Differences in gut microbiota among primary school students with different levels of sugar sweetened beverage consumption / 中国学校卫生

Objective@#To explore the differences in the gut microbiota of primary school students with different levels of sugar sweetened beverage intake, so as to provide scientific evidence for better identification of health risks in children and the development of targeted health policies.@*Methods@#In June 2022, a total of 192 healthy primary school students from Chengdu were selected using a stratified cluster random sampling method. The sugar sweetened beverage intake was assessed through a dietary frequency questionnaire. Based on the median daily sugar sweetened beverage intake, primary school students were categorized into a low intake group ( n =96) and a high intake group ( n =96). The gut microbiota in fresh fecal samples from the two groups of primary school students was analyzed using 16S rRNA high throughput sequencing, and the diversity and community structure differences in the gut microbiota were compared.@*Results@#Children in the low intake group had a sugar sweetened beverage intake of (21.3±1.6) mL/d, while the high intake group had an intake of (269.6±37.3) mL/d. Diversity analysis results showed that there were no statistically significant differences between the low intake and the high intake group in terms of α diversity metrics: Observed_otus index [298.50 (259.75, 342.25), 305.50 (244.25, 367.75)], Goods_coverage index [1.00 (1.00, 1.00), 1.00 (1.00, 1.00)], Chao index [304.18 (260.75, 348.78), 305.88 (245.68, 370.88)], Shannon index [5.88 (5.29, 6.45), 5.71 (4.89, 6.28)] and Simpson index [0.95 (0.91, 0.97), 0.94 (0.88, 0.97)] ( Z =-0.64, -0.76, -0.54, -1.76, -1.67, P >0.05). Furthermore, no statistically significant difference was observed in β diversity between the two groups ( R 2=0.006, P >0.05). At the genus level, the abundance of Blautia [0.033 (0.018, 0.055)] and Fusicatenibacter [0.009 (0.005, 0.015)] were higher in the low intake group compared to the high intake group [0.024 (0.013, 0.041),0.006 (0.003, 0.011)]and differences were statistically significant ( Z =-2.52, -2.81, P <0.05). LEfSe analysis highlighted intergroup differences primarily in Blautia, Fusicatenibacter and Sarcina( LDA= 3.56,3.12,3.53, P <0.05).@*Conclusions@#There is no significant difference in the diversity and overall structure of the gut microbiota in primary school students with different levels of sugar sweetened beverage intake. However, there are species variations at the genus level. The information can serve as a scientific basis for identifying health risks in primary school students and formulating targeted health strategies.

Relationship between ruminative thinking, life events and learning value doubt among junior high school students / 中国学校卫生

Objective@#To explore the mediating effect of rumination between life events and learning value doubt among junior high school students, so as to provide reference for the psychological health education of junior high school students.@*Methods@#From March to July 2023, a total of 930 junior high school students from Guangdong, Jiangsu and Hebei were selected by a combination of convenient sampling methods. Participants completed the Scales of Value of Learning (SVL), Ruminative Response scale (RRS) and Adolescent Self rating Life Events Checklist (ASLEC). The t test and ANOVA were used for inter group comparisons and Pearson correlation analysis was used for correlation analysis and bootstrap method was used for mediating effect test.@*Results@#The life events of junior middle school students were positively correlated with learning value doubt ( r =0.18), rumination ( r = 0.65 ) and its three dimensions (brooding, reflective pondering, and symptom focused rumination) ( r =0.60, 0.59, 0.66). Learning value doubt was positively correlated with rumination ( r =0.15) and its three dimensions ( r =0.07, 0.13, 0.19) ( P <0.05).The symptom focused rumination (effect size=0.09, 95% CI =0.06-0.11) and brooding (effect size=-0.07, 95% CI =-0.09--0.04) dimensions partially mediated the relationship between life events and learning value doubt. In the two influential pathways, symptom focused rumination exerts a stronger impact, and the difference was statistically significant (effect size=0.15, 95% CI =0.11- 0.20 , excluding 0) ( P <0.05).@*Conclusions@#Life events experienced by junior high school students can positively predict learning value doubt through symptom focused rumination, and negatively predict learning value doubt through brooding. Active attention should be paid to the mental health status of junior high school students, intervene promptly when they experience life events, reduce symptom based rumination, and improve their learning enthusiasm.

Snack consumption of children and adolescents in China and its correlation with overweight and obesity / 中国学校卫生

Objective@#To understand the current situation of snack consumption among children and adolescents in China and its relationship with overweight and obesity, so as to provide a basis for formulating strategies of preventing and controlling overweight and obesity in children and adolescents in China.@*Methods@#A total of 1 882 children and adolescents aged 6-17 years old, choosed from 15 provinces, autonomous regions and municipalities according to China Health and Nutrition Survey in 2018, were selected. Snack consumption was investigated by the 24 hour dietary retrospective method for three consecutive days. The pattern of snack consumption was explored by cluster analysis, and the relationship between snack consumption and overweight and obesity was analyzed by Logistic regression.@*Results@#The snack consumption rate was 60.6%, and the percentage of daily energy intake from snacks was 2.4%. Snack consumption characteristics could be divided into four modes. Mode 1 was characterized by daily intake of medium amount of fruit, Mode 2 was characterized by daily intake of small amount of fruit and baked goods, Mode 3 was characterized by daily intake of small amount of fruit, and Mode 4 was characterized by daily intake of medium amount of milk and small amount of fruit. After adjusting the relevant covariates such as energy intake, compared with those who did not eat snacks, the OR (95% CI ) values of the risk of overweight and obesity in different snack consumption patterns were 1.56(0.93- 2.58 ), 0.81( 0.51- 1.24), 1.24(0.94-1.63) and 1.00(0.60-1.63), respectively; the OR (95% CI ) values of percentage of daily energy intake from snacks from low to high quartiles were 1.17(0.81-1.68), 1.32(0.92-1.89), 1.12(0.77-1.61) and 1.00(0.69-1.45), respectively. There was no statistically significant difference( P >0.05).@*Conclusion@#The proportion of Chinese children and adolescents consuming snacks is relatively high, mainly including fruit and its products, milk and its products and baked goods. No association between snack consumption and overweight and obesity has been found.

Analysis of monitoring results of Kashin-Beck disease in Shandong Province from 2016 to 2020 / 中华地方病学杂志

Objective:To analyze the surveillance data of Kashin-Beck disease (KBD) in Shandong Province, master the changes of KBD, and provide scientific basis for formulating prevention and control strategies of KBD and adjustment of the prevention and control focus of KBD.Methods:According to the requirements of the "National KBD Monitoring Plan" and the "Shandong KBD Monitoring Plan", from 2016 to 2020, the disease monitoring was carried out in the villages of KBD areas in Shandong Province, including the number of clinical positive cases, the number of X-ray positive cases, and the number of metaphyseal positive cases. The detection rate was calculated, and the dynamic changes of the disease was analyzed macroscopically.Results:From 2016 to 2020, a total of 1 816 children aged 7 - 12 years were clinically examined in Shandong Province, and no child with KBD was found. A total of 1 224 children were examined by X-ray, among which 1 positive patient was found in 2016 and 2017, respectively, both of whom were metaphyseal changes, with a total detection rate of 0.16%. There were 367 adult patients with KBD in Shandong Province, including 304 patients with grade Ⅰ, 47 patients with grade Ⅱ and 16 patients with grade Ⅲ. All villages in the KBD areas in Shandong Province had reached the elimination standard, with the elimination rate of 100%.Conclusion:No clinical case of KBD is detected in children aged 7 - 12 years in Shandong Province from 2016 to 2020, which has reached the elimination standard and is in a continuous elimination state.

Effect of health education project of a three-year special action for prevention and control of drinking water-borne endemic fluorosis in Shandong Province / 中华地方病学杂志

Objective:To evaluate the effect of health education of a three-year special action for prevention and control of drinking water-borne endemic fluorosis (referred to as drinking water-borne fluorosis) in Shandong Province, and to provide basis for formulating health education measures in the next step.Methods:Nineteen of the disease affected counties (cities and districts) were selected as project counties (cities and districts) in key areas for prevention and control of drinking water-borne fluorosis in Shandong Province in 2018, and 50 disease affected counties (cities and districts) were selected in 2019, and the project counties (cities and districts) were expanded to all of the 105 disease affected counties (cities and districts) in Shandong Province in 2020. Three disease affected townships (towns) were selected in each county (city and district), and health education activities on drinking water-borne fluorosis were carried out in Grade 4 to Grade 6 of the central primary schools and the three villages under its jurisdiction. Students and housewives were selected to conduct questionnaire surveys on prevention and control knowledge of drinking water-borne fluorosis before and after health education. The incidence of dental fluorosis among children aged 8 - 12 years was investigated annually in 6 villages (with children aged 8 - 12 years > 50) , where health education activity was implemented and the incidence of dental fluorosis among children was > 30%, water fluoride content was > 1.5 mg/L and water improvement time was < 5 years.Results:After health education, the awareness rates of drinking water-borne fluorosis in fifth grade pupils [92.46% (4 571/4 944) vs 65.80% (3 334/5 067) in 2018; 94.84% (12 897/13 599) vs 73.55% (9 993/13 587) in 2019; 95.59% (30 407/ 31 809) vs 77.52% (24 463/31 557) in 2020] and housewives [94.12% (2 400/2 550) vs 76.04% (1 939/2 550) in 2018; 94.99% (6 412/6 750) vs 72.00% (4 860/6 750) in 2019; 95.53% (16 183/16 941) vs 78.43% (12 971/16 539) in 2020] were significantly improved (χ 2 = 1 070.47, 2 315.27, 4 456.40, 328.25, 1 294.80, 2 174.63, P < 0.05). After health education in 2020, there were significant differences in the correct answer rates of epidemic causes, hazards and preventive measures of drinking water-borne fluorosis in the questionnaire of fifth grade pupils and housewives (χ 2 = 390.78, 164.94, P < 0.05). The awareness rates of drinking water-borne fluorosis in fifth grade pupils and housewives in the eastern region (Qingdao City, Yantai City and Weifang City) were significantly higher than those in the western region (Dezhou City, Liaocheng City and Heze City) before health education (χ 2 = 547.43, 210.12, P < 0.05), and after health education, the awareness rates increased to more than 90%. The detection rate of dental fluorosis in children decreased year by year (χ 2trend = 27.95, P < 0.05). Conclusions:Through implementation of a three-year special action for prevention and control of drinking water-borne fluorosis in Shandong Province, the awareness rate of fluorosis among target populations has been significantly improved. However, it is still necessary for government departments to further increase investment in health education and carry out health education activities in a deep-going way.

Clinical factors associated with composition of lung microbiota and important taxa predicting clinical prognosis in patients with severe community-acquired pneumonia / 医学前沿

Few studies have described the key features and prognostic roles of lung microbiota in patients with severe community-acquired pneumonia (SCAP). We prospectively enrolled consecutive SCAP patients admitted to ICU. Bronchoscopy was performed at bedside within 48 h of ICU admission, and 16S rRNA gene sequencing was applied to the collected bronchoalveolar lavage fluid. The primary outcome was clinical improvements defined as a decrease of 2 categories and above on a 7-category ordinal scale within 14 days following bronchoscopy. Sixty-seven patients were included. Multivariable permutational multivariate analysis of variance found that positive bacteria lab test results had the strongest independent association with lung microbiota (R2 = 0.033; P = 0.018), followed by acute kidney injury (AKI; R2 = 0.032; P = 0.011) and plasma MIP-1β level (R2 = 0.027; P = 0.044). Random forest identified that the families Prevotellaceae, Moraxellaceae, and Staphylococcaceae were the biomarkers related to the positive bacteria lab test results. Multivariable Cox regression showed that the increase in α-diversity and the abundance of the families Prevotellaceae and Actinomycetaceae were associated with clinical improvements. The positive bacteria lab test results, AKI, and plasma MIP-1β level were associated with patients' lung microbiota composition on ICU admission. The families Prevotellaceae and Actinomycetaceae on admission predicted clinical improvements.

Clinical features of Pneumocystis jirovecii pneumonia / 中华检验医学杂志

Objective:The clinical features, laboratory indices, and imaging data of patients with Pneumocystis jirovecii pneumonia (PJP) were described and analyzed, aiming to provide helpful information for the diagnosis and treatment of PJP. Methods:A retrospective study were conducted with data from 154 PJP patients who visited China-Japan Friendship Hospital from May 2017 to August 2020. Their clinical characteristics, laboratory and imaging data, and clinical outcomes were collected for analysis. The patients were further divided into the death group (51 cases) and the survival group(103 cases). The differences between the groups were compared by using t-test, nonparametric test, and chi-square test. Results:Of the 154 PJP patients, there were 89 males and 65 females, with a mean age of (53.7±14.8) years. Among them, 85.7% (132/154) were on immunosuppressive/glucocorticoids agents within the past month. Besides, 27.9% (43/154) and 33.1% (51/154) had kidney diseases and connective tissue diseases, respectively. The major clinical manifestations in these patients involved fever 82.9% (126/154), cough 59.7% (92/154), and dyspnea 52.6% (81/154). For the laboratory data, the lactate dehydrogenase (LDH) was 561.0 (434.3, 749.0) IU/L and the value increased in 91.3% (95/104) of the patients. The CD4+T-cell lymphocytes in 88.0% (95/108) and 57.4% (62/108) of patients were lower than 400/μl and 200/μl, respectively. Furthermore, (1, 3)-β-D glucan (BG) increased in 74.4% (67/90) of PJP patients (≥100.0 ng/L). For the imaging results, chest computed tomography (CT) showed diffuse ground-glass shadows/grid shadows in 90% (117/130) patients. Compared with the survival group, higher LDH [690.5 (528.8, 932.3) IU/L vs 502.5 (381.8, 657.0) IU/L, Z=-3.375, P=0.001], white blood cell count (WBC) [9.8 (5.8, 12.6) ×10 9/L vs 7.3 (5.0, 10.1) ×10 9/L, Z=-2.392, P=0.017], and age [(69.8±14.5) years vs (50.6±14.0) years, t=-3.756, P=0.001] were found in the death group. Lower lymphocyte ratio [5.3 (3.2, 9.3) % vs 9.6 (5.6, 17.2) %, Z=?3.262, P=0.001] and oxygen partial pressure (PaO 2) levels [(73.2±20.5) mmHg vs (64.8±17.7) mmHg (1 mmHg=0.133 kPa), t=2.345, P=0.021] were also observed in the death group. Furthermore, in the death group, the bacterial and fungal infection rate was higher than the rates in the survival group [55.1% (27/51) vs 21.5% (22/103), χ 2=15.372, P=0.001]. Conclusions:Long-term use of immunosuppressive agents or glucocorticoids predispose to PJP. CD4+T-lymphocytes, LDH, and BG might be used as important auxiliary examinations for PJP patients. Age, LDH, WBC, lymphocyte ratio, PaO 2 and possible combinations with bacterial or fungal infections are more closely related to the prognostic of PJP patients.

Monitoring results of dental fluorosis in children in drinking water-borne endemic fluorosis areas in Shandong Province from 2018 to 2020 / 中华地方病学杂志

Objective:To dynamically monitor the prevalence and trend of dental fluorosis in children in Shandong Province, and to evaluate the prevention and control measures for drinking water-borne endemic fluorosis (referred to as drinking water-borne fluorosis), and to provide scientific basis for the next step.Methods:Totally 40 counties (cities, districts) were selected as project counties (cities, districts) from drinking water-borne fluorosis areas in Shandong Province in 2018, and all counties (cities, districts) were selected in 2019 and 2020, to investigate the situation of water improvement, detect water fluoride content, and investigate the prevalence of dental fluorosis in children aged 8 - 12 years.Results:From 2018 to 2020, the detection rates of dental fluorosis in children aged 8 - 12 years were 10.30% (503/4 884), 8.94% (25 895/289 539) and 8.66% (24 061/277 689), respectively, with statistically significant differences (χ 2 = 27.10, P < 0.001), and the dental fluorosis indexes were 0.21, 0.18 and 0.17, respectively. The total detection rates of dental fluorosis in children of different age groups in the 3 years were 7.26% (6 590/90 775), 7.97% (9 303/116 680), 9.29% (12 167/130 915), 9.29% (12 238/131 670) and 9.95% (10 161/102 072), the differences were statistically significant (χ 2 = 615.71, P < 0.001). In the 3 years, the total detection rate of dental fluorosis was 8.93% (28 101/314 737) in boys and 8.69% (22 358/257 375) in girls, the difference was statistically significant (χ 2 = 10.27, P = 0.001). In 2018 and 2019, the detection rates of dental fluorosis of children aged 8 - 12 years in water fluoride qualified villages [5.74% (235/4 095) and 7.98% (20 200/253 082)] were significantly lower than those in villages with excessive water fluoride [33.97% (268/789) and 15.62% (5 695/36 457), χ 2 = 570.61, 2 283.76, P < 0.001]. Conclusions:The prevalence of dental fluorosis among children aged 8 - 12 years has been effectively controlled, and remarkable results have been achieved in prevention and treatment of drinking water-borne fluorosis in Shandong Province. However, the detection rate of dental fluorosis among children in a few endemic villages is high, so it is necessary to continue to strengthen the monitoring of fluoride content in drinking water and the condition of dental fluorosis among children.

Nutritional status of children and adolescents in 9 provinces of China from 2000 to 2018 / 中国学校卫生

Objective@#To understand the malnutrition status and trends among children and adolescents, and to provide evidence for improving the nutritional status of children and adolescents in 9 provinces of China.@*Methods@#A total of 5 746 children and adolescents aged 7-17 years old from the "China Health and Nutrition Survey" in 2000, 2006, 2011, 2015 and 2018 were selected as the subjects. Variance analysis and Chi square test were used to analyze the BMI of children and adolescents with different characteristics and different types of malnutrition. Linear regression model was used to analyze the trends of BMI, stunting and wasting, and overweight and obesity in children and adolescents with different characteristics.@*Results@#From 2000 to 2018, the BMI of children and adolescents aged 7-17 increased from 17.66 kg/m 2 to 19.08 kg/m 2 ( F =22.88, P <0.05). The prevalence of overweight and obesity increased in both males and females( t =16.65,11.01, P <0.05). Comparison of the rates of wasting and Growth Retardation and overweight and obesity among children and adolescents aged 7-17 years in nine provinces in 2000, 2006,2 011, 2015 and 2018, the difference was statistically significant ( χ 2 wasting and grouth retardation =85.46, 29.55, 41.09, 29.86, 45.29; χ 2 overweight and obesity = 109.12 , 52.21, 98.23, 68.27, 52.49, P <0.05).@*Conclusion@#The prevalence of stunting and wasting of children and adolescents aged 7-17 in 9 provinces of China decreased. The prevalence of overweight and obesity showed an upward trend in 9 provinces of China. There were regional differences among the prevalence of stunting and wasting, as well as overweight and obesity. Active intervention strategies and measures should be taken to improve malnutrition and focus on the prevention of obesity in children and adolescents in China.

The level and significance of CD4 + CD25 + Foxp3 + Treg in peripheral blood of patients with type 2 diabetic peripheral neuropathy / 中国医师杂志

Objective:To investigate the level and significance of CD4 + CD25 + Foxp3 + Treg in peripheral blood of patients with type 2 diabetes mellitus (T2DM) peripheral neuropathy. Methods:160 patients with T2DM (T2DM group) treated in Yancheng First People's Hospital from January 2018 to March 2019 were selected, including 54 patients with peripheral neuropathy and 106 patients without peripheral neuropathy. At the same time, 160 healthy people were selected as the control group to detect the levels of CD4 + CD25 + Foxp3 + Treg and 25-(OH)D 3 in peripheral blood. Pearson correlation analysis was used to analyze the correlation between CD4 + CD25 + Foxp3 + Treg in peripheral blood and other indexes. The receiver operating characteristic (ROC) value curve was used to analyze the predictive value of CD4 + CD25 + Foxp3 + Treg in peripheral blood of type 2 diabetic peripheral neuropathy. Results:The ratio of CD4 + CD25 + Foxp3 + Treg in T2DM group was (7.82±1.03)%, which was significantly lower than that in control group [(15.53±3.82)%, P<0.05]; The duration of T2DM patients with peripheral neuropathy was (7.71±1.18)years, which was significantly longer than that without peripheral neuropathy ( P<0.05), while the proportions of 25-(OH)D 3 and CD4 + CD25 + Foxp3 + Treg were (49.88±12.27)mmol/L and (5.88±1.20)% respectively, which were significantly lower than that without peripheral neuropathy ( P<0.05); Patients with peripheral neuropathy in group T2DM had significantly higher Michigan Diabetic Neuropathy Scores (MDNS) than that in patients without peripheral neuropathy [(14.82±2.01) vs (4.41±0.43), P<0.05]. The CD4 + CD25 + Foxp3 + Treg was positively correlated with 25-(OH)D 3 ( r=0.367, P<0.05), and negatively correlated with MDNS ( r=-0.398, P<0.05); the CD4 + CD25 + Foxp3 + Treg predicted that the area under the ROC curve of T2DM patients with peripheral neuropathy was 0.822, the cut-off value was 6.50%, and the sensitivity and specificity were 80.00% and 72.00% respectively. Conclusions:The level of CD4 + CD25 + Foxp3 + Treg in peripheral blood of T2DM patients decreased, which may play a role in the occurrence and development of peripheral neuropathy.

Analysis of monitoring results of drinking water-borne endemic fluorosis areas in Shandong Province in 2019 / 中华地方病学杂志

Objective:To master the current situation of prevention and control of drinking water-borne endemic fluorosis in Shandong Province, and to provide basic data for control and evaluation of drinking water-borne endemic fluorosis.Methods:From June to December 2019, in accordance with the requirements of the "National Drinking Water-Borne Fluorosis Monitoring Program (2019 Edition)" and "Shandong Province Drinking Water-Borne Fluorosis Monitoring Program (2019 Edition)", cross-sectional survey method was used to monitor the operation of the water supply projects, the fluorine content in drinking water, and the condition of children with dental fluorosis in all the disease affected villages of the drinking water-borne endemic fluorosis counties (cities, districts) in 16 cities of Shandong Province. Water fluorine was detected by "Standard Examination Methods for Drinking Water-Nonmetal Parameters" (GB/T 5750.5-2006), and in accordance with the "Standards for Drinking Water Quality" (GB 5749-2006), the water fluorine content was judged to be qualified or not. The examination and determination of dental fluorosis in children adopted "Diagnosis of Dental Fluorosis" (WS/T 208-2011), and the detection rate of dental fluorosis was calculated, the detection rates of dental fluorosis were compared between water improvement villages and villages without water improvement, qualified water fluorine and unqualified water fluorine villages.Results:There were 9 475 drinking water-borne endemic fluorosis villages in 105 counties (cities, districts) in Shandong Province, of which 9 370 were water improvement villages, and the water improvement rate was 98.89%. Among all the water improvement villages, there were 9 318 projects in normal operation, 45 intermittent projects and 7 scrapped projects. Among all the drinking water-borne endemic fluorosis villages, 8 254 villages were qualified in water fluorine, and the qualified rate of water fluorine was 87.11% (8 254/9 475); among water improvement villages, 8 210 villages were qualified in water fluorine, and the qualified rate of water fluorine was 87.62% (8 210/9 370); among the villages without water improvement, 44 villages were qualified in water fluorine, and the qualified rate of water fluorine was 41.90% (44/105). The qualified rate of water fluorine in water improvement village was significantly higher than that in villages without water improvement (χ 2 = 193.31, P < 0.05). The detection rates of dental fluorosis in children in water improvement villages and villages without water improvement were 8.92% (25 624/287 405) and 12.70% (271/2 134), respectively, and the detection rate of dental fluorosis in children in villages without water improvement was higher than that in water improvement villages (χ 2 = 37.23, P < 0.05). The detection rates of dental fluorosis in children in qualified water fluorine and unqualified water fluorine villages were 7.98% (20 200/253 082) and 15.62% (5 695/36 457), respectively, and the detection rate of dental fluorosis in children in unqualified water fluorine villages was higher than that in qualified water fluorine villages (χ 2 = 2 283.76, P < 0.05). Conclusions:Water improvement and fluorine reduction measures have been implemented in most drinking water-borne endemic fluorosis villages in Shandong Province, the detection rate of dental fluorosis in children in water improvement villages is lower than that in villages without water improvement. However, attention should be paid to the situation of water fluorine exceeding the standard and later management and maintenance to prevent the rebound of the disease.

Benchmark dose of the children's total fluoride intake / 中华地方病学杂志

Objective:By exploring the source of children's total fluoride intake and the relationship between children's total fluoride intake and dental fluorosis prevalence, to calculate the benchmark dose (BMD) of children's total fluoride intake and its 95% confidence lower limit (BMDL), and to provide the basis for revision of "Total Fluoride Intake for Inhabitants" (WS/T 87-2016).Methods:The villages that had water improvement for 5 years and more in 6 provinces of Jiangsu, Shandong, Hebei, Anhui, Henan and Shaanxi were selected as survey sites in April 2014. The water fluoride content of these villages was 0.3 - 3.0 mg/L, tap water samples from the centralized water supply were collected, and fluoride content was detected by ion selective electrode method. Children aged 8 to 12 years were selected, children's dental fluorosis was checked by Dean's method. Children's dietary and drinking water volume were surveyed by duplicate portion study (measurement for 3 d), and dietary fluoride content was detected according to the "Method for Determination of Fluorine in Foods". The mean and standard deviation of drinking water fluoride intake, dietary fluoride intake, and total fluoride intake were measured. According to the dose-response relationship between children's total fluoride intake and the detection rate of dental fluorosis, BMD and BMDL were calculated, and the reference dose (RfD) was calculated based on BMDL.Results:The mean of water fluoride of all 29 villages was 1.26 mg/L (from 0.41 to 2.85 mg/L). Totally 3 043 children aged 8 to 12 years were checked, and the detection rate of dental fluorosis was 30.2% (919/3 034). The lowest detection rate of dental fluorosis was 2.0% (2/100) and the highest was 71.4% (30/42) in the 29 villages. The children's dietary and drinking water volume of 769 person-time aged 8 to 12 years were surveyed, the children's daily drinking water fluoride intake, dietary fluoride intake, and total fluoride intake were (0.83 ± 0.66), (1.13 ± 0.61) and (1.96 ± 0.89) mg/d, respectively. The BMD of children's daily total fluoride intake was 2.43 mg, the BMDL was 2.21 mg, and the RfD was 2.21 mg.Conclusion:The BMD of 8 to 12 years old children's daily total fluoride intake is the same as the allowable limit (2.4 mg) of the national standard "Total Fluoride Intake for Inhabitants" (WS/T 87-2016).

Study of facial nerve F wave in patients with brainstem infarction / 中风与神经疾病杂志

@#ObjectiveTo study the dynamic changes of facial nerve F wave in patients with brainstem infarction，and to explore its value in diagnosis and prognosis evaluation of acute brainstem infarction. MethodsFifty-three patients with brainstem infarction were enrolled in our hospital. Electrophysiological examinations were performed on the 3rd，7th，14th，1st and 3rd days of onset，including the occurrence rate and latency of facial nerve F wave，and compared with the healthy side. Three months after onset，the patients were divided into good prognosis group（mRS≤2） and poor prognosis group（mRS>2） according to mRS neurological function score，and 10 healthy adults were included as control group with the same detection method. The incidence and latency of facial nerve F wave at different time points were compared. Results53 patients with brainstem infarction showed a decrease in the occurrence rate of f wave and an extension in the latency period on the 3rd，7th and 14th days of onset respectively，with a statistically significant difference compared with the healthy side（P<0.05）. However，the incubation period recovered at 3 months after onset，with no significant difference compared with the healthy side（P>0.05），while the occurrence rate was still statistically significant compared with the healthy side（P<0.05）. In patients with different types of brainstem infarction，the occurrence rate and incubation period of f wave in each group decreased to different degrees on the 3rd and 7th day，and the difference was not statistically significant（P>0.05）. The occurrence rate and incubation period of f wave in Raymond-Cestan syndrome group first recovered from the 14th day，with significant difference compared with other groups（P<0.05）. The occurrence rate and incubation period of f wave in Millard-Gubber syndrome group were higher than those in other groups at the 1st and 3rd month of onset，the difference was statistically significant（P<0.05）. On the 3rd and 7th day of onset，the incubation period and occurrence rate of f wave in the two groups increased and decreased，with no significant difference（P>0.05）. From the 14th day on，the incubation period and f wave occurrence in the group with good prognosis first recovered in the group with poor prognosis，with significant difference（P<0.05）. At the 3rd month of onset，the occurrence rate of F wave in the group with good prognosis was significantly higher than that in the group with poor prognosis，and the difference was statistically significant. However，the incubation period of the two groups had obvious recovery，and the difference was not statistically significant（P>0.05）. ConclusionThe changes of facial nerve F wave and latency can occur in patients with brainstem infarction in the early stage，but there is no differential diagnosis value for different types of cerebral infarction in the acute stage，which can provide valuable objective basis for prognosis evaluation after the acute stage.

Experiences in construction of wound repair discipline in Zibo, Shandong Province / 中华创伤杂志

The construction of wound repair discipline in China is still at the initial stage of exploration, and there is no systematic and mature experiences to learn from. The Luzhong Hospital of Beijing University established a professional committee for wound repair, opened a mobile workstation for wound repair, established a wound repair alliance and quality control center, advocated a medical-care integrated treatment model, and carried out academic exchanges and scientific research, the discipline of wound repair in Shandong Province got a rapid development and the pattern of "Zibo mode" of wound repair emerged. The authors introduce the experiences in construction of the discipline of wound repair in Zibo city, in order to provide some references for the grass-roots counterparts.

Campus bullying and anxiety symptoms in boarding middle school students in Anyang / 中国学校卫生

Objective@#To understand the association between bullying and anxiety symptoms of boarding middle school students, and to provide a scientific basis for preventing bullying and promoting mental health of boarding middle school students.@*Methods@#By using stratified cluster random sampling method, 2 823 students were selected from 10 schools in Anyang, Henan Province. Questionnaire survey using self-designed bullying items and Mental Health Scale of Chinese Middle School Students was administered.@*Results@#The overall prevalence of school bullying was 37.9%， with boarding school students(38.9%) being higher than non-boarding school students (37.1%). The anxiety symptom reporting rate of boarding students (42.9%) was higher than that of non-boarding students (27.3%). Binary Logistic regression analysis showed that, compared with non-boarding students, bully victim and bully perpetuator/victim students were more likely to have anxiety symptoms (OR=2.30, 6.04，1.94, 4.23) (P<0.05).@*Conclusion@#There is a correlation between different roles of campus bullying and anxiety symptoms among boarding and non-boarding school students. Boarding school students have a higher risk of anxiety symptoms, especially among those with both experiences of bully perpetuator/victim.

Nontoxic concentrations of OTA aggravate DON-induced intestinal barrier dysfunction in IPEC-J2 cells via activation of NF-κB signaling pathway.

Deoxynivalenol (DON) is well-known enteropathogenic mycotoxin which can alter intestinal barrier functions. Consistently, Ochratoxin A (OTA) ingestion has been found to induce intestinal injuries, including inflammation and diarrhea. However, little is known whether OTA aggravates DON-induced toxicity. This study is designed to explore the effects of OTA on DON-induced intestinal barrier function and involved mechanism. Our results showed either DON or OTA could disrupt intestinal barrier function in a time- and dose-dependent manner, as demonstrated by decreased transepithelial electrical resistance (TEER) and increased paracellular permeability to 4 kDa dextran. However, to eliminate the involvement of cell death, nonlethal concentrations of DON and OTA were used in following experiments. The nontoxic concentration of OTA was observed to aggravate DON-induced intestinal barrier dysfunction, accompanied with tight junction disruption (Claudin-3 and Claudin-4). Moreover, nontoxic concentrations of OTA aggravated DON-induced up-regulation of pro-inflammatory cytokines expression and activated nuclear factor-κB (NF-κB) in IPEC-J2 cells. Adding NF-κB inhibitor (PDTC) alleviated the aggravating effects of nontoxic concentrations of OTA on DON-induced intestinal barrier dysfunction and inflammation. These findings indicate that nontoxic concentrations of OTA promoted DON-induced barrier dysfunction via NF-κB signaling pathway. Our experiment suggests that exposure to nontoxic concentrations of toxins also poses potentially harmful effects.

Drinking water-borne endemic fluorosis in Shandong Province in 2016 / 中华地方病学杂志

Objective To grasp the current situation of drinking water-borne endemic fluorosis in Shandong Province,and provide a scientific basis for formulating preventive strategies.Methods In 2016,according to the "National Surveillance Scheme of Drinking Water-Borne Endemic Fluorosis" and "Shandong Provincial Surveillance Scheme of Drinking Water-Borne Endemic Fluorosis",10 counties (cities,districts) were selected in Shandong Province,3-5 villages were selected in each county (city,district),to investigate the operation of water improvement and fluorine reduction project and the water fluorine,and 1 tap water sample in each village was collected to detect water fluorine.At the same time,dental fluorosis examination was performed on all children aged 8-12 years old and fluorosis X-ray examination was performed on adults aged ≥25 years old.Water fluorine was detected by ion selective electrode method;the water fluorine was determined according to "Standards for Drinking Water Quality" (GB 5749-2006);criteria for diagnosis,grading and epidemic intensity of dental fluorosis were based on "Diagnosis of Dental Fluorosis" (WS/T 208-2011);the diagnostic and grading criteria for skeletal fluorosis were based on the "Diagnostic Criteria for Endemic Skeletal Fluorosis" (WS 192-2008).Results All the 32 villages in 10 counties (cities,districts) changed water,water improvement and fluorine reduction project ran normally,24 villages had qualified water fluorine (≤ 1.20 mg/L),and 8 villages had water fluorine exceeding the standard.The detection rate of dental fluorosis in children was 25.75％ (419/1 627),and the difference between 10 counties (cities,districts) was statistically significant (x2 =288.55,P ＜ 0.01);the dental fluorosis index was 0.48,and the defect rate was 2.77％ (45/1 627).The detection rate of skeletal fluorosis in adults was 4.72％ (72/1 525),and the difference between 10 counties (cities,districts) was statistically significant (x2 =18.83,P ＜ 0.01).Conclusions The problem of water fluorine exceeding the standard in water improvement and fluorine reduction project in Shandong Province is still serious.The condition of fluorosis has not been fully controlled,and the prevention and treatment measures need to be further strengthened.

Methodological evaluation on determination of urinary iodine by an automatic iodine analyzer / 中华地方病学杂志

Objective To evaluate a method for determining the iodine content in urine by an automatic iodine analyzer.Methods The iodine content in urine was determined by an automatic iodine analyzer.Methodological experiments were carried out on the method (including test standard curve linearity and detection limit,precision test,spike recovery test,standard substance determination experiment,method comparison test).The urine samples from the method comparison were obtained from 27 pregnant women collected from Nantantou Village,Baoshan Street,Licheng District,Jinan City,Shandong Province.and the results of the same samples were compared with the results determined by arsenic-cerium catalytic spectrophotometry (GB method).Results The absolute value of correlation coefficient of the mass concentration range (0-300 pg/L) standard curve was ＞ 0.999 0,the detection limit was 2.9 μg/L (the sample volume was 0.25 ml).Precision:the coefficient of variations of the three iodine concentrations in the range of low,medium and high were 3.8％,3.1％,2.3％ (n =18),respectively.Accuracy:the average recoveries were 98.8％,99.5％,101.2％ of low,medium and high urine samples in the range of curves (n =6),and the total average recovery was 99.8％.The measurement results of two urinary iodine standard substance were in the standard value range.Methods comparison experiment:there was no significant difference between the results of 27 urine samples measured by two methods (t =0.40,P ＞ 0.05).Conclusions The method of automatic iodine analyzer in detection of urinary iodine has higher precision and accuracy,less reagent dosage,and simple operation.It is suitable for detection of large quantities of urinary iodine samples.

Evaluation of the effects of health education on endemic fluorosis in Shandong Province / 中华地方病学杂志

Objective To explore the effect of health education on endemic fluorosis in Shandong Province,and provide evidence for further development of health education measures.Methods From 2011 to 2015,using prospective method,19 endemic fluorosis counties (cities,districts) were selected as project counties in Shandong Province each year,and 3 townships (towns) were selected in each project county.Health educational activities on prevention and treatment of endemic fluorosis were carried out in the classes of grade 4-6 in the central primary school;3 administrative villages were selected in each township (town) to carry out community health education activities.Before and after the health education activities,questionnaire surveys on the health education of endemic fluorosis prevention knowledge were conducted among 30 students of grade 5 in the central primary school and 15 housewives lived near the schools in each township (town).Results The results of health education evaluation showed that the'awareness rate of prevention and treatment of endemic fluorosis in school students and housewives were 95.64％ (27 770/29 037) and 92.09％ (14 341/15 573),respectively,which were significantly higher than those before the intervention [69.40％ (20 157/29 043) and 67.40％ (10 375/15 393)],and the differences were statistically significant (x2 =6 926.73,2 928.85,P ＜ 0.05).Among the primary school students and housewives,the knowledge awareness rates of prevention and treatment of endemic fluorosis were increased by 26.24％ and 24.69％,respectively.Conclusion After implementation of endemic fluorosis health education intervention,the awareness rate of prevention and treatment knowledge in local fluorosis areas in Shandong Province is significantly increased,which means we can further expand the scope of health education.

Relationship between blood glucose, blood lipid and body mass index in urban hypertensive communities / 中国基层医药

Objective To analyze the relationship between blood glucose,blood lipid and body mass index (BMI) in elderly patients with hypertension.Methods Form January 2016 to December 2017,376 hypertensive patients over 65 year old in Jinan city were enrolled in this study.The sex,age,BMI,fasting blood glucose and blood lipid were investigated and tested.The prevalence of coronary heart disease and diabetes mellitus in hypertensive patients were investigated,and the relationship between BMI and blood glucose,blood lipid and liver function index were explored.Results Of 376 hypertensive patients,the detection rate of diabetes mellitus was 21.01％ (79/376),221 cases were diagnosed with coronary heart disease,with the detection rate of 58.78％.With the rise of BMI,fasting blood glucose showed an upward trend.Person correlation analysis showed that there was a significant positive correlation between BMI and fasting blood glucose(r =0.167,P =0.003).The difference between TG and TC in different BMI groups was statistically significant(FTG =12.48,P ＜ 0.001;Frc =4.83,P ＜ 0.001).The content of alanine transaminase in the overweight group and obese group was significantly higher than that in the normal body weight group,the difference was statistically significant(F =5.24,P =0.005).Conclusion For elderly hypertensive patients,it is urgent to test blood glucose and coronary heart disease screening.For people over the age of 65,obesity is still an important risk factor for hyperlipidemia and hyperglycemia.Therefore,body weight control is needed in elderly patients with hypertensive.