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Objective:To analyze the surgical types of patients with Kashin-Beck disease (KBD) in Shaanxi Province, and to provide reference for optimizing KBD surgery.Methods:Retrospective analysis was used to investigate KBD patients who underwent surgical treatment, and the patient's information was from the Shaanxi Provincial Endemic Disease Prevention and Control Information System. Patients with incomplete surgical treatment information were excluded, and χ 2 test was used to analyze the impact of factors such as gender, education level, living area, disease severity, and social environment on the selection of different surgical types (free body enucleation or joint replacement) for KBD patients. Using propensity score method to perform a 1 ∶ 1 match on patients with different surgical types, and analyzing the influencing factors of KBD patients receiving different types of surgical treatment through multivariate logistic regression. Results:From 2018 to 2020, a total of 1 084 KBD patients in Shaanxi Province underwent surgical treatment, including 555 males (51.20%) and 529 females (48.80%), with a median age of 64 years old. There were 917 patients (84.59%) in the Guanzhong region (Tongchuan, Xi'an, Weinan, Xianyang, Baoji), 120 patients (11.07%) in the northern Shaanxi region (Yulin, Yan'an), and 47 patients (4.34%) in the southern Shaanxi region (Ankang, Hanzhong, Shangluo). The number of patients with KBD grade Ⅰ,Ⅱ, and Ⅲ was 401 (36.99%), 525 (48.43%), and 158 (14.58%), respectively. Five hundred and forty-eight patients (50.55%) underwent free body enucleation surgery, and 536 patients (49.45%) underwent joint replacement surgery. Univariate analysis showed that different genders, educational levels, living areas, disease severity, economic status, whether to relocate, type of drinking water, type of staple food, and source of staple food were the influencing factors for KBD patients to choose the type of surgery (χ 2 = 81.82, 22.38, 93.68, 22.38, 5.17, 15.68, 13.82, 39.37, 49.63, P < 0.05). Among 374 pairs of patients who underwent free body enucleation and joint replacement through propensity score matching, multivariate logistic regression analysis found that high school and above education level [odds ratio( OR) = 0.42, P = 0.008], Guanzhong region ( OR = 0.12, P < 0.001), relocation ( OR = 0.60, P = 0.004), and drinking well water ( OR = 2.15, P = 0.001) were the influencing factors for KBD patients to choose different surgical types for treatment. Conclusion:When performing surgical treatment for KBD patients in Shaanxi Province, clinicians can consider the severity of the disease, as well as factors such as the education level, living area, relocation status, and type of drinking water of KBD patients, to provide more suitable surgical types for KBD patients.
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Objective:To investigate the iodine nutrition status of residents and its changing trend in Baoji City, Shaanxi Province during the 10 years implementation of a new salt iodine standard, evaluate the prevention and treatment effects, and provide a basis for implementing iodine supplementation measures scientifically.Methods:From 2013 to 2015, each county (district) in Baoji City, Shaanxi Province was divided into 5 districts based on east, west, south, north, and central regions. One town (street, referred to as the town) was selected from each district, and four administrative villages were selected from each town. Fifteen residents from each administrative village were selected to collect edible salt samples from their homes and test the iodine content of the salt. At the same time, one primary school was selected from each selected town, and 42 children (age and gender were balanced) aged 8 - 10 were selected from each primary school for thyroid palpation examination. From 2016 to 2022, each county (district) was divided into 5 districts based on east, west, south, north, and central regions. One town was selected from each district, and one primary school was selected from each town. Forty-two non boarding students aged 8 - 10 were selected from each primary school to undergo thyroid palpation examination, and edible salt samples were collected from their home to detect salt iodine content. At the same time, 4 administrative villages were selected from each town, and 10 households were selected from each administrative village to collect edible salt samples and test the salt iodine content; 21 pregnant women were selected from each of the 5 towns in each county (district) to collect edible salt samples and test the salt iodine content. From 2013 to 2022, synchronous collection of urine samples from children and pregnant women (early, middle, and late pregnancy were balanced) was conducted to detect urine iodine content. Direct titration method was adopted for determination of salt iodine content, and arbitration method was adopted for Sichuan salt and other fortified edible salt (GB/T 13025.7-1999). Thyroid examination was performed according to the Diagnostic Criteria for Endemic Goiter (WS 276-2007). Urine iodine was detected by Arsenic Cerium Catalytic Spectrophotometric Method for Determination of Iodine in Urine (WS/T 107 - 2006).Results:From 2013 to 2022, a total of 37 609 household edible salt samples were collected. The coverage rate of iodized salt, the qualified rate of iodized salt and the consumption rate of qualified iodized salt for each year ranged from 98.00% to 100.00%, 94.16% to 99.55%, and 92.28% to 99.67%, respectively. The median range of salt iodine was 22.42 to 26.80 mg/kg. A total of 25 437 children aged 8 - 10 were examined, and the annual incidence of thyroid enlargement (goiter) ranged from 0.35% to 3.02%. A total of 33 270 urine samples were collected, including 21 698 from children and 11 572 from pregnant women. The median range of urine iodine for children in each year was 203.70 - 275.47 μg/L, median range of urine iodine in pregnant women was 167.65 - 218.57 μg/L. The median urine iodine in children showed a decreasing trend from 2013 to 2022 ( Z = 3.04, P = 0.002); the median urine iodine of pregnant women did not show a significant decrease ( Z = 1.61, P = 0.110). Conclusions:During the 10 years implementation of the new salt iodine standard in Shaanxi Province, all indicators of iodine deficiency disorders monitoring in Baoji City have met the standards and maintained the elimination status of iodine deficiency disorders. The urine iodine levels of children have shown a downward trend, while urine iodine levels of pregnant women do not show significant changes. It is recommended that Baoji City expand the scope of iodine nutrition monitoring for key populations, and effectively carry out iodine supplementation measures scientificlly guided by monitoring information, tailored to local conditions, and classified guidance.
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Objective:To analyze the iodine nutrition status of the population in Baoji City, Shaanxi Province after adjusting the salt iodine content, and evaluate the effectiveness of current prevention and control measures for iodine deficiency disorders (IDD).Methods:IDD surveillance data in Baoji City from 2016 to 2022 (from the Baoji Center for Disease Control and Prevention and the Baoji Maternity and Child Care Hospital) were collected, iodine content in urine of children aged 8 to 10, pregnant women and household salt was analyzed, and the thyroid stimulating hormone (TSH) of neonatal heel blood was determined. Mann-Kendall test and linear trend χ 2 test were used to test the trend. Results:A total of 26 812 salt samples were tested from 2016 to 2022, with a median salt iodine concentration of 24.09 mg/kg and a qualified iodine salt consumption rate of 97.84% (26 234/26 812). A total of 17 877 urine samples of children aged 8 to 10 were tested, with a median urine iodine of 218.41 μg/L, 8 935 urine samples of pregnant women were tested, with a median urine iodine of 184.59 μg/L, and 121 607 blood samples of newborns were tested, with a median TSH of 2.00 mU/L. With the increase of years, there was no significant trend in the median of salt iodine, child urine iodine and maternal urine iodine ( Ztrend = 1.80, - 1.50, 0.30, P > 0.05), however, the median of neonatal TSH showed an overall downward trend ( Ztrend = - 1.97, P = 0.048). As the years increase, the proportion of qualified iodized salt (18 - 33 mg/kg of salt iodine), adequate iodine content of children (100 - 299 μg/L of urine iodine) and appropriate iodine content of pregnant women (150 - 249 μg/L of urine iodine) showed an increasing trend (χ 2trend = 122.74, 26.56, 28.43, P < 0.001), however, the proportion of TSH > 5.0 mU/L in neonatal heel blood decreased linearly (χ 2trend = 1 634.43, P < 0.001). Conclusions:From 2016 to 2022, the salt iodine content and iodine nutrition level of the population in Baoji City have met the national standard for eliminating IDD. It is recommended to strengthen the health education of scientifically eating iodized salt and supplementing iodine.
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Objective:To study the iodine nutrition status of pregnant women in Baoji City Shaanxi Province, and to provide basis for iodine supplementation scientifically in pregnancy period.Methods:From January 2018 to December 2020, 12 counties and districts in Baoji City were divided into 5 districts according to different directions each year, 1 township (sub-district office) was selected from each district and 21 pregnant women from each township (sub-district office) were selected, domestic salt samples and instant urine samples were collected to determine the contents of iodine.Results:A total of 3 783 pregnant women's domestic salt samples were collected, the median salt iodine was 24.00 mg/kg, the difference of median salt iodine among different years was statistically significant ( H = 118.22, P < 0.01). A total of 3 783 urine samples were tested, and the median urinary iodine was 192.44 μg/L. The median urinary iodine of pregnant women in urban, plain and mountainous areas (205.08, 193.61 and 182.75 μg/L) was significantly different ( H = 17.53, P < 0.01); the median urinary iodine of pregnant women in different pregnancy periods (early, mid and late: 194.47, 198.19 and 183.54 μg/L) was significantly different ( H = 6.18, P < 0.05). There was no significant difference in median urinary iodine of pregnant women among different ages ( H = 2.25, P > 0.05). Conclusions:The iodine nutrition of pregnant women in Baoji City is generally at an appropriate level. It is necessary to strengthen the health education for key populations, advocate scientific consumption of iodized salt for improving their iodine nutrition.
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Objective:To investigate the willingness of patients with Kashin-Beck disease (KBD) to accept drug treatment and its influencing factors in Shaanxi Province, in order to provide a reference for promoting the standardized management of KBD patients.Methods:The general information of KBD patients in Shaanxi Provincial Endemic Disease Prevention and Control Information System from January 2018 to December 2020 was collected, including gender, age (< 50, 50 - 79, ≥80 years old), ethnicity (Han nationality, others), education level (primary school and below, junior high school, senior high school and above), occupation (farmer, others), region (northern Shaanxi, central Shaanxi, southern Shaanxi), disease severity (gradeⅠ,Ⅱ,Ⅲ), etc. A face-to-face questionnaire survey was conducted to investigate the willingness of KBD patients to accept drug treatment, mainly including the willingness of patients to accept drug treatment, management services (whether the poor population, participation in medical insurance, disability assessment) and the implementation of comprehensive prevention and control measures (type of drinking water, types and sources of staple food, relocation from other places and returning farmland to forests). Multivariate logistic regression analysis was used to analyze the influencing factors of KBD patients' willingness to accept drug treatment.Results:A total of 58 501 KBD patients were included, including 51.60% (30 185/58 501) males and 48.40% (28 316/58 501) females; the median age was 64 years old; the ethnicity was mainly Han nationality, accounting for 99.87% (58 427/58 501); the education level of primary school and below accounted for 81.76% (47 831/58 501); the occupation was mainly farmers, accounting for 99.24% (58 059/58 501); mainly distributed in central Shaanxi [81.40% (47 619/58 501)]; patients with gradeⅠaccounted for 63.68% (37 254/58 501). Totally 89.02% (52 078/58 501) of KBD patients were willing to accept drug treatment. By multivariate logistic regression analysis, gender, age, education level, disease severity, region, medical insurance, disability assessment, type of drinking water, type of staple food, relocation from other places and returning farmland to forests were the influencing factors of KBD patients' willingness to accept drug treatment ( P < 0.05). Conclusions:KBD patients in Shaanxi Province have a high willingness to accept drug treatment. In the future, the standardized management of KBD patients should take into account the factors such as age, education level, disease severity and region, and implement precise drug treatment.
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【Objective】 To explore the relationship of health literacy with COVID-19 prevention and control knowledge, attitude and practice (KAP) in general population so as to contribute scientific evidence for strengthening health education and promoting health literacy to resist the threat of major infectious disease outbreaks. 【Methods】 In September 2020, a questionnaire survey was conducted in residents selected by a multi-stage random sampling across all the twelve counties/districts of Baoji city. The questionnaire, which was issued by the Chinese Health Education Center, consisted of a health literacy questionnaire and a COVID-19 prevention and control KAP questionnaire. According to the national unified scoring method, the participants were divided into two groups: those who met and those who failed to meet the overall standard of health literacy. The results of the answer to each KAP question were compared between the two groups by Chi-square test or rank sum test. Multivariate binary Logistic regression was used to control confounding effects of socio-demographic characteristics to draw relatively reliable conclusions. 【Results】 A total of 4 544 valid questionnaires were collected, in which 664 (14.60%) met the overall standard of health literacy, but 3 880 (85.40%) failed to do so. Compared with the unmet group, the met group had a higher correct answer rate in 10 of the 11 knowledge-related questions (all P<0.001); showed more positive answer to each attitude-related question in the three aspects, namely, responsibility for the prevention and control of infectious disease transmission, evaluation for COVID-19-related information release and reporting, and evaluation for the government’s COVID-19 prevention and control results (all P<0.001); and acted more actively in 6 of the 7 practice concerning appropriate self-prevention and control behaviors during the COVID-19 outbreak (all P<0.001). Logistic regression analyses confirmed that achieving the overall standard of health literacy played a positive role in each of the contents of COVID-19 prevention and control KAP in study (ORs were between 1.44 and 4.09, all P<0.001). Moreover, the absolute value of regression coefficient of the overall standard of health literacy was the largest compared with all the socio-demographic factors. Logistic regression was used to further analyze relationships between each of the six health dimensions of health literacy and COVID-19 prevention and control KAP, which revealed that the association with safety and first aid, infectious diseases prevention, and health information was the closest. 【Conclusion】 Health literacy is closely related to COVID-19 prevention and control KAP in the general population of Baoji city. Promoting residents' health literacy by targeted health education can play an important and positive role in dealing with the threat of major infectious diseases outbreaks.
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Objective To compare the indexes related to monitoring of iodine deficiency disorders between Xianyang City of Shaanxi Province and Yinchuan City of Ningxia Autonomous Region in 2016 for providing a basis in evaluating control measures to iodine deficiency disorders. Methods In 2016, 13 counties (districts) in Xianyang City and 6 counties (districts) in Yinchuan City were conducted sample surveys in accordance with the requirements of the"National Iodine Salt Monitoring Program", and the surveillance results were analyzed. The main indicators included salt iodine content, urinary iodine content in children aged 8 - 10 and pregnant women and children's goiter rate. Salt iodine content was measured by direct titration according to the "Determination of Iodine in General Test Method for Salt Industry" (GB/T 13025.7-2012). Urinary iodine content was determined using arsenic cerium catalytic spectrophotometry (WS/T 107-2006). Children's goiter was determined by B-ultrasound examination based on the "National Diagnostic Criteria for Endemic Goiter" (WS 276-2007). Results In 2016, Xianyang City and Yinchuan City had monitored 3900 and 1800 salt samples, respectively, the medians of salt iodine were 30.2 and 27.8 mg/kg, respectively. The median of salt iodine in Xianyang City was higher than that in Yinchuan City (Z = 14.58, P < 0.05); non-iodized salt rate (0.18%, 7/3900), unqualified iodized salt rate (0.72%, 28/3900) in Xianyang City were lower than those in Yinchuan City (0.56%, 10/1800;1.50%, 27/1800; χ2=5.86, 7.88, P<0.05), and qualified salt iodide consumption rate in Xianyang City (99.10%, 3865/3900) was higher than that in Yinchuan City (97.94%, 1763/1800, χ2 = 13.24, P < 0.05). The median of urinary iodine in children in Xianyang City (247.75 μg/L) was higher than that in Yinchuan City (223.70 μg/L, Z = 21.04, P < 0.05), and the ratio of urinary iodine < 100 μg/L in Xianyang City (11.92%, 310/2600) was lower than that in Yinchuan City (15.08%, 181/1200, χ2= 7.29, P < 0.05). The median of urinary iodine in pregnant women in Xianyang City (176.86 μg/L) was lower than that in Yinchuan City (187.70 μg/L, Z = 7.33, P < 0.05), and the ratio of urinary iodine < 150 μg/L in Yinchuan City (38.50%, 231/600) was higher than that in Xianyang City (32.00%, 416/1300,χ2=7.72,P<0.05). The thyroid palpate swelling rates of children in Xianyang City and Yinchuan City were 1.94%(53/2730) and 2.22% (28/1260), respectively, the rates between the two cities was not statistically significant (χ2=0.34, P > 0.05). Conclusions The monitoring indexes of iodine deficiency disorders in Xianyang City and Yinchuan City have reached the national standard for eliminating iodine deficiency disorders. In comparison, Yinchuan City should further strengthen the monitoring of iodine nutrition level in children and pregnant women, iodized salt market supervision and health education.
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Objective To investigate health-related quality of life (HRQOL) and influencing factors in adult patients with Kashin-Beck disease (KBD) in Shaanxi Province for improving health-related quality of life of KBD patients.Methods By the two-stage cluster random sampling method,data of 901 cases of KBD patients with the disease severity of grade 1 and higher were collected from higher KBD incidence areas of Baoji,Xianyang and Tongchuan in Shaanxi Province in February 2016.The Chinese version of SF-36 (including 8 dimensions:physical functioning,role-physical,bodily pain,general health,vitality,social functioning,role-emotional,mental health) was used to measure the HRQOL.Multiple linear regression was used to analyze the influencing factors of HRQOL.Results In 901 cases of KBD patients,male accounted for 55.49% (500/901),female accounted for 44.51 (401/901).The median age of patients was 58 (22-83) years old.According to the severity of disease criteria,patients with grade Ⅰ were 37.18% (335/901),patients with grade Ⅱ were 53.50% (482/901) and patients with grade Ⅲ] were 9.32% (84/901).The scores of each dimension of SF-36 scale in patients of male patients had higher scores in GH and MH than women [GH:35 (25,50) vs 30 (20,45),MH:56 (48,72) vs 56 (44,68),.9 < 0.05].There were significant differences in PF,RP,BP,GH,VT and SF scores among different age groups (P < 0.05).Similarly,there were significant differences in PF,RP,GH,VT,SF,RE and MH scores among patients with different educational levels (P < 0.05).Married group was only higher in the PF and SF scores than other marital status groups [PF:55 (40,75) vs 50 (35,65),SF:62 (50,75) vs 50 (38,75),P < 0.05].As expected,there were significant differences in the scores of PF,BP,GH and SF between the severity of diseases.There were also significant differences in the scores of PF,BP,GH,VT,SF and MH in KBD patients from different regions (P < 0.05).According to multiple linear regression analysis results,male was the conservation factor of GH and MH scores compared with female;age was a risk factor for PF,RP,BP,GH,VT and SF scores;compared with the illiterate,primary school education was a protective factor for PF and RE scores,junior high school and above were PF,RP,VT,SF,RE and MH scores protective factors;compared with degree Ⅰ KBD,degree Ⅱ and degree Ⅲ were risk factors for PF,BP,GH and SF scores;compared with Baoji area,Xianyang area was a protective factor of SF score,however,Tongchuan area was a protective factor for PF,GH,VT,SF and MH scores.Conclusions KBD has severely damaged the HRQOL of patients.Priority should be given to age,educational attainment and severity of the disease for developing measures to improve KBD patients' HRQOL in different regions.
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Objective To investigate the level of perceived social support and its influencing factors in Kashin-Beck disease (KBD) patients in Shaanxi Province,and to provide a theoretical basis for improving the service to KBD patients.Methods By the two-stage cluster random sampling method,KBD patients with the severity of disease of grade Ⅰ and above were investigated in Baoji,Xianyang and Tongchuan areas in Shaanxi Province,which were higher incidence areas of KBD.The Chinese version of perceived social support scale (PSSS) was used to measure family support,friend support,and other supportive comprehension social support levels by household survey method,the total score of PSSS is low support state from 12 to 36,intermediate support state from 37 to 60,and high support state from 61 to 84,and the effects of gender,age,education level,marital status,occupation,disease severity and region on the level of perceived social support were analyzed.Results In 901 cases of KBD patients,males accounted for 55.49% (500/901),females accounted for 44.51% (401/901).The median age of patients was 58 years old.According to the severity of KBD criteria,grade Ⅰ patients were 37.18% (335/901),grade Ⅱ patients were 53.50% (482/901) and grade Ⅲ patients were 9.32% (84/901).The median (quartile) PSSS score was 62 (54,70),the low support status accounted for 8.55% (77/901),the intermediate support status accounted for 36.96% (333/901),and the high support status was 54.50% (491/901).Age was a risk factor for friend support,other support dimensions and total score;compared with illiteracy,primary school education was the protective factor of total score,and junior high school and above education was the protective factor of family support dimension and total score.Compared with Baoji area,Xianyang area and Tongchuan area were the protective factors of family support dimension,other support dimension,and total score.In addition,Xianyang area was also a protective factor of friend support dimension.Conclusion The level of perceived social support of KBD patients in Shaanxi is generally above moderate.Age,education,and regional factors are main factors affecting perceived social support.
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BACKGROUND/OBJECTIVES: Dietary pattern and its association with cardio-cerebrovascular disease have not been studied in Baoji city by now. This study was aimed to identify the dietary patterns among Chinese adults in Baoji, and explore the association between these dietary patterns and cardio-cerebrovascular disease. SUBJECTS/METHODS: A total of 4,968 participants were included in this study at 12 counties. With multistage stratified random sampling and semi quantitative food frequency questionnaire, the prevalence of cardio-cerebrovascular disease and dietary intake were investigated in 2013. We used factor analysis to establish dietary patterns. RESULTS: A total of 4,968 participants over 15 years old were included in this study. Five dietary patterns were identified in Baoji: protein, balanced, beans, prudent, and traditional patterns. The protein dietary pattern mainly included animal and plant proteins and was negatively associated with hypertension as well as stroke. The balanced pattern included carbohydrates, protein, and fat and was negatively associated with hypertension as well as stroke. The beans pattern was mainly beans and beans products and was negatively associated with hypertension. The prudent pattern only included staple foods and pickled vegetables and was positively associated with hypertension as well as coronary heart disease. The traditional pattern was representative of local Baoji traditional recipes and was positively associated with hypertension. CONCLUSIONS: The protein, balanced, and beans dietary patterns showed many protective effects on cardio-cerebrovascular disease. Based on these results, Baoji city residents should be encouraged to choose protein, balanced, and beans dietary patterns and abandon prudent and traditional patterns to prevent incidence of hypertension, coronary heart disease, and stroke.
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Adult , Animals , Humans , Asian People , Carbohydrates , Coronary Disease , Fabaceae , Factor Analysis, Statistical , Hypertension , Incidence , Plant Proteins , Prevalence , Surveys and Questionnaires , Stroke , VegetablesABSTRACT
10.3969/j.issn.1000-3606.2013.06.019
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Objective To investigate the possibility and feasibility of the whole genome microarray scanning technique in clinical cytogenetic diagnosis of an uncertain karyotype and mentally retarded child. Methods The karyotype analysis of the mental development delayed child was 47, XY+mar. Genomic DNA was extracted from the peripheral blood and the whole genome microarray scanning technique was used to analyze the derivative chromosome. Results The whole genome microar-ray scanning technique indicated the derivative chromosome fragment had originated from 9p13.1-p24.3. Conclusions Com-paring to conventional cytogenetic analysis methods, the whole genome microarray scanning technique is of high resolution, high-throughput and high accuracy, which can detect the submicroscopic chromosomal aberrations and replace the conven-tional karyotype analysis.