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Objective:To learn about the progress of prevention and control of drinking-water-borne endemic arsenic poisoning in Henan Province, and provide scientific basis for achieving the goal of eliminating high arsenic hazards as scheduled.Methods:From July to August 2019, in accordance with the requirements of the National Monitoring Program for Drinking-water-borne Endemic Arsenic Poisoning, a general survey was carried out in 26 high-arsenic villages in 6 counties of Henan Province to investigate the water improvement situation and the operation of water improvement projects, and the arsenic content in drinking water of households was measured, meanwhile, the arsenic poisoning status of permanent residents in high-arsenic villages was investigated.Results:All 26 villages with high arsenic content in the province had undergone water improvement, with a water improvement rate of 100.00%. A total of 18 water improvement projects were investigated in 26 high-arsenic villages, all of which were operating normally. Twenty-six water samples were collected, and the arsenic content in the household water was < 0.01 mg/L, which met the sanitary standards for drinking water. No patient of endemic arsenic poisoning was found during the survey.Conclusion:In Henan Province, the drinking-water-borne endemic arsenic poisoning has been effectively controlled, and the prevention and control achievements should continue to be consolidated in the future.
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Objective:To investigate the iodine nutritional level of residents in iodine adequate areas in Henan Province, and provide basis for making policy of targeted guidance and rational iodine supplementation.Methods:In the 156 counties of Henan Province in 2020, one township was selected from each location (east, west, south, north and middle) in each county; one school was selected from each township; 40 children aged 8-10 years in the school and 20 pregnant women in the township were selected to collect their urine and salt samples to test urine and salt iodine levels. One third of the counties were selected to examine the thyroid gland of children. Individuals lived in villages with water iodine between 40 and 100 μg/L were included in the study.Results:In iodine adequate areas, a total of 2 097 salt samples were collected from children and tested, the consumption rate of qualified iodized salt was 93.6% (1 962/2 097). A total of 2 096 urine samples were collected from children and tested, and the median urinary iodine was 288.0 μg/L. The goiter rate of children was 0.7% (5/723). A total of 1 068 salt samples from pregnant women were tested, and the consumption rate of qualified iodized salt was 93.0% (993/1 068). A total of 1 068 urine samples from pregnant women were tested, with a median urinary iodine 232.7 μg/L. Stratified by water iodine (40-59, 60-79, 80-100 μg/L), the median urinary iodine of children was 273.8, 288.6, and 305.9 μg/L, respectively, statistically significantly different between groups ( H = 15.79, P < 0.001); the goiter rate of children was ≤2%, and the difference between groups was statistically significant (χ 2 = 7.31, P = 0.026); but the median urinary iodine of pregnant women was not significantly different ( H = 1.82, P = 0.402). Under different water iodine conditions, there was no significant difference in urinary iodine levels in children and pregnant women between the high salt iodine concentration group (≥21 mg/kg) and the low salt iodine concentration group (< 21 mg/kg, P > 0.05). Conclusions:The iodine nutrition level of children in iodine adequate areas in Henan Province is relatively high, and the iodine nutrition of pregnant women is appropriate. The goiter rate of children is at a relatively low level. Continuous surveillance should be conducted to comprehensively evaluate the iodine nutrition level. Various measures will be taken by regions and populations.
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Objective:To investigate the effects of different chemotherapy dose intensity on the short-term efficacy and adverse reactions of patients with advanced colon cancer.Methods:A real-world database of patients with advanced colon cancer in Wangjing Hospital of China Academy of Chinese Medical Sciences and China-Japan Friendship Hospital from January 2017 to December 2020 was established, including 105 patients treated with the same chemotherapy regimen for two consecutive cycles. The patients were grouped according to the average relative dose intensity (ARDI) of chemotherapy, and the population differences, treatment regimens, short-term efficacy and adverse reactions of different chemotherapy dose intensities were evaluated. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of ARDI for short-term efficacy.Results:There were 31 patients in the high dose intensity group (ARDI≥80%) , 34 patients in the medium dose intensity group (80%<ARDI<60%) , and 40 patients in the low dose intensity group (ARDI≤60%) . There were statistically significant differences in age ( χ2=13.20, P=0.010) and Karnofsky functional status (KPS) score ( χ2=7.99, P=0.008) among the high dose intensity group, medium dose intensity group and low dose intensity group. Compared with the low dose intensity group, the proportion of young and middle-aged patients in the high dose intensity group was higher, and the proportion of elderly patients was lower ( χ2=12.63, P=0.002) . Compared with the medium dose intensity group, the proportion of patients with KPS score ≥60 was lower and the proportion of patients with KPS score <60 was higher in the low dose intensity group ( P=0.013) . There was a statistically significant difference in the application of chemotherapy regimen among the three groups ( χ2=22.88, P=0.027) , and there was a statistically significant difference in the application of chemotherapy regimen between the high dose intensity group and low dose intensity group ( χ2=16.25, P=0.009) . The proportions of the high, medium and low dose intensity groups receiving combined chemotherapy were 96.77% (30/31) , 82.35% (28/34) and 80.00% (32/40) respectively. The incidences of chemotherapy drug reduction in the high, medium and low dose intensity groups were 93.55% (29/31) , 100% (34/34) and 100% (40/40) respectively, and the incidences of chemotherapy delay were 41.94% (13/31) , 79.41% (27/34) and 87.50% (35/40) respectively. The objective response rates of the high, medium and low dose intensity groups were 22.58% (7/31) , 14.71% (5/34) and 2.50% (1/40) respectively, with a statistically significant difference ( χ2=7.11, P=0.027) . The disease control rates of the high, medium and low dose intensity groups were 93.55% (29/31) , 91.18% (31/34) and 87.50% (35/40) respectively, with no statistically significant difference ( χ2=0.75, P=0.714) . The differences of carcinoembryonic antigen before and after treatment in the high, medium and low dose intensity groups were 2.09, 0.47 and -0.72 ng/ml respectively, with a statistically significant difference ( χ2=10.09, P=0.006) . Compared with the low dose intensity group, the difference of carcinoembryonic antigen before and after treatment in the high dose intensity group was greater ( χ2=23.12, P=0.005) . The differences of carbohydrate antigen 199 before and after treatment in the high, medium and low dose intensity groups were 2.30, 0.00 and -0.21 U/ml respectively, with a statistically significant different ( χ2=8.85, P=0.012) . Compared with the low dose intensity group, the difference of carbohydrate antigen 199 before and after treatment in the high dose intensity group was greater ( χ2=21.40, P=0.010) . No adverse reactions above grade 3 occurred in the three groups, and the safety was good. The most common adverse reactions were anemia (61.90%, 65/105) , leucopenia (39.05%, 41/105) , neutropenia (29.52%, 31/105) and nausea (36.19%, 38/105) . There were no statistically significant differences in the incidences of adverse reactions among the high, medium and low dose intensity groups (all P>0.05) . ROC curve analysis found that the area under the curve predicting objective response was 0.70, the sensitivity was 92.30%, and the specificity was 52.10% when the chemotherapy ARDI threshold was 64%. Conclusion:In the real world, colon cancer patients receiving high dose intensive chemotherapy have better objective response rate, and tumor markers decreased significantly. The baseline status of colon cancer patients receiving low dose intensive chemotherapy is poor, but there is no statistically significant difference in disease control rate between patients receiving low dose intensive chemotherapy and patients receiving high dose intensive chemotherapy, and the adverse reactions are controllable.
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Objective:To master the provincial-level quality assessment of the self-inspection projects for control and evaluation of drinking water-borne endemic fluorosis in the counties (cities, districts) of Henan Province, so as to ensure the quality of self-inspection.Methods:Totally 30 counties (cities, districts) with drinking water-borne endemic fluorosis in Henan Province were selected as project counties (cities, districts), using consulting and checking data, on-site investigation and review, the implementation of self-inspection projects were audited. The water improvement and the water fluorine content, and the prevalence of dental fluorosis in children aged 8-12 were investigated in villages with drinking water-borne endemic fluorosis, and the provincial-level quality assessment of the self-inspection projects was carried out.Results:A total of 99 villages with drinking water-borne endemic fluorosis in 30 counties (cities, districts) were investigated, and all 30 counties (cities, districts) completed the investigation task of self-inspection projects. A total of 99 water samples were collected, and there were 23 counties (cities, districts) with the same results of county (city, district) self-inspection and provincial-level review of water fluorine, accounting for 76.67%; a total of 5 815 children aged 8-12 were investigated, there were 18 counties (cities, districts) with the same results of county (city, district) self-inspection and provincial-level review of dental fluorosis detection rate, accounting for 60.00%.Conclusions:The self-inspection projects of control and evaluation of drinking water-borne endemic fluorosis at the county (city, district) level in Henan Province are completed well. Most of the self-inspection projects are consistent with the provincial-level review results, but the disease diagnosis ability of grass-roots professional personnel and the detection technical level of laboratory technician in some counties (cities, districts) need to be improved.
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Objective:To understand the prevention and control progress of drinking water-borne endemic fluorosis in Henan Province, to evaluate the effects of prevention and control measures, and provide a basis for adjusting prevention and control strategies.Methods:In 2019, a general survey was conducted in all registered drinking water-borne endemic fluorosis villages in Henan Province to monitor the basic conditions of water improvement, the fluoride content of drinking water and the prevalence of dental fluorosis in children aged 8-12 years. The control compliance (water fluoride content qualified and the detection rate of dental fluorosis of children ≤30%) status of the villages was analyzed, and calculate the compliance rate.Results:A total of 17 504 drinking water-borne endemic fluorosis villages were monitored, among them, 17 352 villages with water improvement and 152 villages without water improvement, with a water improvement rate of 99.1%. Among the 3 685 water improvement projects constructed, 3 448 were in normal operation, and the normal operation rate was 93.6%. There were 13 526 villages with qualified drinking water fluoride content, and the qualified rate of water fluorine was 77.3%; the actual beneficiary population was 11 011 000, and the population benefit rate was 90.1%. The qualified rate of water fluoride in the villages with and without water improvement was 77.9% (13 512/17 352) and 9.2% (14/152), respectively; the qualified rate of water fluoride in the villages with water improvement was significantly higher than that in the villages without water improvement (χ 2=400.58, P < 0.05). A total of 498 527 children of 8 to 12 years old were examined, 68 972 cases of dental fluorosis were detected, the detection rate of dental fluorosis was 13.84%, and the dental fluorosis index was 0.3. The number of villages meeting the control standard was 12 488, and the compliance rate was 71.3%. Conclusions:In Henan Province, the water improvement projects in the drinking water-borne endemic fluorosis areas have been basically implemented, and the disease has been effectively controlled. However, there is still a certain gap with the target of the "13th Five-Year Plan on National Prevention and Control of Endemic Diseases", and timely rectification is needed to ensure the effectiveness of the water improvement projects.
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Objective:To understand the status of drinking water-borne endemic fluorosis in Henan Province, so as to provide scientific basis for improving prevention and control strategies.Methods:Ten counties (districts, referred to as counties) were selected from drinking water-borne endemic fluorosis areas of Henan Province in 2018. Three villages in each project county were selected according to the disease status of mild, moderate and severe conditions, and the operation status of water improvement projects, water fluoride content and dental fluorosis among children aged 8 to 12 years in each diseased village were monitored.Results:Totally 30 villages were surveyed, all of which were in the water improvement projects; a total of 25 water improvement projects were monitored, all of them were in normal operation, and the water fluoride exceeding standard rate was 28.00% (7/25), the qualified rate of water fluoride in the water improvement projects was 72.00% (18/25). Among them, 21 villages were in normal operation and the water fluoride in the water improvement projects met national standard. In which the detection rate of dental fluorosis among children aged 8 to 12 years was 36.71% (606/1 651), the index of dental fluorosis was 0.74, and the epidemic intensity was extremely mild. Water fluoride of water improvement projects in 9 villages exceeded the national standard, where the detection rate of dental fluorosis among children aged 8 to 12 years was 43.57% (261/599), the index of dental fluorosis was 0.78, and the epidemic intensity was extremely mild. The detection rate of dental fluorosis among children in the villages where the water fluoride of water improvement projects exceeded the national standard was higher than that in the villages where the water fluoride of water improvement projects met the national standard (χ 2=8.752, P < 0.01). Conclusions:The excessive fluorine content in the water of water improvement projects is still serious, and the epidemic is still severe. It is necessary to strengthen the scientific demonstration of the water improvement project construction and the project acceptance upon completion, so as to prevent unqualified projects from being put into use. We will carry out regular water quality monitoring and promptly rectify projects with water quality exceeding the standards.