test. For MACCE, all-cause death, and cardiac death, the area under the curves (AUCs) of the rCatLet score were 0.70 (95% confidence intervals [CI]: 0.63-0.78), 0.69 (95% CI: 0.61-0.77), and 0.71 (95% CI: 0.63-0.79), respectively; the AUCs of the CVs-adjusted rCatLet score models were 0.83 (95% CI: 0.78-0.89), 0.87 (95% CI: 0.82-0.92), and 0.89 (95% CI: 0.84-0.94), respectively. The performance of CVs-adjusted rCatLet score was significantly better than the stand-alone rCatLet score in terms of outcome predictions.@*CONCLUSION@#The rCatLet score has a predicting value for clinical outcomes for AMI patients and the incorporation of the three CVs into the rCatLet score will enhance its predicting ability.@*TRIAL REGISTRATION@#http://www.chictr.org.cn , ChiCTR-POC-17013536.

Construction of a schistosomiasis transmission risk assessment system in Wuhan City based on analytic hierarchy process / 中国血吸虫病防治杂志

Objective To construct a schistosomiasis transmission risk assessment system in Wuhan City and preliminary evaluate its application effect, so as to promote the rational allocation of schistosomiasis control resources and accelerate the progress towards schistosomiasis elimination. Methods The schistosomiasis risk assessment indicators were collected through referring schistosomiasis surveillance data of Wuhan City from 2014 to 2020, literature review and expert interviews. Indicators within each criterion and sub-criterion were screened using the Delphi method, and a hierarchical structure model was created based on analytic hierarchy process. Quantitative assignment of each indicator was conducted according to relative importance, and the weight and combination weight of each criterion were calculated in each analytic hierarchy framework to create a schistosomiasis transmission risk assessment system, which was used for the schistosomiasis transmission risk assessment in 12 national schistosomiasis surveillance sites in Wuhan City. Results A three-level schistosomiasis transmission risk assessment system was preliminarily constructed, which included a target layer, 5 criterion layers and 21 sub-criterion layers. Of all indicators in the criterion layer, transmission route had the highest weight (0.433), followed by source of Schistosoma japonicum infection (0.294); and among all indicators in the sub-criterion layer, S. japonicum infection in Oncomelania hupensis and sentinel mice had the highest combination weight (0.125), followed by prevalence of S. japonicum infection in humans (0.091) and bovines (0.053), snail control by chemical treatment (0.049), positive rate of inquiry examinations (0.048), allocation of schistosomiasis control professionals (0.045), and areas of submerged snail-infested settings (0.041). Of the 12 national schistosomiasis surveillance sites in Wuhan City, there were 5 sites with weights of > 0.8, 4 sites with weights of 0.6 to 0.8, and 3 sites with weights of < 0.6 in 2020. Conclusion A schistosomiasis transmission risk assessment system has been constructed based on analytic hierarchy process in Wuhan City, which may provide a evidence-based basis for health resource allocation and decision-making for schistosomiasis control.

A survey on iodine nutrition status of pregnant women in Wuhan from 2016 to 2020 / 中华地方病学杂志

Objective:To understand the iodine nutrition status of pregnant women in Wuhan, and to provide a basis for guiding pregnant women to supplement iodine scientifically and adjust the prevention and control strategy of iodine deficiency disorders.Methods:From May 2016 to September 2020, each district of 13 administrative districts in Wuhan was divided into 5 areas according to east, west, south, north and middle. One township (street) was selected from each area, and 20 pregnant women were selected from each township (street). Edible salt and urine samples were collected to detect the contents of salt iodine and urinary iodine. Salt iodine was determined by direct titration, Sichuan salt and other fortified edible salt by arbitration method; urinary iodine was detected by arsenic-cerium catalytic spectrophotometry. Salt iodine and urinary iodine were analyzed according to different years, regions (central and far urban areas), age [low age (< 25 years old), appropriate age (25 - 34 years old), old age (≥35 years old)], and pregnancy [early pregnancy (< 13 weeks), middle pregnancy (13 - 27 weeks), and late pregnancy (28 - 40 weeks)].Results:A total of 5 200 edible salt samples from pregnant women's homes were collected, and the median salt iodine was 24.41 mg/kg. Among them, there were 32 non-iodized salts, 4 962 qualified iodized salts, and 206 unqualified iodized salts. The coverage rate of iodized salt was 99.38% (5 168/5 200), and the consumption rate of qualified iodized salt was 95.42% (4 962/5 200). A total of 5 200 pregnant women's urine samples were tested, and the median urinary iodine was 161.24 μg/L. Urinary iodine < 150 μg/L was found in central urban area, early pregnancy, middle pregnancy, low age and old age pregnant women in 2016 (141.74, 149.00, 132.34, 135.17, 121.00 μg/L); in early pregnancy, middle pregnancy and old age pregnant women in 2017 (128.00, 149.00, 141.41 μg/L); and in middle pregnancy and old age pregnant women in 2020 (148.95, 138.00 μg/L), which was at iodine deficiency level.Conclusions:Pregnant women in Wuhan are generally at iodine appropriate level, but close to the lower limit of the appropriate value, some pregnant women are at risk of iodine deficiency. It is still necessary to pay close attention to iodine nutrition status of pregnant women, and advocate pregnant women to eat qualified iodized salt actively.

A study on thyroid volume correction method for children aged 8 - 10 years old in Wuhan / 中华地方病学杂志

Objective:To understand the applicability of different thyroid volume correction methods for school-age children in Wuhan, and to explore the appropriate thyroid volume correction methods for school-age children in Wuhan.Methods:From May to August 2019, Hongshan, Hanyang, Hannan, Jiangxia and Dongxihu districts of Wuhan were divided into five sampling areas according to five directions: east, west, south, north and middle. One primary school was selected from each area, and 40 non-boarding students aged 8 - 10 years old (gender balanced) were selected from each primary school as survey subjects. Random urine sample and household edible salt sample were collected to detect urinary iodine and salt iodine contents, and the height, weight and thyroid volume of the children were measured. At the same time, the thyroid volume was corrected by height corrected volume index 1 (HVI1), weight and height corrected volume index (WHVI), body mass index corrected volume (BMIV), body surface area corrected volume (BSAV) and height corrected volume index 2 (HVI2).Results:A total of 1 000 children aged 8- 10 years old were investigated, including 499 boys and 501 girls; among them, there were 269, 321 and 410 children aged 8, 9 and 10 years old, respectively. The median urinary iodine was 247.50 μg/L; the median salt iodine was 23.20 mg/kg; the height, weight and thyroid volume were 140.00 (133.00, 146.00) cm, 31.00 (27.00, 37.00) kg and 2.56 (2.13, 3.21) ml, respectively. A total of 30 children with goiter were detected, and the goiter rate was 3% (30/1 000). The thyroid volumes of boys and girls were 2.57 (2.16, 3.28) and 2.56 (2.10, 3.16) ml, respectively, and the difference was not statistically significant ( U = - 0.981, P > 0.05). The thyroid volumes of children aged 8, 9 and 10 years old were 2.31 (1.98, 2.81), 2.68 (2.13, 3.30) and 2.74 (2.28, 3.35) ml, respectively, and the differences were statistically significant ( H = 47.585, P < 0.01). Spearman correlation analysis showed that the original thyroid volume was positively correlated with height and weight in children aged 8, 9 and 10 years old ( P < 0.01). After HVI1 correction, no correlation was found between thyroid volume and height in children aged 8 years old ( P > 0.05), but thyroid volume was positively correlated with weight ( P < 0.01); thyroid volume was positively correlated with height and weight in children aged 9 and 10 years old ( P < 0.01). After WHVI correction, the thyroid volumes of children aged 8, 9, and 10 years old were negatively correlated with height and weight ( P < 0.01). After BMIV correction, the thyroid volume was positively correlated with height in children aged 8, 9, and 10 years old ( P < 0.01); thyroid volume was negatively correlated with weight in children aged 10 years old ( P < 0.05). After BSAV correction, thyroid volume was positively correlated with weight in children aged 9 years old ( P < 0.05). After HVI2 correction, thyroid volume was positively correlated with weight in children aged 9 years old ( P < 0.01). The thyroid volume obtained by the 5 correction methods were all smaller than the original thyroid volume, and the thyroid volume after BSAV correction was the closest to the original thyroid volume, with a difference of 0.87% - 13.87%. Conclusions:The thyroid volume of school-age children in Wuhan is affected by age, height, and weight, judgment of goiter should be corrected for these factors. BSAV is relatively independent and stable, it can eliminate the effect of height and weight on thyroid volume. It is initially considered that BSAV is suitable for the correction of thyroid volume in school-age children in Wuhan.

Use of microwave scalpel in hepatectomy for hepatocellular carcinoma / 中华肝胆外科杂志

Objective To study the clinical use of microwave scalpel in hepatectomy for hepatocellular carcinoma without hepatic vascular inflow occlusion.Methods A retrospective study was conducted on the clinical data of 126 consecutive patients with hepatocellular carcinoma who were treated at the Department of Hepatobiliary Surgery of the Third Affiliated Hospital of Sun Yat-sen University from December 2015 to August 2018.The patients included 111 males and 15 females,with ages which ranged from 25 to 75 years.These patients were divided into two groups by the different surgical resection methods:the microwave scalpel hepatectomy (MSH) group which employed microwave scalpels to perform hepatectomy (n =42),and the ultrasound scalpel hepatectomy (USH) group which employed ultrasound scalpels (n =84).The perioperative conditions which included baseline data,amount of intraoperative bleeding,liver function after operation,and morbidity of postoperative complications were compared.Results There were no significant differences in the preoperative indexes which included tumor diameter,number of tumors,levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) between the 2 groups (all P ＞ 0.05).In the MSH group,the amount of intraoperative bleeding was 100.0 (100.0,200.0) ml,which was significantly lower than the 300.0 (100.0,400.0) ml in the USH group (P ＜ 0.05).Compared with the USH group,the levels of AST and ALT on postoperative day 1,3,7 after operation in the MSH group were significantly lower (all P ＜ 0.05),and the corresponding albumin levels were significantly higher than the USH group (P ＜0.05).The incidence of complications was 4.8％ (2/42) in the MSH group which was significantly lower than that of 20.2％ (17/84) in the USH group (P ＜ 0.05).Conclusion Microwave scalpel significantly reduced intraoperative bleeding and postoperative complications,and led to less liver functional injury.

Analysis of survey results of iodine deficiency disorders and water iodine in Wuhan City in 2017 / 中华地方病学杂志

Objective To understand the household consumption of iodized salt,iodine nutrition status and water iodine status in Wuhan after implementation of the new iodized salt standard,in order to provide a new scientific basis for prevention and control of iodine deficiency disorders.Methods In 2017,in 13 districts of Wuhan,each district was divided into five sampling areas by east,west,south,north and middle,and one town/street was selected in each district,20 pregnant women and 40 students aged 8-10 years old (half males and females) from one non-boarding elementary school were selected,to collect salt samples from their home.Salt iodine was detected by the "Salt Industry General Test Method for Determination of Iodine" (GB/T 13025.7-2012).According to "Wuhan City's 2017 Endemic Disease Prevention and Control Work Plan",urine samples of children aged 8-10 years old and pregnant women were collected in 8 districts of Wuhan,and urinary iodine levels were tested using the "Arsenic and Cerium Catalyzed Spectrophotometric Method for Determination of Urinary Iodine" (WS/T 107-2006).Goiter of children aged 8-10 years old was examined by B-ultrasonography in 5 districts of Wuhan.Water iodine survey was conducted in 13 districts based on township/street,and water iodine was tested via the arsenic and cerium catalyzed spectrophotometric method (GB/T 5750.5-2006).Results A total of 3 900 edible salt samples were tested,the median of salt iodine was 23.69 mg/kg,the coverage rate of iodized salt was 98.82％ (3 854/3 900),the consumption rate of eligible iodized salt was 95.03％ (3 706/3 900).A total of 1 600 urine samples of children were collected,and the median of children's urinary iodine was 267.00 μg/L.A total of 800 urine samples of pregnant women were collected,and the median of pregnant women's urinary iodine was 182.00 μg/L.A total of 1 000 children were monitored their thyroid gland,with a goiter rate of 1.9％ (19/1 000).A total of 218 water samples were collected,the median of water iodine was 2.90 μg/L (below national standards of 10-100 pμg/L).Conclusions After adjustment of new iodized salt standards in Wuhan,the iodine nutrition status of children and pregnant women are good.However,due to low water iodine content,the geographical environment of Wuhan still belongs to iodinedeficient area.Therefore,it should continue to implement the salt iodization policy and strengthen the monitoring of iodine nutrition in key populations such as children and pregnant women.

Meta-analysis of risk factors of thyroid cancer: base on case-control study / 中华地方病学杂志

Objective Evaluating the main risk factors of thyroid cancer systematicaly,to provide reference for the further development of thyroid cancer prevention strategies.Methods Such databases as PubMed,Cochrane Library,CBM,CNKI,VIP and WanFang were searched from the date of their establishment to June 10 2016 to collect the case-control studies on thyroid cancer.After study selection,assessment and data extraction was conducted by two reviewers independently,meta-analysis was performed by using the RevMan 5.1 software.Results Nineteen studies involving 4 813 thyroid cancer patients and 6 068 comparions were selected.The results of metaanalysis showed that:the risk factors of thyroid cancer mainly included history of benign thyroid disease [odds ratio (OR) =7.31,95％ confidence interval (95％CI,4.37,12.23)],family history of thyroid cancer [OR =5.13,95％CI (3.20,8.23)],high iodine diet [(marine animal food,OR =4.15,95％CI (2.47,6.99)],CT inspection history [OR =3.99,95％CI (2.10,7.60)],Negative emotions [sulking,OR =3.31,95％CI (2.23,4.91)],BMI greater than 25 [OR =2.62,95％CI (1.73,3.97)],high pressure and anxious [OR =2.60,95％CI (1.61,4.21)],getting along with people not harmoniously [OR =2.46,95％CI (1.59,3.81)],the number of pregnancies of women more than three times [OR =2.03,95％CI (1.50,2.76)],age of menarche less than 13,14 years old [OR =1.59,95％CI (1.06,2.37)].Conclusions Thyroid benign disease history,family history of thyroid cancer,high iodine diet,CT examination,BMI greater than 25,bad mood,social interaction,number of pregnancies and other factors are the independent risk factors for thyroid cancer.Corresponding prevention and control measures should be taken according to these risk factors.

Practice of engineering management and its effect on schistosomiasis control in Hankou marshland,Wuhan City / 中国血吸虫病防治杂志

Objective To investigate the Oncomelania hupensis snail control effect of schistosomiasis control engineering in marshland within Wuhan City. Methods The engineering measures including surface barrier removal,molluscicide,flatting surface,topsoil stripping,topsoil covering and ditch renovation were applied to transform Hankou marshland. Then the corre-sponding technical parameters of engineering measures were put forward. The situation of snails was analyzed before and after the transform project. Results The total length and area of the project were 6015 m and 87.21 hm2,respectively,including 17.44 hm2 of topsoil landfill,52.08 hm2 of topsoil covering and 23 new ditches. After the transformation,the average length of the new groove,the groove top width,groove depth,height difference,and the average values of slopes and ditch bottom slope were all increased,while the average values of the width and height of the ditch were decreased. At the same time,the marsh-land beach surface had a new slope that the embankment was higher than the river and no living O. hupensis snails were found then. Conclusions The snail breeding environment in Hankou marshland has been effectively changed by the project. Howev-er,the constant monitoring and engineering management are still needed to consolidate the effect.

Surgical management of primary small cell carcinoma of the esophagus / 中国肿瘤临床

Objective:To retrospectively analyze the survival outcomes of the surgical management of primary small cell carcino-ma of the esophagus. Methods:The medical records were reviewed for patients diagnosed with esophageal carcinoma and underwent esophagectomy from January 2000 to December 2009 at the Department of Thoracic Surgery of the Henan Cancer Hospital. We fo-cused on the clinical data of patients with small cell carcinoma of the esophagus. The Kaplan-Meier approach with log-rank test was used for survival analysis. Results:A total of 5,062 patients underwent esophagectomy with curative intent at the Department of Thorac-ic Surgery of the Henan Cancer Hospital;among which, 57 (1.1%) were diagnosed with small cell carcinoma of esophagus. The most common surgical approach was trans-left thoracic incision esophagectomy. Cervical esophagogastrostomy was performed for all pa-tients. The most common chemotherapy regimen was EP. The overall 5-year survival rate was 12.5%, and the median survival time was 45 months. Among the various stages, the 5-year survival rate and survival time were 25% and 50 months for Stage I, 5.9% and 43 months for Stage II, and 4.3%and 43 months for StageⅢ. Subgroup analysis showed that cases treated with surgery alone had poorer overall median survival time compared with those cases that underwent surgery plus chemotherapy (23.2 months vs. 60.7 months, re-spectively;P<0.01). Even for Stage I patients, thesurgery plus chemotherapysubgroup was associated with a significantly longer me-dian survival time than the surgery alone subgroup (81.9 months vs. 22.3 months, P<0.01). Conclusion:For patients with primary small cell carcinoma of the esophagus, surgery alone cannot provide the optimal prognosis. Surgery combined with systemic chemother-apy can improve the survival time.

Epidemiological analysis of overseas imported malaria in Wuhan City / 中国血吸虫病防治杂志

Objective To analyze the epidemiologic feature of overseas imported malaria in order to provide the evidence for improving the surveillance and control of malaria in Wuhan City. Methods The epidemiological investigation data of overseas imported malaria cases were collected and analyzed with an epidemiological method including plasmodium species epidemic fo?cus distribution domestic distribution population characteristics attack?diagnosis interval clinical grading etc. in Wuhan City from 2008 to 2013. Results A total of 240 overseas imported malaria cases were reported including 180 cases from Afri?can countries and the proportion of Plasmodium falciparum infections was 82.22% and 60 cases from Southeast Asian coun?tries and the proportion of Plasmodium vivax infections was 76.67% and the proportions of the parasite species were significant?ly different between the two regions χ2=105.53 P 0.001 . The male and young adults were dominant. there were no statisti?cal significance between clinical grading and attack?diagnosis interval Z=-0.99 P = 0.32 vocational background χ2=10.61 P=0.10 then clinical symptoms aggravated the situation was occurred more easily among the first attack cases χ2=7.66 P 0.05 and the falciparum malaria cases χ2=24.27 P 0.001 . Conclusions The overseas imported malaria cases are increasing rapidly with years and the malignant malaria cases were more than other malaria cases in Wuhan City. Therefore the surveillance and management of the returnees from malaria endemic areas should be strengthened continually.

Investigation of Capillaria hepatica infection in rodents from Wuhan section of Yangtze River marshland / 中国血吸虫病防治杂志

Objective To understand the prevalence of Capillaria hepatica in rodents from Wuhan section of the Yangtze River marshland. Methods Rodents were trapped in Jiang an section of Wuhan marshland of the Yangtze River. The livers of the rodents were examined for pathological changes by unaided eyes and the liver tissues were examined for the eggs of C. hepati-ca by a microscope. Results According to the natural conditions the investigation was carried out in 6 survey areas. Each sur-vey area was placed with 60 mousetraps and all 360 mousetraps were recovered. A total of 31 rodents rodent density 8.61%were captured and examined including 24 Apodemus agrarius 3 Rattus norvegicus 4 Sorex caecutiens and C. hepatica eggs were found in 1 R. norvegicus 1/3 and not found in A. agrarius and S. caecutiens. Conclusion This study has documented a prevalence of C. hepatica in rodents from Wuhan section of the Yangtze River marshland where is a natural epidemic focus of ca-pillariasis hepatica.

Microarray DNA Chip in Analyzing the Association Between HLA,DRB and Advanced Hepatosplenic Schistosomiasis / 中国寄生虫学与寄生虫病杂志

Objective To explore possible associations between host polymorphism of HLA classⅡgenotypes and advanced hepatosplenic schistosomiasis japonica.Methods 45 advanced schistosomiasis patients(experimental group) and 44 age,and sex,matched patients with chronic schistosomiasis(control group) from the same area were investigated for their HLA class II gene DRB genotypes by genotyping the alleles using microarray DNA chip.The correlation of allele frequencies to advanced hepatosplenic schistosomiasis was compared for the two groups.Results HLA,DRB1*04x exhibited markedly higher frequency in advanced patients than that in control group(P