[Iodine nutritional status of the vulnerable population in Henan province in 2011].

OBJECTIVE: To investigate the iodine nutritional status of the vulnerable population in Henan in 2011. METHODS: From March to December 2011, 44 049 urinary samples of newly married women of childbearing age (363), pregnant women (31 874), lactating women (4893) and children under 2 years (6919) collected from hospitals, maternal and child care hospitals and outpatient department of family planning organizations from 8 cities of Henan province (only including the areas where water iodine was less than 100 µg/L) were tested for urine iodine concentration. The iodine nutritional status of different groups was analyzed. RESULTS: The median of urinary iodine for newly married women, pregnant women, lactating women and children under 2 years was 204.5, 190.9, 145.5 and 185.4 µg/L, respectively (χ(2) = 874.16, P < 0.01). The proportion of urinary iodine below 150 µg/L of pregnant women and below 100 µg/L of lactating women and children under 2 years was 33.0% (10 519/31 874), 24.9% (1218/4893) and 12.4% (855/6919), respectively. The proportion of urinary iodine above 300 µg/L of newly married women was 33.6% (122/363). The median of urinary iodine for pregnant women in the first, second and third trimester was 186.7, 193.8 and 182.5 µg/L, respectively (χ(2) = 55.19, P < 0.01). The median of urinary iodine for the breast-feeding, formula-feeding and mixed-feeding infant under the age of 1 year was 194.8, 85.6 and 176.0 µg/L, respectively (χ(2) = 179.25, P < 0.01). CONCLUSION: The overall iodine nutrient levels of the vulnerable population in Henan in 2011 were appropriate, but there were still some proportions of pregnant and lactating women with low iodine level. The iodine intake of the formula-feeding infants was not sufficient.

[Study on the amount of daily iodine intake of inhabitants living in drinking water with excessive iodine content areas after termination of iodized salt supply].

OBJECTIVE: To investigate the amount of daily iodine intake in the diet of the target population in drinking water with areas of excessive iodine after stopping supply of iodized salt, to provide evidence for developing strategies on control and prevention of excessive iodine. METHODS: 335 objectives were selected by a two-stage sampling method in 4 administrative villages with different iodine contents in drinking water. The amount of drinking water intake and dietary survey for 335 people were done by a door-to-door survey,while the iodine contents in the drinking water of each selected family, local staple food and vegetable were measured. RESULTS: The median level of iodine in drinking water was 431.5 microg/L while the daily amount of iodine intake among the three groups of waters with different iodine contents were all greater than RNI. The daily iodine intake of local people was all greater than UL in the areas where the water iodine contents were more than 300 microg/L. It was of statistical sense that the iodine mean intake per capita per day of the three groups differed at different water iodine levels (P < 0.01). The iodine mean intake per capita per day of the three groups of different water iodine levels increased along with water iodine and showed a uptrend (P < 0.01). 83.2%-98.7% of the daily iodine intake of the three groups was from drinking water and 1.3%-16.8% came from food. The iodine intake had high-positive correlation relation with the content of water iodine (P < 0.01). CONCLUSION: It was concluded that drinking water was the main source of iodine intake in areas with iodine excessive water by the percentage of over 80%. It was necessary to adopt measures to improve the quality of water to decrease the iodine content other than just stopping supplies of iodized salt in the areas where the water iodine contents were greater than 300 microg/L, in order to prevent and control excessive intake of iodine.

Hand-assisted laparoscopic surgery for complex gallstone disease: a report of five cases.

AIM: To describe the use of hand-assisted laparoscopic surgery (HALS) as an alternative to open conversion for complex gall-stone diseases, including Mirizzi syndrome (MS) and mimic MS. METHODS: Five patients with MS and mimic MS of 232 consecutive patients undergoing laparoscopic cholecystectomies were analyzed. HALS without a hand-port device was performed as an alternative to open conversion if the anatomy was still unclear after the neck of the gallbladder was reached. RESULTS: HALS was performed on three patients with MS type I and 2 with mimic MS owing to an unclear or abnormal anatomy, or an unusual circumstance in which an impacted stone was squeezed out from the infundibulum or the aberrant cystic duct impossible with laparoscopic approach. The median operative time was 165 min (range, 115-190 min). The median hand-assisted time was 75 min (range, 65-100 min). The median postoperative stay was 4 d (range, 3-5 d). The postoperative course was uneventful, except for 1 patient complicated with a minor incision infection. CONCLUSION: HALS for MS type I and mimic MS is safe and feasible. It simplifies laparoscopic procedure, and can be used as an alternative to open conversion for complex gallstone diseases.

[Continous intrapartum fetal heart monitoring]

OBJECTIVE: To observe the prognostic value of intrapartum continuous fetal heart monitoring(FHM). METHODS: A review of 150 patients who had intrapartum FHM was performed. The relation between fetal heart rate and amniotic fluid condition, newborn Apgar scores, and delivery method was determined. RESULTS: Among the 150 cases,normal fetal heart rates were recorded in 108 cases. The abnormalities in the other 42 cases with abnormal FHM were as follows: cloudy amniotic fluid 27 cases(64.3%)compared with 17/108 (15.7%) in the normal FHM group (P<0.005); 10 cases (23.8%) had Apgar scores <8 compared with only 2 (1.85%) in the normal FHM group (P<0.005). In the abnormal FHM group,there were 15 cases (35.7%) of spontaneous labor,10 cases (23.8%) of forceps delivery and 17 cases (40.5%) of C-section compared with 81, 3, and 24 (75%,2.8%, and 22.2%) respectively in the normal FHM group (P<0.005). Spontaneous delivery was more common in the normal FHM (75%)compared with abnormal FHM group(35.7%). C-section rate was higher in the abnormal FHM group (40.5%) (P<0.005). CONCLUSION: Intrapartum fetal heart monitoring detects early fetal distress and thus may lead to earlier intervention such as C-section during the perinatal period.