Objective:To recognize the spatial and temporal characteristics of iodine deficiency disorders (IDD), China national IDD surveillance data for the years of 1995-2018 were analyzed.Methods:Time series analysis was used to describe and predict the IDD related indicators, and spatial analysis was used to analyze the spatial distribution of salt iodine levels.Results:In China, the median urinary iodine concentration increased in 1995-1997, then decreased to adequate levels, and are expected to remain appropriate in 2019-2022. The goiter rate continually decreased and is expected to be maintained at a low level. Since 2002, the coverage rates of iodized salt and the consumption rates of qualified iodized salt (the percentage of qualified iodized salt in all tested salt) increased and began to decline in 2012; they are expected to continue to decrease. Spatial epidemiological analysis indicated a positive spatial correlation in 2016-2018 and revealed feature regarding the spatial distribution of salt related indicators in coastal areas and areas near iodine-excess areas.Conclusions:Iodine nutrition in China showed gradual improvements. However, a recent decline has been observed in some areas following changes in the iodized salt supply in China. In the future, more regulations regarding salt management should be issued to strengthen IDD control and prevention measures, and avoid the recurrence of IDD.

碘缺乏危害消除后还需吃碘盐吗? 我国是受碘缺乏严重威胁的国家,根本原因是人们生活的外环境缺碘,生长在这种环境中的动植物含碘量也匮乏.因此,生活在这类地区的人们碘摄入量不够.人类生活的外环境缺碘状态是长期且难以改变的,而碘是人体必需的微量元素,在停止碘摄入的情况下,体内储备的碘仅够维持2～3个月.如果不能长期、持续地坚持补碘,碘缺乏病就会卷土重来,所以必须坚持长期食用碘盐.

2021年5月15日是我国第28个"防治碘缺乏病日",今年的宣传主题是"科学补碘,健康一生!"下面为您带来碘缺乏病防治和科学补碘相关知识,帮助您科学补碘,呵护健康. 1.身体每天需要的碘从哪里来?碘是人体必需元素,体内不能生成,需要从外环境获取.我国居民碘的主要来源是碘盐、食物和饮水.八成以上的碘来自碘盐. 2.沿海地区人群也需要补碘吗?沿海地区居民也可能存在碘缺乏.一项沿海地区居民膳食碘摄入量调查显示,海带、紫菜等富碘食物在沿海地区居民中食用频率并不高,食用量也较少.沿海地区居民膳食中的碘84.2％来自于碘盐,来源于各类食物的碘仅占13.1％,来自饮用水的碘占2.7％.如果食用无碘盐,那么九成以上居民的碘摄入量将会低于推荐量.因此,沿海地区也需要普及碘盐,以保证居民碘摄入,降低碘缺乏的风险.

Iodine deficiency disorders (IDD) are a series of diseases caused by iodine deficiency in the natural environment that include endemic goiter, cretinism, subclinical cretinism, fetal abortion, premature delivery, stillbirth, congenital malformation, etc (1). Since 1993 when the State Council held the “Mobilization meeting of eliminating IDD in China by the year 2000”, the Ministry of Health planned to set up an annual publicity day for the prevention and control of IDD. Through the coordination between the Ministry of Health and other relevant departments, IDD Day was set on May 5 in 1994, and on May 15 since 2002. Since 1994, IDD Day has played an active role in mobilizing all levels leaders of governments and relevant departments as well as the public to support salt iodization in China. After nearly 30 years, the measures have been enriched to include slogans, posters, activities, national workshops, international conferences, and WeChat publicization, webpages, interviews, music videos, etc. IDD knowledge has been successfully spread among Chinese people and therefore ensured the health of masses (2). The national IDD survey shows that China has been in sustainable elimination status of IDD since 2005 (3). The 27th IDD day in China is arriving on May 15, 2020, and the slogans, posters, and music videos have all been prepared well. doi: 10.46234/ccdcw2020.089

Iodine deficiency can impair human health severely and cause iodine deficiency disorders (IDD), including endemic goiter, endemic cretinism, endemic subclinical cretinism, and so on. From 2838 to 2698 BC, China had made effort to control endemic goiter. However, the large-scale prevention work had not started in a real sense until the founding of the New China. At that time, all regions of China except Shanghai were affected by endemic goiter at different levels. Supply of iodized salt, iodized oil, and iodine-rich foods, iodization of drinking water, and iodinated food were the mainly recommended measures for controlling IDD. The surveillance and assessment systems for IDD elimination in China were well organized and carefully designed. Today, China has eliminated IDD on a national basis in many provinces. It is considered one of the most successful IDD elimination programs in the world and has set an excellent example for the rest of the world. According to the most recent national IDD surveillance survey carried out in 2014, China is in the status of sustainable IDD elimination nationwide, which is attributed to the leading roles of government, high-quality and sufficient iodized salt supply, comprehensive legislation, regulations, standards and technical proposals, intensive surveillance and assessment, health-related promotional and educational activities, and international collaboration.

Objective To observe the relationship between hyperthyroidism and vascular endothelial injury.Methods From 2016 to 2017,data of 60 patients with simple hyperthyroidism,autoimmune thyroid disease,cardiovascular and cerebrovascular diseases were collected from the Second Affiliated Hospital of Harbin Medical University.And 60 healthy subjects were enrolled in the same period as a healthycontrol group.The enzyme-linked immunosorbent assay (ELISA) was used to detect the content of vascular endothelial injury markers (vWF),thrombomodulin (TM),endothelin-1 (ET-1),P-selectin in serum of all subjects,as well as the serum thyroid stimulating hormone (TSH),free triiodothyronine (FT3),free thyroxine (FT4),anti-thyroglobulin antibody (TgAb),and anti-thyroid peroxidase antibody (TPOAb) in patients with cardiovascular and cerebrovascular diseases levels.The correlation analysis of vascular endothelial injury in the simple hyperthyroidism group,autoimmune thyroid disease group,cardiovascular and cerebrovascular diseases group and healthy control group was conducted.Results There were statistically significant differences between the he althy control group,the simple hyperthyroidism group,the autoimmune thyroid disease group and the cardiovascular and cerebrovascular diseases group in the serum levels of vWF,TM,ET-1 and P-selectin,respectively (F =6.56,9.19,7.88,12.45,P ＜ 0.05),and the simple hyperthyroidism group,autoimmune thyroid disease group,cardiovascular and cerebrovascular diseases group were significantly higher than the healthy control group (P ＜ 0.05).Correlation analysis showed that the vascular endothelial injury in the patients with simple hyperthyroidism,autoimmune thyroid disease,and cardiovascular and cerebrovascular diseases groups was statistically significantly different compared with the healthy control group,respectively (x2 =5.08,5.08,8.16,P ＜ 0.05);the risk of vascular endothelial injury in each diseased group was 2.37,2.37,and 3.07 times higher than that of the healthy control group,respectively.The abnormal rates of TSH,FT3,FT4,TgAb and TPOAb in patients with cardiovascular and cerebrovascular diseases were 18.33％ (11/60),15.00％ (9/60),15.00％ (9/60),10.00％ (6/60) and 11.7％ (7/60),respectively.Conclusion Simple hyperthyroidism and autoimmune thyroid disease are risk factors of vascular endothelial injury.

Objective Using the iodine level found in epidemiological investigation spot to study the effects of potassium iodate and potassium iodide on morphology and function of thyroid.Methods The mice were divided into four groups randomly according to the mice's weight:normal fodder group(NG),normal potassium iodate group(NO),high potassium iodate group(HO) and high potassium iodide group(HI).After 90 days,the weight of thyroid,the thyroid serum hormone and urinary iodine were tested.Moreover,morphology of thyroid was investigated under light microscope and electronic microscope.Results When iodine dose is 100 μg/L,it could induce colloid goiter and the increase of absolute and relative weight of thyroid.Compared with NG,the serum T4 and urinary iodine increased significantly in HO and HI,the serum T3 had no significant difference between HO and HI.The urinary iodine in HO was higher than that in HI.Compared with NG,there was no significant difference in NO except the urinary iodine.Conclusions When iodine dose is 100μg/L,both potassium iodate and potassium iodide can induce colloid goiter and the change of thyroid's function in mice,and there is no significant difference between them.The utilization of potassium iodate is lower than that of potassium iodide.

OBJECTIVE: The aim of this study was to investigate the effects of regulation of micro-ribonucleic acid (miR)-146 expression targeting the Notch1 pathway on the repair and regeneration of intervertebral nucleus pulposus cells, and to explore the possible underlying mechanism. MATERIALS AND METHODS: Intervertebral nucleus pulposus cells were harvested from rats and cultured in vitro. All cells were randomly divided into 4 groups, including the normal group, the miR-146 inhibitor group, the miR-146 over-expression group and the negative control group. The cells in the normal group were cultured normally. Meanwhile, the cells in the miR-146 inhibitor group and miR-146 over-expression group were transfected with inhibitor-containing plasmid and miR-146-containing plasmid, respectively. However, the cells in the negative control group were transfected with empty plasmid. 24 h after transfection, the cells were collected for subsequent experiments. The differentiation of nucleus pulposus cells was detected via toluidine blue staining. The relative protein expression levels of Notch1, aggrecan (ACAN) and COL II were detected via Western blotting. Meanwhile, the mRNA expressions of miR-146 and Notch1 were detected via quantitative Polymerase Chain Reaction (qPCR). Furthermore, the apoptosis and proliferation of cells were detected via terminal deoxynucleotidyl transferase-mediated dUTP Nick End Labeling (TUNEL) and Cell Counting Kit-8 (CCK-8; Dojindo, Kumamoto, Japan) assay, respectively. RESULTS: Compared with the normal group, toluidine blue positive staining was significantly increased in miR-146 overexpression group (p<0.05), whereas was significantly decreased in the miR-146 inhibitor group (p<0.05). The results of Western blotting revealed that compared with normal group, the protein expression of Notch1 was markedly decreased in miR-146 over-expression group (p<0.05), whereas the expression levels of ACAN and COL II were notably increased (p<0.05). However, the miR-146 inhibitor group exhibited significantly increased the protein expression level of Notch1 (p<0.05), as well as markedly decreased the expressions of ACAN and COL II (p<0.05). The results of qPCR showed that compared with the normal group, the expression level of miR-146 was significantly increased in the miR-146 over-expression group. However, the mRNA expression level of Notch1 was remarkably decreased (p<0.05). Similarly, the miR-146 inhibitor group exhibited significantly decreased expression level of miR-146, as well as markedly increased mRNA expression level of Notch1 (p<0.05). Compared with those in the normal group, the cell proliferation rate was markedly increased, whereas cell apoptosis was remarkably decreased (p<0.05) in the miR-146 over-expression group. Furthermore, the cell proliferation rate was significantly decreased, while the cell apoptosis was remarkably increased (p<0.05) in the miR-146 inhibitor group. CONCLUSIONS: Regulating miR-146 expression can target the Notch1 signaling pathway, thereby exerting important influences on the repair and regeneration of intervertebral nucleus pulposus cells.

Since 1994,China has launched the Universal Salt Iodization strategy to prevent and control the prevalence of iodine deficiency disorders (IDD).In 2005,China achieved the elimination of IDD at the national level.During the last decade,comprehensive measures such as adjusting the iodine content in salt has been taken and the iodine nutrition is optimal for children and pregnant women,the prevention and control of IDD in China has made remarkable achievement.However,there are still many issues during the process of prevention and control of IDD in the future.The mandated requirements of the prevention and control measures should be weaken,the evaluation of residents' iodine nutrition level should be paid attention,and residents' iodine nutrition should be focused on in assessing the elimination of IDD in China.

Universal salt iodisation (USI) has been successfully implemented in China for more than 15 years. Recent evidence suggests that the definition of 'adequate iodine' (100-199 µg/l) be revised to 'sufficient iodine' (100-299 µg/l) based on the median urinary iodine concentration (MUI) in school-age children. The objective of this study was to determine the prevalence of thyroid dysfunction in populations after long-term salt iodisation and examine whether the definition of adequate iodine can be broadened to sufficient iodine based on the thyroid function in four population groups. A cross-sectional survey was conducted in six provinces in the northern, central and southern regions of China. Four population groups consisting of 657 children, 755 adults, 347 pregnant women and 348 lactating women were recruited. Three spot urinary samples were collected over a 10-d period and blood samples were collected on the 1st day. In the study, among the adults, pregnant women and lactating women, the prevalence rates of elevated thyroglobulin antibody and thyroid microsomal antibody levels were 12·4, 8·5 and 7·8 %, and 12·1, 9·1 and 9·1 %, respectively. Abnormally high thyroid dysfunction prevalence was not observed after more than 15 years of USI in China because the thyroid dysfunction rates were all <5 %. The recommended range should be cautiously broadened from adequate iodine to sufficient iodine according to the MUI of school-age children considering the high levels of hormones and antibodies in the other populations. Adults, particularly pregnant women positive for thyroid antibodies, should be closely monitored.

Since the water-borne iodine excessive goiter was firstly found and reported in 19 in Hebei Province, it was confirmed successively. The national water-borne investigation carried out in 2005 demarcated the water-borne iodine excess areas and water-borne iodine excess endemial areas. The high iodine water well was found In 129 counties of 11 provinces, about 30.98 million people of threatened population lived in water-borne iodine excess areas and water borne iodine excess endemial areas. In these areas, the measures of prevention and control was effectively implemented. In 2016, the new standard of iodine excess area was issued, the iodine excess areas redrawed, and in these areas, non-iodized salt should be supplied and the drinking water should be gradually improved of water, and to control the damage of water-borne iodine excess at an early date

OBJECTIVE:To identify stable and specific biomarkers/biomarker combinations for fatigue assessment and establish a discriminant model.PATIENTS AND METHODS:Saliva was collected and electroencephalogram analysis was performed for 47 emergency physicians while awake and after continuoutas duty for 18-24 h. Physicians were divided into the fatigue and non-fatigue groups. Protein spectra of completely quantified saliva specimens were identified before and after long working hours using mass spectrometry. Data were analyzed through Proteome Discoverer software combined with SEQUEST to search protein databases. Proteins were characterized by collision-induced dissociation spectra. A global internal standard (GIS) was added to each group of samples and labeled by tandem mass tags m/z 131.1. All data were compared with GIS, and data between groups were further compared. Qualitative and quantitative data on proteins were exported for fatigue-related proteomic analysis, and a fatigue assessment model was established.RESULTS:We identified 767 salivary proteins in the fatigue group. The correct rates of the discriminant function of the non-fatigue and fatigue groups were 97.1% and 91.7%, respectively (the total correct rate was 95.7%).CONCLUSIONS:We identified 30 fatigue-related protein markers from saliva. We also established a fatigue assessment model for emergency physicians using salivary biomarkers.

OBJECTIVE The aim of this study was to evaluate the impact of the revised Chinese National Standard GB26878-2011 'Iodine Content in Edible Salt' on the iodine status among the Chinese population. METHODS In 2011 and 2014, the probability proportionate to size sampling (PPS) was used in each Chinese province to obtain the representative data. In each sampling unit, school children aged 8-10 years and pregnant women were selected. Key indicators included urinary iodine concentration (UIC), thyroid volume (TV), and the iodine content in edible household salt. RESULTS The median urinary iodine concentration (MUIC) decreased between 2011 and 2014 from 238.6 to 197.9 µg/L in school-age children. The number of provinces with iodine excess decreased to zero. The proportion of children whose UIC was > 300 µg/L was 18.8% and decreased to 11% compared with 29.8% in 2011. There was no significant difference in UIC < 50 µg/L between 2014 (4.3%) and 2011 (3.7%) (P > 0.05). The MUIC among pregnant women in 2014 was more concentrated between 110 and 230 µg/L. The goiter rate among children aged 8-10 years was unchanged, both the goiter rate of 2011 and 2014 remaining below 5%, in view of the sustainable elimination of iodine deficiency disorders. CONCLUSION The National Standard GB26878-2011 'Iodine Content in Edible Salt' that was introduced in March 2012 resulted in an overall improvement in iodine status, reducing the risk of excessive iodine intake in the Chinese population.

In Shanghai, a new iodized salt standard was implemented in 2012. To provide evidence to the government, we compared iodine status before (35 mg/kg) and after (30 mg/kg) adjustment in vulnerable populations living in Shanghai. The probability-proportional-to-size sampling technique was used to select at least 360 pregnant women for urine iodine test and at least 1200 students for thyroid measurement and the household salt test. Of these students, at least 360 performed urine iodine test. The median thyroid volume and the median household salt iodine concentration of children aged 8–10 years were 1.80 ml and 24.8 mg/kg in 2015, and 0.97 ml and 28.3 mg/kg in 2011. The median urine iodine concentration (UIC) of pregnant women was 126.52 and 139.77 μg/L in 2015 and 2011. All differences were statistically significant (P < 0.05). The median UIC of students was 171.40 and 181.63 μg/L in 2015 and 2011, the difference was not statistically significant. Multivariate linear regression analysis showed that thyroid volume in children was associated with sex, age, region, and household salt iodized concentration. The current iodized salt concentration meets the basic needs of the population’s iodine requirements except for pregnant women. Periodic monitoring is necessary particularly in vulnerable groups.

Both Shanghai and Switzerland are developed regions with long-standing salt iodization programs and periodic monitoring. However, the two regions have their own approach to the implementation of the iodized salt policy. In Shanghai, monitoring was carried out every few years, using probability-proportional-to-size sampling technique to select 30 sampling units. Each unit consisted of more than 12 pregnant women and one randomly selected primary school. Urine samples were then taken from the chosen pregnant women and randomly recruited students of that school for iodine test. Data of Switzerland used in this comparative study was extracted from published researches. In Shanghai, the median urinary iodine concentration (UIC) in 2014 was 20% lower than in 1999 (P < 0.05). The median UIC of pregnant women in 2014 was 9.5% lower than that in 2011 (P < 0.05). In terms of iodized salt concentration, opposite to the increasing in Switzerland, it has exhibited a downward trend in Shanghai (P < 0.05). For the years monitored, the iodized salt concentration in Shanghai was significantly (P < 0.05) higher than in Switzerland. Though the UIC of children exhibited a downward trend in Shanghai (P < 0.05), it was still significantly (P < 0.05) higher than in Switzerland over the same monitoring period. However, the UIC in pregnant women was a totally different story, which was significantly (P < 0.05) lower in Shanghai than in Switzerland. Iodized salt is very important for maintaining sufficient iodine level in the population. Appropriate concentration of iodine in fortified salt needs to be decided according to local conditions. Special attention should be paid to the iodine level of pregnant women in Shanghai, and more education about iodine is necessary for the public health.

The prevention of iodine deficiency through salt iodization has been recognized as a global success story, and China stands at the forefront of this achievement with one of the most successful programs in the world. High level political commitment, national mandatory legislation, a state-managed edible salt industry and a complex and highly sophisticated surveillance system have facilitated the success of the program. Challenges have arisen however, including: (i) concern that adequate iodine status in pregnant women cannot be achieved without causing above adequate iodine intakes in children; (ii) declining iodine intake as a result of reductions in salt consumption and increased consumption of processed foods, which may not be made with iodized salt; (iii) the existence of areas with high iodine content in the water; and (iv) declines in household use of iodized salt due to concerns about excess iodine intake and thyroid disease. This article reviews the achievements and challenges of the Chinese Iodine Deficiency Disorders (IDD) Elimination Program and reflects on lessons learned and implications for other national salt iodization programs.

刚刚过去的“全国碘缺乏病防治日”,让人们对日常是否需要在饮食中补碘的关注度再次升温.而就在不久前由中华医学会地方病学分会、中国营养学会主办,中华医学会内分泌分会等单位协办的有关碘与甲状腺疾病的大会上,数百位专家、学者就持续巩固碘缺乏病防治成果达成共识.专家们针对建立碘与甲状腺疾病的基础、预防、临床研究结果交流平台,建立碘盐、碘添加剂、碘检浏等碘相关产品生产者和使用者的信息共享平台,建立国际、国内碘缺乏病防治策略措施的政策沟通平台,以及就国内外碘缺乏病防治、临床和基础研究进展进行了深入交流.

National iodine-deficiency disorder surveillance surveys were conducted in 1999, 2005, and 2011 in China. Probability-proportional-to-size sampling technique was used to select sampling units. The mean of thyroid volume (Tvol) in the 100 to 199 µg/L UIC (urinary iodine concentration) group was significantly lower than that in the 200 to 299 µg/L UIC group in 2011 ( P < .05). The status in the 100 to 199 µg/L versus ≥300 µg/L and 200 to 299 µg/L versus ≥300 µg/L groups in 1999, and 100 to 199 µg/L versus ≥300 µg/L group in 2011 were the same ( P < .05). The mean Tvol in the <100 µg/L UIC group was significantly higher than that in the 100 to 199 µg/L UIC group in 1999 ( P < .05). Both insufficient and excess iodine may be associated with an increase in Tvol, and adequate iodine intake should be defined as median UIC 100 to 299 µg/L.

OBJECTIVE:We aimed to evaluate goiter prevalence and iodine nutritional status in areas with high levels of water iodine; to monitor the prevalence of iodine deficiency disorders (IDD) in areas at high risk of IDD; and to compare the prevalence of goiter and urine iodine (UI) concentrations between children living in the two areas.METHODS:Based on surveillance from 2012-2014, we analyzed the concentration of UI and prevalence of goiter in 8-10-year-old children from 12 high-risk IDD provinces, and from 8 provinces and municipalities with excessive water iodine. We calculated goiter prevalence for each UI level according to World Health Organization (WHO) standards and constructed predictive prevalence curves.RESULTS:The goiter prevalence and median UI of children from areas with high water iodine were not optimal, being above the WHO standards (5% and 100-199 μg/L, respectively), whereas those in high-risk areas fell within the standard. UI and goiter prevalence exhibited a U-shaped relationship in high-risk endemic areas and a parabolic relationship in areas of iodine excess.CONCLUSION:Iodine surplus in high-iodine areas leads to high goiter prevalence and UI. However, in high-risk areas, UI was optimal and goiter prevalence met the national criteria for IDD elimination.

Objective: To monitor iodized salt consumption and evaluate iodine deficiency status in 2014 in China.