Nail Selenium Level and Diabetes in Older People in Rural China / 生物医学与环境科学（英文）

This cross-sectional study aimed to examine the association between selenium levels and diabetes in an older population with life-long natural exposure to selenium in rural China. A total of 1856 subjects aged 65 years or older from four Chinese rural counties with different environmental selenium levels were evaluated. Analysis of covariance models and logistic regression models were used to examine the relationship between nail selenium levels and serum glucose, serum insulin, insulin resistance [using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR)], and the risk of diabetes. The mean nail selenium level was 0.461 μg/g and the prevalence rate of diabetes was 8.3% in this population. The mean nail selenium level was significantly higher in the group with diabetes than in the group without diabetes (P<0.0001). The adjusted odds ratios for diabetes were 2.65 (95% CI: 1.48 to 4.73), 2.47 (95% CI: 1.37 to 4.45), and 3.30 (95% CI: 1.85 to 5.88) from the second selenium quartile to the fourth quartile, respectively, compared with the first quartile group. The mean serum glucose and HOMA-IR in the higher selenium quartile groups were significantly higher than those of the lowest quartile group. However, no significant differences in insulin were observed among the four quartile groups. A long-term, higher level of exposure to selenium may be associated with a higher risk of diabetes. Future studies are needed to elucidate the association between selenium and insulin resistance.

Spatial clustering analysis of Budd-Chiari syndrome in Heze City of Shandong Province / 中国地方病学杂志

Objective To investigate the spatial distribution and clustering areas of Budd-Chiari syndrome in Heze City,Shandong Province,and to provide epidemiological information for further exploring the etiology and related risk factors of the disease.Methods Detailed residential addresses of 342 cases of patients (residents of Heze City) with diaphragm type Budd-Chiari syndrome diagnosed between 1995 and 2004 in Heze Municipal Hospital,Heze Shan County Central Hospital,Affiliated Hospital of Xuzhou Medical College,Shandong Provincial Hospital and Beijing Xuanwu Hospital were collected.Geographic information system (GIS) was used as a platform for data management and display.The nearest neighbor index,Ripley's K(d) function,Ripley's L(d) function and the nearest neighbor clustering method were applied to detect the spatial characters of Budd-Chiari syndrome in Heze City,Shandong Province.Crimestat 3.0 was used for spatial analysis.Results The nearest neighbor distance analysis showed that the nearest neighbor index was 0.6767 (Z =-11.4387,P ＜ 0.01).That was an aggregation at the first-order spatial scale.Within the study area,the first clustering radius of Budd-Chiari syndrome was 6.66 km,and the first clustering strength was 5.40; the average radius of the strongest clustering area was 126.61 km,and the clustering strength was 12.52,while the biggest clustering radius was larger than 222 km.After corrected by population,the gathering strength was slightly higher than that before the correction.Ten first-order hot spots were formed,and 95％ confidence interval aggregation number was 7,which meant the results were statistically significant(P ＜ 0.05),main clustering areas are in Mudan District,Shan County and Juancheng.One secondorder hot spot was gathered based on the first-order hot spot.Conclusions Spatial distribution of Budd-Chiari syndrome in Heze City,Shandong Province has showed spatial aggregation and heterogeneity.This study has a great epidemiological significance for further exploring the cause of Budd-Chiari syndrome.

Surveillance of drinking-water-borne endemic fluorosis in Shandong Province in 2010 / 中国地方病学杂志

Objective To understand the current situation of endemic fluorosis in Shandong Province,and to provide a scientific basis for development of control strategies.Methods In accordance with the requirements of the national Surveillance Scheme of Drinking-Water-Borne Endemic Fluorosis (Trial) and Shandong Provincial Surveillance Scheme of Drinking-Water-Borne Endemic Fluorosis (Trial),and to understand the progress of the province's water-improvement projects,10 counties were chosen in the province,and 10 water-improvement projects were selected in each county.Running condition of the water-improvement projects was investigated,and water fluoride content was tested.Three epidemic villages were chosen as fixed monitoring villages in each county.In each village,fluoride content in drinking water was determined,and dental fluorosis of all children aged 8 to 12 was diagnosed.Water fluoride content was determined by fluoride ion selective electrode method,and dental fluorosis of children aged 8 to 12 was diagnosed by Dean method.Results ① There were 3570 water defluoridation projects in the province,and water-improvement rate was 87.49％ (10 122/11 569).Normal operating projects accounted for 89.10％ (3181/3570),and the passing rate of water fluoride content was 73.14％ (2611/3570),with the maximum water fluoride as 9.71 mg/L.② In the 10 counties,a total of 86 waterimprovement projects were monitored.Normal operation,intermittent operation and scrapped projects accounted for 95.35％ (82/86),3.49％ (3/86) and 1.16％ (1/86),respectively,and passing rate of fluoride content in water was 50.00％ (43/86),and the maximum water fluoride was 5.32 mg/L.③ In the 27 monitored villages with improved water quality,the passing rate of fluoride content in water was 74.07％ (20/27),and the maximum water fluoride was 4.50mg/L.In the 3 monitored villages without improved water quality,villages of mean water fluoride ≤ 1.20 mg/L and ＞ 1.20 mg/L accounted for 33.33％ (1/3) and 66.67％ (2/3),respectively,and the maximum water fluoride was 1.53 mg/L.④ In the 27 monitored villages with improved water quality,the detection rate of dental fluorosis among children aged 8 to 12 was 57.65％(791/1372),and the detection rate of defect type dental fluorosis was 7.80％(107/1372); the index of dental fluorosis was 1.15.In the 3 monitored villages without improved water quality,the detection rate of dental fluorosis among children aged 8 to 12 was 50.97％ (80/155),and the detection rate of defect type dental fluorosis was 7.10％(11/155); the index of dental fluorosis was 1.16.Conclusions In Shandong Province,the running condition of water improvement project to reduce fluoride still needs to be further improved,and the water fluoride is seriously overweight and endemic fluorosis has not been effectively controlled.Preventive measures should be strengthened.

Spatial distribution characteristics of iodine in drinking water in Shandong province between year 2008 and 2010 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To detect the spatial distribution characteristics of iodine in drinking water of residents in Shandong province with spatial autocorrelation analysis.</p><p><b>METHODS</b>The county-based study set Shandong province as a research site. A total of 108 164 water samples from 140 counties were collected. The drinking water iodine data in county-level city between 2008 to 2010 were obtained from Shandong Institute of Prevention and Control for Endemic Disease and was merged with an electronic map to build a spatial database. Global and local Moran's I index were calculated, respectively, and spatial autocorrelation and cluster range of iodine distribution in drinking water in Shandong province were studied by SaTScan software.</p><p><b>RESULTS</b>All counties were further grouped according to the "criteria of delimitation for IDD endemic areas" and "determination and classification of the areas of high water iodine and the endemic areas of iodine excess goiter", and 90 counties were iodine deficiency (< 10 µg/L), 31 were iodine suitable (10 - 150 µg/L), and 19 (> 150 µg/L) were high iodine. For the overall study area, the iodine distribution in drinking water in Shandong province existed spatial autocorrelation (Moran's I = 0.52, Z = 7.4, P < 0.01). For the local scale, the drinking water iodine in 18 counties of Dezhou, Liaocheng and Heze city in western Shandong province was clustered, the local Moran's I were between 0.22 - 1.00 (P < 0.01), which were all high-high clusters, indicating the positive spatial correlation. Spatial analysis using SaTScan software detected two cluster areas including 20 counties, which the centers located in Xiajin and Dingtao county, the cluster radiuses were 57.47 km and 65.58 km respectively. The analysis results were consistent with the results of local spatial autocorrelation.</p><p><b>CONCLUSION</b>There are apparent spatial autocorrelation and strong spatial heterogeneity existed in the iodine distribution in drink water in Shandong province.</p>

Comparison of body fluorine levels in Liangshan and Boxing counties of Shandong province from 2007 to 2009 / 中国地方病学杂志

ObjectiveTo find out the condition of endemic fluorosis in Liangshan and Boxing counties of Shandong province,and to provide the basis for future prevention and treatment of the disease.MethodsIn 2007 -2009,100 water facilities per year were selected in each county and the water fluoride was tested in Liangshan and Boxing counties of Shandong province.Ten households were selected and their water fluoride content was measured.Dental fluorosis prevalence and dental fluorosis index of school children aged 8 - 12 were checked in all monitored places(3 villages in each county).Meanwhile,urinary fluoride was detected in children carried dental fluorosis test.ResultsIn 2007 - 2009,the median of urinary fluoride in Liangshan county was 2.35,3.73 and 1.29 mg/L,respectively; dental fluorosis detection rate was 72.73％ (88/121),78.08％ (57/73),and 70.64％ (77/109),and the dental fluorosis index was 1.43,1.76 and 1.34.While in Boxing county,the median of urinary fluoride was 4.50,6.71 and 5.64 mg/L; dental fluorosis detection rate was 95.93％ (118/123),99.06％ (105/106),94.41％(152/161) and dental fluorosis index was 2.23,2.54 and 2.09,respectively.ConclusionsThe effect of prevention and control of endemic fluorosis in Liangshan county was better than that of Boxing county of Shandong province.Altering water source is an important measure to control endemic fluorosis.More defluoridation project should be carried out in endemic fluorosis areas.

Epidemiological investigation of endemic fluorosis of Shandong province in 2010 / 中国地方病学杂志

Objective To investigate the current status of endemic fluorosis in Shandong province,and to provide a scientific basis for the development of preventive strategies.Methods In accordance with the requirements of the national Technical Implementation Plan for Endcmic Disease Control Project in 2009 and Drinking-Water-Borne Endemic Fluorosis Monitoring Program (trial),ten counties were selected to carry out the epidemiological investigation,to understand the progress and the effect of the water improvement projects; three villages were selected in each county,to determine fluoride content of drinking water,to check dental fluorosis of children aged 8 to 12 and skeletal fluorosis of adults over the age of 25.Water fluoride content was determined by fluoride ion selective electrode method,children dental fluorosis was diagnosed with Dean method and adults skeletal fluorosis by the National Standard for Diagnosis of Endemic Skeletal Fluorosis (WS 192-2008).Results There were a total of 687 improved-water defluoridation projects of the 10 counties,the improved-water rate was 83.34％ (3247/3896).The investigation was taken place in 84 improved-water projects of the 10 counties,the projects running normally accounted for 98.81％ (83/84); 41 projects had water fluoride concentration ≤1.20 mg/L,and the pass rate was 48.81％(41/84),with the maximum water fluoride as 5.76 mg/L.In the 26 villages with improved-water projects of the 10 counties,villages with a mean water fluoride ≤ 1.20 mg/L were 15,which accounted for 57.69％ (15/26),＞ 1.20 mg/L were 11,which accounted for 42.31％ (11/26),with the maximum water fluoride as 5.58 mg/L.In the 4 yet to improve water quality villages of the 10 counties,1 village had mean water fluoride ≤ 1.20 mg/L,3 villages had mean water fluoride ＞ 1.20 mg/L,with the maximum water fluoride as 2.92 mg/L.A total of 1331 children aged 8 to 12 were checked in the 26 improved water villages,the detection rate of dental fluorosis was 59.73％ (795/1331),the index of dental fluorosis was 1.17 and the defect rate was 10.14％ (123/1331).A total of 138 children aged 8 to 12 were checked in the 4 yet to improve water quality villages,the detection rate of dental fluorosis was 51.45％(71/138),the index of dental fluorosis was 0.95 and the defect rate was 0.72％ (1/138).In water quality improved villages and yet to improve water quality villages,X-ray detection rates of skeletal fluorosis were 8.80％ (113/1284) and 3.05％ (6/197),respectively,in adults over the age of 25.Conclusions The water fluoride content of improved-water defluoridation projects exceeds the national standard seriously and fluorosis has not been effectively controlled in Shandong province.

Survey of “iodine suitable” region in iodine-deficient areas in Shandong province / 中国地方病学杂志

ObjectiveTo look into the distribution of “iodine suitable” region in iodine-deficient areas in Shandong province and to provide a scientific basis for guiding the redesignate of iodine-deficient areas and launch scientific supply of iodine.Methods One to 3 copies of water source samples were collected in 105 existing iodine-deficient counties by village.Water iodine content was detected by arsenic-cerium catalytic spectrophotometry.The areas with water iodine content below 10 μg/L was defined as iodine-deficient areas and among 10 - 150 μg/L were “iodine suitable areas” and greater than 150 μg/L were high iodine areas.Results The research was carried out in 14 cities,105 counties,and 1337 towns.We collected 65 716 water samples.Sample recovery efficiency reached 99.8％.The median of water iodine was 5.57 μg/L.In the 1337 towns surveyed,there were 82.05％(1097/1337) of the township with water iodine median ＜ 10 μg/L,17.43％(233/1337) between 10 - 150 μg/L,and 0.52％(7/1337) ＞ 150 μg/L.Conclusions In Shandong province,the water “iodine suitable” regions are distributed scattered with considerable proportion.In iodine-deficient areas,there are areas with high water iodine,and iodine-deficient regions should be redrawn.Emphasis should be put on iodine nutritional status of residents in “high iodine and iodine suitable” regions,and iodine supplementation should be carries out scientifically.

Analysis of monitoring results of endemic fluorosis in Shandong province in 2009 / 中国地方病学杂志

Objective To investigate the current status of endemic fluorosis in Shandong province, and to provide the scientific evidence for making strategies for prevention and control of the disease. Methods According to "The National Technical Scheme for Endemic Disease Control in 2008", thirty-four counties were divided into mild, moderate and severe endemic fluorosis areas and a village was randomly selected from each category of the area to carry out the monitoring of endemic fluorosis. The content of fluoride in drinking water and urine was determined by F-ion selective electrode, dental fluorosis of children aged 8 to 12 was diagnosed by Dean method and skeletal fluorosis diagnosed by clinic and X-rays. Results The monitoring was done in 70 water-improving villages in 34 counties, among which 54 villages had water fluoride content ≤ 1.00 mg/L and accounted for 77.14%(54/70), 16 villages had water fluoride content ＞ 1.00 mg/L and accounted for 22.86%(16/70), the highest water fluoride content was 4.46 mg/L. The monitoring was also carried out in 32 non-water-improving villages in 34 counties, among which 9 villages had water fluoride content ≤ 1.00 mg/L and accounted for 28.12%(9/32), 23 villages had water fluoride content ＞ 1.00 mg/L and accounted for 71.88% (23/32), the highest water fluoride content was 4.09 mg/L. The total rate of dental fluorosis of children aged 8 to 12 was 45.81%(1988/4340), the index of dental fluorosis was 0.97 and the rate of dental damage was 6.91%(300/4340). The urinary fluoride values above 1.40 mg/L were found in 55.33%(1417/2657) of children aged 8 to 12, with the highest urinary fluoride concentrations was 18.53 mg/L. The rate of skeletal fluorosis by clinic and X-rays in adults older than 16 years were 4.25% (2462/57 968) and 28.40%(23/81 ), respectively. The urinary fluoride values above 1.60 mg/L were found in 55.86% (1130/2023) of adults older than 16 years, with the highest urinary fluoride concentrations was 25.44 mg/L. Conclusions Endemic fluorosis in Shandong province has not yet been effectively controlled,control situation is still grim. Prevention efforts need to be further strengthened.

Analysis of survey results of endemic fluorosis in Shandong province in 2008 / 中国地方病学杂志

Objective To investigate the current status of endemic fluorosis in Shandong province, and to provide scientific evidence for the development of control strategies. Methods According to "The National Technical Scheme for Endemic Disease Control in 2007", 19 counties were chosen to carry out the epidemiological investigation in 2008. Water and urinary fluoride were determined by F-ion selective electrode, dental fluorosis of children aged 8 to 12 were diagnosed by Dean method and skeletal fluorosis of adults over the age of 16 were examined clinically and by X-rays. Results In 19 counties, 186 villages were surveyed, 44 villages were found with mean water fluoride ≤ 1.00 mg/L, accounting for 23.66%(44/186);the value ＞ 1.00 mg/L in 142 villages,accounting for 76.34% (142/186);maximum water fluoride 8.88 mg/L. Total detection rate of dental fluorosis of children aged 8 to 12 was 66.35% (4518/6809), dental fluorosis index was 1.55, and defect rate was 15.39%(1048/6809). Children with urinary fluoride ＞ 1.40 mg/L was 83.29%(2149/2580), and the maximum value was 31.92 mg/L. Detection rates of skeletal fluorosis clinically and by X ray among adults over 16 years were 6.37%(5577/87 607) and 20.23% (229/1132), respectively. Conclusions Endemic fluorosis in Shandong province is still serious, prevention efforts need to be further increased.

Correlation between environmental selenium levels and cognitive ability among rural elderly population / 中国地方病学杂志

Objective To explore the correlation between environmental selenium(Se) levels and cognitive ability among rural elderly population, and the effect of Se on cognitive skill of the elderly. Methods Two study sites(Zichuan district and Gaomi city of Shandong) with different environmental Se levels were selected according to rural elderly people ≥ 65 years were extracted by stratified random sampling method in each site. A retrospective survey was carried out using dietary intake questionnaire for the elderly for the past 1 year, and their daily total Se intake was calculated. Questionnaire was also used to obtain cognitive skill information in the elderly people. The Community Screening Instrument for Dementia, the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word List Learning Test, the Indiana University (IU) Story Recall Test, the Animal Fluency Test, and the IU Token Test were applied to assess the cognitive ability. Se level in these samples was analyzed. Correlation between the Se levels of environment and those of human body were analyzed statistically. Results There were 0.163), (0.405 ± 0.086)]mg/kg and nail Se[(147.44 ± 17.42), (117.38 ± 22.48)μg/L]between the two groups (U = 31.59, 25.00, 23.67, all P ＜ 0.01 ). There were positive correlation among the nail Se, environmental Se and Se in all subjects(r = 0.51,0.46, 0.60, all P ＜ 0.01 ). The differences of the CSID total score, the CERAD Word List Learning Test, the CERAD Word List Recall Test and the IU Story Recall Test between the two sites were statistically significant(F = 2.56, 9.18, 7.48, 4.42, all P ＜ 0.05), excluding the Indiana University Story Recall Test.After eliminating possible confounding factors, the Se levels and the CSID total score, the IU Story Recall Test, the Animal Fluency Test and the IU Story Token Test had a significantly positive correlation (r = 0.076, 0.138, 0.042,0.107, P ＜ 0.05 or ＜ 0.01 ), excluding the CERAD Word List Learning Test. Conclusions This study supports the hypothesis that a life long low Se level is associated with lower cognitive ability. The cognitive abilities in the elderly population lived in areas with high environmental selenium levels are significantly higher than that of the elderly lived in areas with low environmental selenium levels.

Survey on iodine nutrition of vulnerable population in iodine deficiency areas of Shandong province / 中国地方病学杂志

Objective To learn the iodine nutritional status of the vulnerable population with different iodine level under the current level of iodized salt in Shandong province and to offer prevention and cure measures.Methods Five groups of vulnerable population including school children aged 8 - 10, pregnant, lactation women, infants and women of childbearing age from mountain areas ( Daiyue, Mengyin counties ) , plain ( Luxian,Gaomi counties ) and coastal (Zhaoyuan county ) of five different iodine deficient areas were investigated in 2007.The thyroids of children aged 8 - 10 were checked by palpation and B ultrasound, their edible salt iodine level was detected by direct titration. The lever of urinary iodine of vulnerable population was examined by arsenic and cerium speetrophotometry. Results The goiter rates of 8 - 10 year-old were 1.8%(9/514) and 1.2%(6/514), respectively by palpation and B-ultrasonic. The mean iodine of 501 edible salt samples was 30.95 mg/kg. The coverage rate of iodized salt was 94.6% (474/501). The rate of qualified iodized salt was 90.4% (453/501). The median of urinary iodine was 216.7 μg,/L. The urinary iodine of school children aged 8 - 10, pregnant, lactation women, infants and women of childbearing age were 234.0, 165.5, 162.4, 257.5, 233.0 μg/L, respectively. Conclusions Current iodine nutritional level is basically appropriate in all groups of vulnerable people. The current iodine content of iodized salt could meet the needs of population from different iodine deficient areas of Shandong province.

Human umbilical vein vascular endothelial cell injury induced by fluoride in vitro / 中国地方病学杂志

Objective To study the effect of different concentrations of fluoride on cultured human umbilical vein vascular endothelial cells(HUVEC). Methods Different doses of sodium fluoride (NaF) were added to HUVEC culture medium, fluoride concentrations were 0(control), 100,400,700,1000,2000 μmol/L, respectively,6 re-set hole in each group. After continuous culture for 48 h, cells and culture medium were collected. Cell morphology was studied by Wright-Giemsa staining; cells apoptosis was determined by acridine orange fluorescence staining; cell activity was measured by methyl thiazolyl tetrazolium (MTT) assay; superoxide dismutase (SOD),glutathione peroxidase(GSH-Px) activity, malonaldehyde(MDA) content, induced nitricoxide synthase(iNOS), and endothelia nitricoxide synthase(eNOS) activity in cell culture medium were determined by spectrophotometry; cell iNOS mRNA and eNOS mRNA expression were detected by RT-PCR; intercellular adhesion molecule-1 (ICAM-1)and vascular cell adhesion molecule-1 (VCAM-1) levels were detected by double antibody sandwich ELISA method.Results With increased dose of fluoride, HUVEC cells decreased, the structure changed. In 400 - 2000 μmol/L group, the SOD activity[(6.627 ± 0.213), (6.668 ± 0.152), (5.935 ± 0.122), (4.755 ± 0.182)kU/L] was lower than those of the control group[(7.457 ± 0.398)kU/L, P ＜ 0.05 or ＜ 0.01], GSH-Px activity[(481.284 ± 43.785),(492.223 ± 16.474), (382.762 ± 25.167), (293.687 ± 24.881 )kU/L] was also lower than those of the control group [(585.078 ± 47.323)kU/L, P ＜ 0.05 or ＜ 0.01], MDA level[(0.609 ± 0.011 ), (0.646 ± 0.016), (0.852 ± 0.013),(1.188 ± 0.045)nmol/L] was higher than those of the control group[(0.512 ± 0.027)nmol/L, P ＜ 0.05 or ＜ 0.01];iNOS activity[(3.604 ± 0.115), (3.615 ± 0.075), (3.848 ± 0.103), (4.275 ± 0.079)kU/L] also was higher than those of the control group[(2.798 ± 0. 136)kU/L, all P ＜ 0.01], iNOS mRNA expression increased, eNOS activity [(5.539 ± 0.079), (5.503 ± 0.064), (5.226 ± 0.142), (4.809 ± 0. 107)kU/L] decreased compared to those of control group[(5.996 ± 0.155)kU/L, P ＜ 0.05 or ＜ 0.01], eNOS mRNA expression decreased; ICAM-1 levels [(0.852 ± 0. 102), (0.886 ± 0.061 ), (0.961 ± 0.158), (1.418 ± 0. 167)μg/L] increased compared to those of the control group[(0.687 ± 0.046)μg/L, P ＜ 0.05 or ＜ 0.01], VCAM-1 levels[(2.719 ± 0.197), (2.946 ± 0.167),(3.173 ± 0.225 ), (3.613 ± 0. 153 ) μg/L] was higher than those of the control group [(2.375 ± 0.067 ) μg/L, all P ＜0.01]. Conclusions High concentrations of fluoride reduce the activity of antioxidant enzymes, which leads to metabolic disorders of nitric oxide and abnormal cytokines expression, thereby inhibiting vascular endothelial cell growth, structural change and induced apoptosis. This is an important factor in high fluoride-induced vascular endothelial injury.

Survey of water improvement project to reduce fluoride in Shandong province / 中国地方病学杂志

Objective To investigate the present situation of water-improving defluoridation project and the distribution of water fluoride in fluorosis areas in Shandong province. Methods In 2005 - 2007, according to "The National and Shandong province Technical Scheme for Endemic Disease Control", the water-improving form,water type and the running status of defluoridation project in 17 cities of Shandong province were investigated, and the water-fluoride of the running projects were determined by F- ion selective electrode. Results A total of 5816projects were built that involved 8776 villages, 110 counties, 17 cities distributed in Shandong province. In which,the drilling of water-improving projects accounting for 94.55% (5499/5816), under-ground water type 97.73%(5684/5816);operating normally accounting for 75.91% (4415/5816), 7246 villages were supplied with the water, beneficiary population 6 946 459 people, non-normal projects accounting for 24.09%(1401/5816), including 1530 diseased villages. There were still 4415 projects running well. The projects with water fluoride lower than 1.0mg/L were 2893, accounting for 65.53% (2893/4415). The water fluoride higher than 1.0 mg/L accounted for 34.47%(1522/4415), ＞ 2.0 mg/L of 548, ＞ 4.0 mg/L of 97, and the maximum value of water fluoride was 9.71mg/L. Conclusions Nearly 1/4 of the water-improving projects in Shandong province are abnormal. The water fluoride of the project of more than 1/3 are exceeding the standard( ＞ 1.0 mg/L) in 4415 projects, and water-fluoride of 97 projects are higher than 4.0 mg/L. More measures should be taken to strengthen the supervision of the projects and monitoring of water fluoride.

Study on genetic polymorphism of human mismatch repair gene hMLH1 and susceptibility of papillary thyroid carcinoma in Chinese Han people / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the associations between the single nucleotide polymorphism of human mismatch repair gene hMLH1 and the papillary thyroid carcinoma (PTC) in Chinese Han people.</p><p><b>METHODS</b>A hospital based 1:1 matched case-control study was carried out. The single nucleotide polymorphism (-93G > A, 1151T > A and 655A > G) for 204 pairs of cases with PTC as well as healthy controls was identified by PCR-RFLP, PCR-ASO and DNA sequencing.</p><p><b>RESULTS</b>With univariate analysis, we found that compared to 1151TT genotype, the TA genotype could increase the PTC risk marginally, with odds ratio (OR) of 2.15 (95%CI: 0.99 - 4.85); While the mutant genotype TA + AA could increase the PTC risk statistically significant, with OR of 2.15(95%CI: 1.02 - 4.69). With 2 x 4 cross-over study, we found that compared to -93GG and 1151TT genotypes, individuals with both -93GA + AA and 1151TA + AA could increase the PTC risk marginally, with OR of 2.50 (95%CI: 0.96 - 6.67); While, compared to 655AA and 1151TT genotypes, individuals with both 655AA and 1151TA + AA could increase the PTC risk statistically significant, with OR of 2.50 (95%CI: 1.02 - 4.73). Multivariate and conditional logistic regression analysis showed the genotype of 1151TA, the history of receiving CT diagnosis, the history of tumor, the negative life events and eating seafood frequently could increase the risk of PTC, with OR of 6.79 (95%CI: 3.18 - 14.49), 3.35 (95%CI: 1.93 - 5.80), 39.03 (95%CI: 3.70 - 41.60) and 3.98 (95%CI: 1.81 - 8.73); While, eating fruit frequently could decrease the PTC risk.</p><p><b>CONCLUSION</b>The 1151TA + AA genotype, the history of receiving CT diagnosis, the history of tumor, the negative life events and eating seafood frequently were the risk factors of PTC, while eating fruit frequently was the protective factor.</p>

Pathological morphology of vascular endothelial injury and arteriosclerosis caused by high fluoride and the effects of selenium / 中国地方病学杂志

Objective To study morphological changes of rabbit artery endothelial cell injury and atherosclerosis caused by high fluoride and the role of selenium. Methods Twenty healthy male New Zealand white rabbits, body weight (2.0 ± 0.5)kg, were randomly divided into control group(drinking deionized water, fed basic diet), fluoride group(drinking fluoride 100 mg/L deionized water, fed basic diet), selenium group(drinking selenium 1 mg/L deionized water, fed basic diet), fluoride plus selenium group(drinking fluoride 100 mg/L deionized water, selenium 1 mg/L of deionized water, fed basic diet). The experimental period was 6 months. At 0, 3, 6 months of the experiment, serum fluorine and selenium levels were determined. At the end of the experiment,thoracic aorta was collected to observe its pathology and ultrastructural changes. Results Serum fluoride was significantly higher at the 3rd and the 6th month of experiment(all P ＜ 0.01 ) in fluoride group[ (0.589 ± 0.146),(0.772 ± 0.175)mg/L] and fluoride plus selenium group[ (0.502 ± 0.094), (0.693 ± 0.158)mg/L] than in control group[ (0.174 ± 0.002), (0.208 ± 0.031 )mg/L] and serum fluoride was significantly higher at 6 months than at 3 months(P ＜ 0.05 ) in fluoride group. Serum selenium was significantly higher at the 3rd and the 6th month of experiment (all P ＜ 0.01 ) in selenium group[ (0.252 ± 0.022), (0.319 ± 0.052)mg/L] and fluoride plus selenium group[ (0.239 ±0.016), (0.294 ± 0.018)mg/L] than in control group[(0.135 ± 0.014), (0.167 ± 0.019)mg/L], and serum selenium was significantly higher at the 6th month than at 3rd month of experiment in selenium group(P ＜ 0.05). Endothelial cell apoptosis indices were (4.92 ± 1.32)%, (30.30 ± 6.80)%, (6.57 ± 2.14)% and (14.29 ± 2.99)%, respectively in control group, fluoride group, selenium group and fluoride plus selenium group. Their main effect of fluorine and selenium was statistically significant (F = 106.833,20.082, all P ＜ 0.01 ). There were antagonistic effect between fluoride and selenium(F = 30.402, P ＜ 0.01 ). Pathological changes of rabbit aortic endothelial cells in fluoride group included endothelial with attached fibrin and red blood cells, and structural of the cells changed, with serious vascular injury; in fluoride plus selenium group apoptosis of endothelial cells decreased, with reduced number of attached red blood cells and fibrin, endothelial cell structure normal, the extent and scope of vascular damage significantly reduced. Conclusions Appropriate amount of selenium inhibits the apoptosis of endothelial cells induced by high fluoride, reduces aortic structural damage caused by high fluoride, and maintains the integrity of endothelial cells, thereby antagonizes the vascular damage and atherosclerosis induced by high fluoride.

Investigation of iodine level in drinking water in iodine deficiency areas in Shandong province / 中国地方病学杂志

Objective To look into the current distribution of iodine deficiency area in Shandong province and to guide the re-defined iodine deficiency area and to supplement iodine scientifically. Methods In 2008, 100 iodine deficiency counties(cities, districts), designated in Shandong province's "to supplement iodized salt to eliminate the hazard of iodine deficiency management regulations", were selected in the study. One to three samples were collected from water source which was used by the majority of local residents in the 100 iodine deficiency places and iodine concentration was tested by As3+-Ce4+ catalyzing spectrophotometry. Results A total of 65 716 water samples were collected. Sample recovery efficiency reached 99.8%(65 572/65 716). The median water iodine was 5.57 μg/L, with 82.05%( 1097/1337 ) of the township(town) met criteria for the classification of iodine deficiency areas(water iodine ＜ 10 μg/L), 17.43%(233/1337) of the township (town) water iodine moderate(water iodine 10 - 150 μg/L), and 0.52%(7/1337)of the township(town) should be defined high iodine areas(water iodine ＞ 150 - 300 μg/L). Conclusions The iodine deficiency areas should be redefined because water iodine concentrations of iodine deficiency areas have changed. We suggest that the smallest place to supply salt with different range of iodine content is set to the township(town).

Investigation on the prevention and control of endemic fluorosis in the southwestern area of Shandong province in 2007 / 中国地方病学杂志

Objective To understand the current status of the prevention and control of endemic fluorosis in the southwestern area of Shandong province. Methods In 2007, the progress of water-improving defluoridation, the operating state and water fluoride content of the water-improving project, which was determined by fluorosis selective ion electrode, and the inhabitant related indexes of endemic fluorosis were extensively surveyed in the three main fluorosis counties-Jiaxiang, Yuncbeng and Liangshan of the southwestern area of Shandong province. Results Among 1371 fluorosis villages in the 3 counties, 53.61%(735/1371) of which had undergone water-improving defluoridation, the rate in Jiaxiang, Yuncheng and Liangshan being 38.0% (220/579),65.51% (378/577) and 63.72% ( 137/215 ) respectively; the normally functioning rate of this project was 76.73% (564/735), projects out of order accounted for 23.27% (171/735). Among 263 well-functioning projects from the three counties, the rate with water fluoride higher than 1.0 mg/L was 35.36%(93/263), the maximum value being 4.17 mg/L. The urine fluoride content of 440 children aged 8 - 12 years and 484 adults over 30 years old were examined in 13 fluorosis villages of the three counties, the geometric mean was 2.98,3.06 mg/L respectively; the individual maximum was 12.83,14.49 mg/L respectively; the detectable rate of dental fluorosis among children aged 8 - 12 was 84.28% (649/770) ,17.66%(136/770) had defect and the index of dental fluorosis was 1.89; the rates of the clinical and X-ray skeletal fluorosis of the adults aged more than 30 were 44.40%(234/527) and 24.67%(130/527) respectively, and the abnormal electrocardiography rate was 32.43% (168/518) in the adult, mostly T-wave abnormality. Conclusions The progress of the water-improving defluoridation in the southwestern area of Shandong province was relatively slow, the water fluoride content of the water-improving projects seriously exceeded standard, and the condition of the fluorosis had not been effectively controlled.

Analysis on investigating results of Kaschin-Beck disease in Shandong province in 2008 / 中国地方病学杂志

Objective To investigate the present status of Kaschin-Beck disease(KBD) in Qingzhou at present, and provide a scientific basis for decision-making in controlling the disease. Methods According to The National Technical Scheme for Endemic Disease Control in 2007, children aged 7 to 12 were chosen to receive clinical and X-ray examination in 3 villages of 2 towns in Qingzhou. Local adults aged 16 years and older were clinically diagnosed in 10 villages of 4 towns and divided into different groups according to the clinical degrees and their ages. The Diagnostic Criteria of Kashin Beck Disease(GB 16003-1995) was carded out by clinical and X-ray diagnosis. Results Two hundred and sixty school children aged 7 to 12 were clinically diagnosed, and the patients of I degree upwards of KBD were not detected. One hundred and ninety-eight school children aged 7 to 12 were examined by X-ray, and the detectable rate was 0(0/198). In 7099 adults aged 16 years old upwards clinically tested, 502 patients of degree I and higher of KBD were detected and the detectable rate was 7.07%(502/7099). The patients distributed mainly in the population aged 36 years old and older, accounting for 99.00% (497/502). Conclusions Although KBD in children have been controlled in Qingzhou, it is still serious in adults. So the monitoring of KBD should be carried on and prevention and control for KBD in adults should be strengthened.

Fluoride analysis of drinking water in endemic fluorosis areas in Shandong province from 2005 to 2007 / 中国地方病学杂志

Objective To investigate the distribution of water-borne fluoride and the current status of water defluoridation project by improving drinking water quality in endemic fluorosis areas in Shandong province,and to provide scientific basis for making strategies in prevention and control of the disease. Methods According to "the National Technical Scheme for Endemic Disease Control in 2004, 2005 and 2006", 113 endemic fluorosis diseased counties(cities, and districts) of the province's 17 cities were screened in order to investigate the fluoride level in drinking water in fluorosis villages, recheck the fluoride level after implementing the water defluoridation project, and investigate the current status of the water defluoridation project. The fluoride level in drinking water was determined by F-ion selective electrode. Results There were a total of 5816 water defluoridation projects in the province. Most of them were carried out by drilling a deep well to get under-ground water. The wells still in good condition were accounted for 72.80% (4234/5816). Intermittent operated wells were accounted for 3.11% (181/5816). Abandoned wells were accounted for 24.09%(1401/5816). Level of water fluoride was determined in 6940samples from fluorosis villages(villages that not carry out the water defluoridation project as well as villages carried out the water defluoridation project with abandoned wells were included) and the value that lower or equal to 1.00mg/L was determined in 2987 villages which accounted for 43.04% (2987/6940). Level of water fluoride that over 1.00 mg/L was found in 3953 villages which accounted for 56.96% (3593/6940), and the highest level of water fluoride was 11.33 mg/L. Level of water fluoride were determined in 4415 samples from water defluoridation project and the value lower or equal to 1.00 mg/L was in 2983 wells which accounted for 65.53%(2983/4415). The value over 1.00 mg/L was in 1522 wells which accounted for 34.47%(1522/4415), the highest value of water fluoride was 9.71 mg/L. Conclusions Level of water fluoride in up to 1/2 of the villages and 1/3 of the projects, is still higher than the standard in Shandong province. Nearly 1/4 of the project has been abandoned. The current situation for endemic fluorosis control is still not good in the province, countermeasures for endemic fluorosis must be carried out as soon as possible and surveillance of water defluoridation project must be strengthened.

Epidemiological investigation on endemic fluorosis along the Yellow River alluvial plain of Shandong province / 中华流行病学杂志

Objective To investigate the current prevalent status of endemic fluorosis in the floodplain area of the lower Yellow River in Shandong province. Methods According to "The National Technical Scheme for Endemic Disease Control in 2008", 16 counties were chosen to carry out the epidemiological survey of endemic fluorosis. Three villages were chosen in each county, to determine the fluoride content of drinking water and to check the dental fluorosis of children aged 8 to 12 year old, the skeletal fluorosis of adults over 16 years of age. Both children and adults were tested for urine fluoride. The content of fluoride in drinking water and urine was determined by F-ion selective electrode while dental fiuorosis of children aged 8 to 12 years old was diagnosed by Dean's method and adults skeletal fluorosis by the National Standard for "Diagnosis of endemic skeletal quality' villages in 16 counties, among which 19 villages had water fluoride content ≤ 1.00 mg/L and accounted for 73.08% ( 19/26), 7 villages had water fluoride content ＞ 1.00 mg/L and accounted for quality' villages in 16 counties, 5 villages had water fluoride content ≤ 1.00 mg/L (accounted for 22.73% ), 17 villages had water fluoride content ＞1.00 mg/L(accounted for 77.27% ), with the highest water fluoride content as 3.38 mg/L. The overall rate of dental fluorosis among children aged 8to 12 years old was 52.18% (1042/1997), with the index of dental fluorosis as 1.17 and the rate of dental damage as 8.01% (160/1997). The urinary fluoride values above 1.40 mg/L were found in 65.00% (845/1300) of children aged 8 to 12 years old, with the highest urinary fluoride concentrations as 18.53 mg/L. The rate of skeletal fiuorosis by clinic and X-rays in adults older than 16 years old were 4.35% ( 1121/25 781 ) and 11.36%(5/44), respectively. The urinary fluoride values above 1.60 mg/L were found as 63.92%(606/948) in adults older than 16 years old, with the highest urinary fluoride concentrations as 21.35 mg/L. Conclusion The status of endemic fluorosis had not been effectively controlled and the situation for endemic fluorosis control was still critical in the floodplain area of the lower Yellow River in Shandong province, suggesting that the preventive approaches on endemic fluorosis control should be strengthened.