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1.
Chinese Journal of Endemiology ; (12): 914-918, 2021.
Article in Chinese | WPRIM | ID: wpr-909124

ABSTRACT

Objective:By investigating the cognitive level and influencing factors of heart failure knowledge in patients with chronic Keshan disease, so as to provide reference for improving the cognitive level of disease-related knowledge of the patients with Keshan disease in the targeted manner.Methods:In 2019, 100 patients with chronic Keshan disease were selected in Jingchuan County, Gansu Province. A questionnaire survey was conducted using the heart failure knowledge questionnaire to conduct correlation and regression analysis on the cognitive level of patients' heart failure knowledge and influencing factors.Results:Patients' average score of the heart failure knowledge level was (6.18 ± 2.72) points, and the scoring accuracy rate was 41.20%. The Spearman correlation analysis indicated that heart failure knowledge level was associated with annual family income ( r = 0.363, P < 0.01), the hospitalization times due to heart failure ( r = 0.304, P < 0.01), and the number of family members ( r = 0.240, P < 0.05). The results of multiple linear regression showed that the cognitive level of heart failure knowledge in male patients was higher than that in female patients ( P < 0.05). The more hospitalization times ( P < 0.05) and the more family members ( P < 0.05) were, the higher the cognitive level of heart failure knowledge was. Conclusions:The cognitive level of heart failure knowledge of patients with chronic Keshan disease is generally low. Medical staff should actively make use of the patient's hospitalization time for health education, and pay attention to the health education of family members of the patients.

2.
Chinese Journal of Endemiology ; (12): 648-651, 2021.
Article in Chinese | WPRIM | ID: wpr-909070

ABSTRACT

Objective:To understand the prevalence of hypertension among residents in Keshan disease areas of Sichuan Province, in order to provide scientific basis for prevention and control of hypertension among residents in Keshan disease areas in Sichuan Province in the future.Methods:From 2017 to 2018, Keshan disease case search was carried out in 28 Keshan disease counties (cities, districts, referred to as counties) in Sichuan Province. According to the results of case search, survey sites were selected. Questionnaire survey and blood pressure measurement on permanent residents of the survey sites were conducted according to the unified Keshan disease monitoring plan by professionals. The diagnostic criteria of hypertension refer to the "Chinese Guidelines for Prevention and Treatment of Hypertension" (2019).Results:Totally 24 709 people aged 16 and over were investigated in 28 counties, and 6 022 patients with hypertension were detected, with a detection rate of 24.4% (6 022/24 709); the prevalence of hypertension was 25.5% (2 597/10 199) in male and 23.6% (3 425/14 510) in female; isolated systolic hypertension accounted for 46.5% (2 798/6 022); the constituent ratio of hypertension was 61.9% (3 725/6 022) in grade one, 27.6% (1 665/6 022) in grade two and 10.5% (632/6 022) in grade three.Conclusions:Although the detection rate of hypertension in Keshan disease areas in Sichuan Province is lower than that in the whole country (26.3%), it is still a long-term public health problem. The monitoring of related diseases and health education should be carried out continuously in Keshan disease areas.

3.
Chinese Journal of Endemiology ; (12): 644-647, 2021.
Article in Chinese | WPRIM | ID: wpr-909069

ABSTRACT

Objective:To master the current status and trend of Keshan disease in Chongqing City, and to provide scientific basis for prevention and treatment of Keshan disease in the future.Methods:In 2019, case search was carried out in 9 Keshan disease areas (counties) in Wanzhou District, Fuling District, Changshou District, Liangping District, Dianjiang County, Fengdu County, Zhong County, and Shizhu County of Chongqing City; five Keshan disease areas (counties) including Wanzhou District, Fuling District, Kaizhou District, Dianjiang County, Kaizhou District and Zhong County were selected as the monitoring sites to carry out key monitoring. Questionnaire survey, clinical examination, and electrocardiogram (ECG) were carried out on monitored subjects. The suspected cases of Keshan disease were examined by cardiac ultrasonography or posterior anterior chest X-ray.Results:A total of 25 728 cases were searched in 471 medical institutions, among which 240 suspected cases of Keshan disease were found, and 2 cases of chronic Keshan disease were confirmed. A total of 4 043 permanent residents were monitored in 5 key monitoring sites, and 813 abnormal ECG were detected, with an abnormal rate of 20.11%. Cardiac ultrasonography was performed in 40 cases, of which 19 (47.50%) cases had decreased cardiac function, 16 cases (40.00%) had thickened ventricular septal, and 11 cases (27.50%) had enlarged heart. In 56 cases of chest X-ray examination, mild, moderate and severe enlargement of heart were 9 (16.07%), 5 (8.93%) and 3 (5.36%), respectively. No case of various types of Keshan disease had been found in cardiac ultrasonography and X-ray examations.Conclusions:Chongqing City is in a stable and low incidence of Keshan disease, but some cases of chronic Keshan disease have been detected. We should continue to carry out the disease monitoring in the future.

4.
Chinese Journal of Endemiology ; (12): 640-643, 2021.
Article in Chinese | WPRIM | ID: wpr-909068

ABSTRACT

Objective:To master the new cases and the condition of Keshan disease (KD) in key endemic areas and provide scientific basis for updating control strategies.Methods:In 2017, sentinel surveillance was carried out in some counties with substandard KD or serious historical KD. Two to three villages with more KD patients and the total population of 1 000 were chosen to investigate. All of the inhabitants were checked by physical examination and electrocardiography. Suspected KD patients were examined by echocardiography. KD was identified according to "Diagnosis of Keshan Disease" (WS/T 210-2011). The confirmed cases were followed up.Results:A total of 70 008 people were examined in 86 counties of 14 provinces. The ratio of male to female was 1.0 ∶ 1.2 (31 720/38 288). The total number of KD patients identified was 308, including 68 chronic KD and 240 latent KD. The detection rates were 44/10 000, 10/10 000 and 34/10 000, respectively. Totally 198 cases of chronic KD and 115 cases of latent KD were followed up, and the follow-up mortality was 8.1% (16/198) and 7.0% (8/115), respectively. In this year, 29 cases of latent KD and 5 cases of chronic KD were newly diagnosed.Conclusion:There are still a number of KD patients including new cases in endemic areas with high prevalence nowadays or in the past indicating the prevention and control of KD should be maintained.

5.
Chinese Journal of Endemiology ; (12): 610-615, 2021.
Article in Chinese | WPRIM | ID: wpr-909063

ABSTRACT

Objective:Through differential miRNA expression profiles and bioinformatics in the peripheral blood of patients with Keshan disease (KD) and healthy control, to explore the possible pathogenesis of KD.Methods:Ten patients with chronic KD (KD group) were selected in the severe disease area of KD in Wulian County, and 10 healthy subjects (control group) were selected in non-KD area of Dongchangfu District, Shandong Province. Blood sample of elbow vein was collected and plasma was separated. RNA-seq technology was used to construct the differential expression profiles of miRNA in KD and control groups. Target mRNAs were screened using Starbase, miRTarBase, miRDB and TargetScan. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were conducted to investigate the possible pathogenesis of KD.Results:Compared the control group and KD group, 132 differentially expressed miRNAs were screened out, including 90 upregulated and 42 downregulated miRNAs. Through Starbase, miRTarBase, miRDB and TargetScan, 53 miRNAs were obtained, 737 targeted mRNAs were obtained. GO analysis showed that the differential genes were mainly involved in the biological processes of Ras protein signal transduction, transmembrane transport, cell cycle regulation, cell adhesion, etc. KEGG pathway analysis showed that the differential genes were mainly involved in viral infection, endocytosis, adhesion spot and actin regulation.Conclusion:In this study, RNA-seq technology is used to obtain differential miRNA expression profiles of KD patients and healthy control, and target pathogenic genes and signaling pathways that may be related to KD are screened out.

6.
Chinese Journal of Endemiology ; (12): 856-860, 2019.
Article in Chinese | WPRIM | ID: wpr-790945

ABSTRACT

Keshan disease (KD) is a unique endemic cardiomyopathy of unknown origin in China.According to the state of heart function and the pathogenesis,KD is divided into four types:acute,sub-acute,chronic and latent.Chronic KD comes on slowly,and the clinical manifestation is chronic cardiac insufficiency.Chronic patients often have poor treatment outcomes,with high mortality and disability.This article summarizes the nonpharmacological treatment of heart failure in chronic KD in order to provide a basis for clinical treatment.

7.
Chinese Journal of Endemiology ; (12): 806-809, 2019.
Article in Chinese | WPRIM | ID: wpr-790933

ABSTRACT

Objective To analyze and evaluate the long-term effects of self-administered family therapy (family therapy) interventions on patients with chronic Keshan disease,and provide guidance for improving patient survival and quality of life.Methods A retrospective analysis method was used to collect case data of patients with chronic Keshan disease who participated in family therapy intervention projects for 2 consecutive years or more in Zoucheng City,Shandong Province from 2008 to 2018.According to the general conditions,clinical signs,the changes of electrocardiogram,cardiac color ultrasound,cardiac function grading,the therapeutic effect and prognosis were evaluated.Results A total of 74 patients with chronic Keshan disease were studied,including 33 males and 41 females,with an average age of 47.63 years old.At the last survey of family therapy,the total effective rate was 78.38% (58/74).Fisher's exact probability test showed that environmental factors had a significant effect on the efficacy of patients with chronic Keshan disease (P < 0.05),indicating that leaving the local epidemic area could affect the patient's efficacy;and the patient's gender,age,occupation,psychological factors and economic status had no significant effect on the efficacy (P > 0.05).Before and after the family therapy,the distribution of cardiothoracic ratio and cardiac function grading were significantly different,and the ventricular high voltage condition was significantly improved (P < 0.05);the patient's cardiac function grading before family therapy and the effect of the last family therapy had a significant effect on the final outcomes (P < 0.05).Conclusions The long-term continuous family therapy intervention has a significant effect on the curative effect of patients with chronic Keshan disease,and can improve the prognosis even better.Family therapy is a scientific intervention that requires long-term adherence.

8.
Chinese Journal of Endemiology ; (12): 782-786, 2019.
Article in Chinese | WPRIM | ID: wpr-790929

ABSTRACT

Objective To analyze the difference of echocardiography in patients with chronic Keshan disease (CKD) at different altitudes areas,explore the effects of altitude on the structure and functional of right heart in CKD patients,and provide a reference for imaging diagnosis of CKD.Methods According to the three step distribution of the terrain in China,30 cases of CKD patients in the first step (altitude > 4 000 m) of Tibet autonomous region were randomly selected as the Tibetan plateau group.In the second step (altitude:1 000-2 000 m),31 cases were randomly selected in Gansu Province as the Loess plateau group.In the third step (altitude < 500 m),42 cases were randomly selected in Shandong Province as the plain group.Echocardiography was used to analyze the morphology,hemodynamics and function of right heart.Results Right atrial transverse diameter (RATD),right ventricular transverse diameter (RVTD),right ventricular lateral wall thickness (RVWT) and main pulmonary artery diameter (MPAD) of the Tibetan plateau group,the Loess plateau group and the plain group (mm:49.75 ± 8.40,45.64 ± 7.63,43.56 ± 7.34;50.89 ± 7.13,46.56 ± 5.62,43.27 ± 6.01;4.75 ± 1.02,3.53 ± 0.61,3.37 ± 0.51;32.87 ± 3.62,28.93 ± 2.12,28.44 ± 2.71) were significant differences among the three groups (F =5.36,12.91,37.08,23.33,P < 0.01).The above indexes of the Tibetan plateau group were higher than those of the Loess plateau group and the plain group (P < 0.05).RVTD of Loess plateau group was higher than that of plain group (P < 0.05).The fractional area change [FAC,(24.85 ± 2.75)%,(26.26 ± 3.42)%,(26.73 ± 3.14)%],tricuspid annular plane systolic excursion [TAPSE,(12.87 ± 1.12),(14.59 ± 1.63),(14.13 ± 1.31) mm] of the Tibetan plateau group,the Loess plateau group and the plain group were significant differences among the three groups (F =3.36,13.47,P < 0.05 or < 0.01);the above indexes of the Tibetan plateau group were lower than those of the Loess plateau group and the plain group (P < 0.05).Tei index (0.87 ± 0.18,0.78 ± 0.16,0.71 ± 0.14),tricuspid flap diastolic maximum filling speed/tricuspid annulus early diastolic peak velocity (E/E',9.48 ± 1.22,8.64 ± 0.91,8.12 ± 1.13),systolic pulmonary artery pressure [SPAP,(49.58 ± 11.76),(44.35 ± 11.41),(42.67 ± 12.13) mmHg,1 mmHg =0.133 kPa] of the Tibetan plateau group,the Loess plateau group and the plain group were significant differences among the three groups (F =12.89,13.99,3.12,P < 0.01 or < 0.05);the Tei index and E/E'of the Tibetan plateau group were higher than those of the Loess plateau group and the plain group (P < 0.05).Tei index,E/E'of the Loess plateau group were higher than those of the plain group (P < 0.05).Conclusions The right heart structure and function of CKD patients are affected by the altitude of their residence.With the increase of altitude,the right heart is enlarged,the right ventricular systolic and diastolic functions are decreased,and SPAP is increased in CKD patients.

9.
Chinese Journal of Endemiology ; (12): 413-417, 2019.
Article in Chinese | WPRIM | ID: wpr-753515

ABSTRACT

Keshan disease is an endemic cardiomyopathy of unclear cause.The major clinical manifestations are cardiac dysfunction and arrhythmia.Based on time course of onset and cardiac function of a suffering patient,Keshan disease is generally classified into four types:acute,sub-acute,chronic and latent types.This article elaborates on the pharmacological mechanisms and dosages of drug treatment for heart failure:diuretics,neurohormonal antagonists,ivabradine,positive inotropic drugs,vasodilators,etc,in order to provide basis for clinical treatment of chronic Keshan disease.

10.
Chinese Journal of Endemiology ; (12): 404-408, 2019.
Article in Chinese | WPRIM | ID: wpr-753512

ABSTRACT

Objective The echocardiography of patients with chronic Keshan disease (CKD) in the plateau and plain areas was compared,to analyze the specific manifestations of echocardiography in patients with high altitude CKD,to provide a reference for imaging diagnosis.Methods From October 2014 to December 2016,34 patients with CKD were selected in the Tibet Autonomous Region [18 males,16 females,aged (44.5 ± 5.6) years old] as plateau group;45 patients with CKD were selected in Shandong Province [21 males,24 females,age (47.3 ± 6.9) years old] as a plain group.Echocardiography was performed on the observed subjects,and cardiac morphology,hemodynamics and cardiac function were analyzed.Results The left atrial diameter (LAD),left ventricular end diastolic diameter (LVEDD),and left ventricular mass (LVM) of the plateau group were (39.2 ± 4.8),(56.5 ± 6.3) mm and (232.4 ± 40.2) g,respectively,which were lower than those of the plain group [(48.3 ± 5.7),(65.2 ± 7.8) mm,(283.7 ± 38.3) g,t =-7.52,-5.30,-5.74,P < 0.01].The right atrial transverse diameter (RATD),right ventricular transverse diameter (RVTD) and right ventricular lateral wall thickness (RVWT) of the plateau group were (47.6 ± 8.5),(50.4 ± 7.3) and (4.8 ± 1.1) mm,respectively,which were higher than those of the plain group [(42.3 ± 7.2),(42.7 ± 6.8),(3.3 ± 0.7) mm,t =2.99,4.81,7.36,P < 0.01].The early diastolic filling velocity (E),the early diastolic peak velocity of the mitral annular (Em) of the plateau group were lower than those of the plain group,E/Em of the plateau group was higher than that of the plain group (t =-2.64,-2.35,2.07,P < 0.05).The fractional area change (FAC) of right ventricular,tricuspid annular plane systolic excursion (TAPSE) and tricuspid annular systolic velocity (S') of the plateau group [(24.9 ± 2.8)%,(13.2 ± 1.2) mm,(6.8 ± 1.0) cm/s] were lower than those of the plain group [(26.3 ± 3.2)%,(14.5 ± 1.3) rmm,(7.5 ± 1.2) cm/s,t =-2.02,-4.53,-2.74,P < 0.05 or < 0.01].The tricuspid annular diastolic velocity (e') of the plateau group was lower than that of the plain group,and tricuspid annular blood flow early diastolic filling velocity maximum (e)/e'was higher than that of the plain group (t =-2.07,2.09,P < 0.05).The systolic pulmonary artery pressure (SPAP) of the plateau group [(48.5 ± 12.3) mmHg,1 mmHg =0.133 kPa] was higher than that of the plain group [(41.6 ± 13.3) mmHg,t =2.34,P < 0.05].Conclusion Compared with CKD patients in plain area,CKD patients in plateau area have showed more obvious right heart enlargement and right ventricular failure,and combined with higher SPAP.

11.
Chinese Journal of Endemiology ; (12): 385-389, 2019.
Article in Chinese | WPRIM | ID: wpr-753508

ABSTRACT

Objective To analyze the situation of Keshan disease in China and provide a scientific basis for adjustment of the control strategies.Methods Relying on the Keshan disease surveillance in 2014 and the "Twelfth Five-Year Plan" Final Assessment Project in 2015 and 2016,in each surveillance site of the 12 provinces including Hebei,Shanxi,Inner Mongolia,Liaoning,Jilin,Heilongjiang,Shandong,Chongqing,Sichuan,Yunnan,Shaanxi,and Gansu,the residents were investigated by face-to-face questionnaire interviews,physical measurements and electrocardiography.Echocardiographic examination and chest X-ray examination were conducted for those patients with suspected Keshan disease.Results In 2014,the data of a total of 171 838 individuals were included in the analyses.A total of 749 cases of Keshan disease were detected in all the survey sites of 12 provinces.The detection rate was 43.6/10 000.Among them,160 cases were chronic,the detection rate was 9.3/10 000;the potential type was 589 cases,the detection rate was 34.3/10 000.In 2015 and 2016,the data of a total of 396 977 individuals were included in the analyses.A total of 2 127 cases of Keshan disease were detected in 12 provinces.The detection rate was 53.6/10 000.Among them,377 cases (9.5/10 000) were chronic,and the potential type was 1 750 cases (44.1/ 10 000).Conclusion There are still natural chronic Keshan disease cases in the endemic area,therefore the prevention and treatment tasks cannot be ignored.

12.
Chinese Journal of Endemiology ; (12): 361-367, 2019.
Article in Chinese | WPRIM | ID: wpr-753504

ABSTRACT

Objective By constructing the differential expression profile of lncRNA/mRNA in peripheral blood plasma of patients with Keshan disease (KSD) and dilated cardiomyopathy (DCM),to explore the commonality and characteristics of the two diseases in molecular mechanism.Methods Ten patients with chronic KSD were selected in the severe disease area of KSD in Shandong Province,and 10 cases of DCM and 10 healthy subjects (control group) were selected in non-KSD area.Blood of elbow vein was collected and plasma was separated.RNA-seq technology was used to construct the differential lncRNA/mRNA expression profile between KSD and control group,DCM and control group,and co-expression and specific expression of partial genes in KSD and DCM were analyzed through Wien analysis.The lncRNA-mRNA co-expression network maps of specific part of KSD,specific part of DCM and common part of the two diseases were constructed,and Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were applied to distinguish the biological function of the two diseases.Results Compared with control group,102 dysregulated mRNAs and 22 dysregulated lncRNAs showed the same trend in KSD and DCM.And 3 606 mRNAs and 451 lncRNAs were only differentially expressed in KSD group,217 mRNAs and 137 lncRNAs were only differentially expressed in DCM group.The differentially expressed lncRNA/mRNA shared between the KSD and DCM groups were mainly about viral transcription,immuno-inflammatory response,oxidative stress signaling pathways.The KSD specific lncRNA/mRNA mainly participated in cell membrane damage and viral myocarditis.The DCM specific lncRNA/mRNA mainly regulated mitochondrial structure and oxidative phosphorylation related enzymes.Conclusion The differentially expressed lncRNA/mRNA shared in KSD and DCM groups are mainly involved in viral transcription,oxidative stress signaling pathways;KSD specific lncRNA/mRNA are mainly related to cell membrane damage and viral myocarditis;DCM specific lncRNA/mRNA mainly regulate mitochondrial structure.

13.
Chinese Journal of Endemiology ; (12): 357-360, 2019.
Article in Chinese | WPRIM | ID: wpr-753503

ABSTRACT

Objective To investigate the relationship between single nucleotide polymorphisms of interleukin 23 receptor (IL-23R) gene and Keshan disease (KD) in Northwest Chinese Han population.Methods A total of 285 Chinese Han subjects from Huangling,Shaanxi,including 79 KD patients (case group) and 206 control subjects (control group) were involved in this study.Genomic DNA was extracted from peripheral venous blood.The polymorphism of genetic variation was genotyped by matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF).All sample groups were tested for Hardy-Weinberg equilibrium using goodness-of-fit x2 test.Differences in genotype distribution between two groups were compared by x2 test.Logistic regression analysis was applied to detect association using age as a confounding factor.Results The gene frequency distribution of IL-23R gene rs10889677 in case group and control group conformed to the Hardy-Weinberg equilibrium (x2 =0.254,P > 0.05).Correlation analysis results:the difference of genotype frequency of IL-23R gene rs10889677 in case group (CC,CA,AA were 6.3%,36.7%,57.0%,respectively) and control group (CC,CA,AA were 5.3%,43.2%,51.5%,respectively) was not statistically significant (x2 =1.008,P > 0.05).After age adjustment,there was no significant difference in genotype frequency of IL-23R gene rs10889677 (x2sdj =0.669,P > 0.05) between two groups.Conclusion There is no correlation between IL-23R gene rs10889677 and KD in Northwest Chinese Han population.

14.
Chinese Journal of Endemiology ; (12): 348-350, 2019.
Article in Chinese | WPRIM | ID: wpr-753501

ABSTRACT

With the huge advances in rural China since 1980s,rampant Keshan disease (KD)has been fading away,and therefore we set an ultimate goal at overall elimination.In recent years,the evaluation results showed that there were still some obstacles in achieving this goal.By explaining the pathogenesis and epidemic mechanism of KD and the factors regulating the fluctuation of the disease,as a kind of local lifestyle disease induced by poverty,the author think,it will be of very low possibility in breaking out again thanks to the long-term exchange of cereal commodities and current poverty relief program.And the next move is to revise the existing criteria for KD elimination and to maintain the state of elimination primarily through health education and social economic improvement in all affected areas.

15.
Chinese Journal of Endemiology ; (12): 896-899, 2018.
Article in Chinese | WPRIM | ID: wpr-701455

ABSTRACT

Objective To observe and analyze the electrocardiogram (ECG) characteristics of patients with chronic Keshan disease and explore the influence of health management on ECG of chronic Keshan disease.Methods ECG data of 130 patients with chronic Keshan disease who were involved in the health management program for Keshan Disease from 2012 to 2014 in the area of Inner Mongolia were analyzed retrospectively (57 were males and 73 were females,aged 51.2 ± 11.5).The survey indexes include general condition,ECG examination before and after implementing the health management program.Results There were abnormal ECG in 130 patients with chronic Keshan disease before implementing the health management program.Among them,87 cases (66.9%) had arrhythmia,74 cases (56.9%) had widening of QRS wave group,56 cases (43.1%) had ST-T changes,51 cases (39.2%) had atrioventricular hypertrophy,9 cases (6.9%) had abnormal Q wave and 5 cases (3.8%) had prolonged Q-T interval.After implementing the health management program,there were 64 cases (49.2%) of arrhythmia in abnormal ECG,48 cases (36.9%) with widening of QRS wave group,40 cases (30.8%) with ST-T changes and 31 cases (23.8%) with atrioventricular hypertrophy,which were significantly lower than those before implementing the health management program (x2 =8.36,10.44,4.23,7.13,P < 0.05).Conclusions The ECG of patients with chronic Keshan disease is varied,among which arrhythmia,QRS wave group prolongs,ST-T changes,atrioventricular hypertrophy are the most common.Health management of patients can make the detection rate of common abnormal changes of ECG decrease obviously.

16.
Chinese Journal of Endemiology ; (12): 595-598, 2018.
Article in Chinese | WPRIM | ID: wpr-701384

ABSTRACT

The problem of Keshan disease (KD) is confused with dilated cardiomyopathy (DCM) is still not solved.KD and DCM have different gene expression profiles,namely,different Micro RNAs (miRNAs) and Long noncoding RNAs (lncRNAs).There may be characteristic miRNAs and lncRNAs in KD and DCM.Systemically study differential gene expression profiles and regulation of noncoding RNAs gene expression and elucidate the different molecular pathogenesis in gene expression and gene expression regulation will provide theoretic basis in identification,prevention and treatment of KD and DCM.

17.
Chinese Journal of Endemiology ; (12): 380-384, 2018.
Article in Chinese | WPRIM | ID: wpr-701337

ABSTRACT

Objective To evaluate the efficacy of telephone interviews on the quality of life of patients with chronic Keshan disease.Methods Totally 120 cases of chronic Keshan disease patients with chronic heart failure and NYHA classification of Ⅱ-Ⅳ were enrolled among the 181 patients with chronic Keshan disease,which confirmed by case search in Heshui County and Zhengning County in Qingyang City,Gansu Province in 2015,general demographic and clinical data were collected.According to the principle of random number table grouping,these 120 patients were randomly divided into a intervention group (n =60) and a control group (n =60).Both groups were given the conventional therapy and encouraged to inquiry or given regular outpatient medical follow-up.The patients in the intervention group received telephone interviews regularly for 6 months,with a interview frequency once a week in the first month,once every two weeks in the second and third months and once a month in the fourth,the fifth and the sixth months,with about 15 to 20 minutes interviews each time.Meanwhile there was no telephone interviews in the control group.At the begining of study,and after 3 months and 6 months of study,quality of life scores were scored according to the Minnesota Heart Insufficiency Scale (MLHFQ).The scores included total quality of life,physical field scores,emotional field scores,and other field scores.The lower the score,the higher the quality of life.Results After 3 months of telephone interviews,the emotional domain score of the intervention group (10.16 ± 4.58) was lower than that of the control group (13.10 ± 5.37,P < 0.05).After 6 months of telephone interviews,the patients in the intervention group (35.60 ± 16.07,6.67 ± 4.01,13.16 ± 4.13) had significantly better quality of life than those in the control group (57.19 ± 14.97,12.43 ± 5.29,18.94 ± 6.68),with lower total points of life quality,emotion area and other area scores.The differences between the two groups were statistically significant (P < 0.05).Conclusions Telephone interviews may promote the quality of life for patients with chronic Keshan disease.It is an effective way in enhancing the ability of chronic Keshan disease management.

18.
Chinese Journal of Endemiology ; (12): 375-379, 2018.
Article in Chinese | WPRIM | ID: wpr-701336

ABSTRACT

Objective To investigate the current condition and risk factors of Keshan disease (KD) in Shandong Province,and to provide a scientific basis for prevention and control of KD.Methods Based on the 2014 scheme of KD surveillance,residents in 38 surveillance sites of 19 counties (cities,districts) were surveyed by questionnaire survey,physical examination,electrocardiograms (ECG),X-ray or echocardiography.At the same time,some residents' hair,grain and soil samples were collected,and the content of selenium in the internal and extemal environment was tested.KD was evaluated in Shandong Province based on the "National Standard of Evaluation Method for Key Endemic Disease Control and Elimination".Results ①In 38 monitoring sites,16 168 residents were surveyed and 164 cases of KD were detected (in which 149 cases of potential,15 cases of chronic),the detection rate was 1.014%.② Totally 2 497 samples of hair (n =763),food (wheat:n =687,corn:n =751) and soil (n =296) were collected and the selenium contents in hair was (0.379 ± 0.120) mg/kg,in wheat and corn were (0.025 ± 0.009) mg/kg and (0.016 ± 0.007) mg/kg,and in soil was (0.132 ± 0.046) mg/kg.③According to the national standard of evaluation content and decision criteria for KD,6 counties achieved the elimination index and 13 counties were in the control level in Shandong Province,the county proportion of eliminating KD was 31.58% (6/19).Conclusions ①The current condition of KD in Shandong Province remains relatively stable.Internal environment selenium content is increased significantly due to improvement of people's living standard and dietary nutrition.②There is still a gap between the number of counties eliminated KD and the "elimination targets" required by the state in Shandong Province.It is recommended to continue to strengthen the team construction in prevention and control of KD and to enhance the investment of money,at the same time,to establish a long-term working mechanism in prevention and control of KD.

19.
Chinese Journal of Endemiology ; (12): 362-365, 2018.
Article in Chinese | WPRIM | ID: wpr-701333

ABSTRACT

Objective To explore expression level of circulating microRNA (miR)-133a and Galectin-3 and their potential clinical application in differential diagnosis between patients with chronic Keshan disease and dilated cardiomyopathy.Methods Twenty-eight patients with chronic Keshan disease and 28 cases of age-and sex-matched healthy people as control from the same severe historical endemic areas of Keshan disease in Heilongjiang Province,and another 28 patients with dilated cardiomyopathy from non-affected areas were chosen for the study.All the subjects were asked for disease history and did physical examination,examined by Doppler echocardiography for left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD),and collected fasting venous blood specimen (elbow vein).The plasma miR-133a and the serum Galectin-3 were determined by Real-time PCR and enzyme-linked immunosorbent method,respectively.Meanwhile,the correlation was analyzed between miR-133a,galectin-3,LVEF and LVEDD.Results The miR-133a and Galectin-3 levels in different groups were statistically different (F =48.789,9.485,P < 0.01).The plasma miR-133a level in chronic Keshan disease group and dilated cardiomyopathy group [median (quartile):0.394 (0.271,0.770),1.665 (0.943,2.713)] were both significantly lower than those in control group [2.382 (1.502,3.302],P < 0.01 or < 0.05],and the plasma miR-133a level in chronic Keshan disease group was lower than that in dilated cardiomyopathy group (P < 0.01).There was no significant difference of serum Galectin-3 level between chronic Keshan disease group and dilated cardiomyopathy group [17.710 (9.624,27.799),12.692 (9.376,26.290) μg/L,P > 0.05],but both were significantly higher than those in control group [8.070 (7.135,9.308) μg/L,P < 0.01].The miR-133a was positively correlated with LVEF (rs =0.297,P < 0.01),while negatively correlated with LVEDD,and Galectin-3 (rs =-0.271,-0.318,P < 0.05 or < 0.01);the serum Galectin-3 was negatively correlated with LVEF (rs =-0.392,P < 0.01),and positively correlated with LVEDD (rs =0.385,P < 0.01).Conclusion The combined application of miR-133a,Galectin-3,LVEF and LVEDD may provide assistance in clinical differential diagnosis of chronic Keshan disease and dilated cardiomyopathy.

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Chinese Journal of Endemiology ; (12): 357-361, 2018.
Article in Chinese | WPRIM | ID: wpr-701332

ABSTRACT

Objective To investigate the relationship between single nucleotide polymorphisms of Bcl-2 related anti apoptotic protein 3 (BAG3) gene and Keshan disease (KD) in north Chinese Han population.Methods In 2002 a total of 285 Chinese Han subjects,including 79 KD patients and 206 control subjects were involved in this study.Genomic DNA was extracted from the peripheral venous blood sample.Blood samples were provided by the Institute of Endemic Disease Prevention,Xi'an Jiaotong University,and stored at 80 ℃.The polymorphism of genetic variation was genotyped by matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF).The data was analyzed using TYPER 4.0 or SPSS16.0 software.All sample groups were tested for Hardy-Weinberg equilibrium using goodness-of-fit x2 test.Differences in genotype distribution and allele frequencies between case and control were compared by x2 test.Logistic regression analysis was applied to detect association using age as a confounding factor.Results All sample group passed the Hardy-Weinberg equilibrium test (P > 0.05).Significant differences were not observed in genotype distribution between cases (rs2234962:CC,CT,TT were 0.0%,0.0% and 100.0%,respectively;rs196295:GG,GA,AA were 22.8%,54.4% and 22.8%,respectively;rs3858339:GG,GT,TT were 5.1%,38.0% and 56.9%,respectively;rs3858340:TT,TC,CC were 5.1%,38.0% and 56.9%,respectively) and controls (rs2234962:CC,CT,TT were 0.0%,1.0% and 99.0%,respectively;rs196295:GG,GA,AA were 21.4%,51.5% and 26.2%,respectively;rs3858339:GG,GT,TT were 5.8%,34.5% and 59.7%,respectively;rs3858340:TT,TC,CC were 5.8%,34.5% and 59.7%,respectively) for rs2234962,rs3858339,rs196295 and rs3858340 on BAG3 gene (x2 =0.685,0.408,0.330,0.330,P > 0.05).Significant differences were not observed in genotype after agecorrecting between cases and controls for 4 SNPs on BAG3 gene (x2 =0.001,0.019,1.009,0.019,P > 0.05).Conclusion The results suggest that the BAG3 gene might not be a susceptibility gene of KD in north Chinese Han population.

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