Interpretation of the 2022 American Academy of Pediatrics guidelines for the management of hyperbilirubinemia in newborn infants / 中国当代儿科杂志

The American Academy of Pediatrics updated the guidelines for the management of hyperbilirubinemia in the newborn infants with a gestational age of ≥35 weeks in September 2022. Based on the evidence over the past 18 years, the guidelines are updated from the aspects of the prevention, risk assessment, intervention, and follow-up of hyperbilirubinemia in the newborn infants with a gestational age of ≥35 weeks. This article gives an interpretation of the key points in the guidelines, so as to safely reduce the risk of bilirubin encephalopathy and unnecessary intervention.

Relationship between Dining Place, Iodine Source, and Iodine Nutrition in School-Age Children: A Cross-Sectional Study in China / 生物医学与环境科学（英文）

OBJECTIVE@#This study assesses the impact of iodine-rich processed foods and dining places on the iodine nutritional status of children.@*METHODS@#School-aged children (SAC) in seven provinces in China were selected by school-based multi-stage sampling. Urinary iodine, salt iodine, and thyroid volume (TVOL) were determined. Questionnaires were used to investigate dining places and iodine-rich processed foods. The water iodine was from the 2017 national survey. Multi-factor regression analysis was used to find correlations between variables.@*RESULTS@#Children ate 78.7% of their meals at home, 15.1% at school canteens, and 6.1% at other places. The percentage of daily iodine intake from water, iodized salt, iodine-rich processed foods, and cooked food were 1.0%, 79.2%, 1.5%, and 18.4%, respectively. The salt iodine was correlated with the urinary iodine and TVOL, respectively (r = 0.999 and -0.997, P < 0.05). The iodine intake in processed foods was weakly correlated with the TVOL (r = 0.080, P < 0.01). Non-iodized salt used in processed foods or diets when eating out had less effect on children's iodine nutrition status.@*CONCLUSION@#Iodized salt remains the primary source of daily iodine intake of SAC, and processed food has less effect on iodine nutrition. Therefore, for children, iodized salt should be a compulsory supplement in their routine diet.

Interpretation of the clinical guideline for point-of-care ultrasonography in the neonatal intensive care unit in the United States / 中国当代儿科杂志

In December 2022, the American Academy of Pediatrics released a clinical guideline for point-of-care ultrasonography (POCUS) in the neonatal intensive care unit (NICU). The guideline outlined the development and current status of POCUS in the NICU, and summarized the key elements and implementation guidelines for successful implementation of POCUS in the NICU. This article provides an overview of the key points of the clinical guideline and analyzes the current status of POCUS in China, providing a reference for the implementation of POCUS in neonatal care in China.

Chinese Medicine Involving Triple Rehabilitation Therapy for Knee Osteoarthritis in 696 Outpatients: A Multi-Center, Randomized Controlled Trial / 中国结合医学杂志

OBJECTIVE@#To determine the effects of Chinese medicine (CM) involving triple rehabilitation therapy on the progression of knee osteoarthritis (KOA).@*METHODS@#A total of 722 patients recruited from 38 community health service centers located in China from March 2013 to March 2017 were randomly divided into treatment and control groups equally, using a cluster randomization design. Health education combined with CM involving triple rehabilitation therapy for KOA (electro-acupuncture, Chinese medicinal herb fumigating-washing, and traditional exercises) was administered in the treatment group while conventional rehabilitation therapy (physical factor therapy, joint movement training, and muscle strength training) was administered in the control group. Patients with a visual analog scale (VAS) scores ≽4 were treated with dispersible meloxicam tablets (7.5 mg, once daily). The Lequesne index scores, VAS scores, range of motion (ROM), lower limb muscle strength, knee joint circumference, quantitative scores of KOA symptoms, and the short-form 36 item health survey questionnaire (SF-36) scores were measured for each patient at 5 checkpoints (before treatment, at the 2nd week and the 4th week during the 4-week treatment period, at 1 month and 3 months after end of treatment), and adverse reactions were observed also.@*RESULTS@#A total of 696 patients completed the entire process, with 351 in the treatment group and 345 in the control group. At all treatment checkpoints, the treatment group demonstrated better outcomes than the control group with regard to the total Lequesne index scores, effective rate and improvement rate of the total Lequesne index scores, VAS scores, lower limb muscle strength, knee circumference, quantitative scores of KOA symptoms, and SF-36 scores as well (P<0.05 or P<0.01). No adverse reactions were encountered in this study.@*CONCLUSIONS@#CM involving triple rehabilitation therapy can alleviate KOA-related pain and swelling, improve lower limb muscle strength, promote flexion and activity of the knee and improve the quality of life in patients undergoing KOA. It is suitable for patients with early or mid-stage KOA. (Registration No. ChiCTR-TRC-12002538).

Effect of Tongfengning on Expression of Renal Urate Transporter in Hyperuricemia Rats / 中国实验方剂学杂志

Objective:Study on the mechanism of Tongfengning in promoting uric acid excretion from the perspective of urate transporter and mRNA in renal of hyperuricemia （HUA） model rats. Method:The 80 sprague-dawley rats were randomly divided into two groups， the blank group with 20 rats and the model group with 60 rats. Rats in model group were established as hyperuricemia （HUA） models by intraperitoneal injection of oxonic acid potassium salt （OAPS） and intragastric administration ethambutol hydrochloride （EMB） once a day for 21 days. After successful modeling， rats in the model group were divided into the model group， Tongfengning group and benzbromarone group， with 20 rats per group. Tongfengning solution （15.3 g·kg-1·d-1） was administered to the Tongfengning group by gavage feeding. Rats in benzbromarone group were administered 5.2 mg·kg-1·d-1 benzbromarone suspension， whereas those in the blank group and the model group were administered the equivalent amount of normal saline for 21 days. On days 14th and 21st following intervention， urine， blood， and kidney were collected from rats， serum uric acid （SUA） and urinary uric acid （UUA） levels， blood urea nitrogenand（BUN） and creatinine（CRE） levels and the expression of urate transporter proteins and their mRNAs of all rats were detected by enzyme-colorimetric method， urease method， sarcosine oxidase method， Western blot and Real-time quantitative PCR（Real-time PCR）， respectively. Result:On days 14th and 21th following intervention， compared with blank group， SUA， CRE and BUN levels， and urate transporter 1（URAT1），glucose transporter 9（GLUT9） expression increased（P<0.05，P<0.01）， whereas UUA level， and adenosine triphosphate-binding cassette transporter protein G2（ABCG2）， organic anion 1（OAT1）， organic anion 3（OAT3） expression decreased in the model group（P<0.05，P<0.01）. Compared with model group， SUA， CRE and BUN levels， and URAT1， GLUT9 expression decreased in Tongfengning group and the benzbromarone group（P<0.05）， whereas UUA level， and ABCG2， OAT1， OAT3 expression increased（P<0.05）. Creatinine and BUN levels decreased in the Tongfengning group（P<0.05，P<0.01）， with the trend much better than the benzbromarone group（P<0.05）. On day 21st， except for the BUN level did not change much compared with day 14th， all the rest indicators got improved obviously. Conclusion:Intraperitoneal injection of OAPS and intragastric administration of EMB can cause HUA models with renal dysfunction. Tongfengning reduced URAT1， GLUT9 mRNA and protein expression， and upregulated ABCG2， OAT1， OAT3 mRNA and protein expression in the rat kidney， which may be one of the mechanisms of promoting uric acid excretion. Tongfengning has a certain protective effect on renal function.

Application of Mental Rotation Test in Motor Imagery Ability Assessment for Stroke Patients / 中国康复理论与实践

Objective:To study the judgment strategies of stroke patients facing different visual stimulus and the main factors affecting the mental rotation test results. Methods:From May to October, 2018, 15 stroke patients and 15 age-sex-education-matched healthy controls accepted standard software-based mental rotation tests with four kinds of visual stimulus: hand back, hand palm, Chinese characters and alphabets. Reaction time and response accuracy were recorded. All the subjects were assessed with Montreal Cognitive Assessment (MoCA), and the patients were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) additionally. Results:When hand back, hand palm and alphabets worked as visual stimulus, the response accuracy was less in the patients than in the controls (F > 7.027, P < 0.05). For all the tests, the reaction time was more in the patients than in the controls (F > 14.827, P < 0.001). The main effect of rotation angle was significant to reaction time when picture of hands as visual stimulus (F > 7.747, P < 0.001), while it was the least at 0°. The MoCA scores negatively correlated with reaction time in both groups (r < -0.375, P < 0.05), as well as the FMA-UE scores in the patients (r < -0.581, P < 0.05). Conclusion:Different types of visual stimulus may affect the judgment strategies and results of mental rotation test. Motor imagery ability is impaired for stroke patients, however, the basic reaction model maintains somehow.

Effect of Tongfengning Serum Containing on Expression of Urate Transporter in HK-2 Induced by Uric Acid / 中国实验方剂学杂志

Objective: Study on the mechanism of Tongfengning in reducing serum uric acid from the perspective of renal urate transporter. Method: The human renal tubular epithelial cells(HK-2)was randomly divided into normal group, model group, Tongfengning low, medium and high dose group (7.65,15.3,30.6 g·kg-1) and benzbromarone group (50 μmo1·L-1),different culture media were given for intervention.HK-2 and cell supernatant were collected after 24 h of intervention. The expressions of urate transporter 1 (URAT1), glucose transporter 9 (GLUT9), organic anion transporter 1(OAT1), organic anion transporter 3(OAT3), and ATP-binding cassette superfamily G member 2 (ABCG2) protein and mRNA were detected in HK-2 of all groups by Western blot and Real-time PCR. Result: Compared with normal group, the expression of URAT1, GLUT9 protein and mRNA was significantly increased(PPPPPConclusion: Tongfengning can regulate the reabsorption and secretion of uric acid in renal tubules, promote the excretion of uric acid in kidney and reduce the level of serum uric acid by down-regulating the expression of URAT1, GLUT9 protein and mRNA in HK-2 and up-regulating the expression of ABCG2 protein and mRNA. It is suggested that the regulation of renal uric acid transporter protein may be one of the specific mechanisms of Tongfengning to reduce serum uric acid by promoting dampness and turbid removal. OAT1, OAT3 protein and mRNA were not expressed in HK-2 cultured in vitro.

LW-AFC,a new formula derived from Liuwei Dihuang decoction,ameliorates behavioral and pathological deterioration via modulating the neuroendocrine-immune system in Alzheimer disease mouse models / 中国药理学与毒理学杂志

OBJECTIVE Alzheimer disease(AD),the most common cause of dementia among older people, could not be prevented, halted, or reversed up till now. A large body of pharmacological study has revealed that Liuwei Dihuang (LW) possesses potential therapeutic effects on AD. LW-AFC is key fractions from LW.In the present study,we investigated the effect of LW-AFC on AD mouse models. METHODS PrP-hAβPPswe/PS1ΔE9(APP/PS1) mice and senescence-accelerated mouse prone 8 strain (SAMP8), classic AD animal models, were employed. After the treatment of LW-AFC, mice were cognitively evaluated in behavioral experiments. Neuron loss, amyloid-β (Αβ) deposition, and Αβ level were analyzed using Nissl staining, immunofluorescence, and an AlphaLISA assay, respectively. Multiplex bead analysis, a radioimmunoassay, immunochemiluminometry, and an ELISA were used to measure cytokine and hormone levels.Lymphocyte subsets were detected using fl ow cytometry. RESULTS LW-AFC ameliorated the cognitive impairment observed in APP/PS1and SAMP8 mice,including the impairment of object recognition memory,spatial learning and memory,and active and passive avoidance. In addition, LW-AFC alleviated the neuron loss in the hippocampus, suppressed amyloid-β(Αβ)deposition in the brain,and reduced the concentration of Aβ1-42in the hippo-campus and plasma of APP/PS1 mice. LW-AFC treatment also significantly restored the imbalance of hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-gonadal (HPG) axis, enhanced the proliferation of splenocytes,corrected the disorder of lymphocyte subsets,and regulated the abnormal production of cytokine in APP/PS1 and SAMP8 mice. Effects of LW-AFC on pharmacodynamics and neuroendocrine immunomodulation network in APP/PS1 and SAMP8 mice were better than meman-tine and donepezil. CONCLUSION LW-AFC ameliorated the behavioral and pathological deterioration of AD mouse models via the restoration of the NIM network, which supports the use of LW-AFC as a potential agent for AD therapy.

Liuwei Dihuang Decoction improves cognitive impairments via regulating immune system in APP/PS1 transgenic mouse,a mouse model of Alzheimer disease / 中国药理学与毒理学杂志

OBJECTIVE To investigate the effect and mechanisms of Liuwei Dihuang Decoction (LW)on cognition in PrP-hAβPPswe/PS1ΔE9(APP/PS1)transgenic mice.METHODS LW was adminis-trated with oral for 3 months.The locomotor activity test was performed to investigate the spontaneous motor activity of mice. The Morris water maze test and shuttle box test were performed to investigate the spatial learning and memory and active avoidance response respectively.The Αβ deposits and neuron loss in the hippocampus was detected by immunofluorescence staining and nissl staining respectively. The flow cytometry was employed to investigate the lymphocyte subsets of the mice.The 3H-thymidine incorporation was performed to investigate the splenocytes proliferation. RESULTS The treatment of LW ameliorated the impairments of spatial learning and memory and active and passive avoidance in APP/PS1 mice. The administration of LW alleviated neuron loss in the brain, suppressed amyloid-β (Αβ) deposits in the hippocampus of APP/PS1 mice. The treatment of LW significantly increased ConA-and LPS-induced proliferation of splenocytes,increased CD3+T cells and CD19+B cells in the spleen lymphocytes and reduced Gr1+cells in APP/PS1 mice.CONCLUSION This data indicated the adminis-tration of LW ameliorated behavioral and pathological deterioration via regulating immune function.

Contribution of luteinizing hormone to Alzheimer’s disease / 国际药学研究杂志

Luteinizing hormone(LH)is a gonadotropin of hypothalamic-pituitary-gonadal axis(HPG), secreted by the anterior pituitary. The secretion of LH is directly controlled by the release of gonadotropin releasing hormone(GnRH), acts at the ovaries and testes to stimulate the production of gonadal hormones. Aging leads to increases in LH, and higher serum levels of LH has been observed in Alzheimer’s disease(AD)patients when compared to age-matched controls. Evidences from basic research and epidemiological investigation support the critical role of elevated LH in pathogenic process of AD and deteriorating cognitive decline. Here we summarize the recent discoveries containing human AD epidemiological evidence for LH, cognitive impairments resulting from LH activity, LH in AD pathology and LH receptor signaling mechanisms.

Relationship between differential expression of renal AT1 and Mas receptor proteins and kidney injury in mice subjected to limb ischemia-reperfusion / 解放军医学杂志

Objective To explore the role of imbalance of local renin angiotensin system (RAS) in renal injury by observing the changes of AT1 and Mas receptor protein expression in renal and the degree of renal injury after limb ischemia-reperfusion (LIR) in mice. Methods The hind legs of ICR mice were rendered ischemic by using a tourniquet to block blood flow. The tourniquet was release after 2 hours to initiate reperfusion. Forty-eight 8-week-old male ICR mice were randomly assigned into 8 groups (6 in each group), including a control group and 7 model groups of 10min, 0.5h, 1h, 2h, 4h, 6h and 12h after reperfusion. Histopathological technique was used to observe morphological changes in renal tissue, and pathological score was assessed. Automatic biochemical analyzer was employed to determine the contents of serum creatinine and urea. Western blotting was performed to determine the expression of AT1 and Mas receptor protein in renal tissue. Results Pathological changes were found in renal tissue of model mice, including interstitial congestion, edema, inflammatory cell infiltration, and epithelial cell degeneration, and the injury score elevated gradually along with the length of reperfusion time. Biochemical results showed that the contents of serum creatinine and urea increased with the prolongation of reperfusion time, reaching the highest level at 4h point.Western blotting showed that the expression of AT1 protein decreased significantly and of Mas receptor protein increased significantly with the prolongation of perfusion time. Conclusion The renal damage is gradually increased after LIR, and the expression imbalance of AT1/Mas receptor proteins may be involved in the damage process.

Biological characteristics of β-secretase: Research advances / 国际药学研究杂志

β-secretase，a type I transmembrane aspartic protease, initiates b-amyloid protein(Aβ) formation by cleaving β- amyloid precursor protein between Met596and Asp597or between Tyr606and Glu607to generate N-terminal fragment of Aβ. β-Secretase has many members，and aspartic proteinase β-site amyloid precursor protein-cleaving enzyme 1 (BACE1) is the most famous of them. Because BACE1 plays a significant role in the pathogenesis of Alzheimer’ s disease (AD) and a neurodegenerative disease# it has been studied fully. In this article，we review the gene and protein structure，transcription and translation，intracellular trafficking and metabolism of BACE1 and summarize substrates and homologous enzymes of BACE1. This work provides some reference for BACE1 as a drug target on AD.

Analysis of monitoring results of children dental fluorosis in drinking-water-borne endemic fluorosis areas in Liaoning province in 2011 / 中国地方病学杂志

Objective To investigate the prevalence of children dental fluorosis in drinking-water-borne endemic fluorosis areas in Liaoning province and to evaluate the disease prevention effects of water improvement measures.Methods Haicheng city,Linghai city,Faku county,Fumeng county,Liaoyang county and Jianping county six endemic fluorosis diseased counties (cities) of Liaoning province were included in the study in September 2011.In each county,3 water improvement villages were selected as survey points.In each surveyed village,children aged 8-12 were generally surveyed the prevalence of dental fluorosis.One tap water sample was collected in each surveyed village for determination of water fluorine.level.Results A total of 786 children aged 8-12 were examined; 110 of them were found with dental fluorosis; detection rate of dental fluorosis was 14.0％ ; no defect case of dental fluorosis was found,and dental fluorosis index was 0.27.Among the cases,very mild were 76 cases,and the detection rate was 9.7％; mild 33 cases,the detection rate was 4.2％; moderate 1 case,the detection rate was 0.1％; and no severe case.Four cases were in the eight-year-old group,accounting for 3.6％ of the total number of cases; 20 in the 9-year-old group,accounting for 18.2％ ; 26 in the 10-year-old group,accounting for 23.6％; 32 in the 11-year-old group,accounting for 29.1％; and 28 in the 12-year-old group,accounting for 25.5％.The differences of detection rates of dental fluorosis of children in each age groups were statistically significant (x2 =13.57,P ＜ 0.05).Water fluoride of the 18 water samples ranged from 0.34 to 2.03 mg/L; 77.8％ (14/18) of the water improvement areas reached the control standard for endemic fluorosis areas.Conclusion The prevalence of dental fluorosis in the areas with high fluoride in drinking water remains high,the measures of water improvement should be strengthened.

Verification of an improved method for determination of urinary iodine by As3+-Ce4+ catalytic spectrophotometry / 中国地方病学杂志

Objective To verify the feasibility and application value of an improved method for determination of urinary iodine by As3+-Ce4+ catalytic spectrophotometry.Methods Adults urine samples were collected,iodine calibration curves of 0-300 μg/L and 300-1200 μg/L were prepared,and urinary iodine was determined by the improved As3+-Ce4+ catalytic spectrophotometric method.Lyophilized human urinary iodine ingredient standards were used to validate linearity and range,limit of detection,precision and accuracy of this improved detection method.Results The linear range of the calibration curve was 0-300 μg/L,the detection limit was 1.8 μg/L,and the range of correlation coefficient was-0.9995--0.9997.When measuring urinary iodine at 40-80,100-149,200-280 μg/L,the relative standard deviations were 1.5％,0.8％ and 0.5％.When measuring urinary iodine at 40-80,100-149,150-180 μg/L,the average recoveries were 97.8％,99.8％ and 96.6％.Two given values of urinary iodine of national standard samples were (73.0± 9.0) and (206.0± 10.0)μg/L,and the results determined by this method were (75.5 + 0.9) and (207.5 ± 1.9)μg/L,and the relative deviation was 3.4％ and 0.7％,respectively,the results determined were all within the given value range.The linear range of the calibration curve was 300-1200 μg/L,the detection limit was 305.2 μg/L,the range of the correlation coefficient was-0.9996--0.9999.When measuring urinary iodine at 300-400,500-600 and 1000-1200μg/L,the relative standard deviations were 0.6％,1.0％ and 0.7％.When measuring urinary iodine at 300-499,500-599 and 600-700 μg/L,the average recoveries were 99.7％,99.2％ and 100.4％.Two given values of urinary iodine of national standard samples were (558.3 ± 3.5) and (884.8 ± 4.7)μg/L,the results determined by this method were (556.0 + 17.0) and (883.0 ± 28.0)μg/L,and the relative deviation was 0.4％ and 0.2％,respectively,the results were all within the given value range.Conclusions This method extends the detection range of iodine concentration,and improves precision and accuracy.This method greatly reduces the amount of arsenic used therefore reduces environmental pollution,which is suitable for promotion.

Association between blood pressure level and the development of memory dysfunction in patients with hypertension / 中华心血管病杂志

<p><b>OBJECTIVE</b>It is known that hypertension may be implicated the development of memory dysfunction. Our study tests the hypothesis that prevalence of memory dysfunction is closely linked with the level of SBP (systolic blood pressure) and DBP (diastolic blood pressure) in hypertension patients.</p><p><b>METHODS</b>Non-stroke hypertension patients aged 18-75 years (n = 196, age 54 ± 10, 101 male) with diagnosed hypertension for more than one year were included. Memory function was measured by the Rivermead Behavioral Memory Test Second Edition (RBMTII, 2003). The general information was obtained through questionnaire.</p><p><b>RESULTS</b>RBMTII total score, the ability of recall name, remember storing article, recall faces, delayed route memory and orientation score were significantly decreased in proportion with increasing blood pressure (P < 0.05: hypertension III vs. II and I). RBMTII total score, the ability of recall name, and recall faces were significantly lower in hypertension II group compared to hypertension I group (P < 0.05). The age, male gender, years of hypertension, level of SBP and BMI were risk factors of memory dysfunction while the years of education was protective factor of memory dysfunction. The morbidity of memory dysfunction in patients with hypertension was higher and more serious with increasing blood pressure level (χ(2) = 10.389, P < 0.01).</p><p><b>CONCLUSIONS</b>Our results suggest that blood pressure is positively related to increased risk of memory dysfunction. The age, male gender, years of hypertension, level of SBP and BMI are risk factors of memory dysfunction while the years of education is protective factor of memory dysfunction.</p>

An analysis of the intelligence level of children born in different time periods after iodized salt was supplied in regions with iodine deficiency in Liaoning province / 中国地方病学杂志

objecfive To know and compare the intelligence level of children born in different time periods in regions with iodine deficiency disorders(IDD)in Liaoning province.Methods All 7-14 year-old children from ten schools were chosen as the subjects respectively from six villages in each of the six counties and in regions with iodine deficiency,who were respectively born at the initialization of iodinated salt supplying period(1978-1980);non-iodinated salt supplying period(1981-1990);recovery of supplied iodized salt period(1991-1995);universal iodized salt period(1996-2000),respectively.Intelligence quotient(IQ)was measured by Combined Ravens Test in China(CRT-C)and Combined Ravens Test-the Rural,in China,2nd edition(CRT-RC2).Results IQ of children during the non-iodized salt period(91.9±14.3)was significantly lower than the initial supply of iodized salt period(95.8±14.6,q=8.60,P<0.01),recovery of supplied iodized salt period(99.7±14.7)was significantly higher than the initial supply of iodized salt period, non-iodized salt sales period(q = 9.53, 18.13, all P < 0.01 ),universal salt iodization( 104.3 ± 14.9) was significantly higher than the initial supply of iodized salt period, non-iodized salt sales period, recovery of supplied salt iodization(q = 20.00,28.00,10.46, all P < 0.01). Children's rate of mental retardation (IQ≤69) was higher in non-iodinated salt supplying period (6.7%, 88/1314 ) than the initial supply of iodized salt (4.4%, 21/471, χ2 = 3.85, P < 0.05), recovery of supplied iodized salt period(3.3%,48/1470) was significantly lower than non-iodinzed salt supplying period (χ2 = 15.37, P < 0.01), universal salt iodization period(2.7%, 36/1344) was lower than the initial supply of iodized salt period(χ2 = 4.41, P < 0.05) and non-iodinzed salt supplying period(χ2 = 26.34, P < 0.01 ). The IQ and intelligent retarded rates in children born during the initial years of iodinated salt supplying period were not different. The IQ of the children during ten years of non-iodized salt supplying period fluctuated in a "∪" curve, while the intelligent retardation rates in a "∩" curve.The children born during the period of recovery supplied iodized salt increased their IQ and lowered the retardation rates year after year. The IQ of the children in universal iodized salt period kept on increasing while intelligent retarded rates reduced to the lowest level. Conclusions The intelligence level of children born in regions with IDD during non-iodized salt supplying period is remarkably lower than that of the beginning years of iodinated salt supplying period. The intelligence level of children born after universal iodized salt period is remarkably higher than that of the initial iodinated salt supplying period and recovery of supplied iodized salt period, respectively.

Application of global positioning systems and geographic information systems in drinking water defluoridation project in Liaoning province / 中国地方病学杂志

Objective To establish information management systems of drinking water defluoridation project in water-related endemic fluorosis areas and investigate the status of drinking water defluoridation project in Liaoning, provide the basis for the development of control measures. Methods Global positioning systems (GPS)and geographic information systems(GIS) were used in the study in August 2006 - July 2008. Water defluoridation projects of 1234 in 48 counties(cities, districts) in drinking water type of fluorosis areas were positioned. Latitude and longitude, water samples, water fluoride content were collected or tested. GIS was used to establish information management system of water defluoridation projects. Results We have established information management system for the facilities of decreasing water fluorine in drinking water type of endemic fluorosis regions in Liaoning. One thousand two hundred and thirty four defluoridation facilities distributed in east longitude between 39.39° - 43.37°,north latitude between 119.25° - 125.50°, and altitude between - 6.60 and 801.14 meter in 48 endemic fluorosis counties in 13 cities. Nine hundred and twenty seven facilities for decreasing fluorine were able to supply water regularly, accounting for 75.1% of investigated projects;29 facilities was .not yet completely rebuilt, accounting for 2.4%;278 facilities(supply water for 344 villages) were out of order or discarded for 22.5% of investigated projects.Water fluorine contents of 63 facilities were greater than 1.2 mg/L, accounting for 6.8% of investigation project.Facilities working regularly and water fluorine was in accord with hygienic standard for drinking water facilities were 70.0%. Conclusions The establishment of Liaoning province defluoridation project information management system in the whole province of drinking water type of fluorosis areas provides scientific basis for accurate decision-making on prevention and control of the disease.

Endemic fluorosis:prevalence and prevention in Liaoning Province / 中国地方病学杂志

Objective To investigate the status of control of endemic fluorosis in Liaoning Province.Methods To investigate the prevalence rate of endemic fluorosis and water fluoride content in regions with different extent of endemic fluorosis,dental fluomsis among 8-12 years old children and clinical fluorosis at adult above 16 years old were extensively surveyed,urinary fluoride among 8-12 years old children was detected.Results We surveyed 842 undefluorided drinking water in endemic fluorosis villages and 1234 projects of improving drinking water in 1829 endemic fluorosis viflages.Water fluoride content was 0.01-7.10 mg/L in unimproved drinking water in endemic fluorosis resions,averaging(0.96±0.64)mg/L;29.2%(246/842)of the endemic fluorosis regions had a fluoride content more than 1.2 mg/L In 1234 projects of improving drinking water.drinking water fluoride content was between 0.06-7.67 mg/L.The project normally operated and having a fluoride content≤1.2 mg/L accounted for 68.31%(843/1234),while 31.69%(391/1234)of the projects did not function well.The prevalence of dental fluomsis in 8-12 years old child ren in endemic fluorosis regions was 24.4%(2960/12 127),the prevalence of clinical fluorosis among adults was 2.22%(1900/85 636).The prevalente of dental fluorosis in slight,moderate and serious fluorosis regions had remarkable statistics differences(X2＝19.25,P＜0.01).The prevalence of dental fluorosis of children in serious fluorosis regions was the highest,reaching 100%,while the prevalence of skeletal fluorosis wns 18.03%(97/538).The median of urinary fluoride was 2.01.2.00mg/L in serious and slight fluomsis regions,respectively.Conclusions Endemic fluorosis is still serious.so we need urgently to improve water in serious fluorosis regions without defluoridaton of drinking water.Endemic fluomsis resions where worn-out and closed defluoriding projects exist need defluoriding management.

The value of the dynamic mechanical spinal test in the management of automated percutaneous lumbar discectomy / 介入放射学杂志

Objective To prospectively assess the predictive power of centralization phenomenon in the curative effect of automated PLD.Methods The survey population was consisted of 109 patients with inclusion heraiation demonstrated by CT/MRI,74 men and 35 women with average age of 43.1 years(17～75 years). All were complained of low back pain,with varying degrees of lower extremity pain and altered sensation, lasting for more than 2 months;including one symptomatic disc in 99 patients and two symptomatic discs in 10 patients.Patients were undergone dynamic mechanical spinal test and reported whether the test would aggravate their pain.The assessment included forward flexion,extension,rotation of the trunk to the right and left, rotation to the left with fight extension,rotation to the fight with left extension,and whether straight leg raising in the supine position would aggravate back pain or leg pain.Symptom resposes were categorized into three groups:centralization group(CG),partial-centralization group(PCG)and noncentralization group(NCG). Centralization of pain is the progressive retreat of the most distal extent of the referred or radicular pain toward or to the lumbar midline.Noncentralization of pain is the peripheralization of pain in one or more directions, and no change in the distal-most pain location or intensity.All patients received a single therapy with PLD. Results A follow-up of 109 patients for 3 to 6 months,including 46 cases with 24 as exellent and 22 as good reaching 100% of excellent good rate in CG by MacNab standards;43 cases with 5 as exellent,29 as good,9 as fair and poor,with total effective rate of 79.1% in PCG.Twenty cases of NCG symptoms showed no improvement and therefore surgery was considered.Conclusions Centralization phenomenon occurrence during initial mechanical evaluation is a very accurate predictor for successful PLD outcome.Nonoccurrence of centralization would accurately predict poor PLD outcome and thus helpful as early predictor of the need for surgical treatment.