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<p><b>OBJECTIVE</b>To study the variation tendency of hypertension in two rural areas in Gansu, and provide epidemiological evidence to evaluate the hypertension of rural residents.</p><p><b>METHODS</b>Using equidistant random sampling method and cross-sectional sentinel monitoring, two remote natural villages, Yangzhuang and Xiangming, at Yellow river and Yangtze river valley were selected as hypertension monitoring site. From 1990 to 2012, clinical examination to the resident above 18 years old was carried out continuously for 23 years, 11 164 cases were included.</p><p><b>RESULTS</b>Hypertension prevalence of tested cases increased with years, Yangzhuang monitoring site increased from 6.9% (16/232) in 1990 to 36.7% (216/597) in 2012 with an increase of 29.8%, and Xiangming monitoring site increased from 3.4% (16/474) in 1995 to 20.6% (120/582) in 2011 with an increase of 17.2%. Total prevalence of Yangzhuang (24.1%, 1505/6240) was significantly higher than Xiangming (11.4%, 578/4924) (χ(2) = 277.9, P < 0.01). Total hypertension prevalence of 18 - 35 years old group was 9.9% (292/2944) in Yangzhuang and 4.2% (63/1495) in Xiangming, Yangzhuang was higher than Xiangming (χ(2) = 43.7, P < 0.01). Total hypertension prevalence of above 35 years old group was 36.8% (1213/3296) in Yangzhuang and 14.1% (515/3429) in Xiangming, Yangzhuang was higher than Xiangming (χ(2) = 417.7, P < 0.01). The growth rates of hypertension prevalence in 18 - 35 years old group of both areas (Yangzhuang: 823.5%, Xiangming: 614.3%) were higher than 35 years old group (Yangzhuang:310.5%, Xiangming: 368.0%), but the hypertension prevalence of above 35 years old group was higher than 18 - 35 years old group. Hypertension prevalence of male was 25.4% (761/2992) in Yangzhuang and 11.7% (238/2047) in Xiangming, Yangzhuang was higher than Xiangming (χ(2) = 145.8, P < 0.01), hypertension prevalence of female was 22.7% (738/3248) in Yangzhuang and 11.2% (340/2877)in Xiangming, Yangzhuang was higher than Xiangming (χ(2) = 125.1, P < 0.01). While the difference between male and female had no statistical significance in both areas.</p><p><b>CONCLUSION</b>Hypertension of the two monitoring points was in high epidemic trend, but with different epidemic trend. From different region and environment research to discuss the cause of hypertension can provide scientific evidence for prevention and control.</p>
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Adolescent , Adult , Female , Humans , Male , Young Adult , China , Epidemiology , Hypertension , Epidemiology , Obesity , Epidemiology , Population Surveillance , Prevalence , Risk Factors , Rural PopulationABSTRACT
Objective To systematically assess the efficacy of different programs regarding the selenium supplementation formulae used for prevention and treatment of Kaschin-Beck disease (KBD) in children.Methods PubMed,EMBASE,Cochrane Library,SCI expanded,CNKI (Chinese National Knowledge Infrastructure),VIP (Chinese Science and Technique Journals Database),CBM (The Chinese Biomedical Database),Wanfang Database,CSCD (Chinese Science Citation Database)had been electronically searched.All the searching processes were up-dated to Dec 2012 to identify randomized trials (RCTs) and non-RCTs to compare the selenium supplementation formulae with placebo or with no intervention.Two reviewers assessed the methodological quality of the study design,including RCTs or non-RCTs according to Cochrane Handbook for Systematic Reviews of Interventions 5.1 or a checklist described by Deeks J J,et al,respectively.Data was extracted independently.Results There were 14 RCTs and 12 non-RCTs papers included,but showing low methodological quality.Data from Meta analysis showed that selenium supplementation had caused the following progresses:radiologic improvement (RR=3.28,95％CI:2.06-5.22),higher hair selenium (SMD=2.05,95％ CI:1.00-3.11) lower new radiologic lesions (OR=0.18,95％ CI:0.09-0.36) than in the placebo or with no treatment groups.Both selenium and vitamin C supplementation did not show differences in radiologic improvement of metaphysis (RR=1.01,95％CI:0.84-1.22).Combination of selenium and vitamin E supplementation showed higher radiologic improvement than the placebo group.Combination of selenium and vitamin C supplementation had no influence on the difference in radiologic improvement or hair selenium than selenium supplementation.Selenium-enriched yeast showed higher radiologic improvement than sodium selenite (70.83％ vs.48.84％,P＜0.05).Selenium fertilization showed higher radiologic improvement than the nontreatment group (RR=3.98,95％ CI:2.25-7.05).Comprehensive intervention program and ‘grain drying approach' also showed certain effects.Conclusion Selenium supplementation could lead to better radiologic improvement and hair selenium,with lower new radiologic lesions.Current evidence supported its benefits on prevention and treatment of KBD.Large sample sized and well-designed trials together with the reporting on adverse outcome remained necessary.
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Objective To evaluate the reliability and validity of the application of condensed Chinese version of the MOS 36-item short form health survey (SF-36) in assessment of quality of life among adult patients with Kashin-Beck disease,and to provide a scientific basis in rehabilitation of the patients.Methods Four hundred and twenty seven eases of adult patients with Kashin-Back disease and 419 healthy individuals randomly selected in Kashin-Beck disease endemic areas in 8 counties of Gansu province were surveyed with the SF-36.The reliability of the SF-36 was assessed by split-half reliability and Cronbach's α coefficient and the validity through principal component factor analysis and correlation analysis,etc.The dimension scores of different people were obtained by analysis of variance and univariate t-test.Results The split-half reliability of all the 8 dimensions was greater than 0.6 and the Cronbach's α coefficient was greater than 0.8; the pearson correlate coefficients of all the items to their dimensions were greater than 0.391.SF-36 contained 8 domains and 2 summary scales in the factor analysis.The score differences of quality of life in different ages of the patients,different stages of the disease were statistically significant (all P ＜ 0.05).Conclusion The SF-36 is practical in studying the quality of life among adult patients with Kashin-Beck Disease.
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Objective To understand distribution of the endemic fluorosis areas and running status of water-improving defuoridation projects in Gausu province. Methods In 2006, Gansu province endemic fluorosis areas, the content of fluoride in drinking water was measured in villages where water was not improved, running status of delluoridation projects was investigated and the content of fluoride in drinking water were determined in villages where water was improved. Dental fluorosis and skeletal fluorosis prevalence were examined in children in identified high-fluorlde villages. The fluorine content in drinking water was determined by F-ion selective electrode, dental fluorosis of children was diagnosed using Dean method, and adults skeletal fluorosis was diagnosed according to "National Standard for Clinical Diagnosis of Endemic Skeletal Fhiorosis" (GB 16396-1996). Results Water samples were examined in 1997 villages of 26 countries, among which water fluoride content was higher than 1.0 mg/L in 598 villages, accounting for 29.94%(598/1997). All 1215 water-improving and defluoridation projects had been investigated, among which 94.90%(1153/1215) of the projects were functioning well, and intermittent and abandoned projects accounted for 2.96%(36/1215) and 2.14%(26/1215). Mean fluoride of treated water of 1084 water-improving and defluoridation projects had water fluoride content ≤ 1.0 mg/L, accounted for 90.79%(1084/1194) ; mean fluoride of water from 1068 water-improving and defluoridation projects had water fuoride content ≤ 1.0 mg/L, accounting for 91.75%(1068/1164). Total 86 390 children of 8 to 12 year-old were examined, the detectable rate of dental fluorosis was 22.47%(19 414/86 390) and 142 211 adults above 16 year-old were examined, the detectable rate of skeletal fluorosis was 4.20%(5967/142 211). Conclusions Some villages yet have water fluoride content exceeding the standard. Some projects are abandoned and running badly, leading to fluoride content exceeding the standard. In a few areas, the prevalence of children dental fluorosis and adult skeletal fluorosis still exists in Gansu province, the task of prevention and control for endemic fluorosis is still arduous. We must raise the effect of prevention and treatment of this disease.
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Objective To observe the incidence and clinical characteristics of chronic Keshan disease in recent years, and to provide evidence for diagnosis of the disease. Methods From March to August 2009, 163 patients with chronic Keshan disease were chosen from Shandong, Sichuan, Inner Mongolia and Cansu. Of these patients, 62 cases were from Shandong, 34 cases from Sichuan, 37 cases from Inner Mongolia, and 30 cases from Gansu. All of the subjects underwent detailed natural history of the disease, careful physical examination and electrocardiogram (ECG), X-ray chest radiography and cardiac ultrasound examination. The incidence and clinical features were analyzed. Results Adults accounted for 98.8%(161/163) and children for 1.2%(2/163) in 163 cases of chronic Keshan disease, with an average age of 45.8 years. Slow onset accounted for 62.6%(102/163), other types that evolved into chronic-type accounted for 37.4%(61/163). Low blood pressure( 116.5/72.4 mmHg),often with cardiac function grade Ⅱ accounted for 65.6%(107/163). Common symptoms were: palpitation[86.5%(141/163)], asthma [76.7% (125/163)], fatigue[76.1%(124/163)], precordial discomfort [54.6% (89/163)], dizziness[50.3%(82/163)], edema of lower limbs[44.8%(73/163)], and anorexia[38.0%(62/163)]. Common signs were: low-weak first heart sound[66.9%(109/163)], heart enlargement[64.4%(105/163)], apical pulse dispersion[42.3%(69/163)], arrhythmia[40.5%(66/163)], hepatomegalia[39.3%(64/163)], systolic murmur [25.2%(41/163)], and edema[20.9%(34/163)]. Abnormal ECG detection rate was 93.9%(153/163), with common types followed by ST-T changes[ST-T changes, ST segment changes, Tchange, 36.2%(59/163)], ventricular premature [occasional and frequent ventricular premature, 26.4% (43/163)], complete right bundle branch block [25.8% (42/163)], atrial fibrillation[19.0%(31/163)], and atrioventricular conduction block[8.6%( 14/163)]. X-ray results showed that significant and moderate heart enlargement were common, accounting for 73.4%( 105/143), followed by mild enlargement of 25.2%(36/143). Color doppler ultrasound examination results showed that the atrio-ventricular cavity diameter increased, followed by left ventricular end-systolic diameter increased[81.3%(52/64)], left ventricular end-diastolic diameter increased[65.6%(42/64)], left atrial enlargement[51.6%(33/64)], right atrial enlargement [43.8%(28/64)], and right ventricular enlargement[32.8%(21/64)]. Left ventricular wall and interventricular septum thinning accounted for 15.6%( 10/64) and 7.8%(5/64), respectively. Conclusions In recent years, most cases of chronic Keshan disease occur as natural chronic type, and at older age at onset with low blood pressure.Main clinical features of the disease are cardiac enlargement, inadequate tissue perfusion, and venous stasis performance caused by cardiac decompensation. Correct diagnosis of chronic Keshan disease can be made based on these clinical features.
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Objective To investigate the distribution of water fluoride and the present status of water-improving defuoridation projects in the endmie fluorosis areas in Gansu Province in 2006. Methods The content of fluoride in drinking water in 18 endemic disease counties was screened, and the defluoridation projects built after the 1980s were supervised and inspected. The content of fluoride in drinking water was assessed by F-ion selective electrode. Results Fluoride content was determined in water of 6260 sources in 1252 fluorosis villages in 18 counties, with 63.50% (3975/6260)≤1.0 mg/L and 36.50%(2285/6260)>1.0 mg/L. Nine hundred and ninty-seven water-improving and clefluoridation projects had been investigated in 16 counties, among which 95.49% (952/997) were function well, and projects intermittently running or abandoned respectively accounted for 3.11% (31/997) and 1.40%(14/997). Nine hundred and eighty-three sources of water treated by the water-improving and defluoridation projects had been determined for fluoride content, it turned out that 91.76% (902/983) were within the standard, only 8.24% (81/983) were not; as for outlet and leftover water of 934 water-improving and defluoridatian projects determined for water fluoride content, qualified projects accounted for 92.08% (860/934) and 91.97%(859/934), leaving 7.92%(74/934) and 8.03%(75/934) disqualified, respectively. Water-improving and defluoridation projects mostly relied on drilling a well in gaining under-ground water or collecting surface-ground water, so under-ground water and surface-ground water are the majority. Conclusions Water fluoride content exceeds the standard in some of the villages. A few projects do not function well. Fluorosis damage still exists in Gansu Province, therefore countermeasures for endemic fluorosis must be carried out as promptly as possible and surveillance on water-improving and defluoridation projects must be strengthened and managed.
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Objective To evaluate the running status of the water-improving projects in Gansu Province in order to further improve the supervising mechanism and raise the efficiency of defluoridation in drinking water.Methods The water-improving projects,either being normal,or intermittent,or discarded and the cause of abnormal running in 33 counties in Gansu Province were surveyed with unified standard method.Fluoride content in water was determined by F-ion selective electrode.Results 993 water improving projects covering 3389 fluorosis villages were surveyed,682 projects worked well[68.68%(682/993)]and had supplied water with normal fluoride contents to 2174 villages[64.15%(2174/3389)]and benefited 116.56 hundred thousand populations.And the rest 311[31.32%(311/993)]projects worked abnormally or supplied unqualified fluoride water.The main causes were the exceeded lasting life,insufficiency of water resources,high fluoride content in water and unqualified administration.Conclusions Most of the water-improving projects in Gansu Province are basically running normally,but about 1/3 of the projects do not function well,so the management of the projects must be improved and consummated.
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Background and Objective Keshan disease is clinically characterized as a dilated eardiomyopathy. We analyze the prevalence trend during last decade of hypertension and Keshan-disease in Yangzhuang village which was a Keshan-disease epidemic area.Method The survey including medical history,blood pressure and ECG were carried out every two years during the follow up 13 years.Results During follow up period,the total detection rate(hypertension:13.4 % vs Keshan-disease:10.7 %,?~2=8.555,P=0.002)and the accumulative rate of hypertension were higher than those of Keshan-disease,which was on the contrary to that before 1993,when increasing rate of Keshan-disease was higher than hypertension.Furthermore,the accumulative increasing rate of hypertension was 240.0%,which was higher than the national average level during corresponding period with no significant differences between female and male.Conclusion The detection rate of hypertension in Keshan disease epidemic area was higher than the average rate nation-wide.Whether the hypertension prevalence was re- lated to Keshan-disease needs further investigation.