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Objective:To analyze the influencing factors of dental fluorosis of children in the drinking-water-borne endemic fluorosis (referred to as drinking-water-borne fluorosis) areas with qualified drinking water.Methods:In 2020 and 2021, the cluster sampling method was used to select the children aged 8 to 12 years old from the drinking-water-borne fluorisis areas with qualified drinking water in Tianjin City for water and urine fluoride detection, dental fluorosis examination and questionnaire survey, and logistic regression and classification tree model were used to analyze the influencing factors of dental fluorosis in children.Results:A total of 3 795 cases children aged 8 to 12 years old were investigated, and 1 001 cases of dental fluorosis were detected, and the detection rate of dental fluorosis was 26.38% (1 001/3 795). The results of logistic analysis showed that age [odds ratio ( OR) = 1.193, 95% confidence interval ( CI): 1.115 - 1.277], high urinary fluoride (1.84 - 19.40 mg/L, OR = 1.510, 95% CI: 1.169 - 1.952) and the number of permanent residents at home ≥6 ( OR = 1.377, 95% CI: 1.090 - 1.739) were risk factors of dental fluorosis in children; and the mother's with higher education level (college degree or above, OR = 0.664, 95% CI: 0.441 - 0.999), the years of water improvement ≥5 years (5 - < 10 years, OR = 0.193, 95% CI: 0.157 - 0.238; ≥10 years, OR = 0.254, 95% CI: 0.193 - 0.333) were protective factors of dental fluorosis in children. The results of classification tree model analysis showed that the years of water improvement contributed the most to the prevalence of dental fluorosis among children in the drinking-water-borne fluorisis areas with qualified drinking water, followed by age, number of permanent residents at home and urinary fluoride. The area under the receiver operating characteristic curve (AUC) of logistic regression model and classification tree model were 0.730 (95% CI: 0.711 - 0.748) and 0.721 (95% CI: 0.702 - 0.739), respectively, with good fitting effect. Conclusion:The detection rate of children's dental fluorosis in the drinking-water-borne fluorosis areas with qualified drinking water is mainly related to the years of water improvement, age, the number of permanent residents at home and urinary fluoride.
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Objective:To understand the current status of overweight and obesity, the iodine nutrition level and goiter among children in Tianjin, and explore their relationships, so as to effectively adjust the prevention and control measures.Methods:From January 2019 to December 2020, one primary school was selected from all towns or streets in 16 districts of Tianjin, and non-boarding children aged 8 to 10 (age and gender balanced) were selected from each primary school. The number of children sampled in towns or streets in each district was as even as possible. Every year, 200 children from each district were investigated for height, weight, iodine of household edible salt, urinary iodine and thyroid volume. Body mass index (BMI) was calculated and its relationship with iodine nutrition level and goiter of children was analyzed.Results:A total of 6 552 children were investigated, and the median urinary iodine was 178.95 μg/L, the goiter rate was 2.15% (141/6 552). There was no significant difference in iodine content of household edible salt among children in different BMI groups ( P = 0.835), but the difference in thyroid volume was statistically significant ( P < 0.001). By constructing a restrictive cubic spline model, the risk of goiter in children of different age groups increased with increase of BMI ( P < 0.001 or P = 0.002). Conclusions:The BMI of children is closely related to thyroid volume. The influence of height and weight should be considered in diagnosis of goiter of children.
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Objective To investigate the situation of drinking water fluorosis in Tianjin, to study the benchmark dose of urinary fluoride, and to provide a reference for the formulation of the standard for urinary fluoride. Methods Three fluorosis endemic areas were selected in Tianjin, and three villages in each area were selected in this study. The water fluoride was detected, and the prevalence of dental fluorosis and the urinary fluoride of children aged 8-12 years old were investigated. Results The prevalence of dental fluorosis and urinary fluoride content in children in the villages with water fluoride exceeding the standard were significantly higher than those in the villages with water fluoride qualified, and the difference was statistically significant (χ2=88.821, P＜0.001; Z=6.089, P＜0.001). The analysis of the prevalence of dental fluorosis in children showed that the younger the age, the lower the prevalence and severity of dental fluorosis (χ2trend=14.584, P2trend= 20.525, P2=0.736, P=0.391; χ2=3.649, P=0.456). There were significant differences in urinary fluoride between children with different ages and genders (H=14.768, P=0.011; Z=-2.526, P=0.012). According to the level of urinary fluoride, the children were divided into 5 groups. With the increase of urinary fluoride concentration, the prevalence of dental fluorosis gradually increased and the difference was statistically significant (χ2trend=16.348, P<0.001), showing a dose-effect relationship. Based on the prevalence of dental fluorosis in children, BMDS was used to calculate the BMD and BMDL, which were 2.20 mg/L and 1.54 mg/L, respectively. Conclusion The water reform and fluoride reduction in Tianjin has achieved certain results. There is a dose-effect relationship between urinary fluoride and prevalence of dental fluorosis in children, and the reference dose value is slightly higher than the current standard, suggesting that the current standard can be updated timely.
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Objective To understand the iodine nutrition status of pregnant women in Tianjin from 2015 to 2019, and to provide a theoretical basis for pregnant women's scientific iodine supplement in the future. Methods A total of 6 939 pregnant women were randomly selected from 16 districts in Tianjin. The urine samples and home salt of the pregnant women were collected to test iodine content. Results The iodine content was determined in a total of 6 939 household salt samples of the pregnant women. The coverage rate of iodized salt was 81.78%, the consumption rate of qualified iodized salt was 66.85%, and the median salt iodine content was 25.96 mg/kg. A total of 6,938 urine samples were determined for iodine content. The median urinary iodine of the pregnant women (154.26 µg/L) reached an appropriate level of iodine nutrition, but there was an imbalance in the regional distribution (suburbs < urban areas, pregnant women in the third trimester of suburbs < pregnant women in the third trimester of urban areas, and non-elderly pregnant women in the suburbs < non-elderly pregnant women in the suburban areas). Spearman correlation analysis found that urinary iodine was positively correlated with salt iodine and the coverage rate of iodized salt (all P<0.05). The urinary iodine level in pregnant women who consumed uniodized salt was lower than the level in those who consumed qualified iodized salt (P<0.05). Conclusion The coverage rate of iodized salt and the consumption rate of qualified iodized salt in Tianjin had not yet reached the national standard for eliminating iodine deficiency disorders. Although the median urine iodine level of pregnant women generally reached an appropriate level, the level of pregnant women's urinary iodine in the suburbs was significantly lower than that in urban areas. The urinary iodine level of pregnant women in the first trimester, suburban areas (pregnant women in the first and third trimester) and pregnant women who consumed uniodized salt were still in the iodine deficiency level. Therefore, it is necessary to continue to strengthen the monitoring of pregnant women's iodine nutrition, strengthen the promotion of scientific consumption of qualified iodized salt in key populations, and provide a basis for formulating a scientific iodine supplementation policy for pregnant women.
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Objective To comprehensively evaluate the health education effects of iodine deficiency disorders in different areas of Tianjin, and to provide a reference for improving the quality of iodine deficiency disorders health education. Methods The rank sum ratio method (RSR), TOPSIS and fuzzy combination were used to comprehensively evaluate the effect of health education intervention on iodine deficiency disorders in 16 areas of Tianjin. Results The evaluation results of RSR, TOPSIS and fuzzy combination method ranked N, D, and E areas in the last three places, while G, F, and P areas ranked first, second, and third. Combined with the RSR method, it was shown that in the evaluation of the effects of iodine deficiency health education interventions in 16 areas, the health education effect in G, F and P areas was classified as superior, the health education effect in D ,E and N areas was classified as inferior, and other areas were moderate. Conclusion The fuzzy combined RSR-TOPSIS method avoided the limitation of using either RSR or TOPSIS alone and made the conclusion more objective and accurate, and provided comprehensive quantitative results for the health education of iodine deficiency diseases in different areas of Tianjin. This fuzzy combination method objectively evaluated the intervention effect of health education in different areas, which provides a reference for improving the quality of health education for iodine deficiency disorders.
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Objective To investigate the influence of different water-improving defluoridation projects and different water-improving years on children's dental fluorosis,and to provide a scientific basis for further defluoridation of drinking water.Methods Totally 1/4 endemic fluorosis villages in all agricultural-related areas of Tianjin were selected by random sampling method from 2016 to 2017.The situation of water-improving defluoridation project was investigated in these villages.The ways of water improvement included municipal water supply,double pipe network,barreled water,low fluorine well and centralized water supply.The years of water improvement were ＞ 15,＞ 10-15,5-10,and ＜ 5 years,respectively.Totally 821 water samples (surface water,barreled water and groundwater) were collected.Fluoride ion selective electrode method was used for determination of water fluorine content.According to the "Diagnosis of Dental Fluorosis" (WS/T 208-2011),the prevalence of dental fluorosis in children aged 8 to 12 was examined.Results A total of 524 villages with drinking water endemic fluorosis and 35 870 children aged 8 to 12 were investigated in Tianjin.The water improvement rate was 73.28％ (384/524).Water fluoride qualified village accounted for 53.24％ (279/524).The detection rate of dental fluorosis was 47.98％ (17 209/35 870),the detection rate of dental fluorosis was different with different water improvement methods (x2 =1 955.742,P ＜ 0.05).Children's dental fluorosis detection rate in the area of municipal water supply was lower (33.19％,4 121/12 416),while that in double pipe network reconstruction area was 43.37％ (995/2 294).Children's dental fluorosis detection rates in the areas of barreled water supply,low fluoride well and centralized water supply were higher (58.47％,6 268/10 720;66.84％,1 719/2 572;53.75％,623/1 159).The median of water fluoride in the renovated area of municipal water supply was 0.24 mg/L,and the proportion of villages with water fluoride ≤ 1.2 mg/L was 100.00％ (133/133).With the increase in water-improving years (more than 10 years),children's dental fluorosis prevalence [＞ 15,＞ 10 ～ 15 years were 17.41％ (428/2 459),14.19％ (266/1 875)] in the areas of municipal water supply reached the control standards (≤30％).Conclusions The improvement of the municipal water supply network is thorough,which can meet the requirement of continuously ensuring the safety of drinking water for residents,especially those over 10 years.Other forms of water-improving need to be further optimized.
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Objective@#To explore the effects of endoplasmic reticulum stress-induced apoptosis in thyroid injury of rats caused by excessive fluoride intake.@*Methods@#All 40 Wistar rats were randomly divided into four groups, control group, low fluoride group, medium fluoride group and high fluoride group. The rats in control group were fed with tap water (fluoride concentration=0.344 mg/L) and the experimental rats were fed with the water contaminated fluoride with the dose of 5, 10 and 20 mg/L. 10 rats (female: male=1∶1) in each group were sacrificed after 8 months of exposure through drinking water. The contents of urine fluoride were detected by fluorine ion selective electrode method. Morphology of thyroid was observed through light microscope and apoptosis in thyroid were detected by the terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay. The mRNA and protein expressions of glucose-regulated protein 78 (GRP78) and C/EBP homologous protein (CHOP) were analyzed by RT-PCR and immunohistochemistry respectively, and results were compared among groups.@*Results@#The contents of urine fluoride in all fluoride treated groups were separately (4.74±1.88), (7.70±2.82) and (10.50±2.92) mg/L, which were gradually higher than that of control group (2.23±0.54) mg/L (P<0.05). Morphological changes were found in thyroid tissues of fluoride treated groups, thyroid follicular hyperplasia or even no cavity cell clusters were observed. Apoptosis in thyroid were notably increased in fluoride treated groups. The mRNA expression levels of GRP78 in all fluoride treated groups were separately 1.30±0.42, 1.39±0.29 and 1.50±0.27, which were significantly higher than that of control group (0.93±0.24) (P<0.05). And the mRNA expression levels of CHOP in medium and high fluoride groups were separately 1.17±0.29 and 1.30±0.26, which were significantly higher than that of control group (0.91±0.20) (P<0.05). The protein expression levels of GRP78 and CHOP in medium and high fluoride groups were respectively 29.68±4.04, 29.90±3.74 and 4.05±1.62, 4.44±1.81, which were significantly higher than those in the control group (separately 23.80±6.36, 2.27±0.89) (P<0.05).@*Conclusion@#Excessive-fluoride intake can induce thyroid injury, and endoplasmic reticulum stress-induced apoptosis might be involved in the injury.
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Objective To explore the thyroid volume of children aged 8-10 years in non-iodine high area and iodine high area of Tianjin and to analyze the relationship between thyroid volume and urinary iodine level.Methods In 2016-2017,a cross-sectional study was conducted in non-iodine high area and iodine high area in Tianjin.Totally 356 and 199 children aged 8-10 years were selected,respectively.The urine samples of children were collected and the iodine concentration in urine was measured by "As3+-Ce4+ catalytic spectrophotometry".The thyroid volume was monitored by B ultrasonic method.Results The medians of urinary iodine in the 8,9 and 10 years old age groups in iodine high area (500.00,443.00,407.00 μg/L) were higher than those of non-iodine high area (189.39,168.35,189.90 μg/L,Z =7.162,7.536,6.126,P ＜ 0.05).The thyroid volume of children aged 8 and 9 years in iodine high area (2.81,2.91 ml) was higher than that in non-iodine high area (2.31,2.44 ml,Z =3.474,3.264,P ＜ 0.05).There was a weak correlation between urinary iodine and thyroid volume (r =0.109,P ＜ 0.05).Conclusion The urinary iodine level and thyroid volume of children aged 8 and 9 in iodine high areas are higher than those in non-iodine high areas.
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Objective@#To investigate the effects of fluoride exposure on the thyroid hormone level and intelligence in rats and to investigate the biomarkers of intellectual impairment induced by high fluoride exposure.@*Methods@#A total of 24 clean healthy Sprague-Dawley rats were randomly divided into control group (tap water containing 0.344 mg/L fluoride) and low-, medium-, and high-fluoride exposure groups (tap waters containing 10, 50, and 100 mg/L sodium fluoride, respectively). One male rat was cohabited with two female rats in the same group. After the offspring rats were weaned, 12 offspring rats (male/female ratio=1∶1) with a similar body weight in each group were subjected to the same treatment for the parental offspring. The offspring rats were sacrificed on the 60th day after birth. The weight of offspring rats was measured. Serum thyrotropin (TSH) , free triiodothyronine (FT3) , and free thyroxine (FT4) levels were measured by enzyme-linked immunosorbent assay. The learning and memory abilities of the rats were evaluated by Morris water maze test. The expression of mitochondrial fission 1 (Fis1) and mitofusin 1 (Mfn1) in blood was measured by Western blot.@*Results@#The offspring rats in the medium-and high-fluoride exposure groups had significantly lower serum TSH and FT4 levels than those in the control group (P<0.05). The place navigation test showed that the offspring rats in the medium-and high-fluoride exposure groups had significantly longer escape latency than those in the control group (P<0.05) , and the high-fluoride exposure group had a significantly longer escape distance than those in the control group (P<0.05). The spatial probe test showed that the offspring rats in the low-, medium-, and high-fluoride exposure groups had significantly shorter swimming time and distance in the target quadrant and total swimming time and distance than those in the control group (P<0.05). Compared with the offspring rats in the control group, those in the low-, medium-, and high-fluoride exposure groups had significantly higher expression of Fis1 (P<0.05) , and those in the low- and medium-fluoride exposure groups had significantly higher expression of Mfn1 (P<0.05) .@*Conclusion@#High fluoride exposure can reduce the secretion of thyroid hormone and the abnormality of mitochondrial dynamics in peripheral lymphocytes may provide a clue to identifying the biomarkers of intellectual impairment induced by fluoride exposure.
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Objective To study the intake of iodine and iodine nutritional status of adults and provide a scientific basis for choosing appropriate salt iodine content in the region.Methods By using multi stage random sampling method,according to the four corners of 4 directions,4 non water iodine counties or districts were selected from Nankai District,Jixian County,Dagang District and Hangu District.Totally 1 to 4 administrative villages were selected (neighborhood committees) from each district or county as the survey points.Ten to 15 households were selected from each survey points.All the members more than 18 years old of each household were investigated (excluding pregnant and lactating women).Of the 225 households,404 people,salt iodine of the family,urinary iodine and water iodine were detected.The questionnaire survey was used to investigate the daily salt intake of residents per capita.The daily intake of iodine was calculated by the method of dietary frequency.Salt iodine content was detected by direct titration method;iodine in water was detected by cerium sulfate catalytic spectrophotometry;urinary iodine was detected by arsenic cerium catalytic spectrophotometry.Results A total of 24 drinking water samples were tested,the median water iodine was 8.0 μg/L.A total of 225 salt samples and 404urine samples were tested,the medians of family salt and urinary iodine were 23.30 mg/kg and 149.0 μg/L,respectively.Investigation was done on salt intake and dietary intake of 393 people,the per capita consumption of salt intake was (11.45 ± 5.70) g/d.Salt supplied 148.75 μg/d iodine and food supplied 82.47 μg/d iodine.The total contribution rate of iodized salt to the total iodine intake was 68.99％ (193.18/280.00) in the population of iodized salt consumer.The value of urinary iodine and iodine intake were correlated (r =0.170,P ＜ 0.05).Conclusions The adult iodine nutrition in Tianjin city is in the appropriate level.Iodized salt is the main source of iodine intake for adults,so salt iodine is a indispensable iodine nutrition source for adults.
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Objective To identify antimicrobial susceptibilities of community-acquired Staphylococcus aureus infections and the risk factors of severe infections.Methods Clinical data of 184 cases of community-acquired Staphylococcus aureus infections collected from 4 hospitals in Ningbo during May 2008 and May 2013 were reviewed.Microbial sensitivity test and virulence genes ( pvl and tst) detection were performed in clinical isolates, and SCCmec genotyping was performed in methicillin-resistant Staphylococcus aureus ( MRSA) strains.Binary logistic regression analysis was used to identify the risk factors for severe infections.Results Among 184 cases of community-acquired Staphylococcus aureus infections, 39 ( 21.20%) were severe cases. Staphylococcus aureus strains were highly resistant to penicillin, erythromycin and clindamycin, but more than 75% strains were sensitive to oxacillin, aminoglycosides, quinolones, rifampicin and vancomycin.Logistic regression analysis showed that advanced age (OR=1.024, 95%CI:1.005-1.043, P<0.05), malignant tumor (OR=15.288, 95%CI:1.609-145.229, P<0.05) , autoimmune diseases or long-term hormone therapy ( OR=12.102, 95%CI:2.082-70.338, P <0.01 ) were risk factors for severe community-acquired Staphylococcus aureus infections. Conclusions Strains isolated from the patients with community-acquired Staphylococcus aureus infections in Ningbo are usually sensitive to oxacillin, aminoglycosides, quinolones, rifampicin and vancomycin, which may be recommended for clinical use.Elder patients and those with malignant tumor, autoimmune diseases or long-term hormone therapy are more likely to develop severe Staphylococcus aureus infections.