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@#Abstract: Objective To analyze the pathogenic characteristics and epidemiological significance of human plague related strains in Qinghai Province in recent 30 years, so as to provide scientific basis for on-the-spot disposal and prevention and control measures of plague outbreak in Qinghai Province. Methods A total of 35 strains of Yersinia pestis isolated from 29 typical human plague outbreaks in Qinghai Province from 1980 to 2011 were selected and studied by biochemical fermentation experiments. Virulence factors detection of Fraction 1 antigen (Fra1), virulence antigen (VW), pigmentation (Pgm) and Yersinia pestis Ⅰ (PstⅠ), determinants and genotyping of differential regions (DFRs) were used to study the pathogenic characteristics. At the same time, according to the epidemic situation of human and animal plague in Qinghai Province in recent years, the current situation of plague prevention and control and epidemic characteristics were analyzed. Results The biotypes of 35 strains of Yersinia pestis were classical, and the biotypes of 29 strains (82.86%) were of Qinghai-Tibet Plateau type, mainly distributed in southern Qinghai and around lake areas, 2 strains (5.71%) belonged to Qilian Mountains type, mainly distributed in Qilian mountains, and 6 genotypes were identified by DFR. Among them, 16 were type 5, 12 were type 8, 2 were type 10, 1 was type 36, 3 were type 30 and 1 was type 1b, the strains of type 5 and 1b were mainly distributed around the lake and the southern foot of Qilian Mountains, while the strains of type 8, 10, 36 and 30 were mainly distributed in the southern part of Qinghai. Conclusions The pathogen of Yersinia pestis in Qinghai Plateau has complex biochemical types, the epidemic situation among animals is continuous year after year, the situation of prevention and control is serious, the occurrence and prevalence of plague seriously endanger people's health and social development, so it is necessary to do a solid job in the prevention and control of plague to ensure the safety of people's lives.
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Objective:To investigate the prevalence and the risk factors of Helicobacter pylori( H. pylori) infection in Qinghai Province with a multi-center cross-sectional study. Methods:From May to December in 2021, stratified sampling was conducted in Xining City, Haidong agricultural district, Hainan Tibetan Autonomous Prefecture, Haibei Tibetan Autonomous Prefecture and Yushu Tibetan Autonomous Prefecture by 20 centers, including the Affiliated Hospital of Qinghai University, Qinghai Red Cross Hospital and Qinghai Renji Hospital, etc. A questionnaire survey was carried out among the individuals undergoing routine health checkups. The questionnaire included general information, lifestyle and family history, etc. 13C-urea breath test was performed to diagnose H. pylori infection. Chi-square test, trend Chi-square test, segmentation method and multivariate logistic regression analysis were performed for statistical analysis. Results:The infection rate of H. pylori in Qinghai area was 53.6% (2 531/4 724). The age distribution of infection was statistically significant ( χ2=15.95, P=0.007), the infection rate in individuals aged 15 to<30 was higher than that of individuals aged 60 to< 75 (57.6%, 626/1 086 vs.49.5%, 231/467), and the difference was statistically significant ( χ2=8.83, P=0.003). With the increase of age, the infection rate decreased in female over 30 years old ( χ2trend=5.89, P=0.015). There were statistically significant differences in H. pylori infection rate among different ethnic groups ( χ2=28.13, P<0.001); the infection rate of Tibetan population was higher than that of Han population (62.9%, 313/498 vs. 51.5%, 1 804/3 503), and the difference was statistically significant ( χ2=22.56, P<0.001). The H. pylori infection rate in people living at an altitude >3 500 m was higher than that of people living at an altitude between 1 500 m and 3 500 m (61.8%, 327/529 vs. 52.5%, 2 204/4 195), and the difference was statistically significant ( χ2=16.25, P<0.001). Compared with those without corresponding habits, the infection rate of H. pylori was higher in smokers (62.1%, 1 081/1 740 vs. 48.6%, 1 450/2 984), in people who had the habit of eating hand grabbed mutton (55.4%, 967/1 744 vs. 52.5%, 1 564/2 980), raw garlic (55.5%, 968/1 744 vs. 52.4%, 1 563/2 980), spicy food (55.6%, 1 471/2 647 vs. 51.0%, 1 060/2 077), sweet food (55.2%, 1 187/2 149 vs. 52.2%, 1 344/2 575), the infection rate of tea drinkers was lower (50.5%, 1 135/2 247 vs. 56.4%, 1 396/2 477), and the differences were statistically significant ( χ2=80.94, 3.89, 9.63, 4.36, 4.13 and 16.19, all P<0.05). The results of logistic regression analysis indicated that Tibetan ( OR=1.379, 95% confidence interval (95% CI) 1.120 to 1.699), the Hui people ( OR=1.362, 95% CI 1.117 to 1.662), living at an altitude over 3 500 m ( OR=1.355, 95% CI 1.107 to 1.657), smoking ( OR=1.847, 95% CI 1.629 to 2.094), and spicy food ( OR=1.224, 95% CI 1.084 to 1.382) were independent risk factors of H. pylori infection (all P<0.05). Conclusions:The infection rate of H. pylori in Qinghai Province is higher than the average level in inland China. The infection rate of people with different ages, nationalities, altitudes of residence, occupations, living and eating habits were different. The infection rate of female over 30 years old is decreasing year by year. The infection risk is high in Hui people and Tibetan, spicy food lovers, smokers and people living at an altitude >3 500 m.
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Objective: To analyze the epidemiological characteristics of pneumoconiosis in Qinghai Province from 2011 to 2020, and to provide a basis for the formulation of prevention and control strategy. Methods: In April 2021 , the cases of pneumoconiosis were monitored by the Occupational Disease and Health Hazard Factors Monitoring Information System in Qinghai Province from 2011 to 2020. The distribution of pneumoconiosis, the composition of diseases and the working years exposed to dust were analyzed. Results: All 1026 cases of pneumoconiosis were newly diagnosed in Qinghai Province from 2011 to 2020, silicosis and coal worker pneumoconiosis were the main diseases (78.36% ,804/1026). Stage Ⅰ pneumoconiosis were 484 (47.17%,484/1026) cases. 359 (34.99%,359/1026) cases, 315 (30.70%,315/1026) cases and 252 (24.56%, 252/1026) cases had been diagnosed respectively in Xining City, Haidong City and Haixi Prefecture; 628 (61.21%,628/1026) cases and 418 (40.74%, 418/1026) cases engaged in mining industry and large-sized enterprise, respectively. The working years exposed to dust in silicosis cases were shorter than that in coal worker pneumoconiosis and other pneumoconiosis (P <0.05). Conclusion: The pneumoconiosis area and industry focus in Qinghai Province is obvious. The supervision and adninistration of small and micro scale employers should be strengthened to protect the health rights and interests of workers, especially for the key area and industry.
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Humans , Anthracosis/epidemiology , China/epidemiology , Coal Mining , Dust , Health Services Accessibility , Human Rights , Pneumoconiosis/epidemiology , Silicosis/epidemiologyABSTRACT
Objective To amplify and sequence Coxl and Nadl genes in Echinococcus multilocularis isolates from Qinghai Province, and to create phylogenetic trees and molecular clocks, so as to provide evidence for estimating the evolutionary relationships and origins of E. multilocularis in Qinghai Province. Methods Twenty-two post-surgical specimens of patients with hepatic alveolar echinococcosis were sampled from Qinghai Provincial People’s Hospital in 2017. The Coxl and Nadl genes were amplified from E. multilocularis samples and sequenced. Then, the gene sequences were aligned to the Coxl and Nadl genes of Echinococcus species in GenBank database. The intra-species variation was observed, and the phylogenetic tree and molecular clock were created. Results All E. multilocularis samples shared more than 99% genetic homology with the sequences of Coxl and Nadl genes from the E. multilocularis Asian strain in the GenBank database. A total of 6 genotypes were identified, including 2 isolates that had no 100% homology with the sequences of known genes in the GenBank database. Phylogenetic tree analysis revealed remarkable clustering of the E. multilocularis samples with the E. multilocularis Asian strain, and the E. multilocularis isolates from Qinghai Province were estimated to date back to 94 000 years ago by the molecular clock. Conclusions The present study characterizes 6 E. multilocularis genotypes in Qinghai Province, including 2 novel genotypes. Asian strain is the predominant strain of E. multilocularis in Qinghai Province, and the E. multilocularis isolates from Qinghai Province date back to 94 000 years ago.
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Objective To investigate the clinical characteristics of patients with advanced hepatic alveolar echinococcosis, so as to provide more evidence for the diagnosis and treatment of advanced hepatic alveolar echinococcosis. Methods The clinical records of 175 cases with hepatic alveolar echinococcosis admitted to the Affiliated Hospital of Qinghai University from 2012 to 2017 were retrospectively reviewed. Results Among the 175 cases with hepatic alveolar echinococcosis, the male to female ratio was 1∶1.6, and the mean age was (38.6 ± 12.9) years (range, 11 to 69 years). 93.7% of the patients (164 cases) were Tibetan, and 79.4% (139 cases) were from Guoluo Prefecture. 73.7% (129 cases) were herdsmen, and 58.3% (102 cases) were illiterate. The major clinical symptoms included upper abdominal pain, yellowing of skin and mucosa, and scleral icterus. 69.1% of the lesions were located in bilateral livers, and 63.4% of the cases have 2 and more lesions. 53.7% of the cases have their inferior vena cava involved by the lesions. In addition, the most affected neighboring organ was diaphragmatic muscle (21.7%), and lung was the most affected distant metastatic site (40.6%). Conclusions Advanced hepatic alveolar echinococcosis is highly prevalent in Guoluo Prefecture, Qinghai Province. Screening of this disease is required in this region and rational treatment scheme should be developed.
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Objective To investigate the clinical characteristics of patients with advanced hepatic alveolar echinococcosis, so as to provide more evidence for the diagnosis and treatment of advanced hepatic alveolar echinococcosis. Methods The clinical records of 175 cases with hepatic alveolar echinococcosis admitted to the Affiliated Hospital of Qinghai University from 2012 to 2017 were retrospectively reviewed. Results Among the 175 cases with hepatic alveolar echinococcosis, the male to female ratio was 1∶1.6, and the mean age was (38.6 ± 12.9) years (range, 11 to 69 years). 93.7% of the patients (164 cases) were Tibetan, and 79.4% (139 cases) were from Guoluo Prefecture. 73.7% (129 cases) were herdsmen, and 58.3% (102 cases) were illiterate. The major clinical symptoms included upper abdominal pain, yellowing of skin and mucosa, and scleral icterus. 69.1% of the lesions were located in bilateral livers, and 63.4% of the cases have 2 and more lesions. 53.7% of the cases have their inferior vena cava involved by the lesions. In addition, the most affected neighboring organ was diaphragmatic muscle (21.7%), and lung was the most affected distant metastatic site (40.6%). Conclusions Advanced hepatic alveolar echinococcosis is highly prevalent in Guoluo Prefecture, Qinghai Province. Screening of this disease is required in this region and rational treatment scheme should be developed.
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Objective To investigate the distribution characteristics of gallbladder diseases in children with hepatic alveolar echinococcosis, and to analyze the related factors for hepatic alveolar echinococcosis and gallbladder diseases. Methods The clinical data of hepatic alveolar echinococcosis patients under 18 years were collected in Qinghai Provincial People’s Hospital-from January 2012 to December 2017, and the gallbladder-related complications in the surgically treated patients with hepatic al-veolar echinococcosis were analyzed. Results The clinical data of 51 child patients with hepatic alveolar echinococcosis were collected and analyzed. According to the PNM classification criteria of WHO, P1, P2 and P3 in the 51 patients accounted for 37.25% (19/51), 41.18% (21/51) and 19.60% (10/51), respectively. According to the diagnostic criteria (WS 257–2006) of China for echinococcosis, the patients of infiltration type, calcification type and liquefaction cavitary type accounted for 66.67% (34/51), 21.57% (11/51) and 11.76% (6/51), respectively. Among the 51 patients, 78.43% (40/51) of the patients had clinical symptoms of biliary tract disease, and 58.82% (30/51) had gallbladder-related complications. The operations were performed on 40 patients, and 77.50% (31/40) of them had the postoperative complications. The results of binary multivariate logistic regression analysis showed that the clinical image classification, the liver segment distribution, size, location and number of lesions of hepatic alveolar echinococcosis were important correlative factors for the occurrence of gallbladder complications in hepatic alveolar echinococcosispatients. Conclusions The incidence of complications related to gallbladder diseases is higher in the children with hepatic alveolar echinococcosis in Qinghai Province, and it has great influence on the operation mode and the occurrence and prognosis of postoperative complications. The early diagnosis and treatment of alveolar echinococcosis in children is particularly important.
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Objective To amplify and sequence Coxl and Nadl genes in Echinococcus multilocularis isolates from Qinghai Province, and to create phylogenetic trees and molecular clocks, so as to provide evidence for estimating the evolutionary relationships and origins of E. multilocularis in Qinghai Province. Methods Twenty-two post-surgical specimens of patients with hepatic alveolar echinococcosis were sampled from Qinghai Provincial People’s Hospital in 2017. The Coxl and Nadl genes were amplified from E. multilocularis samples and sequenced. Then, the gene sequences were aligned to the Coxl and Nadl genes of Echinococcus species in GenBank database. The intra-species variation was observed, and the phylogenetic tree and molecular clock were created. Results All E. multilocularis samples shared more than 99% genetic homology with the sequences of Coxl and Nadl genes from the E. multilocularis Asian strain in the GenBank database. A total of 6 genotypes were identified, including 2 isolates that had no 100% homology with the sequences of known genes in the GenBank database. Phylogenetic tree analysis revealed remarkable clustering of the E. multilocularis samples with the E. multilocularis Asian strain, and the E. multilocularis isolates from Qinghai Province were estimated to date back to 94 000 years ago by the molecular clock. Conclusions The present study characterizes 6 E. multilocularis genotypes in Qinghai Province, including 2 novel genotypes. Asian strain is the predominant strain of E. multilocularis in Qinghai Province, and the E. multilocularis isolates from Qinghai Province date back to 94 000 years ago.
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Objective To investigate the distribution characteristics of gallbladder diseases in children with hepatic alveolar echinococcosis, and to analyze the related factors for hepatic alveolar echinococcosis and gallbladder diseases. Methods The clinical data of hepatic alveolar echinococcosis patients under 18 years were collected in Qinghai Provincial People’s Hospital-from January 2012 to December 2017, and the gallbladder-related complications in the surgically treated patients with hepatic al-veolar echinococcosis were analyzed. Results The clinical data of 51 child patients with hepatic alveolar echinococcosis were collected and analyzed. According to the PNM classification criteria of WHO, P1, P2 and P3 in the 51 patients accounted for 37.25% (19/51), 41.18% (21/51) and 19.60% (10/51), respectively. According to the diagnostic criteria (WS 257–2006) of China for echinococcosis, the patients of infiltration type, calcification type and liquefaction cavitary type accounted for 66.67% (34/51), 21.57% (11/51) and 11.76% (6/51), respectively. Among the 51 patients, 78.43% (40/51) of the patients had clinical symptoms of biliary tract disease, and 58.82% (30/51) had gallbladder-related complications. The operations were performed on 40 patients, and 77.50% (31/40) of them had the postoperative complications. The results of binary multivariate logistic regression analysis showed that the clinical image classification, the liver segment distribution, size, location and number of lesions of hepatic alveolar echinococcosis were important correlative factors for the occurrence of gallbladder complications in hepatic alveolar echinococcosispatients. Conclusions The incidence of complications related to gallbladder diseases is higher in the children with hepatic alveolar echinococcosis in Qinghai Province, and it has great influence on the operation mode and the occurrence and prognosis of postoperative complications. The early diagnosis and treatment of alveolar echinococcosis in children is particularly important.
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Objective To investigate the demographical data,clinical data and outcomes of patients with Hydatid disease. Methods The data of 493 Hydatid disease patients collected from January 2013 to June 2017 in Qinghai Province were treated with the Epi Data 3.02 to record the data in duplicate and establish Hydatid disease database,which was then analyzed with SPSS 17.0 for statistical analysis.Results There were 409 cases of Cystic Echinococcosis and 84 cases of Bursal Echinococcosis. The male patients accounted for 42%,and the female for 58%.The curative rate of CE2 and CE4 patients was higher than that of patients with CE1,CE3 and CE5,with sig-nificant differences(χ2=3.502,Р=0.835).The cure rate of patients with cystic echinococcosis was significantly higher than that of Bursa edulis(χ2=30.275,Р=<0.01).The difference was statistically significant in view of the affected position(χ2= 17.521,Р = 0.020). In view of Child-Pugh classification and immunological examination on the outcome of the disease,the difference was statistically significant(χ2= 17.521,Р = 0.020;χ2= 15.731,Р < 0.022). In view of the operation method,the different was statistically significant(χ2= 57.389,Р < 0.01). Conclusion The data of Hydatid disease patients in Qinghai province were establisheded,which provides scientif-ic and detailed and clinical data on Hydatid disease.
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@#Objective To investigate the malaria knowledge of CDC staff and their demands on related training in malaria non⁃endemic areas，so as to provide the reference for planning the appropriate curriculum. Methods All the participants who were the staff of county CDCs all over Qinghai Province and attended the provincial training workshop were surveyed. A self⁃administered questionnaire survey was carried out and the data was statistically analyzed. Results A total of 115 participants were involved in this survey. They were mostly（85.21%）from county CDCs. The general knowledge of malaria among the respondents was well，and the average rate of correct answers was 70.35%. However，the answers to the general knowledge of malaria and anti⁃malaria treatment were not well enough. The rates of correct answers were 61.96% and 48.99% respectively. The differences among the groups of job title ranking，department of working and level of CDC were not significant（F = 0.13-2.02，all P > 0.05）. The number of correct answers was significantly increased after the training course. The average score after the training was 79.20±15.16 while the pre⁃training score was 70.34±17.46（t = 3.86，P < 0.05），especially in the answers to general malaria knowledge and malaria surveillance and response（t = 4.30，4.97，both P < 0.05）. The general knowledge of malaria was considered as the most need of training as 80% of the respondents voted“Yes”，according to the demand analysis. There was no significant difference among the different groups（F = 0.61-3.11，both P > 0.05）. Conclusion The malaria knowledge is well mastered by the staff of CDCs in Qinghai Province，and the further training courses are requested and addressed in the target areas such as general malaria knowledge，anti⁃malaria treatment，malaria surveillance and response.
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OBJECTIVE:To improve the distribution rate of essential medicines,to meet the medication needs in primary health care institutions. METHODS:The in essential medicine distribution in primary health care institutions was analyzed,and combined with the current essential medicine policy regulations,problems existed in the bidding work program of distribution enterprises that made by health departments were summarized,and countermeasures were put forward. RESULTS & CONCLUSIONS:Resources in medicament circulation industry get further integration,the industrial structure is optimized and upgraded,and the distribution rate is comprehensively improved after the implementation of national essential medicine system in Qinghai province. But there are still some problems,including serious monopolies in wholesale and sales enterprises,insufficient supply of some biding drugs,low distribution rate,inadequate supervision of relevant authorities,unreasonable regional distribution of drug retail stores and low qual-ity of distribution companies. For above-mentioned problems,relevant government departments should strengthen supervision and propaganda of relevant laws,regulations and policies for medicine distribution,intensity to supervise medical institutions,intro-duce competition mechanism,establish advanced pharmaceutical distribution and increase capital investment in drug sales in remote areas to effectively improve distribution rate of essential medicines and meet the needs of primary medical institutions.
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Objective To understand the situation of prevention and control knowledge of echinococcosis in students in Qin?ghai Province,so as to provide an evidence for effective prevention and control of echinococcosis. Methods The students of Grade Four or above were randomly selected with the multi?stage stratified cluster sampling method and investigated with the questionnaire about echinococcosis in Qinghai Province. Results Totally 23 600 students were selected and surveyed,with the pass rate of 66.0%(15 566 cases). The pass rates of the male and female students were 65.1%(7 947 cases)and 66.9%(7 619 cases)respectively,and the difference was significant(χ2=8.454,P<0.01). The difference of pass rates among different dis?tricts of Qinghai Province was statistically significant(χ2=3 848.619,P<0.01). Conclusion The general aware rate of echino?coccosis knowledge in students is not high in Qinghai Province,and therefore,it is necessary to enhance the health education, especially for students in pasturing areas.
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OBJECTIVE: To establish a one-step esterification derivative analysis method for fatty acids in Cordyceps sinensis. and analyze and compare the composition and content of fatty acids of 12 samples from five counties of Yushu prefecture of Qinghai province. METHODS: Qualitative and quantitative analysis of fatty acids was performed by gas chromatography-mass spectrometry (GC/MS) in combination with comparison to reference substances, then the data was compared. RESULTS: Thirteen kinds of fatty acids of C14-C20 were found with a total amount of 79.81 - 160.20 mg · g-1. For a same sample, palmitic acid, oleic acid, and linoleic acid were the three kinds of fatty acids with the highest contents, the total content of which accounted for 92.81% -95.66% of the total 13 fatty acids. The proportion of unsaturated fatty acid was much higher than that of saturated fatty acids, and the ratio of UFA/SFA was 4.23-6.63. The fatty acids of 18 carbon and 16 carbon were the component with the highest amount and content, and the ratio of C18/C16 ranged from 4.04 to 6.19. Furthermore, the composition of the 13 fatty acids was basically consistent, while the content and proportion of the fatty acids varied greatly in samples from different origins. CONCLUSION: The method of fatty acids determination in Cordyceps sinensis set up by this research is simple, accurate, and reproducible, which is suitable for the fatty acids analysis in natural Cordyceps sinensis. The qualitative and quantitative data of the fatty acids could provide references for better recognition of the value of Cordyceps sinensis and further studies on its quality control.
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Objective Though X-ray measurement of metacarpal bones of right hand in children aged 7-12 in Kaschin-Beck disease (KBD) endemic areas in Xinghai County,Qinghai Province,to provide scientific basis for KBD diagnosis and research on growth and development of children in KBD endemic areas.Methods In 2012,277 children aged 7-12 were carried out clinical examination and right hand X-ray photos in KBD endemic areas,Xinghai County,Qinghai Province.Metacarpal bones were measured by electronic digital vernier caliper,and the axis length and width of the metacarpal bones and its metacarpal bone index were calculated.All data were analyzed by SPSS 19.0 software.Results The axis lengths of the metacarpal bones were in an order of 2.metacarpal ＞ 3.metacarpal ＞ 4.metacarpal ＞ 5.metacarpal ＞ 1.metacarpal in 6 different age groups and different genders; the width of 1.metacarpal bone was the widest; the width of 4.metacarpal bone was the smallest,and the rest of metacarpal bones were similar.The metacarpal bone indexes of female [(7.96 ± 0.76),(8.24 ± 0.92),(8.24 ± 0.71),(8.26 ± 0.92),(8.60 ± 1.02),(8.67 ± 0.84)mm] were higher than those of male's[(7.30 ± 0.78),(7.53 ± 0.77),(7.98 ± 0.90),(7.79 ± 0.56),(7.96 ± 0.64),(8.17 ± 0.92)mm,F =4.302,P ＜ 0.05].Conclusion The axis length,width and index of metacarpal bones of right hand in children between KBD endemic areas and no-KBD endemic areas are similar.
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OBJECTIVE: To establish an HPLC method for simultaneous determination of 15 nucleosides in Cordyceps sinensis, and investigate the differences in the composition and contents of these 15 nucleosides in 12 samples from 5 counties of Yushu prefecture, Qinghai province.
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To classify and identified the nematode parasized in ruminant in Qinghai province,the mature nematode specimen parasized in Tibetan sheep,goat,yak,ox and camel was collected and classified systematically,by adopting classfication systems of Yamaguti(1961).All those specimens belong to 24 genera of 15 families of 6 orders in nematade of Nemathelminthes Class,of which 85 kinds of nematodes were sorted out,among them 13 lung nematodes,71 digestine nematode and 1 muscle nematode were classified.
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Parasitological and dissection methods were used to confirm Echinococcus infection and echinococcosis in animals,and to understand the epidemiological situation in final and intermediate animal hosts in Qinghai Province. Three Echinococcus species were found in the Province including E. granulosus,E. multilocularis and E. shiquicus. The prevalence of hydatid disease showed a tendency of increase with an average rate of over 50% in yaks and sheep. Higher prevalence in wild animals as intermediate host was found in the southern plateau,while that in final hosts such as dogs and wolves,the prevalence was higher in the area of Qilian mountain. There is a complex chain of life cycle of the parasites among animals,which poses a threat to the health of human population. Effective measures to control the disease in animals are urgently needed.