Survey results of drinking water iodine level in some areas of Jiangsu Province in 2020 / 中华地方病学杂志

Objective:To dynamically observe the changes in iodine level in residents' drinking water after the change of regional water supply mode (2020) in Jiangsu Province.Methods:The survey of water iodine level was conducted from June to October 2020 in administrative villages of Jiangsu Province with a median water iodine ≥40 μg/L in 2017. The survey mainly covered 1 537 administrative villages in 21 counties (cities and districts) of 5 cities, including Huaian City, Lianyungang City, Suqian City, Yancheng City, and Xuzhou City. Based on the standard of "Definition and Demarcation of Iodine Deficient Areas and Iodine Adequate Areas" (WS/T 669-2020), the administrative villages with a median water iodine of 40 - 100 μg/L were classified as iodine adequate areas. Water iodine testing was conducted using the "Method for Water Iodine Testing in Iodine Deficient and High Iodine Areas" recommended by the National Reference Laboratory for Iodine Deficiency Disorders.Results:Totally 1 498 administrative villages in Jiangsu Province were monitored in 2020, all of which had centralized water supply. The minimum value of water iodine in all administrative villages was 1.2 μg/L and the maximum value was 606.7 μg/L, and the median water iodine was 35.2 μg/L. Among them, 206 administrative villages had median water iodine < 10 μg/L, accounting for 13.75% (206/1 498); 610 administrative villages had median water iodine from 10 to < 40 μg/L, accounting for 40.72% (610/1 498); 635 administrative villages had median water iodine from 40 to 100 μg/L, accounting for 42.39% (635/1 498); and 47 administrative villages with median water iodine > 100 μg/L, accounting for 3.14% (47/1 498). Except for Sucheng District in Suqian City, Xinyi City and Gulou District in Xuzhou City, Qingjiangpu District and Xuyi County in Huaian City, and Guannan County in Lianyungang City, the median water iodine in the administrative villages of the remaining 15 counties (cities and districts) in 2020 decreased significantly compared to 2017, and the differences were statistically significant ( P < 0.05). Conclusion:After change of regional water supply mode in 2020, in most monitored counties (cities and districts) of Jiangsu Province, the water iodine level of administrative villages has decreased significantly compared to 2017.

Analysis of surveillance results of drinking water-borne endemic fluorosis in Jiangsu Province in 2021 / 中华地方病学杂志

Objective:To learn about the implementation of prevention and control measures in drinking water-borne endemic fluorosis areas and the trend of the disease change in Jiangsu Province.Methods:In March to October 2021, a general survey was carried out in 1 972 villages with drinking water-borne endemic fluorosis in 27 counties (cities and districts) of Jiangsu Province, the operation of water improvement projects in the villages was monitored, and the water fluoride content was determined. The prevalence of dental fluorosis among children aged 8 to 12 years in all the villages was investigated.Results:The 1 972 villages with drinking water-borne endemic fluorosis had completed water improvement, and all water improvement projects were operating normally and the water was qualified. Among them, 1 774 villages in the disease affected areas had achieved the control goal, accounting for 89.96%; and there were 198 villages in the disease affected areas with control measures up to the standard, accounting for 10.04%. A total of 47 water improvement projects were monitored, including 2 small-scale water improvement projects, accounting for 4.26%. There were 45 large-scale water improvement projects, accounting for 95.74%. A total of 125 790 children aged 8 to 12 years were examined, and 12 625 cases of dental fluorosis were detected. The detection rate of dental fluorosis was 10.04%, and the dental fluorosis index was 0.19. The detection rate of dental fluorosis in children aged 8 to 12 years was 9.98% (1 854/18 579), 10.27% (2 704/26 323), 9.48% (2 765/29 152), 9.73% (2 835/29 145) and 10.92% (2 467/22 591), respectively, with statistically significant difference (χ 2 = 10.51, P = 0.015). Among the 198 villages with control measures up to standard, according to the historical water fluoride, the detection rate of dental fluorosis in children in each water fluoride range (1.20-2.00, 2.01-3.00, 3.01-4.00, > 4.00 mg/L) was 37.73% (698/1 850), 43.17% (1 176/2 724), 45.50% (769/1 690) and 55.20% (802/1 453), respectively, with a statistically significant difference (χ 2 = 104.15, P < 0.001). Conclusion:The water improvement measures in drinking water-borne endemic fluorosis areas in Jiangsu Province have achieved significant results, which still need to be further consolidated.

Effectiveness evaluation of health education on drinking-water-borne endemic fluorosis in Jiangsu Province from 2014 to 2018 / 中华地方病学杂志

Objective:To evaluate the effect of health education on drinking-warter-borne endemic fluorosis in Jiangsu Province.Methods:From 2014 to 2018, a total of 12 counties (districts) with drinking-warter-borne endemic fluorosis were selected to carry out public health education activities, and 3 townships were chosen in each project county (district). School health education activities were carried out in the classes of grade 4 - 6 in the central primary school in each selected twonship. In the meantime, 3 villages were chosen in each selected township where the health education activities in the community were carried out. Before and after the health education activities, questionnaire surveys on knowledge of drinking-warter-borne endemic fluorosis prevention were conducted among 30 students in one class of grade 5 in the central primary school and 15 housewives lived near the central primary school in each township.Results:After the health education activities, the rates of knowledge awareness in the students and the housewives were 94.83% (15 362/16 200) and 95.14% (7 706/8 100), respectively, which were significantly higher than those before the health education activities [63.88% (10 348/16 200) and 65.94% (5 341/8 100)], and the differences were statistically significant (χ 2 = 4 700.00, 2 200.00, P < 0.001). There were no statistical differences in the rates of knowledge awareness in the students and housewives before the health education activities from 2014 to 2018 (χ 2 = 8.43, 0.88, P = 0.077, 0.928). Before the health education activities, the rate of knowledge awareness in the students was lower than that in the housewives, and the difference was statistically significant (χ 2 = 10.03, P = 0.002). After the health education activities, there was no statistical difference between the rate of knowledge awareness in the students and that in the housewives (χ 2 = 1.07, P = 0.301). Conclusions:The rates of knowledge awareness in the students and the housewives are increased significantly after the health education activities. We should expand the coverage of health education. Wide, deep and persistent health education in more ways for different people are needed to consolidate the achievements.

Investigation and analysis of thyroid nodules and goiter in school-age children in different water iodine areas of Jiangsu Province / 中华地方病学杂志

Objective:To analyze the detection rate of thyroid nodules and goiter in school-age children in different water iodine regions and investigate the difference of thyroid nodule and goiter in school-age children with different age, gender and body mass index (BMI) in Jiangsu Province.Methods:In 2017, three villages with water iodine values of 8.1, 51.2 and 115.4 μg/L (iodine deficient group, iodine appropriate group and iodine high group) were selected as survey sites in Xuzhou City, Jiangsu Province, where the supply of iodized salt was suspended. One primary school was selected from each village, and children aged 8 to 10 years old (age balance, half male and half female) were selected from each primary school as the survey subjects. Urine sample were collected, urinary iodine level was determined, height and weight were measured, and neck B ultrasound was performed.Results:A total of 131, 140 and 138 school-age children aged 8 to 10 years old were investigated in the iodine deficient group, iodine appropriate group and iodine high group, respectively, with a total of 409 children. The detection rates of thyroid nodules were 6.9% (9/131), 15.0% (21/140) and 16.7% (23/138), respectively, and the detection rates of goiter were 1.5% (2/131), 1.4% (2/140) and 6.5% (9/138) in the three groups, respectively. There were statistically significant differences in the detection rates of thyroid nodules and goiter in different water iodine groups (χ 2 = 6.92, 6.37, P < 0.05). The detection rates of thyroid nodules in different age groups were 9.5% (12/126), 11.3% (16/142) and 17.7% (25/141), the differences were statistically significant (χ 2 = 9.05, P < 0.05). The detection rates of thyroid nodules were 11.6% (24/207), 14.4% (29/202), and 12.5% (39/313), 16.9% (14/83), 0/9 and 0/4 in the subjects of different gender and BMI, the differences were not statistically significant (χ 2 = 0.69, P > 0.05). The detection rates of goiter in the subjects of different gender, age and BMI were 1.4% (3/207), 5.0% (10/202); 2.4% (3/126), 6.3% (9/142), 0.7% (1/141); 1.6% (3/313), 4.8% (4/83), 3/9 and 1/4. The differences were statistically significant (χ 2 = 4.07, 7.66, P < 0.05). Conclusion:The detection rate of thyroid nodules in school-age children in different water iodine regions in Jiangsu Province may have a certain relationship with age, and the detection rate of goiter may have a certain relationship with age, gender and BMI.

Analysis of children's iodine nutrition and thyroid B-ultrasound examination results in Suqian City of Jiangsu Province / 中华地方病学杂志

Objective:To understand the iodine nutritional status and the prevalence of goiter and thyroid nodules among children in Suqian City, and to provide a basis for prevention and treatment of iodine deficiency disorders.Methods:From May 2019 to July 2020, the counties (districts) in Suqian City were divided into 5 areas according to east, west, south, north, and middle, each area selected 1 township (street) every year, and 40 non-boarding students aged 8 - 10 years were selected (balanced age and gender) from 1 primary school from each township (street). Children's urine samples and household salt samples were collected to detect urinary iodine and salt iodine contents, and some children were subjected to thyroid examination and height and weight measurements.Results:A total of 1 999 urine samples were collected from children aged 8 to 10 years, and the median urinary iodine was 221.0 μg/L. There was a statistically significant difference among different counties (districts, H = 147.89, P < 0.05). A total of 1 999 edible salt samples were collected from children's homes, and the salt iodine content was (24.01 ± 4.55) mg/kg. Among them, iodized salts was 1 979, the coverage rate of iodized salt was 99.00%; the qualified iodized salts was 1 910, and the iodized salt qualified rate was 96.51%, and the consumption rate of qualified iodized salt was 95.55%. A total of 1 000 cases of children's thyroid were examined, and 22 cases of goiter, 51 cases of solid thyroid nodules, and 54 cases of thyroid cyst were detected, and the detection rates were 2.20%, 5.10%, and 5.40%, respectively. There were significant differences in the detection rates of solid nodules and cysts beteen different counties (districts, χ 2 = 16.41, 37.66 , P < 0.05), but there was no significant difference in the detection rates of goiter (χ 2 = 8.65 , P > 0.05). According to Spearman correlation analysis, children's thyroid volume was positively correlated with height and weight ( r = 0.403, 0.315, P < 0.05). Conclusions:The iodine nutrition of children in Suqian City is at an excessively suitable level of iodine, and the salt iodine monitoring indicators meet the national iodine deficiency disorders elimination standards (the coverage rate of iodized salt ≥ 95%, and the consumption rate of qualified iodized salt > 90%). The children's thyroid volume is affected by factors such as height and weight.

Comparison on Skin Permeability of Corydalis Rhizoma Total Alkaloid Patches at Shenque Acupoint and Non-acupoint Administration / 中国实验方剂学杂志

ObjectiveTo compare the differences in resistance and structure of skin between acupoints and non-acupoints， and to study the difference in skin permeability characteristics of Corydalis Rhizoma total alkaloid patches （CTTP） after administration at Shenque acupoint and non-acupoint， so as to provide experimental support for its clinical acupoint application to prevent and treat chronic pain. MethodTaking corydaline （CD）， tetrahydropalmatine （THP） and corydalis L （CDL） as evaluation indexes， and the quantitative analysis was carried out by high performance liquid chromatography （HPLC）. The mobile phase was methanol-0.04 mol·L-1 phosphoric acid aqueous solution （70∶30， pH 6.0 adjusted with triethylamine）， the detection wavelength was 281 nm. In vitro transdermal test in Franz diffusion cell and in vivo transdermal test were used to study the skin permeability characteristics of CTTP through Shenque acupoint and non-acupoint administration. At the same time， the skin resistance between Shenque acupoint and non-acupoint was measured before and after the administration， and the distribution of the drug in each layer of the skin was compared by freezing sectioning， and visual verification was performed with fluorescence inverted microscope. ResultAfter 24 h of administration， the results of in vivo and in vitro experiments showed that the cumulative permeation and retention of CD， THP and CDL at Shenque acupoint skin were higher than those at non-acupoint skin （P<0.05， P<0.01）， the skin resistance of Shenque acupoint was lower than that of non-acupoint at all time points. The fluorescence microscopic observation results showed that the drug content of each layer of the skin was all Shenque acupoint>non-acupoint， indicating that the skin of Shenque acupoint had better effect on drug penetration and storage than non-acupoint. ConclusionThe 24 h cumulative permeation and retention of CTTP in Shenque acupoint skin are higher than those in non-acupoint skin， and the mechanism may be related to the thin skin， low electrical resistance and large number of hair follicle bodies at Shenque acupoint.

Comparison on Skin Permeability of Corydalis Rhizoma Total Alkaloid Patches at Shenque Acupoint and Non-acupoint Administration / 中国实验方剂学杂志

ObjectiveTo compare the differences in resistance and structure of skin between acupoints and non-acupoints， and to study the difference in skin permeability characteristics of Corydalis Rhizoma total alkaloid patches （CTTP） after administration at Shenque acupoint and non-acupoint， so as to provide experimental support for its clinical acupoint application to prevent and treat chronic pain. MethodTaking corydaline （CD）， tetrahydropalmatine （THP） and corydalis L （CDL） as evaluation indexes， and the quantitative analysis was carried out by high performance liquid chromatography （HPLC）. The mobile phase was methanol-0.04 mol·L-1 phosphoric acid aqueous solution （70∶30， pH 6.0 adjusted with triethylamine）， the detection wavelength was 281 nm. In vitro transdermal test in Franz diffusion cell and in vivo transdermal test were used to study the skin permeability characteristics of CTTP through Shenque acupoint and non-acupoint administration. At the same time， the skin resistance between Shenque acupoint and non-acupoint was measured before and after the administration， and the distribution of the drug in each layer of the skin was compared by freezing sectioning， and visual verification was performed with fluorescence inverted microscope. ResultAfter 24 h of administration， the results of in vivo and in vitro experiments showed that the cumulative permeation and retention of CD， THP and CDL at Shenque acupoint skin were higher than those at non-acupoint skin （P<0.05， P<0.01）， the skin resistance of Shenque acupoint was lower than that of non-acupoint at all time points. The fluorescence microscopic observation results showed that the drug content of each layer of the skin was all Shenque acupoint>non-acupoint， indicating that the skin of Shenque acupoint had better effect on drug penetration and storage than non-acupoint. ConclusionThe 24 h cumulative permeation and retention of CTTP in Shenque acupoint skin are higher than those in non-acupoint skin， and the mechanism may be related to the thin skin， low electrical resistance and large number of hair follicle bodies at Shenque acupoint.

Analysis of the investigation results of iodine content in drinking water in Jiangsu Province in 2017 / 中华地方病学杂志

Objective:To investigate the iodine content distribution of drinking water in Jiangsu Province.Methods:In 2017, the iodine content in drinking water of residents in townships (streets, hereinafter referred to as townships) of Jiangsu Province was investigated. Administrative villages (neighborhood committees, hereinafter referred to as administrative villages) of Jiangsu Province were selected as units for the investigation of townships with the median water iodine greater than 10 μg/L. Delimitation criteria: the median iodine content of water < 40 μg/L was iodine deficiency area, 40-100 μg/L was suitable iodine area, and > 100 μg/L was high iodine area.Results:A total of 1 285 townships were surveyed in 101 counties (cities, districts) in 13 cities, and the median water iodine in townships was 7.28 μg/L. Among them, there were 875 townships with median water iodine < 10 μg/L, accounting for 68.09%; 315 townships 10-< 40 μg/L, accounting for 24.51%; 56 townships 40-100 μg/L, accounting for 4.36%; 39 townships > 100 μg/L, accounting for 3.04%. The water iodine survey at the administrative village level was conducted in 5 864 administrative villages in 410 townships in 6 cities. Among them, 769 administrative villages with median water iodine < 10 μg/L, accounting for 13.11%; 3 558 administrative villages 10 - < 40 μg/L, accounting for 60.68%; 613 administrative villages 40 - 100 μg/L, accounting for 10.45%; and 924 administrative villages > 100 μg/L, accounting for 15.76%.Conclusion:According to the water iodine, there are iodine deficiency, suitable iodine and high iodine areas in Jiangsu Province, mainly in iodine deficiency areas.

Practice and thinking of Otorhinolaryngology Clinical Skill Competition / 中华医学教育探索杂志

This paper introduces the clinical skill competition organized by the faculty of Otolaryngology Department of Shanghai Jiao Tong University School of Medicine, and analyzes the main problems in implementing items of basic life support, single ear compression bandage, debridement and suturing, foreign body removal from pharynx and larynx area, nasal packing and hemostasis and comprehensive skills. According to contestants' performances, their abilities in clinical analysis and operating skills have been tested, and their professional humanities have been cultivated. Thus, the aim of "promoting learning through examination and substituting competition for practice" is achieved through the competition. Clinical skill competitions can be used widely as supplement form of medical education for its practicability, entertainment, innovation and interaction.

A survey of comorbidity and health behaviors of diabetic patients in an area of Beijing / 中国医师杂志

Objective:By investigating the prevalence of comorbidity and health behaviors among diabetes patients in Beijing, to provide reference for effective health management of diabetic patients.Methods:Based on a cross-sectional survey of 10 334 diabetic patients managed by a community health information center in Beijing from 2012 to 2014, the data of 10 334 diabetic patients were analyzed systematically. The common diseases investigated included cardiovascular and cerebrovascular diseases, orthopedic diseases, chronic respiratory/pulmonary diseases, tumors, chronic kidney diseases and other chronic diseases disease. At the same time, the health behaviors of diabetic patients were investigated, including diet behavior, exercise, work intensity, traffic mode, smoking and sleeping.Results:⑴ There were 521 patients with simple diabetes and 9 813 patients with comorbidity. The prevalence of comorbidity was 94.96%. ⑵ There were 6 279 patients with one kind of comorbidity, accounting for 63.99%; 2 726 patients with two kinds of comorbidity, accounting for 27.78%; 808 patients with two or more kinds of comorbidity, accounting for 8.23%; among them, there were 6 153 patients with cardiovascular and cerebrovascular comorbidi-ty, accounting for 62.70%. ⑶ There were significant differences in diet taste preference, whether they often eat unhealthy food, whether the dietary structure is reasonable, intake of tofu and bean products, average daily vegetable, average daily fruit, average daily egg, average daily fish and meat, reduced food intake, regular exercise, exercise mode, duration of each exercise, comprehensive classification of physical activity, other physical exercise, comprehensive score of exercise, working hours per week, walking time to work or shopping, cycling time to work or shopping, transportation for going to work or shopping, walking out in good weather, smoking, sleep difficulties between simple diabetes and comorbidity patients ( P<0.05). Conclusions:The incidence of diabetic comorbidity is high, among which cardiovascular and cerebrovascular diseases are the most common. There are some differences in diet behavior, exercise, work, transportation and sleep between simple diabetes and comorbidity patients, which may be the cause of comorbidity.

Application of multi-touch virtual anatomy system in the otolaryngology teaching / 中华医学教育探索杂志

The residents and low-grade resident trainees of the Department of Otorhinolaryngology Head and Neck Surgery of the Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine were selected as subjects. In the multi-touch virtual anatomy system, the lecturers made the anatomical signs of otolaryngology head and neck surgery, and applied them through the training method. Then the teachers explained the three sub-specialties of the nose, throat, neck and ear in the multi-touch virtual dissection table. The teaching method can stimulate the learning interest because of its vivid three-dimensional sense. The characteristics of teaching and learning are beneficial to the cultivation of medical education teachers. In addition, the one-time investment of equipment breaks through the supply bottleneck of traditional anatomical consumables and promotes active learning among medical students. The multi-touch virtual anatomy system can effectively improve the teaching methods, facilitate the interesting teaching, and has broad application prospects in medical teaching.

Preliminary study on the application of real-time anatomical demonstration in the theoretical teaching of otorhinolaryngology-head and neck surgery / 中华医学教育探索杂志

Objective@#To investigate the effects of real-time anatomical demonstration and traditional teaching in otorhinolaryngology-head and neck surgery.@*Methods@#Students who studied this course from Shanghai Jiao Tong University School of Medicine were divided into two groups: clinical students in 5-year program (n=22) were assigned to the experimental group and students from"5+3" stomatology major (n=35) were assigned to control group. Both groups had two class hours, with the same teacher teaching at the same day. Students in the experimental group were taught with theoretical teaching combined with real-time anatomical demonstration, while students in the control group was taught with traditional theoretical teaching with multimedia content. Students in the two groups completed the questionnaire and received quiz; SPSS 19.0 was used to perform the independent-samples T test of between-group data.@*Results@#According to the questionnaire, scores for different items of the teaching method in the experimental group were higher than those in the control group. But according to the examination scores, average scores of the theoretical examination in the control group was (85.143±8.268), which was obviously higher than that of (64.545±11.434) in the experimental group, with statistically significant differences (t=7.885, P=0.000).@*Conclusion@#Teaching effect combined with real-time anatomical demonstration is not obvious to short-term examination, which may be related to the short-term understanding and absorption of knowledge for students in different majors, but it is coherent with the difference of entrance-examination scores of students from the two groups. This teaching model can stimulate students' interest in learning, and help them choose their professions, which may have certain advantages in the future long-term teaching effect.

Analysis of water iodine content in Jiangsu rural water factory / 中华地方病学杂志

Objective To further understand and master the distribution and influencing factors of water iodine in Jiangsu Province.Methods From 2012 to 2014,half of the water plants in rural centralized water supply monitoring plants in 63 counties (cities,districts) of Jiangsu Province were selected as survey sites,and the types of monitoring,types of water plants,types of water sources,self-inspection ability,disinfection situation,water treatment methods were investigated and analyzed.One sample of peripheral water was collected from each survey site to determine the water iodine content.Results From 2012-2014,there were 938 samples of river water were monitored,and the median water iodine was 5.9 μg/L.There were 57 samples of lake water were monitored,the median water iodine was 6.8 μg/L.There were 228 samples of reservoir water were monitored,and the median water iodine was 7.1 μg/L.There were 43 samples of gully pond water were monitored,and the median water iodine was 6.9 μg/L.There were 5 474 samples of deep well water were monitored,and the median water iodine was 28.2 μg/L.There were 162 samples of shallow well water were monitored,and the median water iodine was 30.9 μg/L.There was a statistically significant difference in the median iodine content of water samples from different water sources (x2 =844.9,P ＜ 0.05).The differences of median iodine of lake water,reservoir water,gully pond water,deep well water and shallow well water among different monitoring types were significant (x2 =9.6,6.3,9.7,121.2,38.1,P ＜ 0.05).The differences of median iodine of river water,reservoir water,deep well water and shallow well water among different types of water plants were significant (x2 =109.5,39.0,153.3,7.6,P ＜ 0.05).The iodine contents of fiver water,lake water,deep well water and shallow well water had significant difference in selfinspection ability of different water plants (x2 =62.5,5.1,29.9,10.1,P ＜ 0.05).The iodine content of reservoir water,deep well water and shallow well water were significandy different in different disinfection situation (x2 =12.1,12.4,35.7,P ＜ 0.05).The medians iodine of river water,reservoir water,deep well water and shallow well water had significant difference in different water treatment methods (x2 =9.5,21.2,102.4,46.9,P ＜ 0.05).Conclusions The water iodine contents of water samples in different types of water sources in rural area of Jiangsu Province are different.The level of water iodine is affected by factors such as monitoring type,type of water plant,self-inspection ability,disinfection situation and water treatment method.

Preliminary study on the application of real-time anatomical demonstration in the theoretical teaching of otorhinolaryngology-head and neck surgery / 中华医学教育探索杂志

Objective To investigate the effects of real-time anatomical demonstration and traditional teaching in otorhinolaryngology-head and neck surgery.Methods Students who studied this course from Shanghai Jiao Tong University School of Medicine were divided into two groups:clinical students in 5-year program (n=22) were assigned to the experimental group and students from"5+3" stomatology major (n=35) were assigned to control group.Both groups had two class hours,with the same teacher teaching at the same day.Students in the experimental group were taught with theoretical teaching combined with real-time anatomical demonstration,while students in the control group was taught with traditional theoretical teaching with multimedia content.Students in the two groups completed the questionnaire and received quiz;SPSS 19.0 was used to perform the independent-samples T test of between-group data.Results According to the questionnaire,scores for different items of the teaching method in the experimental group were higher than those in the control group.But according to the examination scores,average scores of the theoretical examination in the control group was (85.143 ± 8.268),which was obviously higher than that of (64.545 ± 11.434) in the experimental group,with statistically significant differences (t=7.885,P=0.000).Conclusion Teaching effect combined with real-time anatomical demonstration is not obvious to short-term examination,which may be related to the short-term understanding and absorption of knowledge for students in different majors,but it is coherent with the difference of entrance-examination scores of students from the two groups.This teaching model can stimulate students' interest in learning,and help them choose their professions,which may have certain advantages in the future long-term teaching effect.

Clinical application of cartilage replantation in situ from amputated ear in the reconstruction of ear in secondary stage / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the feasibility and clinical effect of reconstruction the ear using cartilage from amputated ear.@*Methods@#30 patients (22 males, 8 females, age 22-50, 18 cases right ear, 12 cases left ear) with partial auricles defects received replantation of amputated ears using the cartilages from the amputated ears from January, 2013 to June, 2017.Firstly, an advancements postauricular skin flap was made.Secondly, the skin of the amputated ear was removed and its cartilage was retained, then the cartilage was sutured in situ to form cartilage bracket.Finally, the postauricular crimp scalp flap was sutured to form the helix structure.After three months, the back of the reconstructive ear was repaired with the full thickness graft to restore the cranio-auricular angle.@*Results@#Thirty cases were applied with this method to repair the defects.The sizes of auricle contour were good, and the cranio-auricular angles were restored after skin-grafting.The ear shape was stable in 3-6 months′ follow-up.VAS was used to evaluate patients satisfaction.All parameters before and after the procedure had significant difference (P<0.05).@*Conclusions@#Patients with partial auricles defects can receive replantation of amputated ears using the cartilages from the amputated ears which has the advantage of short treatment period, satisfactory clinical effect and avoidance using the costal cartilages.Its long-term effect is stable.

Analysis of monitoring results of drinking-water fluorosis in Jiangsu Province from 2011 to 2015 / 中华地方病学杂志

Objective To understand the drinking water type fluorosis in Jiangsu Province, dynamically monitor the disease trends, and to evaluate the operation effect of the water project comprehensively. Methods Twenty-six fluorosis districts and counties in Xuzhou, Lianyungang, Suqian, Huaian and Yancheng were selected as the monitoring sites. The change of water improvement engineering and the value of water fluoride were surveyed and tested. There were three different situations of changed water: the water improvement engineering operated normally was the first, the water improvement engineering operated abnormally or water fluorine excesses the standard was the second,and without water improvement was the last.The teeth of children aged 8 to 12 years were checked according to the method of Dean. The skeletal fluorosis of adults was checked according to "Diagnostic Criteria of Endemic Skeletal Fluorosis"(WS 192-2008) by X-ray inspection. Results The normal operation rates of changed water project from 2011 to 2015 were 100.00% (30/30), 85.29% (29/34), 82.50% (33/40), 95.92% (47/49),and 97.83%(45/46),and the excessive rates of water fluorosis for normal operating engineering were 13.33%(4/30),17.24%(5/29),9.09%(3/33),14.89%(7/47),and 11.11%(5/45).The dental fluorosis detection rates of children aged 8 to 12 years were 33.68% (194/576), 28.30% (711/2 512), 36.25% (1 577/4 350), 22.06% (837/3 794), and 20.44% (903/4 417) from 2011 to 2015, the differences were statistically significant (χ2= 190.952, P < 0.05). The dental fluorosis detection rates in the three situations of water changed annually was statistically significant (χ2=129.336, 130.402, 21.419, P < 0.05). The detection rates between three different water conditions were 21.88% (2 857/13 057), 57.23% (1 156/2 020), 36.54%(209/572), and the differences were statistically significant (χ2=206.295, P < 0.05). Differences between the villages with water improvement engineering changed but not worked and the villages with water improvement engineering changed and worked well and the villages without the water improvement engineering were statistically significant(χ2=200.861,36.336,P<0.0125).The difference of detection rates between the villages with normal operation and the villages without water improvement was not statistically significant(χ2=2.131, P>0.0125).The X-ray detection rates of skeletal fluorosis in adults from 2011-2015 were 17.83% (51/286), 16.61% (49/295), 15.36% (51/332), 10.95% (53/484), and 5.16% (16/310); urinary fluoride range was 0.02 - 22.0 mg/L; the geometric average was 0.67 - 4.06 mg/L, there was no statistical significant difference of skeletal fluorosis distribution annually(χ2=6.060, P > 0.05). Conclusion The general condition of drinking water type fluorosis in Jiangsu Province from 2011 to 2015 is gradually under control, but the engineering operation and water quality improvement still need to be improved; water change project not functioning or with excess fluorine is more harmful to children's teeth.

Analysis of monitoring results of drinking water-based fluorosis in the 17 diseased areas in Jiangsu Province in 2015 / 中华地方病学杂志

Objective To master the condition of drinking water fluorosis in Jiangsu Province and the operation of improved-water project,and to provide a scientific basis for further prevention and treatment of drinking water fluorosis.Methods In 2015,17 drinking water fluorosis counties were selected in Jiangsu Province,and 3 villages in each county were selected as monitoring sites,when the number of drinking water fluorosis villages was less than 3,all of the drinking water fluorosis villages were selected as monitoring sites.To know the progress and running conditions of the improved-water facilities,water samples were collected to determine the fluorosis level.All children aged 8-12 years were monitored for dental fluorosis.Two monitoring counties were selected to monitor the X-ray changes and urinary fluoride of adults with skeletal fluorosis.Results A total of 47 villages were surveyed,46 of which had water improved,and 1 had water unimproved.The rate of water improved was 97.87％ (46/47).The number of improved-water facilities that were operating normally was 45,and the rate was 97.83％ (45/46).The number of intermittent operation was 1.The number of improved-water facilities with qualified water fluoride was 42,and the rate was 91.30％ (42/46).In the villages with normal improved-water facilities,and qualified water fluoride,the total rate of dental fluorosis of children aged 8 to 12 was 15.56％ (600/3 855),and the dental fluorosis index was 0.29.In the villages with normal improved-water facilities,but unqualified water fluoride,the total rate of dental fluorosis of children aged 8 to 12 was 57.30％ (267/466),and the dental fluorosis index was 1.21.The range of water fluoride in water unimproved villages was 1.2-2.0 mg/L,and the total rate of dental fluorosis of children aged 8 to 12 was 40.91％ (36/88),and the dental fluomsis index was 0.66.The detection rate of skeletal fluorosis in adults was 5.16％(16/310),the geometric mean of urinary fluoride was 0.67 mg/L,and the range of urinary fluoride was 0.02-2.76 mg/L.Conclusions The improved-water projects in drinking-water fluorosis areas in Jiangsu Province have achieved a certain effect,but water fluoride is unqualified in some water projects.We should strengthen the maintenance and supervision of the water projects to ensure the normal operation of water projects.

Analysis of surveillance results on iodine deficiency disorders in Jiangsu Province in 2014 / 中华地方病学杂志

Objective To investigate the current status of iodine deficiency disorders (IDD) in Jiangsu Province and to evaluate the effects of preventive and control measures on IDD in Jiangsu Province in 2014.Methods With the use of probability proportional to size sampling method (PPS),30 counties (cities,districts)in Jiangsu Province were selected.Only 1 primary school was selected in each county (city,district) and 50 students of 8-10 years old (halt male and half female,uniformly distributed in age groups) were selected in each school.Goiter,salt iodine,urinary iodine,height and weight were examined.Thirty students from Grade 5 in each school were selected at random,and health education questionnaire survey was conducted.In the area where the primary school located,5 housewives were selected and a questionnaire survey was conducted.Two-5 drinking water samples from the village where the primary school located were collected and the water iodine concentration was tested.Urine samples and salt samples from 20 pregnant women and 10 lactating women in the village where the primary school located were collected,and urinary iodine and salt iodine were detected.Thyroid volume was measured by palpation method and ultrasound.Urinary iodine was detected by arsenic cerium catalytic spectrophotometry (WS/T 107-2006).The iodine level in salt was determined by direct titration;the salt samples from Sichuan and other enhanced salt were detected by arbitration (GB/T 13025.7-1999).Water iodine was tested using the method suitable for iodine deficiency and high iodine areas (recommended method of reference laboratory of national iodine deficiency disorders).Results A total of 1 524 children aged 8-10 years old were examined.Forty-two children had goiter by palpation method and the goiter rate was 2.76％ (42/1 524).Forty-one children had goiter by ultrasound and the goiter rate was 2.69％ (41/1 524).Totally 1 523 urine samples of children aged 8-10 years old were tested and the median of urinary iodine was 208.03 μg/L.A total of 1 524 salt samples were tested,the coverage rate of iodized salt was 97.44％ (1 485/1 524) and the qualified rate of iodized salt was 96.43％(1 432/1 485).The consumption rate of qualified iodized salt was 93.96％(1 432/1 524) and the consumption rate of non-iodized salt was 2.56％(39/1 524).The rates of knowledge awareness about IDD among students and housewives were 81.36％ (2 287/2 811)and 91.18％ (424/465),respectively.Sixty drinking water samples were collected and the median of water iodine was 16.83 μg/L.Six hundred urine samples of pregnant women and 304 urine samples of lactating women were tested.The median of urinary iodine was 155.16 and 138.33 μg/L,respectively.Conclusions After achieving the goal of eliminating IDD,the control effect in Jiangsu Province is sustainable.The crowd's risk of iodine deficiency has declined significantly.

Analysis of iodine nutrition in residents of coastal and inland areas of Jiangsu Province / 中华地方病学杂志

Objective To master iodine intake ways of children in Yancheng (coastal) and Zhenjiang (inland) cities,analyze their urinary iodine difference and provide solid evidence for adjustment of salt iodine and adequate iodine intake level of local residents.Methods Totally 50％ counties were randomly selected in Yancheng and Zhenjiang cities and 5 towns were sampled in each county in 2014,local water iodine,domestic salt iodine,local eating habits and urine iodine of children 8-10 years old were investigated,and the influences of different iodine intake ways on urine iodine level were analyzed.Results The median of water iodine was 4.76 μg/Lin Zhenjiang (n =40) and 50.80 μg/L in Yancheng (n =50),the difference was statisticelly significant in two cities (Z =6.93,P ＜ 0.05).Totally 2 400 salt samples were tested,the mean of salt iodine was (24.20 ± 5.07) mg/kg in Yancheng (n =1 500) and (22.87 ± 2.77) mg/kg in Zhenjiang (n =900),the difference was statisticelly significant in two cityies (t =7.23,P ＜ 0.05).The salt intake level in Zhenjiang (10.69-± 9.00) g/d appeared to be higher than that in Yancheng (8.40 ± 3.57) g/d,but the difference was not statistically significant (t =1.62,P ＞ 0.05).Totally 1 200urine samples were tested,the urine iodine level of Zhenjiang got higher results (265.83 μg/L,n =450) than that of Yancheng (182.15 μg/L,n =750,Z =12.18,P ＜ 0.05).The ratio of water iodine intake/salt iodine intake was about 1 ∶ 4 in Yancheng and 1 ∶ 50 in Zhenjiang,while residents in Zhenjiang got 21％ of daily iodine through extra ways.Eating habits like eating out did not have significant impact on urine iodine.Conclusions Based on the water iodine level,Yancheng is considered to be a appropriate iodine level area while Zhenjiang is a lack region.However,Zhenjiang has a higher urine iodine level than Yancheng,which is more than adequate to the recommendation.Salt iodine is a main iodine source in both cities.In iodine appropriate and deficiency areas,eating habits and food choices may play a more important role than geochemical factors in iodine intakes among residents.

Outcome analysis of drinking-water type endemic fluorosis in Jiangsu in 2012 / 中华地方病学杂志

Objective To know the state of endemic fluorosis,running state of water improvement project in Jiangsu Province,and to provide a scientific basis for adjusting control measures against the disease.Methods Nine key counties were selected from the endemic fluorosis areas as survey spots in Jiangsu in 2012.Three villages in each spot were selected as survey villages.To known the progress and running conditions of water facilities,water samples were collected to determine the fluorosis level.All children aged 8 to 12 were tested for dental fluorosis at the survey villages.The fluorine content in water was determined with F-selective electrode (WS/T 106-1999).Dental fluorosis was diagnosed byased on the Dean method.Results Twenty-seven villages were investigated,the number of villages that had water quality improved was 26,the rate was 96.30％ (26/27);the number of villages that did not have water quality improved was 1,the rate was 3.70％ (1/27).Among the 26 facilities,21 improved-water facilities ran normally,the rate was 80.77％ (21/26);2 facilities ran with intermittently water supply,the rate was 8.70％ (2/26);3 facilities were scraped,the rate was 11.54％ (3/26).In the villages with normal improved-water facilities and qualified water fluorosis,the total rate of dental fluorosis of children aged 8 to 12 was 22.74％ (380/1 761),the index of dental fluorosis was 0.45.In the villages with abnormal improved-water facilities and excessive water fluorosis,the total rate of dental fluorosis of children aged 8 to 12 was 66.51％ (143/215),the index of dental fluorosis was 1.45.The total rate of dental fluorosis of children aged 8 to 12 was 42.86％ (12/28) in the villages which had not changed water source,the index of dental fluorosis was 0.86.Conclusion Improvement of water decreasing fluorine project in Jiangsu Province has a certain effect on children's dental fluorosis,but some of the water fluorosis projects are scrapped,and excess fluorine water should be taken seriously.