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Objective:To learn about the incidence of hypertension in residents of arsenic exposure areas of Togtoh County, Inner Mongolia Autonomous Region, and to analyze the influencing factors of hypertension.Methods:In Inner Mongolia Autonomous Region, Ciweigou of Togtoh County, a drinking water-type endemic arsenic poisoning area, and Lanjiayao of Horinger County, a non-arsenic poisoning area with similar living habits and economic conditions, permanent residents who had lived for ≥10 years were selected as the survey subjects. Totally 116 residents of Ciweigou (exposure group) and 68 residents of Lanjiayao (control group) were included in the survey. Blood pressure was measured and the contents of arsenic, selenium, lead and chromium in urine were detected, multivariate logistic regression was used to analyze the influencing factors of hypertension.Results:The detection rates of hypertension in exposure group and control group were 53.45% (62/116) and 70.59% (48/68), respectively, and the difference between the two groups was statistically significant (χ 2 = 5.33, P = 0.022). The contents of arsenic, selenium and chromium in urine of exposure group were higher than those of control group, and the content of lead in urine was lower than that of control group, and the differences were statistically significant ( Z = 13.04, 6.34, 11.28, - 9.91, P < 0.001). The results of multivariate logistic regression analysis showed that female, age ≥60 years old and high urinary arsenic content were the influencing factors of hypertension [odds ratio ( OR) = 2.074, 2.004, 0.424, 95% confidence interval ( CI): 1.113 - 3.866, 1.035 - 3.879, 0.219 - 0.820] in arsenic exposure areas. Conclusion:Female, age ≥60 years old and high urinary arsenic content are the influencing factors of hypertension in arsenic exposure areas of Togtoh County, Inner Mongolia Autonomous Region.
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Objective To evaluate the construction effect of a national comprehensive prevention and control demonstration area for chronic diseases in a banner county in Inner Mongolia, and to provide a scientific basis for deepening the construction of the demonstration area and improving the formulation of chronic disease prevention and control strategies and measures. Methods Using the chronic disease nutrition monitoring data of residents aged 18 and over in a banner county in Inner Mongolia in 2015 and 2018, the prevalence, awareness, and management and treatment rates of the main chronic diseases of residents with different characteristics, as well as the changes in healthy behaviors and lifestyles were compared and analyzed. SPSS25.0 software was used for data analysis. The classification variables were mainly described by rate and composition ratio. The comparison of rates of various indicators between the two years was performed using 2 test. Multivariate logistic regression analysis was used to analyze statistical correlation between the continuous construction of the demonstration area from 2015 to 2018 and the various indicators. The test level was α=0.05. Results In 2015 and 2018, 621 and 600 residents aged 18 and above were investigated respectively. The prevalence of diabetes (8.17%) and the prevalence of dyslipidemia (28.13%) of residents in the demonstration area in 2018 were lower than those in the demonstration area in 2015 (12.08% and54.91%, respectively), and the differences were statistically significant (P<0.05). In 2018, the diabetes awareness rate (71.43%), diabetes treatment rate (71.43%), diabetes management rate (38.78%), and dyslipidemia awareness rate (51.50%) of residents in the demonstration area were higher than those in the demonstration area in 2015 (42.67%, 42.67%, 13.33%, and 31.09%, respectively), and the differences were statistically significant (P<0.05). In 2018, the current smoking rate (20.83%) of residents in the demonstration area, the drinking rate within one year (31.67%), insufficient intake of fresh vegetables (51.00%), and excessive intake of edible salt (47.83%) were all lower than those of residents in the demonstration area in 2015 (30.43%, 45.57%, 71.18%, and 78.42%, respectively), and the differences were statistically significant (P<0.05). The results of multivariate logistic regression analysis showed that the continuous construction of the demonstration area was statistically correlated with dyslipidemia (OR=0.31, 95%CI: 0.24-0.39), diabetes awareness (OR=3.92, 95%CI: 1.68-9.12), diabetes treatment (OR=4.53, 95%CI:1.75-11.70), diabetes management (OR=5.82, 95%CI: 1.94-17.52), awareness of dyslipidemia (OR=1.57, 95%CI: 1.04-2.38), current smoking (OR=0.60, 95%CI:0.44-0.82), drinking within one year (OR=0.46, 95%CI: 0.35-0.61), and insufficient intake of fresh vegetables (OR=0.45, 95%CI: 0.35-0.58). Conclusion The construction of a national demonstration zone for comprehensive prevention and control of chronic diseases can significantly reduce the prevalence of major chronic diseases among residents in a banner county in Inner Mongolia, improve the self-management level of patients with chronic diseases, and promote the development of healthy behaviors and lifestyles.
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Objective:To study the effect of water improvement on urinary arsenic methylation metabolism in population exposed to arsenic through drinking water.Methods:A cluster sampling method was used to select drinking water type arsenism areas in Bayannur City, Inner Mongolia Autonomous Region. Permanent residents lived in the arsenism areas for more than 10 years were selected as the survey subjects. Urine samples ( n = 874, 111, 145) were collected in 2004 (before water improvement), 2014 (4 years after water improvement) and 2017 (7 years after water improvement), respectively, and some subjects were followed up in 2014 and 2017. High performance liquid chromatography-inductively coupled plasma mass spectrometry (HPLC-ICP-MS) was used to detect different forms of arsenic metabolites in urine [inorganic arsenic (iAs), monomethylarsonic acid (MMA), dimethylarsenic acid (DMA)], and total arsenic (tAs), the iAs percentage (iAs%), MMA percentage (MMA%), DMA percentage (DMA%), monomethylation rate (PMI), dimethylation rate (SMI), and the ratio of MMA to DMA (MMA/DMA) were calculated. The content and distribution of urinary arsenic metabolites in people exposed to arsenic before and after water improvement were compared and analyzed. Results:Compared with 2004, the levels of iAs, MMA, DMA, tAs and iAs% in urine of arsenic exposed population in 2014 were lower ( Z =-14.12,-12.79,-14.27,-14.21,-6.90, P < 0.001), the levels of MMA%, DMA% and PMI were higher ( Z =-3.22,-2.91,-6.90, P < 0.05); in the same drinking water arsenic exposed population, compared with 2004, the levels of iAs, MMA, DMA, tAs and iAs% in urine ( n = 48) were lower ( Z =-5.57,-5.53,-5.54,-5.55,-2.86, P < 0.05) in 2014, and PMI level was higher ( Z =-2.86, P = 0.004). Compared with 2014, the levels of iAs% and MMA/DMA in urine of arsenic exposed population in 2017 were lower ( Z =-4.97,-2.25, P < 0.05), the levels of MMA, DMA, tAs, DMA%, PMI and SMI were higher ( Z =-4.01,-5.39,-4.77,-4.61,-4.97,-2.25, P < 0.05); in the same drinking water arsenic exposed population, compared with 2014, the level of iAs% in urine ( n = 28) was lower ( Z =-2.87, P = 0.004) in 2017, the levels of DMA% and PMI were higher ( Z =-2.32,-2.87, P < 0.05). Conclusion:Water improvement could significantly reduce the levels of urinary arsenic metabolites iAs, MMA, DMA and tAs and increase the level of DMA% in arsenic exposed population.
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Objective To describe the development status of the prevention and control of chronic non-communicable diseases (hereinafter referred to as "chronic diseases") at home and abroad, and to explore coping strategies suitable for the prevention and control of chronic diseases in China. Methods Through literature review relevant data on chronic diseases as well as the prevention and control strategies and measures were collected. A comprehensive analysis on the data was conducted. Results The epidemic trend of chronic diseases is relatively serious both in China and in the world. To cope with the rapid development and epidemic of chronic diseases, China and many other countries have implemented relevant policies to curb the growth and development of chronic diseases and have achieved different results to a certain extent. Conclusion Chronic diseases have become the main cause of death and health threats in human society. The implementation and practice of chronic disease prevention and control strategies should be strengthened, in combination with successful experience at home and abroad, to rapidly develop the strategies for the prevention and control of chronic diseases in line with national conditions in China.
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Objective:To investigate the distribution of arsenic content in drinking water of residents in Inner Mongolia Autonomous Region, and to provide a scientific basis for formulation of detailed prevention and control measures for endemic arsenic poisoning.Methods:From 2017 to 2019, water arsenic survey was carried out in all natural villages in 103 banners (counties, districts) of 12 leagues (cities) in Inner Mongolia Autonomous Region, and drinking water samples were collected according to different water supply modes (engineering water supply, physical and chemical water purification, decentralized water supply). Among them, engineering water supply: one factory water sample was collected from each water modification project in dry season and wet season; and one terminal water sample was collected in historical arsenism area/high arsenic exposed villages covered by the project. Physical and chemical water purification: one water sample was collected from each household. Decentralized water supply: in historical arsenism area/high arsenic exposed villages, one water sample was collected from each household; in the villages with historical qualified water arsenic, one household was selected according to the five directions of east, south, west, north and middle, and one water sample was collected from each household. The content of arsenic in water was detected by atomic fluorescence spectrometry and a distribution map of water samples with excessive arsenic was drawn using ArcGIS 10.2 software.Results:A total of 90 455 water samples were collected, including 31 617 water samples for engineering water supply, 2 702 water samples for physical and chemical water purification, and 56 136 water samples for decentralized water supply. The medians of water arsenic content of engineering water supply, physical and chemical water purification, and decentralized water supply were 1.00, 1.00 and 0.50 μg/L, respectively, and the differences among different water supply modes were statistically significant (χ 2 = 1 147.831, P < 0.05). A total of 486 water samples with excessive arsenic were detected, the detection rate was 0.54% (486/90 455). The detection rates of water samples with excessive arsenic in engineering water supply and decentralized water supply were 1.48% (469/31 617) and 0.03% (17/56 136), the detection rate of water samples with excessive arsenic in engineering water supply was higher than that in decentralized water supply (χ 2 = 775.401, P < 0.05); there was no water samples with excessive arsenic in physical and chemical water purification. The top three areas with the detection rates of water samples with excessive arsenic were Bayannaoer [15.38% (343/2 230)], Hohhot [2.00% (86/4 293)], and Ordos [0.85% (50/5 848)]. ArcGIS 10.2 software showed that the water samples with excessive arsenic were mainly distributed in the western region in the shape of focal and block, and only existed sporadically in the eastern region. Conclusions:The detection rate of water samples with excessive arsenic in engineering water supply in Inner Mongolia Autonomous Region is high, the water samples with excessive arsenic are mainly distributed in the western region in the shape of focal and block, and sporadically in the eastern region. The management and supervision of engineering water supply should be strengthened, in areas where the water arsenic exceeds the standard, we should take physical and chemical water purification measures, such as change water sources, increase water purification equipment, and improve water purification technology to reduce arsenic hazards, so as to ensure that residents can drink qualified water.
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Objective:To explore the prevalence and risk factors of thyroid diseases in the physical examination population of Hohhot.Methods:From July 2017 to July 2018, 3 100 health examinees from Inner Mongolia National Examination Medical Center were selected as subjects for questionnaire survey, thyroid function test and thyroid ultrasound examination; a multinomial logistic regression model was used to analyze the relationship between relevant investigation factors and different types of thyroid diseases (simple thyroid nodules, simple thyroid dysfunction, and thyroid dysfunction with nodules).Results:Among the 3 100 healthy examinees, there were 2 885 effective responders, including 743 males and 2 142 females, aged (46.23 ± 12.32) years; the simple thyroid nodules, simple thyroid dysfunction, and thyroid dysfunction with nodules were 909, 648, and 619 cases, respectively, and the detection rates were 31.51%, 22.46%, and 21.46%, respectively. Logistic regression analysis results showed that age [35 - 54 years old: odds ratio ( OR) = 1.30, 95% confidence interval ( CI): 1.01 - 1.68; ≥55 years old: OR = 2.30, 95% CI: 1.68 - 3.14, P < 0.05], gender ( OR = 1.65, 95% CI: 1.32 - 2.07, P < 0.05), obesity ( OR = 1.35, 95% CI: 1.08 - 1.70, P < 0.05), and mental stress [significant: OR = 1.64, 95% CI: 1.09 - 2.48; some: OR = 1.54, 95% CI: 1.02 - 2.32, P < 0.05] were the risk factors affecting the occurrence of simple thyroid nodules. The age (35 ~ 54, ≥55 years old), gender, bad mood (a little), and mental stress (significant) were risk factors that affected the occurrence of simple thyroid dysfunction; eating high iodine food was its protective factor. The age (35 ~ 54, ≥55 years old), gender, obesity, and thyroid family genetic history were risk factors for thyroid dysfunction with nodules; the consumption of iodized salt was its protective factor. Conclusions:Older women are high-risk groups for thyroid diseases. Obesity, bad mood, mental stress will increase the risk of the disease. Daily consumption of iodized salt and moderate consumption of high iodine food can reduce the risk of the disease.
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Objective:To investigate the levels of urinary arsenic metabolites in arsenic-exposed people with different degrees of skin lesions.Methods:A cluster sampling method was used to select people with different degrees of skin lesions in the drinking water arsenic poisoning area of Bayannaoer City, Inner Mongolia Autonomous Region. According to the "Standard of Diagnosis for Endemic Arsenism" (WS/T 211-2001), the research subjects were divided into four clinical grading: normal, suspicious, mild, moderate and above on the basis of the degrees of skin lesions. Urine samples from any 1 middle section were collected, and the levels of urinary arsenic metabolites of different forms in different clinically graded people were detected by inductively coupled plasma mass spectrometry (ICP-MS).Results:A total of 522 people were included, including 309 males and 213 females; the age was (39.11 ± 12.38) years old, ranging from 11 to 65 years old. There were 337, 80, 31, 74 people in normal, suspicious, mild, moderate and above clinical grading, the levels of inorganic arsenic (iAs, medians: 15.46, 37.16, 104.46, 163.06 μg/L), monomethylarsonic acid (MMA, medians: 15.95, 33.27, 82.80, 123.84 μg/L), dimethylarsenic acid (DMA, medians: 78.16, 147.86, 301.28, 371.30 μg/L), total arsenic (tAs, medians: 113.90, 220.94, 501.25, 684.46 μg/L), iAs percentage (iAs%, medians: 15.66%, 15.53%, 21.67%, 21.65%), MMA percentage (MMA%, medians: 13.51%, 15.40%, 17.14%, 16.43%), DMA percentage (DMA%, medians: 70.37%, 67.98%, 63.25%, 61.23%), monomethylation rate (PMI, medians: 0.84, 0.84, 0.78, 0.78), dimethylation rate (SMI, medians: 0.84, 0.81, 0.79, 0.79), and ratio of MMA to DMA (MMA/DMA, medians: 0.20, 0.23, 0.27, 0.27) were compared in different clinically graded people, the differences were statistically significant ( H = 97.98, 96.44, 85.50, 95.08, 38.58, 29.94, 51.98, 38.58, 43.20, 43.20, P < 0.01). Compared with normal people, iAs, MMA, DMA, tAs, MMA%, and MMA/DMA levels significantly increased, and SMI level significantly decreased in suspicious, mild, moderate and above people ( P < 0.017); compared with normal people, iAs% level significantly increased, and DMA% and PMI levels significantly decreased in mild, moderate and above people ( P < 0.017). Conclusion:The levels of urinary arsenic metabolites in arsenic-exposed people with different degrees of skin lesions are different, showing a dose-response relationship.
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Objective:To investigate the prevalence of residents in a drinking water-borne endemic arsenism area in Togtoh County Inner Mongolia.Methods:In a drinking water-borne endemic arsenism area (Togtoh County of Inner Mongolia), eighty-five permanent residents (residence time ≥20 years) of Hedgehog Valley were selected as exposure group. In the same period, 58 people from a non-arsenism area (Lanjiayao of Helingeer County) were selected as the control group. The general situation of the respondents was investigated, and water arsenic, urine arsenic, blood glucose, blood lipids, blood pressure, liver function, renal function, electrocardiogram and abdominal B-ultrasound were analyzed in both groups. The exposure group was divided into the disease group and the non-disease group according to whether arsenic poisoning skin lesions occurred, and the general conditions and blood pressure changes in the two groups were analyzed.Results:In the exposure group and control group, there were no significant differences among the indicators such as sex, age, smoking, drinking and taking vitamin or calcium tablet ( P > 0.05). Arsenic concentration [Median (interquartile range)] in drinking water of the exposure group was 163.34 (35.34) μg/L, and in urine was 269.72 (152.54) μg/L. Arsenic concentration in drinking water of the control group was 2.96 (5.62) μg/L, and in urine was 24.21 (28.63) μg/L. There were no statistical differences in blood glucose, blood lipids between the exposure group and control group (χ 2 = 0.865, 0.886, P > 0.05); but liver function, renal function, sinus arrhythmia and fatty liver were significantly different statistically (χ 2 = 4.654, 4.355, 4.725, 12.423, P < 0.05); the detection rate of abnormal blood pressure in control group was higher than that of the exposure group (χ 2 = 16.289, P < 0.01). Skin lesions occurred in 24 patients (28.24%) in the exposure group and no skin lesions in 61 patients (71.76%). In disease group, 14 cases (58.33%, 14/24) smoked, the proportion of smoking was higher than that of cases in non-disease group(31.15%, 19/61, χ 2 = 5.360, P < 0.05); and the prevalence of hypertension (50.00%, 12/24) in cases of disease group was higher than that of cases in non-disease group (26.23%, 16/61, χ 2 = 4.406, P < 0.05). Conclusions:Long-term exposure to arsenic might injure liver function and renal function, and enhance the risk of arrhythmia and fatty liver. Smoking may be a risk factor for skin lesions in residents of drinking water-borne endemic arsenism area.
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Objective@#To understand the epidemic situation and control effect of drinking-water type endemic arsenism in Inner Mongolia Autonomous Region from 2009 to 2018, and provide a basis for further development and improvement of prevention and control strategies.@*Methods@#In 2009-2018, 38 diseased villages were selected from 8 cities in Inner Mongolia Autonomous Region as fixed monitoring sites to investigate the water improvement situation of the village and the operation of the water improvement project, and to detect the arsenic content of the water; physical examinations were carried out on all the resident populations who were exposed or previously exposed to high levels of arsenic water in the monitoring villages, and the changes in the condition of arsenic poisoning patients were observed; 30 adult urine samples were collected from each monitoring village to detect urinary arsenic levels.@*Results@#The water improvement rate of the 38 monitoring villages increased from 84.21% (32/38) in 2009 to 100.00% (38/38) in 2013, and continued to maintain; the normal operation rate of water improvement project increased from 64.29% (9/14) in 2009 to 100.00% (18/18) in 2016, and continued to maintain; the qualified rate of water arsenic content of water improvement project increased from 64.29% (9/14) in 2009 to 88.89% (16/18) in 2018; the proportion of qualified project covered population increased from 47.79% (4 846/10 140) in 2009 to 84.35% (5 370/6 366) in 2018. In 2009-2018 the detection rate of arsenic poisoning in the water arsenic content qualified village was 9.17% (3 968/43 276), and the detection rate in the unchanged water and water arsenic exceeded villages was 7.48% (805/10 759); there was no new case for ten consecutive years. There were significant differences in urinary arsenic levels of the water arsenic content qualified villages, the unchanged water and water arsenic exceeded villages between different years (H=424.04, 100.35, P < 0.05); the urinary arsenic level of water arsenic content qualified villagers was lower than that of the unchanged water and water arsenic exceeded villages in the same year (P < 0.05).@*Conclusions@#During the 10-year monitoring period, the prevalence of arsenic poisoning has been effectively controlled. The water improvement rate and the normal operation rate of the project remain in good condition, but the qualified rate of water arsenic still should to be improved.
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Objective To understand the iodine nutritional status of medical examination people and the thyroid dysfuction rates under different urinary iodine.Methods A total of 2 650 medical examination people from Inner Mongolia National Examination Medical Center from March to December of 2018 were selected.The average age was (46.2 ± 12.5) years old,including 697 males and 1 953 females.Blood samples were collected for determination of thyroid function [thyroid stimulating hormone (TSH),thyroid peroxidase antibody (TPOAb),thyroglobulin antibody (TgAb),free thyroxine (FT4),and free triiodothyronine (FT3)],and according to the results of the examination,people were divided into normal thyroid function,subclinical hypothyroidism,subclinical hyperthyroidism,hypothyroidism,hyperthyroidism,autoimmune antibody abnormalities,and other abnormal groups.Urine samples were collected to detect urinary iodine levels,to analyze the thyroid dysfuction rates of each group people and different urinary iodine.The thyroid function was detected by automatic electrochemiluminescence immunoassay analyzer,the urinary iodine was determined by arsenic cerium catalytic spectrophotometry.Results Among the 2 650 medical examination people,there were 1 270 patients with abnormal thyroid function,and the total abnormal rate was 47.92％.The abnormal rates of males and females were 28.84％ (201/697) and 54.74％ (1 069/1 953),respectively,and the abnormal rate of females was higher than that of males (x2 =376.19,P ＜ 0.05).The urinary iodine medians of each group were 145.38,152.60,103.21,176.31,134.17,138.92,and 127.00 μg/L,all in the appropriate range of iodine (100-199 μg/L).Thyroid abnormal rates [55.56％ (125/225),50.86％ (445/875)] of urinary iodine ≥ 300 μg/L (iodine excess) group and ＜ 100 μg/L (iodine deficiency) group were higher than that of 100-199 μg/L group [44.70％ (460/1 029),x2 =12.65,12.61,P ＜ 0.05].Among thyroid abnormal people,autoimmune antibody abnormalities people was the most,accounting for 69.61％ (884/1 270).Urinary iodine was positively correlated with FT4 and FT3 (r =0.04,0.05,P ＜ 0.05);FT4 was negatively correlated with TSH and TgAb (r =-0.20,-0.73,P ＜ 0.05),and it was positively correlated with FT3 (r =0.52,P ＜ 0.05);TPOAb was positively correlated with TgAb (r =0.64,P ＜ 0.05).Conclusions Urinary iodine of medical examination people is in the appropriate range of iodine,indicating that the overall iodine nutritional status is good.However,some people still have iodine excess and iodine deficiency,both of which lead to an increase in thyroid abnormal rate.
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Objective To understand the epidemic situation and control effect of drinking -water type endemic arsenism in Inner Mongolia Autonomous Region from 2009 to 2018, and provide a basis for further development and improvement of prevention and control strategies. Methods In 2009 - 2018, 38 diseased villages were selected from 8 cities in Inner Mongolia Autonomous Region as fixed monitoring sites to investigate the water improvement situation of the village and the operation of the water improvement project, and to detect the arsenic content of the water; physical examinations were carried out on all the resident populations who were exposed or previously exposed to high levels of arsenic water in the monitoring villages, and the changes in the condition of arsenic poisoning patients were observed; 30 adult urine samples were collected from each monitoring village to detect urinary arsenic levels. Results The water improvement rate of the 38 monitoring villages increased from 84.21％ (32/38) in 2009 to 100.00％ (38/38) in 2013, and continued to maintain; the normal operation rate of water improvement project increased from 64.29％ (9/14) in 2009 to 100.00％ (18/18) in 2016, and continued to maintain; the qualified rate of water arsenic content of water improvement project increased from 64.29％ (9/14) in 2009 to 88.89％ (16/18) in 2018; the proportion of qualified project covered population increased from 47.79％ (4846/10140) in 2009 to 84.35％ (5370/6366) in 2018. In 2009 - 2018 the detection rate of arsenic poisoning in the water arsenic content qualified village was 9.17％ (3968/43276), and the detection rate in the unchanged water and water arsenic exceeded villages was 7.48％ (805/10759); there was no new case for ten consecutive years. There were significant differences in urinary arsenic levels of the water arsenic content qualified villages, the unchanged water and water arsenic exceeded villages between different years (H = 424.04, 100.35, P < 0.05); the urinary arsenic level of water arsenic content qualified villagers was lower than that of the unchanged water and water arsenic exceeded villages in the same year (P < 0.05). Conclusions During the 10-year monitoring period, the prevalence of arsenic poisoning has been effectively controlled. The water improvement rate and the normal operation rate of the project remain in good condition, but the qualified rate of water arsenic still should to be improved.
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Objective To understand the changes of skin lesions in population exposed to arsenic through drinking-water in Inner Mongolia after changing water source for 12 years,and to evaluate the long-term harmful effects and the delayed injury to human body due to arsenic exposure and the effect of changing water.Methods The stratified random cluster sampling investigation objects (data derived from the Inner Mongolia Autonomous Region Comprehensive Center for Disease Control and Prevention) of the arsenic exposure area before water reform (2004) as the foundation,in 2017,we selected three administrative villages (changed water in 2005) in Bayan Nur City of Inner Mongolia as survey sites.The objects of this study were residents who had been living in the survey site and were eligible for previous survey (n =80,35 males and 45 females).To compare the skin damage of the residents exposed to arsenic before and after the water changed,the water samples of the survey objects were measured arsenic content.According to the content of water arsenic,the respondents were divided into low,medium and high exposure groups (10-,150-,≥300 μg/L),to analyze clinical classification in skin damage before and after changing water.Results The water arsenic content after changing [1.42 (0.18-33.45) μg/L] was lower than those before the changes [238.20 (14.56-824.70) μg/L,Z =-8.34,P ＜ 0.05].A total of 63 persons with skin keratinization,7 persons with hyperpigmentation and 19 persons with depigmentation were identified after the changes of drinking water source,while 38,3 and 18 persons were respectively found before the changes.The detection rate of skin keratinization after water changes was significantly higher than that before water changes [78.8％ (63/80) vs 47.5％ (38/80),x2 =16.78,P ＜0.05].According to the clinical classification of skin damage,23 patients were normal,44 patients were suspicious,10 patients were mild,and 3 patients were moderate or severe after the water changes,compared with those before the water changes (38,18,6 and 18 persons were respectively found),the clinical fractional suspicious detection rate of skin damage in the arsenic exposed population increased,and the medium-severe detection rate decreased,and the differences were statistically significant (x2 =17.80,12.33,P ＜ 0.05).The detection rate of the clinical score of moderate-severe skin damage in men was significantly decreased,and the difference was statistically significant (x2 =7.65,P ＜ 0.05).The normal detection rate of female skin lesions was reduced,and the rate of suspected detection was increased (x2 =5.48,7.65,P ＜ 0.05).In the high-and medium-dose groups,41.9％ (13/31) and 42.9％(12/28) of the arsenic exposure population had a reduced clinical classification of skin damage.The ratios of clinical classification severity of skin damage in the high-,medium-and low-dose groups were 25.8％ (8/31),25.0％ (7/28),and 42.9％ (9/21).The differences were statistical significantly by linear trend chi-square test (x2 =12.96,P ＜ 0.05).Conclusions The skin lesions exposed to arsenic could be effectively improved after changing water.But the skin lesions still appear in some cases due to long-term chronic arsenic exposure.The long-term effects caused by arsenic should be explored persistently.
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Objective To provide a basis for development of preventive measures through dynamical monitoring of the changing trends of endemic fluorosis areas and the prevalence of drinking-water-borne endemic fluorosis.Methods Using simple random sampling method,thirty monitoring villages in 11 counties of Inner Mongolia were selected as fixed monitoring villages from 2012 to 2016.The operation of water improvement projects was investigated,and water fluoride content was tested.Dental fluorosis of all 8 to 12-year-old students was diagnosed in the villages.Stratified random sampling by age was used to select 50 adults over 25-year-old in each monitoring village,and skeletal fluorosis was examined by X-ray.Results ①In 2012-2016,the water-improved rate of monitoring villages was 78.67％ (118/150).Of all the water-improved projects,normal operating projects accounted for 92.98％ (106/114).The exceeded rate of water fluoride in water-improved village was 31.36％ (37/118).②The detection rate of dental fluorosis and community fluorosis index (CFI) in children aged 8-12 of the villages with normal operating projects and qualified fluoride content were 20.88％ (533/2 553) and 0.41;the detection rate of dental fluorosis and CFI of the villages with water-improved projects under abnormal operation or excessive fluoride were 49.53％ (318/642) and 0.98;the detection rate of dental fluorosis and CFI of the villages without water-improved projects were 37.14％ (442/1 190) and 0.76.③The detection rate of X-ray skeletal fluorosis in adults of the villages with normal operating projects and qualified fluoride content was 18.97％ (140/738);the detection rate of X-ray skeletal fluorosis in adults of the villages with water-improved projects under abnormal operation or excessive fluoride was 31.53％ (111/352);the detection rate of X-ray in adults of the villages without water improvement projects was 31.17％ (96/308).Conclusions Up to now,in Inner Mongolia Autonomous Region,some villages have not yet improved their drinking water quality,water fluoride content in some projects has exceeded the standard seriously,the prevalence of dental fluorosis in children aged 8-12 is very mild,there are still moderate and severe endemic areas.So the orevention and control measures of the water-improved defluoridation need to be further strengthened.
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Objective To detect retinoid X receptor α (RXRα) mRNA expression in blood of subjects exposed to different concentrations of arsenic via drinking water, to analyze the relationship between RXRα mRNA expression and skin lesion caused by arsenic,and further to explore the skin lesion mechanism of arsenic. Methods Study sites were selected by molecular epidemiology method from high arsenic drinking water area of Bayannur City. Two hundred and thirty-five subjects who had been lived in high arsenic area for more than 10 years were selected;blood samples and water samples were collected from the subjects; according to arsenic concentration in drinking water,they were divided into four groups,<10 μg/L(control group),10-<100 μg/L(low dose group),100- <200 μg/L (middle dose group), and ≥200 μg/L (high dose group). Skin hyperkeratosis and pigment abnormity examination were conducted. The RXRα mRNA expression level in blood samples was detected by real-time quantitative PCR, and then the relationship between expression of RXRα mRNA and different levels of arsenic exposure,and skin lesion induced by arsenic were analyzed. Results ①The results showed that there was a dose-effect relationship between the prevalence of hyperkeratosis, pigment abnormity and arsenic exposure (χ2= 14.597, 12.825, P < 0.05); ②With increasing of arsenic exposure, RXRα mRNA expression in blood decreased firstly and then increased (F = 8.312, P < 0.05), which were significantly different statistically from those of control [(1.20 ±0.53)×10-3]and low dose groups[(0.92 ± 0.49)×10-3,P<0.05];RXRα expression was significantly higher in high dose group[(1.40 ± 0.45)×10-3]than those of middle and low dose groups [(1.12 ± 0.58,0.92 ± 0.49)×10-3,P<0.05]; ③The RXRα mRNA expression in people with different level of skin damage (hyper keratosis and pigment abnormity)were statistically significant(F=4.206,4.389, P< 0.05); degree Ⅲ[(1.98 ± 0.38) × 10-3] hyperkeratosis patients compared with degree Ⅰ [(1.11 ± 0.52) × 10-3] and degree Ⅱ [(1.13 ± 0.42) × 10-3], RXRα mRNA expression was significantly different (P < 0.05), degree Ⅱ and higher degrees [(1.61 ± 0.54) × 10 -3] pigment abnormity patients compared with control [(1.15 ± 0.52)×10-3],RXRα mRNA expression was significantly different (P < 0.05). Conclusions Chronic arsenic exposure has an effect on RXRα mRNA expression in blood. There is a relationship between abnormal expression of RXRα mRNA and skin lesion induced by arsenic.
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Objective To study the relationship between hair selenium content and arsenism among population from endemic arsenism area caused by coal combustion in the southern of Shaanxi Province.Methods Four high-arsenic-exposed villages in southern Shaanxi Province were selected as the study area,and the nonarsenic-exposed villages nearby were selected as the control area,90 hair samples of residents exposed to high arsenic in the study area and 14 hair samples of residents in the control area were collected.Inductively Coupled Plasma Mass Spectrometry (ICP-MS) was used to determine the contents of arsenic and selenium in hair samples.Selenium/hair arsenic (Se/As) value was calculated,and the relationship between selenium content in hair samples and arsenicosis was analyzed.Results The geometric mean of selenium concentration in hair from the study area was 8.72 mg/kg,which was significandy higher than that from the control area (0.54 mg/kg,t =9.811,P ＜ 0.05).However,selenosis case was not found in the study area.Selenium content in hair was not obviously correlated with arsenism (r =0.075,P ＞ 0.05),while the Se/As value was negatively associated with the grade of arsenism (P ＞ 0.05).The geometric mean of selenium content in hair of female from the study area was 12.79 mg/kg,which was higher than that in hair of male (6.5 mg/kg,t =1.738,P ＜ 0.01).Meanwhile,the Se/As value in hair of female from the study area (1.15) was significantly higher than that in hair of male (0.65,t =3.218,P ＜ 0.05).Conclusions The environment of the study area is polluted by arsenic and selenium derived from stone-coal burning.Antagonism between arsenic and selenium might reduce the toxicity of selenium.Therefore,selenosis is not found in the study area.In addition,antagonism between arsenic and selenium might also induce lower prevalence of arsenism for female in the studly area.
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Objective To investigate the arsenic methylation level of people chronically exposed to different levels of arsenic in drinking water.Methods A cluster sampling method was used to select 874 cases that had drank different concentration arsenic-contaminated water from arsenic endemic area in Bayannaoer City.They were divided into four groups according to arsenic exposure level:control (≤ 10 μg/L),low (＞ 10-50 μg/L),medium (＞ 50-200 μg/L) and high groups (＞ 200 μg/L),146,155,224,349 cases,respectively.The content of arsenic in drinking water and the arsenic species in urine were analyzed by inductively coupled plasma mass spectrometry (ICPMSS) and the results were expressed as median.Results The inorganic arsenic (iAs),monomethylarsonic acid (MMA),dimethylarsinic acid (DMA),and total-arsenic (tAs) in urine of low,medium and high groups increased following increasing of arsenic exposure level (x2 =605.08,609.96,615.83,628.64,all P ＜ 0.017) and iAs％,MMA％ and MMA/DMA significantly increased following increasing of arsenic exposure level (x2 =112.30,56.60,86.47,all P ＜ 0.017).DMA％,PMI and SMI significantly decreased following increasing of arsenic exposure level (x2 =125.80,112.30,86.47,all P ＜ 0.017).In the four groups,iAs％ of female were 11.39％,12.28％,13.47％ and 17.58％,they were significantly lower than those of male's (15.52％,16.19％,17.45％,21.86％,Z =-4.22,-3.79,-4.60,-6.71,all P ＜ 0.05);and DMA％ were 76.95％,74.05％,72.76％,and 68.64％ in the four groups respectively,and the PMI of female were 0.89,0.88,0.87,and 0.82,both DMA％ and PMI were significantly higher than those of male in each group (71.17％,69.39％,67.36％,61.29％,0.84,0.84,0.83,0.78,Z =-4.00,-3.34,-5.50,-7.24,-4.22,-3.79,-4.60,-6.71,all P ＜ 0.05).In control group,arsenic metabolites levels of people were not significantly different in the three age groups (all P ＞ 0.05).Compared to the ≤30 age group,the MMA,DMA and tAs of 31-45 age group increased and DMA,DMA％,PMI of ≥46 age group increased while iAs％ decreased in high group (μg/L:72.71 vs 109.13,307.90 vs 419.50,505.59 vs 684.60,307.90 vs 418.26;64.31％ vs 68.45％,0.79 vs 0.83,20.71％ vs 17.35％,x2 =10.72,10.24,8.20,10.24,9.89,20.96,20.96,all P ＜ 0.017).Compared to the 31-45 age group,DMA％ and PMI of ≥46 age group increased while iAs％ decreased (64.91％ vs 68.45％,0.80 vs 0.83,20.14％ vs 17.35％,x2 =9.89,20.96,20.96,all P ＜ 0.017).Conclusion There is a significant dose response relationship between arsenic metabolites and arsenic exposure level,and arsenic methylation is related to gender and age.
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Objective Through measuring and analyzing blood Heat shock proteins (HSP) 70 and HSP90 mRNA expression of different levels of arsenic exposure population,to explore the relationship between HSP70 and HSP90 mRNA expression and endemic arsenic poisoning.Methods The study subjects included a total of 226 residents exposed to arsenic via drinking water from two townships in the city of Bayannur (Shengfeng Township and Hangjinhouqishahai Township Wuyuan County) in Inner Mongolia Autonomous Region in 2011.The residents were divided into four groups according to drinking water arsenic concentration:control group (drinking water arsenic concentration ＜ 10 μg/L),low exposure group (drinking water arsenic concentration 10-＜ 100 μg/L),middleexposure group (drinking water arsenic concentration 100-＜ 200 μg/L),and high exposure group (drinking water arsenic concentration ≥200 μg/L).Epidemiological investigation was carried out.Real-time PCR technology was used to detect the expression levels of blood HSP70 and HSP90 mRNA.And the relationships between the expression of HSP70 and HSP90 mRNA and water arsenic and urinary arsenic levels were analyzed.Results ①With the increase of arsenic concentration,the expression level of HSP70 mRNA increased first and then decreased.The HSP70 mRNA in the blood of high exposure group [2.44 × 10-3 (1.72 × 10-3)] and middle exposure group [3.01 × 10-3 (1.95 × 10-3)] were significantly different from that in the control group [2.27 × 10-3 (1.09 × 10-3),P ＜ 0.05].There was significant difference between the middle exposure group [3.01 × 10-3 (1.95 × 10-3)] and the low and high exposure groups [2.38 × 10-3 (1.55 × 10-3),2.44 × 10-3 (1.72 × 10-3),P ＜ 0.05].The expression of HSP70 mRNA in blood of male [2.71 × 10-3 (1.90 × 10-3)] was slightly higher than that of female [2.34 × 10-3 (1.35 × 10-3),t =2.523,P ＜ 0.05].② With the increase of arsenic concentration,the expression level of HSP90 mRNA increased first and then decreased.The expression of HSP90 mRNA in the middle exposure group [1.29 × 10-2(1.04 × 10-2)] was significantly different from that in the control group [1.04 × 10-2 (0.83 × 10-2),P ＜ 0.05].The differences of HSP90 mRNA between the high exposure group [1.19 × 10-2 (0.88 × 10-2)] and the low and middle exposure groups [1.23 × 10-2 (0.68 × 10-2),1.29 × 10-2 (1.04 × 10-2)] were statistically significant (P ＜ 0.05).③The relative expression of HSP70 mRNA showed a U-shaped regression relationship with the level of urinary arsenic exposure (R2 =0.031,P ＜ 0.05),and the expression of HSP90 mRNA was also correlated with urinary arsenic and nail arsenic (R2 =0.049,0.036,P ＜ 0.05).Conclusion Chronic arsenic exposure affects blood HSP70 and HSP90 mRNA expression.
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Objective To understand the changes of arsenic poisoning in drinking water arsenic poisoning areas in Inner Mongolia Autonomous Region,to provide a scientific basis for timely adjustment of local arsenic poisoning prevention and control measures.Methods In accordance with the requirements of the national "Surveillance Scheme of Drinking-Water-Borne Endemic Arsenism",38 villages were selected from 8 cities as monitoring sites in Inner Mongolia Autonomous Region in 2015.The situation of the villages in improving water quality and operation of the arsenic reducing projects was investigated,water samples were collected to detect water arsenic content of all the monitoring villages exposed or previously exposed to high arsenic water in the resident population,and 30 adult patients with arsenic poisoning were tested urine arsenic level.Results Thirty-eight monitored villages had changed the water sources;the change rate was 100.00％ (38/38).Water arsenic content qualified projects were 17,covering 36 villages.The project with water arsenic content exceeded the national standard was 1,the rate of exceeded standard was 5.56％ (1/18),covering 2 monitored villages.In the 36 water arsenic content qualified natural villages,4 163 people were examined,and arsenic poisoning patients detection rate was 10.21％ (425/4 163).The incidence of mild,moderate,severe and skin cancer cases was 7.59％ (316/4 163),1.68％ (70/4 163),0.86％ (36/4 163) and 0.07％ (3/4 163),respectively,no new cases and new skin cancer cases.In the natural villages where the content of arsenic in water exceeded the standard,461 resident people who were drinking high arsenic water were examined.The detection rate of arsenic poisoning patients was 3.69％ (17/461),no moderate,severe,new and skin cancer cases.A total of 1 107 patients with arsenic poisoning were tested for urinary arsenic levels in the 36 villages with normal water available and water arsenic levels in the range of 0.000-0.441 mg/L with a median of 0.011 mg/L.The content of urinary arsenic in 60 patients with arsenic poisoning was detected in the 2 natural villages with the arsenic content exceeded the standard.The range was 0.030-0.268 mg/L and the median was 0.155 mg/L.Conclusions The projects of anti-arsenic water have effects in Inner Mongolia Autonomous Region.But there are still water projects with water arsenic content exceeded the standard,which seriously affects the health of residents,and the water management and maintenance of water projects needs to be strengthened.
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Objective To investigate the iodine nutrition level of vulnerable people in Inner Mongolia after adjustment of iodized salt standard and to provide theoretical bases for scientific iodine supplementation. Methods In 2013, 3 cities were selected from eastern, central and western parts of Inner Mongolia in accordance with the random number table, 3 or 4 counties were selected from each target city, 5 units according to their sub-area position of east, south, west, north and center were selected from each county, and then 1 township was selected from each unit, 5 groups of target population including school children aged 8- 10, women of childbearing age, pregnant and lactating women and infants each at least 10 people were investigated in each township. Edible salt samples from their homes and urine samples were collected. The direct titration method among the generic methods of iodide testing for salt production industry (GB/T 13025.7-2012) was used to determine the salt iodine level, and As3+-Ce4+catalytic spectrophotometry using ammonium per sulfate digestion (WS/T 107-2009) was used to test the urinary iodine level. Results Totally 3 300 samples of edible salt from local residents had been examined and median iodine was 26.20 mg/kg. The median of urinary iodine was 190.6μg/L of 1 289 school-age children;was 183.6μg/L of 621 women of childbearing age; was 178.2 μg/L o f 876 pregnant women; was 178.6 μg/L of 664 lactating women and was 167.7μg/L of 599 infants. Conclusion After adjustment of iodized salt standard, iodine nutrition level is suitable in all vulnerable people.
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Objective Though measuring the expression levels of blood aryl hydrocarbon receptor (AhR) and cytochrome P-450 1A1 (CYP1A1),to explore the relationship between the expression levels and chronic arsenic poisoning induced skin changes.Methods Totally 233 residents were selected in Hanggin Rear Banner arsenic exposure area of Bayannur City,according to water arsenic concentrations,these people were divided into control (＜ 10 μg/L,55 people),low (10-＜ 100 μg/L,47),medium (100-＜ 200 μg/L,45) and high (≥200 pg/L,86) arsenic exposure groups.Real-time PCR was used to detect the expression levels of blood AhR and CYP1A1 mRNA,which were presented in median and quartile [M (Q1-Q3)],and the relationships between their expression levels and keratosis,depigmentation of skin were analyzed.Results The relative expression levels of AhR and CYP1A1 mRNA in high-dose groups were 3.18 × 10-3 (2.42 × 10-3-4.45 × 10-3) and 1.58 × 10-3 (0.80 ×10-3-2.73 × 10-3),which were higher than those in control groups [2.30 × 10-3 (1.53 × 10-3-3.20 × 10-3) and 1.00 × 10-3 (0.59 × 10-3-2.09 × 10-3)],and the difference were statistically significant (all P ＜ 0.05).Compared with control group,the detectable rates of arsenic poisoning,keratosis and depigmentation of skin were higher,and the differences were statistically significant (x2 =20.187,15.848,21.595,all P ＜ 0.05).The detectable rates of arsenic poisoning,keratosis and depigmentation of skin were increased with increase of water arsenic concentrations (x2 =19.012,15.269,16.868,all P ＜ 0.05).Compared with normal [2.54 × 10-3 (1.79 × 10-3-3.43 × 10-3),2.57 × 10-3 (1.78 × 10-3-3.52 × 10-3)],AhR mRNA relative expression levels [4.45 × 10-3 (3.47 × 10-3-8.04 × 10-3),4.45 × 10-3 (4.02 × 10-3-6.25 × 10-3)] of degree Ⅲ keratosis and depigmentation of skin were increased,and the differences were statistically significant (all P ＜ 0.05).Conclusions Chronic arsenic exposure affects the expression level of AhR and CYP1A1 mRNA.Blood AhR mRNA expression may have relationship with endemic arsenic poisoning induced skin change,but blood CYP1A1 mRNA expression may have nothing to do with endemic arsenic poisoning induced skin change.