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Objective To investigate the effects of IL-21,IL-23 and IL-4 in the pathogenesis of Guillain-Barré syndrome(GBS) of children,and to analyze the influence of intravenous immunoglobulin(IVIG) on the serum levels of IL-21,IL-23 and IL-4 in GBS patients.Methods Forty-one pediatric patients with GBS hospitalized in our department from Jan.2005 to Sep.2012 were studied.According to the time of IVIG administration,patients were divided into group A and group B,given IVIG respectively within the 7th day and the 8th-12th day.According to Hughes score,patients were divided into mild group and severe group.The serum levels of IL-21,IL-23 and IL-4 were detected by means of ELISA before and after treatment.Results Before treatment,the serum levels of IL-21,IL-23 and IL-4 had no signifiant difference between group A and group B.After treatment,the serum levels of IL-21,IL-23 in group A and group B were significantly decreased than those before treatment (all P ＜ 0.05),with no significant difference in IL-4 levels.There was no signifiant difference in group A and group B in the serum levels of IL-21,IL-23 and IL-4 after treatment (all P ＞0.05).In the severe group,the serum levels of IL-21,IL-23 were significantly higher than those in the mild group before and after treatment (all P ＜ 0.05),with no significant difference in IL-4 levels.After treatment,the serum levels of IL-21,IL-23 were significantly decreased than those before treatment in the mild group and the severe group (all P ＜ 0.05),with no significant difference in IL-4 levels.Conclusions The serum levels of IL-21,IL-23 are significantly increased in GBS children,indicating they play an important role in the pathogenesis of GBS.Levels of IL-21 and IL-23 are significantly decreased after administration of IVIG,which showed that IVIG could inhibit the secretion of IL21 and IL-23,reduce cellular inflammatory response,and eventually prevent the development of GBS.IL-4 secretion is not obviously affected with IVIG,it might have a role in the recovery of GBS.
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ObjectiveTo find out the condition of endemic fluorosis in Liangshan and Boxing counties of Shandong province,and to provide the basis for future prevention and treatment of the disease.MethodsIn 2007 -2009,100 water facilities per year were selected in each county and the water fluoride was tested in Liangshan and Boxing counties of Shandong province.Ten households were selected and their water fluoride content was measured.Dental fluorosis prevalence and dental fluorosis index of school children aged 8 - 12 were checked in all monitored places(3 villages in each county).Meanwhile,urinary fluoride was detected in children carried dental fluorosis test.ResultsIn 2007 - 2009,the median of urinary fluoride in Liangshan county was 2.35,3.73 and 1.29 mg/L,respectively; dental fluorosis detection rate was 72.73％ (88/121),78.08％ (57/73),and 70.64％ (77/109),and the dental fluorosis index was 1.43,1.76 and 1.34.While in Boxing county,the median of urinary fluoride was 4.50,6.71 and 5.64 mg/L; dental fluorosis detection rate was 95.93％ (118/123),99.06％ (105/106),94.41％(152/161) and dental fluorosis index was 2.23,2.54 and 2.09,respectively.ConclusionsThe effect of prevention and control of endemic fluorosis in Liangshan county was better than that of Boxing county of Shandong province.Altering water source is an important measure to control endemic fluorosis.More defluoridation project should be carried out in endemic fluorosis areas.
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Objective To investigate the current status of endemic fluorosis in Shandong province, and to provide the scientific evidence for making strategies for prevention and control of the disease. Methods According to "The National Technical Scheme for Endemic Disease Control in 2008", thirty-four counties were divided into mild, moderate and severe endemic fluorosis areas and a village was randomly selected from each category of the area to carry out the monitoring of endemic fluorosis. The content of fluoride in drinking water and urine was determined by F-ion selective electrode, dental fluorosis of children aged 8 to 12 was diagnosed by Dean method and skeletal fluorosis diagnosed by clinic and X-rays. Results The monitoring was done in 70 water-improving villages in 34 counties, among which 54 villages had water fluoride content ≤ 1.00 mg/L and accounted for 77.14%(54/70), 16 villages had water fluoride content ＞ 1.00 mg/L and accounted for 22.86%(16/70), the highest water fluoride content was 4.46 mg/L. The monitoring was also carried out in 32 non-water-improving villages in 34 counties, among which 9 villages had water fluoride content ≤ 1.00 mg/L and accounted for 28.12%(9/32), 23 villages had water fluoride content ＞ 1.00 mg/L and accounted for 71.88% (23/32), the highest water fluoride content was 4.09 mg/L. The total rate of dental fluorosis of children aged 8 to 12 was 45.81%(1988/4340), the index of dental fluorosis was 0.97 and the rate of dental damage was 6.91%(300/4340). The urinary fluoride values above 1.40 mg/L were found in 55.33%(1417/2657) of children aged 8 to 12, with the highest urinary fluoride concentrations was 18.53 mg/L. The rate of skeletal fluorosis by clinic and X-rays in adults older than 16 years were 4.25% (2462/57 968) and 28.40%(23/81 ), respectively. The urinary fluoride values above 1.60 mg/L were found in 55.86% (1130/2023) of adults older than 16 years, with the highest urinary fluoride concentrations was 25.44 mg/L. Conclusions Endemic fluorosis in Shandong province has not yet been effectively controlled,control situation is still grim. Prevention efforts need to be further strengthened.
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Objective To investigate the present situation of water-improving defluoridation project and the distribution of water fluoride in fluorosis areas in Shandong province. Methods In 2005 - 2007, according to "The National and Shandong province Technical Scheme for Endemic Disease Control", the water-improving form,water type and the running status of defluoridation project in 17 cities of Shandong province were investigated, and the water-fluoride of the running projects were determined by F- ion selective electrode. Results A total of 5816projects were built that involved 8776 villages, 110 counties, 17 cities distributed in Shandong province. In which,the drilling of water-improving projects accounting for 94.55% (5499/5816), under-ground water type 97.73%(5684/5816);operating normally accounting for 75.91% (4415/5816), 7246 villages were supplied with the water, beneficiary population 6 946 459 people, non-normal projects accounting for 24.09%(1401/5816), including 1530 diseased villages. There were still 4415 projects running well. The projects with water fluoride lower than 1.0mg/L were 2893, accounting for 65.53% (2893/4415). The water fluoride higher than 1.0 mg/L accounted for 34.47%(1522/4415), ＞ 2.0 mg/L of 548, ＞ 4.0 mg/L of 97, and the maximum value of water fluoride was 9.71mg/L. Conclusions Nearly 1/4 of the water-improving projects in Shandong province are abnormal. The water fluoride of the project of more than 1/3 are exceeding the standard( ＞ 1.0 mg/L) in 4415 projects, and water-fluoride of 97 projects are higher than 4.0 mg/L. More measures should be taken to strengthen the supervision of the projects and monitoring of water fluoride.
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Objective To understand the current status of the prevention and control of endemic fluorosis in the southwestern area of Shandong province. Methods In 2007, the progress of water-improving defluoridation, the operating state and water fluoride content of the water-improving project, which was determined by fluorosis selective ion electrode, and the inhabitant related indexes of endemic fluorosis were extensively surveyed in the three main fluorosis counties-Jiaxiang, Yuncbeng and Liangshan of the southwestern area of Shandong province. Results Among 1371 fluorosis villages in the 3 counties, 53.61%(735/1371) of which had undergone water-improving defluoridation, the rate in Jiaxiang, Yuncheng and Liangshan being 38.0% (220/579),65.51% (378/577) and 63.72% ( 137/215 ) respectively; the normally functioning rate of this project was 76.73% (564/735), projects out of order accounted for 23.27% (171/735). Among 263 well-functioning projects from the three counties, the rate with water fluoride higher than 1.0 mg/L was 35.36%(93/263), the maximum value being 4.17 mg/L. The urine fluoride content of 440 children aged 8 - 12 years and 484 adults over 30 years old were examined in 13 fluorosis villages of the three counties, the geometric mean was 2.98,3.06 mg/L respectively; the individual maximum was 12.83,14.49 mg/L respectively; the detectable rate of dental fluorosis among children aged 8 - 12 was 84.28% (649/770) ,17.66%(136/770) had defect and the index of dental fluorosis was 1.89; the rates of the clinical and X-ray skeletal fluorosis of the adults aged more than 30 were 44.40%(234/527) and 24.67%(130/527) respectively, and the abnormal electrocardiography rate was 32.43% (168/518) in the adult, mostly T-wave abnormality. Conclusions The progress of the water-improving defluoridation in the southwestern area of Shandong province was relatively slow, the water fluoride content of the water-improving projects seriously exceeded standard, and the condition of the fluorosis had not been effectively controlled.
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Objective To investigate the distribution of water-borne fluoride and the current status of water defluoridation project by improving drinking water quality in endemic fluorosis areas in Shandong province,and to provide scientific basis for making strategies in prevention and control of the disease. Methods According to "the National Technical Scheme for Endemic Disease Control in 2004, 2005 and 2006", 113 endemic fluorosis diseased counties(cities, and districts) of the province's 17 cities were screened in order to investigate the fluoride level in drinking water in fluorosis villages, recheck the fluoride level after implementing the water defluoridation project, and investigate the current status of the water defluoridation project. The fluoride level in drinking water was determined by F-ion selective electrode. Results There were a total of 5816 water defluoridation projects in the province. Most of them were carried out by drilling a deep well to get under-ground water. The wells still in good condition were accounted for 72.80% (4234/5816). Intermittent operated wells were accounted for 3.11% (181/5816). Abandoned wells were accounted for 24.09%(1401/5816). Level of water fluoride was determined in 6940samples from fluorosis villages(villages that not carry out the water defluoridation project as well as villages carried out the water defluoridation project with abandoned wells were included) and the value that lower or equal to 1.00mg/L was determined in 2987 villages which accounted for 43.04% (2987/6940). Level of water fluoride that over 1.00 mg/L was found in 3953 villages which accounted for 56.96% (3593/6940), and the highest level of water fluoride was 11.33 mg/L. Level of water fluoride were determined in 4415 samples from water defluoridation project and the value lower or equal to 1.00 mg/L was in 2983 wells which accounted for 65.53%(2983/4415). The value over 1.00 mg/L was in 1522 wells which accounted for 34.47%(1522/4415), the highest value of water fluoride was 9.71 mg/L. Conclusions Level of water fluoride in up to 1/2 of the villages and 1/3 of the projects, is still higher than the standard in Shandong province. Nearly 1/4 of the project has been abandoned. The current situation for endemic fluorosis control is still not good in the province, countermeasures for endemic fluorosis must be carried out as soon as possible and surveillance of water defluoridation project must be strengthened.
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Objective To investigate the current prevalent status of endemic fluorosis in the floodplain area of the lower Yellow River in Shandong province. Methods According to "The National Technical Scheme for Endemic Disease Control in 2008", 16 counties were chosen to carry out the epidemiological survey of endemic fluorosis. Three villages were chosen in each county, to determine the fluoride content of drinking water and to check the dental fluorosis of children aged 8 to 12 year old, the skeletal fluorosis of adults over 16 years of age. Both children and adults were tested for urine fluoride. The content of fluoride in drinking water and urine was determined by F-ion selective electrode while dental fiuorosis of children aged 8 to 12 years old was diagnosed by Dean's method and adults skeletal fluorosis by the National Standard for "Diagnosis of endemic skeletal quality' villages in 16 counties, among which 19 villages had water fluoride content ≤ 1.00 mg/L and accounted for 73.08% ( 19/26), 7 villages had water fluoride content ＞ 1.00 mg/L and accounted for quality' villages in 16 counties, 5 villages had water fluoride content ≤ 1.00 mg/L (accounted for 22.73% ), 17 villages had water fluoride content ＞1.00 mg/L(accounted for 77.27% ), with the highest water fluoride content as 3.38 mg/L. The overall rate of dental fluorosis among children aged 8to 12 years old was 52.18% (1042/1997), with the index of dental fluorosis as 1.17 and the rate of dental damage as 8.01% (160/1997). The urinary fluoride values above 1.40 mg/L were found in 65.00% (845/1300) of children aged 8 to 12 years old, with the highest urinary fluoride concentrations as 18.53 mg/L. The rate of skeletal fiuorosis by clinic and X-rays in adults older than 16 years old were 4.35% ( 1121/25 781 ) and 11.36%(5/44), respectively. The urinary fluoride values above 1.60 mg/L were found as 63.92%(606/948) in adults older than 16 years old, with the highest urinary fluoride concentrations as 21.35 mg/L. Conclusion The status of endemic fluorosis had not been effectively controlled and the situation for endemic fluorosis control was still critical in the floodplain area of the lower Yellow River in Shandong province, suggesting that the preventive approaches on endemic fluorosis control should be strengthened.
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Objective To understand the fulfillment of control measures of endemic fluorosis and find out the prevalent trend of this disease in Shandong Province from 1992 to 2006 in order to provide a scientific basis for the set up of control strategies. Methods According to "the National Survey Scheme of Endemic fluorosis", Huantai County in 1992-1996 and Liaagshan County in 1997-2006 were selected, where water-improving defluoridation and the contents of water fluoride were searched in two counties; dental fluorosis and urine fluoride in children aged 8-12 years old, clinical and X-ray skeletal fluorosis in adult over 16 years old were searched respectively in Lijia Village of Huantai County and Dongxu Village of Liangshan County. Results One hundred percent(304/304) high-fluoride villages of Huantai County in 1992 and 63.72% (137/215) villages of Liangshan County in 2006 had finished the project of water-improving defluoridation; the rate of high-fluorine water(>1.0 mg/L) in normal operation projects was 5.00%(5/100)-17.14%(18/105) in Huantai County from 1992 to 1996, and 18.97%(11/58)-45.61%(26/57) in Liangshan County from 1997 to 2006. The water fluoride of Lijia Village was<1.0 mg/L from 1992 to 1996, the water fluoride of Dongxu Village was<0.5 mg/L from 1997 to 2006. The detection rate of dental fluorosis of children aged 8-12 years at Lijia Village dropped from 30.86%(25/81) in 1992 to 10.13%(8/79) in 1996(χ2=12.41, P<0.05), and the Dongxu Village dropped from 68.95%(151/219) in 1997 to 0(0/38) in 2006(χ2=222.04, P<0.01). In the Lijia and Dongxu Villages, urine fluoride in children aged 8-12 years old was lower than 1.40 mg/L. In the adults over 16 years of the two villages, the positive rate of X-ray skeletal fluorosis of Lijia Village dropped from 30.0%(15/50) in 1992 to 13.95%(6/43) in 1996(χ2=3.41, P>0.05), and all the cases were in degree I, the rate of Dongxu Village dropped from 64.58%(31/48) in 1997 to 16.67% (4/24) in 2006(χ2=14.71, P<0.01), and no eases of degrees Ⅲ was detected. Conclusions The progress of water defluoridation was uneven in 2 counties, slow in Liangshan County; and the water fluoride in part of the project exceeded standard; the water fluorid of 2 surveyed villages was normal and the endemic fluorosis was under control. More financial input is requested to accelerate the process of water defluoridation and to reinforce the management of the projects and illness monitoring, thus to reduce the harm of fluorosis to the limit.