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Objective:To analyze the epidemic characteristics of Cornona virus disease 2019 (COVID-19) in Wangkui County, Heilongjiang Province, and to provide a reference for optimizing epidemic prevention and control strategies.Methods:The epidemic characteristics of COVID-19 in Wangkui County, Heilongjiang Province in January 2021 were analyzed by applying the national infectious disease report system and information management system of Heilongjiang Provincial Center for Disease Control and Prevention, the public health emergency report management information system, the epidemiological investigation report of the Heilongjiang Provincial Center for Disease Control and Prevention and Suihua Municipal Certer for Disease Control and Prevention, and the epidemic information publicly released by the Health Commission of Heilongjiang Province.Results:From January 9 to February 5, 2021, 804 cases infected with Cornona virus were reported in Wangkui County, with an infection rate of 280.29/100 000. The epidemic affected 20 districts and counties in 6 cities, including Suihua, Harbin, Mudanjiang, Qiqihar, Yichun and Daqing. The sex ratio of male to female was 1.08 ∶ 1.00 (418 ∶ 386), the age ranged from 3 months to 93 years old, and the median age was 50 years old. The proportion of confirmed cases and asymptomatic infection was 1.23 ∶ 1.00 (444 ∶ 360), there were significant differences in gender, age and occupation between them ( P < 0.05). There were 314 places where the aggregation epidemic occurred, with family aggregation as the main way (300 households, 95.54%). The places with the highert average number of cases were banquets (25.75 cases/place) and grocery stores/chess and card rooms (16.00 cases/place). Conclusions:In January 2021, the epidemic of COVID-19 in Wangkui County is a typical outbreak in rural areas of North China. The main reasons for the rapid spread of the epidemic are a large number of gathering activities, frequent contact of personnel in confined spaces and other factors.
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Objective:To master the new cases and the condition of Keshan disease (KD) in key endemic areas and provide scientific basis for updating control strategies.Methods:In 2017, sentinel surveillance was carried out in some counties with substandard KD or serious historical KD. Two to three villages with more KD patients and the total population of 1 000 were chosen to investigate. All of the inhabitants were checked by physical examination and electrocardiography. Suspected KD patients were examined by echocardiography. KD was identified according to "Diagnosis of Keshan Disease" (WS/T 210-2011). The confirmed cases were followed up.Results:A total of 70 008 people were examined in 86 counties of 14 provinces. The ratio of male to female was 1.0 ∶ 1.2 (31 720/38 288). The total number of KD patients identified was 308, including 68 chronic KD and 240 latent KD. The detection rates were 44/10 000, 10/10 000 and 34/10 000, respectively. Totally 198 cases of chronic KD and 115 cases of latent KD were followed up, and the follow-up mortality was 8.1% (16/198) and 7.0% (8/115), respectively. In this year, 29 cases of latent KD and 5 cases of chronic KD were newly diagnosed.Conclusion:There are still a number of KD patients including new cases in endemic areas with high prevalence nowadays or in the past indicating the prevention and control of KD should be maintained.
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Objective To analyze the difference of echocardiography in patients with chronic Keshan disease (CKD) at different altitudes areas,explore the effects of altitude on the structure and functional of right heart in CKD patients,and provide a reference for imaging diagnosis of CKD.Methods According to the three step distribution of the terrain in China,30 cases of CKD patients in the first step (altitude ＞ 4 000 m) of Tibet autonomous region were randomly selected as the Tibetan plateau group.In the second step (altitude:1 000-2 000 m),31 cases were randomly selected in Gansu Province as the Loess plateau group.In the third step (altitude ＜ 500 m),42 cases were randomly selected in Shandong Province as the plain group.Echocardiography was used to analyze the morphology,hemodynamics and function of right heart.Results Right atrial transverse diameter (RATD),right ventricular transverse diameter (RVTD),right ventricular lateral wall thickness (RVWT) and main pulmonary artery diameter (MPAD) of the Tibetan plateau group,the Loess plateau group and the plain group (mm:49.75 ± 8.40,45.64 ± 7.63,43.56 ± 7.34;50.89 ± 7.13,46.56 ± 5.62,43.27 ± 6.01;4.75 ± 1.02,3.53 ± 0.61,3.37 ± 0.51;32.87 ± 3.62,28.93 ± 2.12,28.44 ± 2.71) were significant differences among the three groups (F =5.36,12.91,37.08,23.33,P ＜ 0.01).The above indexes of the Tibetan plateau group were higher than those of the Loess plateau group and the plain group (P ＜ 0.05).RVTD of Loess plateau group was higher than that of plain group (P ＜ 0.05).The fractional area change [FAC,(24.85 ± 2.75)％,(26.26 ± 3.42)％,(26.73 ± 3.14)％],tricuspid annular plane systolic excursion [TAPSE,(12.87 ± 1.12),(14.59 ± 1.63),(14.13 ± 1.31) mm] of the Tibetan plateau group,the Loess plateau group and the plain group were significant differences among the three groups (F =3.36,13.47,P ＜ 0.05 or ＜ 0.01);the above indexes of the Tibetan plateau group were lower than those of the Loess plateau group and the plain group (P ＜ 0.05).Tei index (0.87 ± 0.18,0.78 ± 0.16,0.71 ± 0.14),tricuspid flap diastolic maximum filling speed/tricuspid annulus early diastolic peak velocity (E/E',9.48 ± 1.22,8.64 ± 0.91,8.12 ± 1.13),systolic pulmonary artery pressure [SPAP,(49.58 ± 11.76),(44.35 ± 11.41),(42.67 ± 12.13) mmHg,1 mmHg =0.133 kPa] of the Tibetan plateau group,the Loess plateau group and the plain group were significant differences among the three groups (F =12.89,13.99,3.12,P ＜ 0.01 or ＜ 0.05);the Tei index and E/E'of the Tibetan plateau group were higher than those of the Loess plateau group and the plain group (P ＜ 0.05).Tei index,E/E'of the Loess plateau group were higher than those of the plain group (P ＜ 0.05).Conclusions The right heart structure and function of CKD patients are affected by the altitude of their residence.With the increase of altitude,the right heart is enlarged,the right ventricular systolic and diastolic functions are decreased,and SPAP is increased in CKD patients.
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Objective The echocardiography of patients with chronic Keshan disease (CKD) in the plateau and plain areas was compared,to analyze the specific manifestations of echocardiography in patients with high altitude CKD,to provide a reference for imaging diagnosis.Methods From October 2014 to December 2016,34 patients with CKD were selected in the Tibet Autonomous Region [18 males,16 females,aged (44.5 ± 5.6) years old] as plateau group;45 patients with CKD were selected in Shandong Province [21 males,24 females,age (47.3 ± 6.9) years old] as a plain group.Echocardiography was performed on the observed subjects,and cardiac morphology,hemodynamics and cardiac function were analyzed.Results The left atrial diameter (LAD),left ventricular end diastolic diameter (LVEDD),and left ventricular mass (LVM) of the plateau group were (39.2 ± 4.8),(56.5 ± 6.3) mm and (232.4 ± 40.2) g,respectively,which were lower than those of the plain group [(48.3 ± 5.7),(65.2 ± 7.8) mm,(283.7 ± 38.3) g,t =-7.52,-5.30,-5.74,P ＜ 0.01].The right atrial transverse diameter (RATD),right ventricular transverse diameter (RVTD) and right ventricular lateral wall thickness (RVWT) of the plateau group were (47.6 ± 8.5),(50.4 ± 7.3) and (4.8 ± 1.1) mm,respectively,which were higher than those of the plain group [(42.3 ± 7.2),(42.7 ± 6.8),(3.3 ± 0.7) mm,t =2.99,4.81,7.36,P ＜ 0.01].The early diastolic filling velocity (E),the early diastolic peak velocity of the mitral annular (Em) of the plateau group were lower than those of the plain group,E/Em of the plateau group was higher than that of the plain group (t =-2.64,-2.35,2.07,P ＜ 0.05).The fractional area change (FAC) of right ventricular,tricuspid annular plane systolic excursion (TAPSE) and tricuspid annular systolic velocity (S') of the plateau group [(24.9 ± 2.8)％,(13.2 ± 1.2) mm,(6.8 ± 1.0) cm/s] were lower than those of the plain group [(26.3 ± 3.2)％,(14.5 ± 1.3) rmm,(7.5 ± 1.2) cm/s,t =-2.02,-4.53,-2.74,P ＜ 0.05 or ＜ 0.01].The tricuspid annular diastolic velocity (e') of the plateau group was lower than that of the plain group,and tricuspid annular blood flow early diastolic filling velocity maximum (e)/e'was higher than that of the plain group (t =-2.07,2.09,P ＜ 0.05).The systolic pulmonary artery pressure (SPAP) of the plateau group [(48.5 ± 12.3) mmHg,1 mmHg =0.133 kPa] was higher than that of the plain group [(41.6 ± 13.3) mmHg,t =2.34,P ＜ 0.05].Conclusion Compared with CKD patients in plain area,CKD patients in plateau area have showed more obvious right heart enlargement and right ventricular failure,and combined with higher SPAP.
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Objective To analyze the situation of Keshan disease in China and provide a scientific basis for adjustment of the control strategies.Methods Relying on the Keshan disease surveillance in 2014 and the "Twelfth Five-Year Plan" Final Assessment Project in 2015 and 2016,in each surveillance site of the 12 provinces including Hebei,Shanxi,Inner Mongolia,Liaoning,Jilin,Heilongjiang,Shandong,Chongqing,Sichuan,Yunnan,Shaanxi,and Gansu,the residents were investigated by face-to-face questionnaire interviews,physical measurements and electrocardiography.Echocardiographic examination and chest X-ray examination were conducted for those patients with suspected Keshan disease.Results In 2014,the data of a total of 171 838 individuals were included in the analyses.A total of 749 cases of Keshan disease were detected in all the survey sites of 12 provinces.The detection rate was 43.6/10 000.Among them,160 cases were chronic,the detection rate was 9.3/10 000;the potential type was 589 cases,the detection rate was 34.3/10 000.In 2015 and 2016,the data of a total of 396 977 individuals were included in the analyses.A total of 2 127 cases of Keshan disease were detected in 12 provinces.The detection rate was 53.6/10 000.Among them,377 cases (9.5/10 000) were chronic,and the potential type was 1 750 cases (44.1/ 10 000).Conclusion There are still natural chronic Keshan disease cases in the endemic area,therefore the prevention and treatment tasks cannot be ignored.
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Objective To explore expression level of circulating microRNA (miR)-133a and Galectin-3 and their potential clinical application in differential diagnosis between patients with chronic Keshan disease and dilated cardiomyopathy.Methods Twenty-eight patients with chronic Keshan disease and 28 cases of age-and sex-matched healthy people as control from the same severe historical endemic areas of Keshan disease in Heilongjiang Province,and another 28 patients with dilated cardiomyopathy from non-affected areas were chosen for the study.All the subjects were asked for disease history and did physical examination,examined by Doppler echocardiography for left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD),and collected fasting venous blood specimen (elbow vein).The plasma miR-133a and the serum Galectin-3 were determined by Real-time PCR and enzyme-linked immunosorbent method,respectively.Meanwhile,the correlation was analyzed between miR-133a,galectin-3,LVEF and LVEDD.Results The miR-133a and Galectin-3 levels in different groups were statistically different (F =48.789,9.485,P ＜ 0.01).The plasma miR-133a level in chronic Keshan disease group and dilated cardiomyopathy group [median (quartile):0.394 (0.271,0.770),1.665 (0.943,2.713)] were both significantly lower than those in control group [2.382 (1.502,3.302],P ＜ 0.01 or ＜ 0.05],and the plasma miR-133a level in chronic Keshan disease group was lower than that in dilated cardiomyopathy group (P ＜ 0.01).There was no significant difference of serum Galectin-3 level between chronic Keshan disease group and dilated cardiomyopathy group [17.710 (9.624,27.799),12.692 (9.376,26.290) μg/L,P ＞ 0.05],but both were significantly higher than those in control group [8.070 (7.135,9.308) μg/L,P ＜ 0.01].The miR-133a was positively correlated with LVEF (rs =0.297,P ＜ 0.01),while negatively correlated with LVEDD,and Galectin-3 (rs =-0.271,-0.318,P ＜ 0.05 or ＜ 0.01);the serum Galectin-3 was negatively correlated with LVEF (rs =-0.392,P ＜ 0.01),and positively correlated with LVEDD (rs =0.385,P ＜ 0.01).Conclusion The combined application of miR-133a,Galectin-3,LVEF and LVEDD may provide assistance in clinical differential diagnosis of chronic Keshan disease and dilated cardiomyopathy.
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Objective To carry out a pilot investigation into fungus diversity in corn samples harvested from Keshan disease areas and obtain the information of dominant fungi,to predict possible secondary toxins in future study.Methods In Keshan disease areas (Heshui County and Zhengning County of Gansu Province,Yuanbao Town of Heilongjiang Province) and non-Keshan disease area (Harbin suburbs of Heilongjiang Province),5 samples of newly harvested corn from local plants were collected via the simple random sampling method,and the samples (n =20) were put in a sterile bags and sealed,numbered and transported to laboratory,placed in the incubator for cultivating mould fungi,cuhured for 2 weeks,and fungal DNA was extracted.The DNA samples were sent to Beijing Auwegene Technology Co Ltd for quality inspection,and sequencing analysis of fungal internal transcribed spacer 1 (ITS1) region was done using modern high-throughput DNA sequencing technique and MiSeq PE3000 platform,the rationality of sequencing data was analyzed through the rarefaction curve and the Shannon-Wiener curve trend to be gentle or not,and the true condition of the fungal community in the sample was tested by species composition Coverage ＞ 99％ or not,the difference in fungal community was studied between Keshan disease group and non-Keshan disease group based on the relative abundance of the fungal species in each group.Results A total of 513 869 high quality sequences were obtained,and 528 operational taxonomic unit (OTU) classifications were produced.The trend of rarefaction curve and Shannon-Wiener curve were gradually flattening,they showed that the sequences of the data were reasonable;and coverage ＞ 99％ showed that data could reflect the true situation of the fungal community.Analysis of species composition showed that there was a great overlap of fungal species between Keshan disease group and non-Keshan disease group,the relative abundance of the genus Wickerhamomyces,Candida and Aspergillus in Keshan disease group were higher than that of non-Keshan disease group.Conclusion Genus Wickerhamomyces,Candida and Aspergillus may be the dominant fungi associated with Keshan disease,it can be considered for secondary toxins studies.
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Objective To investigate the relationship between nucleotide excision repair cross-complementing (ERCC) gene polymorphisms [single nucleotide polymorphism (SNP) sites: rs11615, rs13181, rs238406, rs6498486, rs17655] and susceptibility to endemic arsenic poisoning. Methods The study recruited 848 subjects, including 348 cases and 500 controls, from populations exposed to high arsenic levels through drinking water in northwest China, and 3 - 5 ml venous blood was collected. The genotypes were determined using polymerase chain reaction and restriction fragment length polymorphism techniques(PCR-RFLP). Logistic regression analysis was used to assess the association of genotypes with endemic arsenic poisoning. Results The polymorphisms of rs11615 (ERCC1), rs238406 (ERCC2), rs6498486 (ERCC4) and rs17655 (ERCC5) and endemic arsenic poisoning were not related(P > 0.05). Participants who carried the CC genotype or at least one C allele for the ERCC2 rs13181 had an increased risk of endemic arsenic poisoning[OR(95%CI)=1.63(1.13,2.34),1.64(1.14,2.34)]compared with wild type homozygous individuals. Conculsions There is no positive correlation between the polymorphisms of ERCC1 rs11615, ERCC2 rs238406, ERCC4 rs6498486, ERCC5 rs17655 and endemic arsenic poisoning. ERCC2 rs13181 polymorphism increases the risk of endemic arsenic poisoning.
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Objective To study the platelet inhibition rate of foreign clopidogrel,domestic clopidogrel,combined domestic clopidogrel and tongxinluo and their effct on major adverse cardiovacular events (MACE) after PCI.Methods Two hundred and twenty patients after PCI were divided into foreign clopidogrel treatment group (n=77),domestic clopidogrel treatment group (n=80),combined domesticclopidogrel and tongxinluo treatment group (n =63).The high platelet reactivity (HPR) in 3 groups was detected by thrombelastography after PCI.The incidence of MACE in 3 groups was compared.Results The incidence of left anterior descending branch lesion was lower,the number of sacculi was smaller,and the incidence of HPR was higher in foreign clopidogrel treatment group than in domestic clopidogrel treatment group and combined domestic clopidogrel and tongxinluo treatment group after PCI (63.6％ vs 87.5％ vs 77.8％,P=0.002;2.3±1.1 vs 2.8±1.4 vs 2.7±1.5,P=0.026;24.7％ vs 21.3％ vs 11.1％,P=0.030).The incidence of HPR was significantly higher in foreign clopidogrel treatment group than in combined domestic clopidogrel and tongxinluo treatment group (24.7 ％ vs 11.1％,P =0.040).No significant difference was found in the incidence of MACE in 3 groups (P ＞ 0.05).Conclusion The incidences of MACE of domestic clopidogrel and foreign clopidogrel are similar.Combined clopidogrel and tongxinluo can improve the platelet inhibition rate after PCI.
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Objective To explore the relationship between single nucleotide polymorphism (SNP) locus rs1058587,rs1059519 and rs1059369 polymorphisms of growth differentiation factor-15 (GDF-15)gene and susceptibility to chronic Keshan disease in Gansu Province.Methods Using the case-control study method,56 individuals with chronic Keshan disease were taken as case group,and 53 individuals without chronic Keshan disease from the same villages were selected as control group in Gansu Keshan disease areas,venous blood samples were collected,and ethylenediamine tetraacetic acid disodium salt (EDTA) was used for anticoagulation,and the samples were sent for gene sequencing.Univariate and multivariate logistic regression analyses were conducted to analyze the influence of genotypes of rs1058587,rs1059519 and rs1059369 on the prevalence of chronic Keshan disease,and the risk factors for disease were expressed as odds ratio (OR).Results The age of the 56 patients in the case group was (60.93 + 21.99) years old,15 males and 41 females;the age of the 53 residents in control group was (47.49-+ 33.61) years old,26 males and 27 females.There was no significant difference in age between the two groups (t =46.16,P ＞ 0.05);the difference in gender was statistically significant (x2=5.76,P ＜ 0.05).The differences of allele frequencies of case group and control group rs1058587 (C:36.6％,32.1％,G:63.4％,67.9％),rs1059369 (A:61.6％,72.6％,T:38.4％,27.4％) between the two groups were not significantly different (x2 =0.50,3.00,P ＞ 0.05);the differences of allele frequencies of GDF-15 rs1059319 (C:25.0％,40.6％,G:75.0％,59.4％) between the two groups were significantly different (x2 =6.01,P ＜ 0.05).The genotype frequency distribution of GDF-15 gene rs1058587,rs1059519 and rs1059369 in the case group and the control group was not significantly different between the groups (P ＞ 0.05).However,in the case group,the mutant GG frequency of rs1059519 locus was higher than wild type CC (x2 =5.33,P ＜ 0.05).In multivariate logistic regression analysis,women were 3.81 times more likely to suffer from chronic Keshan disease than men,and people aged 45 or older were 5.30 times more likely to suffer from chronic Keshan disease than those younger than 45.The heterozygous and mutant types of GDF-15 gene rs1058587 and rs1059369 were compared with wild type,and the difference was not statistically significant (ORrs1058587 =0.46,0.50,ORrs1059369 =1.30,2.59,P ＞ 0.05);there was no significant difference between the heterozygous type of GDF-15 gene rs1059519 and wild type (OR =3.34,P ＞ 0.05),and the difference between the mutant and wild type was statistically significant (OR =8.58,P ＜ 0.05).Conclusions In this study,we find women of the study population are more likely to have chronic Keshan disease than men,and aged≥45 is a risk factor for chronic Keshan disease.Genetic polymorphisms of GDF-15 gene rs1058587,rs1059369 are not associated with susceptibility to chronic Keshan disease,and a certain correlation between genetic polymorphism of rs1059519 locus and susceptibility to chronic Keshan disease.
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Objective To investigate the relevance ratio of abnormal electrocardiogram (ECG) and describe the abnormal ECG index among the residents in Keshan disease (KD) area.To assess the KD illness severity and provide comparable quantitative indicators,provide the scientific basis for elimination of KD.Methods Non probability sampling method was used,and monitoring stations with the highest incidence of KD at the county level were selected in 2012.Clinical examination and 12 lead ECG was carried out.According to The KD Diagnosis Standard (WS/T 210-2011),eight common changes in ECG of KD were scored.According to age and sex group,check the abnormal rate of ECG detection of Keshan disease,while analysed the changes of abnormal ECG index score in latent KD patients and chronic KD patients.Abnormal ECG index to determine:If there was one change,the score was 1 and the abnormal ECG index was 1.And so on,the highest score was 8.Results Totally 61 831 residents were surveyed and 9 634 were found with abnormal ECG,and the relevance ratio of abnormal ECG was 15.58％;totally 3 862 residents had eight ECG changes of KD and the relevance ratio was 6.25％;totally 508 residents were diagnosed with KD and the relevance ratio was 0.82％.The relevance ratio of abnormal ECG among all age groups was statistically different (x2 =3 065.64,P ＜ 0.05).The relevance ratio of abnormal ECG in women was higher than that of men [3.91％ (2 419/61 831) vs 2.33％ (1 443/61 831),x2 =86.30,P＜ 0.05].Abnormal ECG index score was (1.06 ± 0.25) which was not statistically different between gender [men:(1.07 ± 0.27) vs women:(1.06 ± 0.24),t =1.41,P ＞ 0.05].The abnormal ECG index score in latent KD patients was lower than that of chronic KD patients [(1.09 ± 0.30) vs (1.60 ± 0.69),t =-4.87,P ＜ 0.05].In eight ECG changes,the most check out items were T wave and/or ST segment changes (2 816).Conclusions The relevance ratio of abnormal ECG in KD area is at a higher level.The abnormal ECG index can be used to assess the KD illness severity and provide comparable quantitative indicators,in order to provide a new train of thought for the evaluation of KD elimination.
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Objective In this paper,major issues for all those who have been selected in China national treatment program for patients with chronic Keshan disease (CNTP-CKD) were uncovered through evaluation of the annually reported data from participating provinces,in order to improve the performance quality of the program.Methods The datasets 2005-2012 were merged after cleaning them,and the composition of the treated patients was statistically analyzed,including gender and age distribution,diagnosis evidence for chronic Keshan disease (ECG,cardiothoracic ratio by X-ray,heart function grade of NYHA),and proportion of cases who had received treatment more than once.Results ①A total of 2 649 patients participated in the treatment,of them 1 115 patients were males accounting for 42.1％ (1 115/2 649),1 534 patients were females accounting for 57.9％ (1 534/2 649).Age of the patients were mainly distributed in 41 to 70 years old,and 24 CKD patients under 10 years accounting for 0.9％ (24/2 649).②2 313 cases of the involved patients were diagnosed with sufficient evidence,accounting for 81.9％ (2 313/2 823) and 121 cases with full misdiagnosis,accounting for 18.1％ (121/2 823).③There were 881 patients been treated for more than once,accounting for 38.3％ (881/2 301) of the number of treatment.Conclusions ① Diagnosis for CKD remains a key problem,suggesting that medical record for each patient diagnosed by province-level doctors' needs to be built up as early as possible.The rate of patient treatment for more than once is low which is not beneficial to the patients.② Treatment period for CKD patients is highly recommended to expand to at least one year,and the disease should be enrolled in the free cost list of the new rural cooperative medical system (NCMS).
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Objective To survey the prevalence of hypertension in population of Keshan disease endemic areas, in order to provide a scientific basis for prevention and control of hypertension in rural areas of our country.Methods One hundred and twenty villages were selected as the survey places based on case-finding from 15 provinces including Gansu, Hebei, Henan, Heilongjiang, Jilin, Liaoning, Shaanxi, Shandong, Shanxi, Hubei, Yunnan,Sichuan, Guizhou, Chongqing and Mongolia in 2009.The subjects were permanent residents in the survey places.Basic situation of all subjects was collected through the questionnaire survey and blood pressure was measured by a clinician.Diagnostic criterion for hypertension was based on the Chinese Guidelines for the Management of Hypertension.Results Totally 33 558 subjects aged 18 and over were surveyed, including 8 699 hypertension patients.The positive rate of hypertension was 25.9％ (8 699/33 558), among that 26.3％ (3 532/13 408) were males,and 25.6％ (5 167/20 150) were females.The positive rate of hypertension increased with age (x2 =3 348.325, P ＜0.05).In the classification of hypertension, the proportion of stage 1, 2 and 3 hypertension and isolated systolic hypertension was 31.8％ (2 770/8 699), 26.1％ (2 273/8 699), 17.2％ (1 492/8 699) and 24.9％ (2 164/8 699),respectively.Conclusions The positive rates of hypertension in Keshan disease endemic areas are higher than those of the national average (18.8％).Hypertension is a serious public health problem in Keshan disease endemic areas.The strategy of hypertension prevention and control should be formulated for remote rural areas.
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Objective To evaluate the effect of self-treatment and observe the change of heart morphology and function in patients with Keshan disease by echocardiography.Methods The left atrium diameter(LAd),left ventricular end-diastolic diameter(LVEDd),the thickness of interventricular septum in end diastolic(IVSTd),the thickness of left ventricular posterior wall in end-diastolic(LVPWTd),the left ventricular mass(LVM),the left ventricular mass index(LVMI),the relative wall thickness(RWT),the left ventricular ejection fraction(LVEF)and the mitral valve flow E/A ratio(E/A)were measured before the self treatment by echocardiography,and also measured on the 3rd month and 6th month after self-treatment with the same method,and observed the change of the parameters above.Results The LAd,LVEDd,IVSTd,LVPWTd,LVM,LVMI and RWT decreased on the 3rd month after self-treatment compared with prior self-treatment,and decreased on the 6th month further.There was significant difference between the prior self-treatment and post self-treatment(P＜0.05).The mitral valve flow E/A ratio and LVEF increased on the post self-treatment compared with the prior self-treatment slightly,but there was no statistical difference(P＞0.05).Conclusions Left ventricular hypertrophy and remodeling in patients with Keshan disease were prevented and reversed,and the cardiac function were improved after the self-treatment.Echocardiography can be used to evaluate the effect of self-treatment on patients with Keshan disease and can provide direction for clinical treatment.