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Objective:To analyze the external quality control assessment results of urinary iodine, salt iodine and water iodine in iodine deficiency disorders laboratories in Qinghai Province, to evaluate the testing capacity of provincial, municipal and county-level laboratories and the operation of external quality control network, so as to provide quality assurance for consolidating and eliminating iodine deficiency disorders.Methods:In 2021, 1 provincial, 8 municipal, and 43 county-level laboratories in Qinghai Province had participated in the assessment of urinary iodine and salt iodine, while 1 provincial and 8 municipal-level laboratories had participated in the assessment of water iodine. The assessment results were evaluated using the method of reference value ± uncertainty of external quality control samples.Results:All laboratories that participated in the assessment had provided feedback. One provincial-level laboratory passed the assessment of urinary iodine, salt iodine, and water iodine. Among 8 municipal-level laboratories, 2 laboratories failed the urinary iodine assessment, with a pass rate of 6/8; the assessment of salt iodine and water iodine in 8 laboratories were all qualified. Among 43 county-level laboratories, 7 laboratories failed the urinary iodine assessment, with a pass rate of 83.7% (36/43); the assessment of salt iodine in 43 laboratories were all qualified.Conclusions:The external quality control network of iodine deficiency disorders laboratories in Qinghai Province has fully covered all municipal and county-level laboratories. The testing capability of provincial-level laboratory is stable and maintains a high level; the testing quality of some municipal and county-level laboratories is still unstable and needs to be further strengthened.
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Objective:To follow up the iodine nutrition and intellectual development of school children aged 8-10 years old in Nangqian County of Qinghai Province after 9 years of the implementation of iodine deficiency disorders intervention measures with iodine supplement as the main measure.Methods:In order to improve the iodine nutritional status of the population in Nangqian County, free iodized salt distribution, health education and other intervention measures for iodine deficiency disorders were implemented for 9 consecutive years since 2013. In May 2012 (before iodine supplementation) and September 2021 (after iodine supplementation), the same 5 townships (towns) were selected, and children aged 8-10 years old (half male and half female, age balanced) born locally in the central primary school of each township (town) were selected as the survey subjects. Household edible salt samples and random urine samples were collected for salt iodine and urinary iodine detection; the second revised version of the Chinese Combined Raven's Test (rural version) was used to assess the intelligence quotient (IQ) of children. The Flynn effect (FE) gain was used to adjust IQ, the corrected IQ = (IQ starting point value - current year's IQ value) - FE gain (calculated by 0.74/year). The differences of salt iodine and urinary iodine related indexes, IQ value and corrected IQ were compared before and after iodine supplementation.Results:After iodine supplementation, the coverage rate of iodized salt reached 100.00% (300/300), and the consumption rate of qualified iodized salt reached95.00% (285/300), the median urinary iodine increased to 157.20 μg/L, and all indexes met the elimination standard of iodine deficiency disorders. The IQ value of children aged 8-10 years old after iodine supplementation was 99.00 ± 14.90, significantly higher than that before iodine supplementation (82.00 ± 13.20, F = 156.82, P < 0.001). The FE gain in 9 years was 6.66, and the actual IQ gain of children aged 8-10 years old after iodine supplementation was 10.34. There were statistically significant differences in IQ value before and after iodine supplementation in male and female children ( F = 78.84, 78.88, P < 0.001). After iodine supplementation, there was a statistically significant difference in IQ value between children in the 8-year-old group and the 10-year-old group ( P = 0.010). There were statistically significant differences in IQ value before and after iodine supplementation in 8, 9 and 10 years old groups ( F = 55.23, 65.79, 36.85, P < 0.001). Conclusion:Intervention measures for iodine deficiency disorders, mainly iodine supplement, can significantly improve the iodine nutrition status of children aged 8-10 years old, and significantly promote the intellectual development of children.
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Objective:To learn about the detection quality and external quality control assessment of fluoride and arsenic in laboratories at all levels in Qinghai Province.Methods:The Z-score method was used to analyze and evaluate the evaluation results of 1 provincial, 8 municipal and 43 county level laboratories of disease prevention and control institutions participating in the external quality control assessment of water fluoride and brick tea fluoride in Qinghai Province in 2021, as well as 1 provincial, 1 municipal and 2 county level laboratories of disease prevention and control institutions participating in the external quality control assessment of water arsenic and urine arsenic. The feedback rate and qualification rate of external quality control of each assessment laboratory were calculated.Results:In 2021, the feedback rate of external quality control of water fluoride, brick tea fluoride, water arsenic and urine arsenic in provincial and municipal level laboratories of Qinghai Province were 100.00%; except that the qualified rate of water fluoride was 7/9, the qualified rate of external quality control of other projects was 100.00%. The feedback rate of external quality control of water fluoride, brick tea fluoride, water arsenic and urine arsenic in county level laboratories was 100.00%; except that the qualified rate of water fluoride was 86.05% (37/43), the qualified rate of external quality control of other projects was 100.00%. In the specific assessment results of the laboratory, the assessment results of water fluoride sample FS20210101 from 1 provincial, 1 municipal and 2 county level laboratories, and FS20210102 from 1 county level laboratory were suspicious; the assessment results of water fluoride sample FS20210101 from 3 county level laboratories were not satisfactory; the assessment results of fluoride and arsenic sample in other laboratories were satisfactory.Conclusions:The qualified rate of external quality control of fluoride and arsenic in laboratories at all levels in Qinghai Province is relatively high, but some county level laboratories are still dissatisfied with the assessment results of water fluoride. Therefore, it is necessary to strengthen the detection level of water fluoride in laboratories.
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Objective:To analyze the external quality control assessment results of fluoride in brick tea in the provincial, city (prefecture) and county (city, district)-level endemic fluorosis laboratories in Qinghai Province, and to evaluate the testing capabilities of laboratories at all levels.Methods:The Z-score method was used to analyze and evaluate the results of provincial, city (prefecture) and county (city, district)-level laboratories that participated in the external quality control assessment of fluoride in brick tea in Qinghai Province from 2014 to 2020, and│Z│≤2 was qualified; 2 <│Z│ < 3 was basic qualified; │Z│≥3 was unqualified.Results:From the feedback, the feedback rate of external quality control of fluoride in brick tea in provincial and city (prefecture)-level laboratories in Qinghai Province from 2014 to 2020 was 100.00%; the feedback rate of county (city, district)-level laboratories from 2014 to 2018 was 100.00%, and there were no feedback units in 2019 and 2020. From the assessment of qualification, the qualification rate of provincial, city (prefecture)-level laboratories was 100.00% in all other years except one unit failed in 2017; the qualification rate of county (city, district)-level laboratories was 100.00% in 2014, 2015, 2016 and 2019, and there were 6 unqualified units in other years.Conclusions:From 2014 to 2020, some endemic fluorosis laboratories in Qinghai Province still fail to pass the external quality control assessment of fluoride in brick tea. In the future, it will be the focus of work to strengthen personnel training and improve the detection ability.
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Objective:To evaluate the water fluoride detection ability of county (city, district) level (referred to as the county-level) laboratories in Qinghai Province.Methods:During the "13th Five-Year Plan" period (2016 - 2020), 4, 4, 4, 43, 43 county-level laboratories in Qinghai Province were organized to participate in the national water fluoride external quality control assessment, and the assessment results were evaluated by Z-ratio scoring method.Results:The response rate of county-level laboratories was 86.05% (37/43) in 2019, and 100.00% in other years. The qualified rate of county-level laboratories was 100.00% from 2016 to 2018; in 2019 and 2020, the assessment was fully covered, and the qualified rate was 81.40% (35/43) and 95.35% (41/43), respectively. Compared with 2019, the response rate and qualified rate in 2020 increased significantly, and the differences were statistically significant (χ 2 = 6.450, 4.074, P < 0.05). In the past 5 years, two assessment samples│Z│ < 1 in each laboratory were the most common, but with two assessment samples 2≤│Z│ < 3 in some qualified laboratories. Conclusion:The consistency of water fluoride determination in Qinghai Province is not very ideal, and the detection ability of county-level laboratories still needs to be strengthened.
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Objective:To understand the water iodine content in Qinghai Province and draw a distribution map of water iodine, so as to provide a basis for scientific supplementation of iodine and continuous elimination of iodine deficiency hazards.Methods:In 2017, in all counties (cities, districts) in Qinghai Province, with townships (towns, streets, referred to as townships) as the unit, the residents' drinking water samples were collected, water iodine content was tested, the median water iodine was calculated, and the water iodine distribution map of Qinghai Province was drew.Results:Totally 1 836 drinking water samples were collected in 392 townships, the median water iodine was 1.7 μg/L. Townships that had the median water iodine < 5 μg/L, in the range of 5 to 10 μg/L and > 10 μg/L accounted for 80.6% (316/392), 17.1% (67/392) and 2.3% (9/392), respectively. Among all townships, the highest of the median water iodine was 24.8 μg/L. Based on the results, water iodine distribution map of Qinghai Province, water iodine distribution map of Xining City and water iodine distribution map of Haidong City were compiled.Conclusions:Iodine deficiency is widespread throughout natural environment in Qinghai Province. Hence, salt iodization measures to prevent iodine deficiency disorders should be implemented continuously. According to the water iodine distribution map, the people should be guided to supplement iodine scientifically.
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Objective:To verify the revised method of cerium sulfate catalytic spectrophotometry for iodide index of "Standard Examination Methods for Drinking Water-Nonmetal Parameters" (GB/T 5750.5-2006).Methods:From July to September 2019, the Laboratory of Department for Endemic Disease Prevention and Control of Qinghai Institute for Disease Prevention and Control verified the revised method (determination of iodide in drinking water by cerium sulfate catalytic spectrophotometry) of cerium sulfate catalytic spectrophotometry (hereinafter referred to as original method) in "Standard Examination Methods for Drinking Water-Nonmetal Parameters" (GB/T 5750.5-2006). The revised method was verified according to the requirements of "Standard Examination Methods for Drinking Water-Water Analysis Quality Control" (GB/T 5750.3-2006), including standard curve, detection limit, precision, accuracy and actual sample determination.Results:The linear range of the revised method was 0 - 20.0 μg/L, the correlation coefficient was - 0.999 4 - 0.999 8, and the detection limit was 0.231 μg/L. The relative standard deviation ( RSD) of low, medium and high iodine water samples of 6 times detection ranged from 1.4% to 9.6%, and the recoveries of low and medium water samples ranged from 89.0% to 108.0%. The detection results of national first-class reference materials for iodine composition analysis in water were within the range of standard value ± uncertainty. There was no significant difference in the test of results of 12 tap water samples between the revised method and the original standard method ( t = - 0.075, P > 0.05). Conclusion:The revised method has a good linear relationship of standard curve, high precision and accuracy, and good reproducibility, is simple and easy to operate, and is suitable for promotion and application.
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Objective:To investigate the dietary iodine intake of people in different areas of Qinghai Province, and to provide the basis for scientific iodine supplementation and continuous elimination of iodine deficiency hazards.Methods:From 2018 to 2019, according to administrative division, natural geographical regions, population distribution and economic development level of Qinghai Province, a total of 14 survey sites were selected. One village was selected from each survey site, and 20 households were selected from each village, the salt samples and 24 h urine samples of all family members were collected to detect salt iodine and urinary iodine. One drinking water sample was collected at the five directions of east, west, south, north and middle of each village to detect water iodine. Salt iodine was detected by direct titration, urinary iodine and water iodine were detected by arsenic-cerium catalytic spectrophotometry. At the same time, the 3-day weighing method was used to investigate the diet, the daily dietary iodine intake per capita (the result was expressed as average) and the proportion of dietary iodine in urinary iodine were calculated, the daily dietary iodine intake per capita of different production modes (agricultural region and pastoral region), different geographical environment (Hehuang Valley, Qaidam Basin, Qilian Mountain and Qingnan Plateau), different nationalities (Han, Tibetan, Hui, Mongolian, Tu, Salar) and different economic levels (< 8 000, 8 000 -, 10 000 -, ≥12 000 Yuan) were compared.Results:A total of 999 people from 280 families were surveyed, including 511 males and 488 females. The median water iodine of each survey site was less than 10 μg/L, all of which were environmentally iodine-deficient areas. A total of 280 salt samples were collected, the median salt iodine was 26.0 mg/kg, and the consumption rate of qualified iodized salt was 100% (280/280). A total of 999 urine samples were tested, and the median urinary iodine of people was 192.5 μg/L, which was at an appropriate level of iodine. There was no statistically significant difference ( t =-1.599, P > 0.05) in the daily dietary iodine intake per capita (28.53, 33.44 μg) of people in agricultural region ( n = 643) and pastoral region ( n = 356). The daily dietary iodine intake per capita (25.38, 33.30, 32.98, 34.79 μg) of people in Hehuang Valley ( n = 448), Qaidam Basin ( n = 125), Qilian Mountain ( n = 157), and Qingnan Plateau ( n = 269) were compared, the difference was statistically significant ( F = 2.883, P < 0.05); among them, the daily dietary iodine intake per capita in Hehuang Valley was lower than that in Qingnan Plateau ( P < 0.05). The daily dietary iodine intake per capita of different nationalities were compared, the difference was statistically significant ( F = 3.647, P < 0.05), Salar ( n = 68) and Tibetan ( n = 239) were higher (37.21 and 32.21 μg). The daily dietary iodine intake per capita (38.97, 17.01, 30.86, 33.14 μg) of annual per capita disposable income < 8 000 ( n = 194), 8 000-( n = 221), 10 000-( n = 302), ≥12 000 Yuan ( n = 282) were compared, the difference was statistically significant ( F = 9.407, P < 0.05). The proportions of dietary iodine in urinary iodine of various population ranged from 5.35% to 15.54%. Conclusions:The iodine nutrition of people in Qinghai Province is suitable, the dietary iodine intake of people is closely related to geographical environment, nationality and economic level. But the proportion of dietary iodine in urinary iodine is relatively low, the consumption of iodized salt is still the main way for people to intake iodine, and it is also the main measure to continuously eliminate the harm of iodine deficiency in Qinghai Province.
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Objective:To understand the situation of drinking water-borne endemic fluorosis (short for drinking water fluorosis) in Huangzhong, Ping'an and Ledu districts of Qinghai Province and operation status of water improvement projects, and to evaluate the effect of control measures.Methods:In historical drinking water fluorosis villages of Huangzhong, Ping'an and Ledu districts of Qinghai Province in 2018, the status of water improvement, the operation of water improvement projects and the content of water fluoride were investigated; the dental fluorosis of 8-12 years old children in all investigated villages was checked; 3 villages from 3 districts were selected, X-ray examination for skeletal fluorosis and urinary fluoride detection of adults over 25 years old of age were performed.Results:Eight-two historical drinking water fluorosis villages in 3 districts were investigated and all the villages had water improvement projects, in addition, the water improvement projects were operating normally, and the water fluoride content ranged from 0.10 to 0.37 mg/L, which were in line with the drinking water fluoride content standard (< 1.2 mg/L). Totally 2 503 children aged 8-12 years old were examined, the detection rate of dental fluorosis was 6.03% (151/2 503), the index of dental fluorosis was 0.13, the epidemic intensity was negative; the detection rates of dental fluorosis in 3 districts were 6.24% (129/2 068), 4.05% (7/173), 5.73% (15/262), respectively, reaching the control standard (< 30%), and the detection rate of dental fluorosis in 81 villages was less than 30%; 198 adults over 25 years old were examined, the detection rate of skeletal fluorosis was 5.05% (10/198), the geometric mean of urinary fluoride was 0.81 mg/L, and skeletal fluorosis cases were mainly in the age group over 40 years old, all of them were mild cases.Conclusions:The fluoride content in drinking water and the detection rate of children's dental fluorosis are all up to the control standard, and the condition of skeletal fluorosis is significantly reduced after the implementation of water improvement measures in Huangzhong, Ping'an and Ledu districts. It can be seen that the prevention and control of drinking water fluorosis in Huangzhong, Ping'an and Ledu districts have achieved good results, but later management and condition monitoring of water improvement projects should be strengthened to prevent the disease from rebounding.
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Objective:To study the epidemic status of drinking tea type endemic fluorosis in Qinghai Province.Methods:In 2019, in counties (cities, districts, referred to as counties) that had the habit of drinking brick tea in 8 cities (prefectures) of Qinghai Province, epidemiological investigation of drinking tea type endemic fluorosis was carried out in villages. Ten households were randomly selected from each village, to investigate the demographic data of each household and the drinking situation of brick tea, residents' drinking water and brick tea samples were collected to determine the fluorine content, and calculate the daily per capita tea fluorine intake. At the same time, skeletal fluorosis was examined in all adults over 25 years old, and dental fluorosis was examined in all children aged 8 to 12 years old in survey sites. The content of fluorine in tea and water was detected by ion selective electrode method; the diagnosis of skeletal fluorosis was based on "Diagnostic Criteria for Endemic Skeletal Fluorosis" (WS 192-2008), the diagnosis of dental fluorosis was based on "Diagnosis of Dental Fluorosis" (WS/T 208-2011).Results:The mean (range) of fluorine of the 3 602 water samples was 0.31 (0.20 - 1.00) mg/L. The geometric mean (range) of fluorine of the 31 067 brick tea samples was 646 (40 - 2 295) mg/kg, the fluorine content of the brick tea ≤300 mg/kg accounted for 7.80% (2 422/31 067) of the total samples. The proportion of drinking Fu brick-tea was 89.97% (27 952/31 067); and the daily per capita tea fluorine intake was 1.93 mg, the daily per capita tea fluorine intake in Guoluo, Yushu and Hainan prefectures were higher than the health standard (3.50 mg). The detection rate of skeletal fluorosis in adults was 0.16% (2 357/1 484 907), Yushu Prefecture was the highest [29.23% (592/2 025)], followed by Guoluo Prefecture, which was 8.21% (771/9 393). The detection rate of dental fluorosis in children was 4.79% (8 076/168 623), Yushu Prefecture was the highest [32.61% (1 562/4 790)].Conclusion:Drinking tea type endemic fluorosis is prevalent in Qinghai Province, with obvious regional characteristics, covering a large population. The disease is relatively popular in Yushu Prefecture and Guoluo Prefecture.
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Objective:To analyze the assessment results of the external quality control in iodine deficiency disorders laboratories at all levels in Qinghai Province so as to provide quality assurance for monitoring and control effect evaluation of iodine deficiency disorders.Methods:The results of urinary iodine, salt iodine, and water iodine quality control assessments at the provincial, city (state) and county-level iodine deficiency disorders laboratories were analyzed in Qinghai Province from 2013 to 2018 (sourced from the annual evaluation results issued by National Reference Laboratory for Iodine Deficiency Disorders). Among them, there were 1 provincial, 8 city (state) and 43 county-level (2017, 2018) laboratories participated in the urinary iodine assessment; 1 provincial, 8 city (state) and 30 county-level (43 in 2017 and 2018) laboratories participated in the salt iodine assessment; 1 provincial and 8 city (state)-level laboratories participated in the water iodine assessment.Results:From 2013 to 2018, the feedback rates and qualified rates of provincial and city (state)-level laboratories participated in the urinary iodine external quality control assessment were 100.0%; the feedback rates of 43 county-level laboratories (2017 and 2018) were 100.0%, and the qualified rates were 93.0%(40/43) and 88.4%(38/43), respectively. The feedback rates and qualified rates for salt iodine assessment in provincial and city (state)-level laboratories were 100.0%; the county-level laboratories feedback rates were 100.0%, and the qualified rates were > 90.0% except for 2014. And the feedback rates of provincial and city (state)-level laboratories for water iodine assessment were 100.0%; the qualified rate of provincial-level laboratory was 100.0%, and the city (state)-level laboratories were 100.0% except 2016 (7/8).Conclusions:The quality control network of Qinghai Province's iodine deficiency disorders laboratories has fully covered all city (state) and county-level laboratories. Provincial, city (state)-level laboratories have stable and reliable levels of urinary iodine, salt iodine, and water iodine; some individual county-level laboratories testing capabilities still need to be improved.
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Objective To analyze the operation of water improvement projects in drinking water-borne fluorosis areas of Qinghai Province and the trend of dental fluorosis in children aged 8 to 12 years, and to evaluate the effects of prevention and control measures comprehensively, so as to provide basis for improving prevention and control strategies. Methods In 2009 - 2017, according to the "Qinghai Drinking Water Endemic Fluorosis Surveillance Program", four project counties of Huangyuan, Minhe, Hualong and Guide were selected in Qinghai Province. Three villages in each project county were selected according to their mild, moderate and severe conditions, and monitored the operation of water improvement projects, water fluoride content and dental fluorosis among children aged 8 to 12-year-old in each diseased village. Results In 2009-2017, the normal operation rate of water improvement projects increased from 2/8 to 7/8; the batch operation rate of the projects decreased from 5/8 to 1/8; the number of abandoned projects decreased from 1 to 0; the number of people covered by qualified water fluoride increased from 9962 to 80760 people; there was no significant difference in water fluoride content between different years (F = 0.758, P > 0.05). The total detection rate of children's dental fluorosis was 33.01％(1812/5489) from 2009 to 2017, the index of dental fluorosis was 0.65, and the epidemic intensity was slightly prevalent;the detection rate of children's dental fluorosis was 30.02％(951/3168) in villages with normal operation of water improvement projects and qualified water fluoride content, the index of dental fluorosis was 0.58, and the epidemic intensity was marginal;the detection rate of children's dental fluorosis was 32.72％(583/1782) in villages with abnormal operation of water improvement projects or excessive fluoride, the index of dental fluorosis was 0.66, and the epidemic intensity was slight; the detection rate of children's dental fluorosis in villages without changing the water was 51.58％ (278/539), and the index of dental fluorosis was 1.04, belonging to the moderate epidemic intensity; the detection rate of children's dental fluorosis in villages without changing the water was significantly higher than that in villages with normal operation of water improvement projects and qualified water fluoride content (χ2 = 102.30, P < 0.01). Conclusions The water improvement project in drinking water-borne fluorosis areas is running well and the operation rate is increasing year by year. The detection rate of dental fluorosis in children aged 8-12 years old in villages with normal operation of water improvement projects and qualified water fluoride content was significantly lower than that in villages without changing the water. The monitoring of fluorosis and the maintenance of water-renovation projects should be strengthened, and the problem of drinking water for residents in villages without changing the water should be resolved as soon as possible.
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Objective To understand the epidemic situation of tea-drinking-borne fluorosis among children in Haixi Prefecture of Qinghai Province,and to provide basis for taking pertinent prevention and control measures.Methods In 2017,three townships (towns) were selected from five counties (cities) in Golmud,Delingha,Dulan,Ulan and Tianjun,Haixi,and one village (villages excluding excessive water fluoride) was selected from each township (town) as the investigation site.Fluoride content in drinking water,tea fluoride content and dental fluorosis in children aged 8-12 years were investigated.Water fluoride was determined using "Standard Test Method for Drinking Water" (GB/T 5750.5-2006);brick tea fluoride content was detected using "The Fluoride Content in Brick Tea" (GB 19965-2005);children's dental fluorosis was diagnosed using "Diagnosis of Dental Standard for Fluorosis"(WS/T 208-2011).Results Totally 75 drinking water samples were collected from each county (city).The water fluoride content ranged from 0.35 to 0.41 mg/L,with an average value of 0.37 mg/L,which was lower than the national drinking water fluoride standard of 1.00 mg/L.The fluoride content of 150 brick tea samples ranged from 206.0 to 796.0 mg/kg,with an average value of 629.8 mg/kg.A total of 1 325 children aged 8-12 were examined.The detection rate of dental fluorosis was 13.43％ (178/1 325),the index of dental fluorosis was 0.27,and the overall epidemic intensity was negative.The epidemic intensity in Dulan and Tianjun counties was marginal.There were significant differences in the detection rate of dental fluorosis among children of different ages (x2=35.26,P ＜ 0.05),and dental fluorosis was increased with ages in children.The detection rate of dental fluorosis in boys and girls was 13.31％ (90/676) and 13.56％ (88/649),respectively,with no significant difference (x2 =0.02,P ＞ 0.05).Conclusions There is an epidemic of tea-drinking-borne fluorosis among children in 5 counties (cities) of Haixi Prefecture.Although the epidemic is mild,it should not be ignored.Health education and publicity work for tea-drinking-borne fluorosis should be strengthened.
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Objective To detect urinary bio-markers of hydroxyproline (HYP) and c-terminal telopeptide of collagen type Ⅱ (CTX-Ⅱ) among population from Kashin-Beck disease (KBD) regions in Qinghai Province,and to provide the scientific data for prevention and control of adult KBD.Methods According to the "Diagnosis of Kashin-Beck Disease" (WS/T 207-2010),using case-control study,120 KBD patients (males 55,females 65) and 89 healthy controls (males 41,females 48) in Qinghai KBD regions were divided into case group and control group.Morning urine samples were collected.HYP and CTX-Ⅱ contents were analyzed by enzyme-linked immunosorbent assay (ELISA),then these results were corrected with creatinine.All the data were analyzed by SPSS 17.0 software.Results There was no significant difference in the age of male and female between case group and control group (t =1.813,1.131,P ＞ 0.05).The medians of urinary HYP and CTX-Ⅱ contents among male patients were 74.91 μg/μmol Cr and 630.77 ng/μmol Cr,respectively,which were higher than those of control groups (51.38 μg/μ mol Cr,401.32 ng/μmol Cr,Z =3.068,3.246,P ＜ 0.01).The medians of urinary HYP and CTX-Ⅱ contents among female patients were 91.07 μg/μmol Cr and 637.17 ng/μmol Cr,respectively,compared with those of control groups (88.37μg/μmol Cr,546.47 ng/μmol Cr),there was no significant difference in HYP content (Z =0.273,P ＞ 0.05),however,the difference in CTX-Ⅱ content was statistically significant (Z =2.002,P ＜ 0.05).Conclusion The urinary HYP contents of male patients with KBD change significantly,while the degradation of type Ⅱ collagen in male and female patients increases,and CTX-Ⅱ could reflect the metabolic changes of collagen in KBD.
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Objective To understand the epidemiological prevalence of drinking-tea type fluorosis in Haidong Region,Qinghai Province,and provide scientific data for its prevention and control.Methods According to the investigation plan of drinking-tea type fluorosis in China,cross sectional survey was adopted to select 6 counties in Haidong Prefecture from May to July in 2016.Five townships were selected according to the eastern,western,north and south directions,1 administrative village was randomly selected in each township (town) as the survey site.Water and brick tea samples were collected to test fluoride ion concentration;dental fluorosis in children aged 8 to 12 years and adult skeletal fluorosis were examined.Fluorine ion selective electrode was used to determine fluoridated fluoride (WS/T 106-1999),fluorine in urine (WS/T 30-1996) and fluorine content in brick tea (GB 19965-2005).Dental fluorosis was examined by Deans method.The diagnosis of skeletal fluorosis was referred to the "Diagnostic Criteria for Endemic skeletal Fluorosis" (WS 192-2008).Results Fifty-seven drinking-water and 56 brick-tea samples were determined,the means of fluoride in drinking water and brick-tea were 0.25 mg/L and 724.71 mg/kg [which was significantly higher than the national standard (300 mg / kg)],respectively.Totally 1 207 urinary samples of children and 1 428 urinary samples of adults were determined,the geometric means of urinary fluoride of children and adults were 0.57 and 0.62 mg/L,respectively;2 677 children and 1 968 adults were examined,the rate of dental fluorosis among children was 15.09％ (404/2 677),its index was 0.26,the prevalence rate of clinic skeletal fluorosis among adults was 2.44％ (48/1 968).Conclusion The fluoride content of brick tea in 6 counties of Haidong Prefecture of Qinghai is higher than that of the national standard.Local residents are still exposed to high fluoride brick tea,and health education and publicity should continue to be strengthened.
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Objective To understand the prevalence state of drinking-tea type fluorosis in Hainan Prefecture,Qinghai Province,and provide scientific data for its prevention and control.Methods In 2016,a cross-sectional survey method was used to select five counties of Guide,Guinan,Xinghai,Gonghe and Tongde in Hainan according to "National Investigation Measure of Prevalence of Drinking-tea Type Fluorosis".In each county,5 villages (towns) were selected according to the directions of east,west,north,south and center positions,and 1 administrative village was randomly selected in each village (town) as the survey site.All the children aged 8 to 12 years old at the survey site and 60 adults aged 16 years old and older at each survey site were selected as the survey subjects.We investigated the volume of brick-tea water consumed per day among objective population with questionnaire,and collected water,brick-tea water and urine samples (if each region has one water source,we collected one water sample,if this place have different water sources,we collected all the water samples from each water source;brick-tea water samples were collected based on different locations;more than 12 urine samples were collected in each survey site).The fluoride concentration in water,urine and tea water were detected with fluoride ion-selective electrode,the dental fluorosis of children aged 8-12 years were diagnosed by "Diagnosis of Dental Fluorosis" (WS/T 208-2011),and clinic skeletal fluorosis of population was diagnosed based on the "Diagnostic Criteria for Endemic Skeletal Fluorosis" (WS 192-2008).Results The medians of fluoride in drinking water,drinking-tea water were 0.29 and 1.43 mg/L,respectively.The mean of daily fluoride intake of each person was 1.82 mg,and the geometric mean of urinary fluoride was 0.83 mg/L;the rate of dental fluorosis among children was 14.06％ (559/3 975),its index was 0.24,the prevalence rate of clinic skeletal fluorosis among adult was 8.01％ (119/1 484).The rate of dental fluorosis among children in Tongde County was the highest,about 15.96％ (83/520),while the rate of dental fluorosis among children in Guinan County was the lowest,about 10.76％ (111/1 032).The prevalence rate of clinic skeletal fluorosis among adult in Xinghai County was the highest,about 10.87％ (30/276),while Tongde County was the lowest,about 5.75％ (15/261).Conclusions The prevalence of drinking-tea type fluorosis is relative low.However,the local population are still under the risk of brick-tea with high fluoride,so it is necessary to strengthen the health education propaganda to keep the population healthy.
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Objective To investigate the relationship between thyroid volume and multiple body indexes such as urinary iodine level,height,and weight,respectively,in order to provide a theoretical basis for evaluation of goiter disease in the future. Methods The height and weight were measured, and urine samples were collected from children aged 8 to 10 years old from 10 township schools of Nangqian County in Qinghai Province in 2014 and urinary iodine was tested via the As (Ⅲ)-Ce4+catalytic spectrophotometry method. Meanwhile, the thyroid volume was immediately measured via the B-ultrasound method. Statistical analyses were employed finally to assess the difference and correlation between thyroid volume and multiple physiological indexes including urinary iodine level, height, weight, gender and age. Results The thyroid volume of 773 children aged 8 to 10 years old showed skewed distribution (W = 0.088, P < 0.05), with median of 3.53 ml and quartile of 3.05, 4.15 ml. The thyroid volume was not significantly different between different urinary iodine levels (H = 1.644, P > 0.05). There were significant differences of the thyroid volume among different height groups, weight groups and age groups (H=59.845,64.888,28.590,P<0.05),and the thyroid volume was positively correlated with height weight and age,respectively(r = 0.389, 0.359, 0.155, P < 0.05). Conclusions The thyroid volume is related to the level of children's physiological parameters, such as age, height, weight. Therefore, the diagnosis of thyroid volume via the B-ultrasound method for a individual child should not only take age,but also height and weight into account, to reduce the diagnostic error of goiter disease.
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Objective To understand the pathway of iodine intaking among Tibetan, and provide basic data for prevention and control of iodine deficiency disorders (IDD). Methods Through the method of random sampling, the boarding and day student aged 8 - 10 and women of childbearing age were conducted dietary survey to understand the condition of food intaking via the 24 h review method in 2015. Samples of urine, drinking water, dried beef, milk, Qula and fried noodles were collected and tested iodine level. Results Due to taking iodized salt three times a day with meals, the median of urinary iodine among 492 investigated boarding students was 179.2 μg/L;differently, the median of urinary iodine among 298 day students in this investigation was 79.6 μg/L who taking iodized salt only at lunch at school;and in the study, the median of urinary iodine among 158 women of childbearing age who took iodine-free salt daily was 33.7 μg/L. The iodine contents in 51 drinking water samples, 66 dried beef samples, 48 milk samples, 20 Qula samples and 37 fried noodle samples were quantified respectively, and the average iodine contents of each food were 0.8 μg/L in drinking water, 59.1 μg/kg in dried beef, 61.5 μg/kg in milk, 226.4 μg/kg in Qula and 17.0 μg/kg in fried noodles. The acceptable daily intake (ADI) of iodine of the boarding and day students aged from 8 to 10 and women of child bearing age were 234.0, 126.4 and 76.7 μg/d, respectively, among which the ADI of iodine with iodized salt were 208.0, 78.0 and 0.0 μg/d. Conclusion Consuming iodized salt is a main method to get iodine among Tibetans in Nangqian County, so that it is significant to carried out this measure for a long time for free to let them have iodized salt every day instead of iodine-free one.
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Objective To observe the illness change trend of drinking water type endemic arsenic poisoning in Qinghai Province, comprehensively evaluate the effect of prevention and control measures, in order to provide a scientific basis for timely adjustment of the prevention and control measures. Methods From 2010 to 2013, according to the Drinking Water Type Endemic Arsenic Poisoning Monitoring Programs, 3 villages in 2 counties within Qinghai Province were randomly selected as monitoring sites. The arsenic content in drinking water of residents was measured, water improvement projects in all monitoring villages were investigated; at the same time an investigation of arsenic disease in resident population was conducted, and urinary arsenic content was monitored. Arsenic in drinking water and urine was determined by hydride generation atomic fluorescence spectrometry, and arsenic poisoning was diagnosed using Endemic Arsenic Poisoning Diagnostic Criteria (WS/T 211-2001). Results Of the three water improvement projects, two were water arsenic exceeded the standard, and one was intermittently operated. From 2010 to 2013, the arsenic poisoning detec tion rate in Baoning Village was 27.30% (193/707), 31.90%(245/768), 29.35%(221/753) and 28.22%(219/776); in Kecai Village was 32.62%(107/328), 34.83%(124/356), 31.26%(131/419) and 29.35%(118/402);and in Manimotai Village was 56.58%(43/76), 52.81%(47/89), 45.10%(46/102) and 34.69% (34/98), there was no significant difference statistically of the arsenic poisoning detection rates in the three monitored villages in the 4 years (χ2 =3.09, 0.04, 0.92, all P>0.05). From 2010 to 2013, women arsenic poisoning detection rate was 36.45%(203/557), 40.59%(246/606), 36.12%(225/623) and 34.77%(218/627), respectively;men was 25.27%(140/554), 28.01%(170/607), 26.57%(173/651) and 23.57%(153/649), respectively;women arsenic poisoning detection rates were higher than those of men (χ2 = 16.25, 21.32, 13.49, 19.38, all P < 0.05). Arsenic poisoning detection rate of people younger than 60 years old had a tendency to increase with age. In 2012 and 2013, 105 and 93 urine samples were tested, respectively; urinary arsenic geometric mean was 0.113 and 0.149 mg/L. Conclusions Water improvement projects and water quality are not optimistic, and prevalence of arsenic poisoning is still at a higher level. A sound long-term monitoring program should be established as soon as possible, the management and maintenance of water improvement projects should be strengthened, and the monitoring and prevention work should not be neglected.
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Objective To analyze the radiographic characteristics of right hand X-ray film of adult patients with Kaschin-Beck disease (KBD) in Qinghai Province, to understand the most affected locations in adult KBD. Methods According to the criteria of KBD diagnose (WS/T 207-2010), 111 cases of patients were taken X-ray films of right hands. Joint space narrow, joint deformity, subchondral sclerosis, osteophyte, coarse and irregularity of joint, marginal retraction sign and capsule changes were chosen as the descriptive indexes, and these indexes were analyzed with SPSS 17.0. Results A total of 111 cases adult patients with KBD were examined right hand by X-ray, abnormality on X-ray film were 103 cases, the abnormal rate was 92.79%. The most affected fingers were Ⅱ- Ⅳphalanx bones, Ⅱphalanx bones accounted for about 92.23% (95/103), Ⅲ phalanx bones accounted for about 99.03% (102/103), and Ⅳ phalanx bones accounted for about 99.03% (102/103). There was significant difference of the abnormality between th e proximal phalanx and the middle phalanx among the Ⅱ - Ⅳ phalanx bones(χ2=79.33, P<0.05). Abnormal numbers of joint deformity, marginal retraction sign, coarse and irregularity of joint, osteophyte, capsule changes and joint space narrow in the proximal phalanx were 212, 7, 134, 47, 15 and 115 in Ⅱ - Ⅳ proximal phalanx, respectively; while the abnormal numbers of joint deformity, marginal retraction sign, coarse and irregularity of joint, osteophyte, capsule changes and joint space narrow in the middle phalanx were 77, 37, 137, 26, 19 and 126 in Ⅱ - Ⅳmiddle phalanx, respectively. Conclusion The Ⅱ - Ⅳ phalanx bones of right hand are the most affected locations in adult KBD.