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Yun Z.,Shandong Institute for Prevention and Control of Endemic Disease | Gao J.,Shandong Institute for Prevention and Control of Endemic Disease | Yin Y.,Shandong Institute for Prevention and Control of Endemic Disease | Bian J.,Shandong Institute for Prevention and Control of Endemic Disease | And 2 more authors.
Chinese Journal of Endemiology | Year: 2014

Objective: To understand the status of endemic fluorosis in Shandong Province. Methods: In accordance with the requirements of the "National Surveillance Scheme of Drinking-Water-Type Endemic Fluorosis (Trial)" and "Shandong Provincial Surveillance Scheme of Drinking-Water-Type Endemic Fluorosis (Trial)", ten counties (cities, districts) were chosen in the province, and ten water-improvement projects were selected in each county (city, district). The operating effect of water-improvement projects was investigated; one peripheral water sample of each project was collected, and water fluoride content was tested. Three epidemic villages were chosen as fixed monitoring villages in each county (city, district). In the villages that had changed water source, one peripheral water sample was collected; in unchanged water source villages, one water sample was collected following five different directions of the east, the west, the south, the north and the center of the water source location; and the water fluoride content was tested. All students aged 8 to 12 were checked for dental fluorosis in the monitoring villages. The fluoride content in drinking water was detected by fluoride ion selective electrode method, and dental fluorosis was diagnosed by Dean's method. Results: CD In the 10 counties (cities, districts), a total of 85 water-improving projects were monitored, and all the projects were in normal operation; the water fluoride contents of 47 projects were qualified, and the qualified rate of water fluoride content was 55.29%(47/85), with the maximum of water fluoride content was 4.74 mg/L.


Liu Y.,Shandong Institute for Prevention and Control of Endemic Disease | Guo R.,Shandong Institute for Prevention and Control of Endemic Disease | Huang J.,Shandong Institute for Prevention and Control of Endemic Disease | Wang X.,Shandong Institute for Prevention and Control of Endemic Disease | And 2 more authors.
Chinese Journal of Endemiology | Year: 2014

Objective: To investigate the epidemic status of endemic fluorosis in Shandong Province, Jining City, and to provide a basis for prevention and control of the disease. Methods Based on "Shandong Provincial Project Technical Solutions for Endemic Fluorosis", Rencheng, Jinxiang, Yutai, Jiaxiang and Liangshan Counties in Jining were selected as monitoring sites. According to the illness situation of mild, moderate or serious districts, one village was selected as a major survey site from each county (district). There were a total of 15 such villages selected. Survey content included drinking water fluorine level; dental fluorosis of children, adults' clinical skeletal fluorosis and urinary fluorine levels; water and urinary fluoride content were determined by the method of fluoride ion selective electrode; dental fluorosis of children was diagnosed by Deans method and clinical diagnosis was based on the "Diagnostic Criteria of Endemic Skeletal Fluorosis" (WS 192-2008). Results: Sixty-one water samples from 15 villages of five counties (districts) were tested. Fluoride levels of 9 out of the 61 samples were exceeded the national standard ( > 1.0 mg/L), and the rate was 14.75%; 1 sample > 2.0 mg/L, and the maximum water fluoride was 2.25 mg/L. Seven hundred and seventeen people's real time urinary fluoride was detected in the 15 villages, including 420 children and 297 adults, and the geometric mean were 1.53 and 1.69 mg/L, respectively. Clinical examination of 755 children aged 8 to 12 showed that the detection rate of dental fluorosis was 26.89% (203/755); defect rate was 9.12% (29/755) and dental fluorosis index weres 0.65. The detection rate of clinical skeletal fluorosis of 11 565 adults was 4.76% (550/11 565), including 303 moderate or serious cases. Conclusions: The situation of excessive water fluorine in outside environment in Jining City has been controlled at a certain degree; groups urinary fluoride level is closed to the normal upper limit; the prevalence of dental fluorosis or skeletal fluorosis has been suppressed at a certain degree, therefore, the results of control should be further consolidated and expanded, in order to completely eliminate the fluoride hazard.


Bian J.,Shandong Institute for Prevention and Control of Endemic Disease | Wen Y.,Shandong Institute for Prevention and Control of Endemic Disease | Lin X.,Shandong Institute for Prevention and Control of Endemic Disease | Yang Q.,Shandong Institute for Prevention and Control of Endemic Disease | Gao J.,Shandong Institute for Prevention and Control of Endemic Disease
Chinese Journal of Endemiology | Year: 2014

To establish an animal model of high-iodine and low-protein in Wistar rats, and to observe the effect of combined excess-iodine and low-protein diet on growth, metabolism and morphological changes in thyroid.According to body weight [(110 ± 10)g] and sex (half male and half female), one hundred and ninety-two Wistar rats, 1 month after weaning, were randomly divided into 1 normal iodine control group (NI), 2 10-fold excess-iodine group (10HI), 3 50-fold excess-iodine group (50HI), 4 100-fold excess-iodine group (100HI), 5 low-protein control group (LC), 6 low-protein and 10-fold excess-iodine group (L10HI), 7 low-protein and 50-fold excess-iodine group (L50HI), 8 low-protein and 100-fold excess-iodine group(LlOOHI). Twenty-four rats were in each group, with the experimental period of 6 months. The iodine content of NI and LC groups was 4.65 μg/d; 10HI, 50HI and 100HI groups were 46.50, 232.50 and 465.00 μg/d, respectively. The animal's body weight, water and feed consumption were recorded weekly. At the end of 60, 120, 180 days, urine and blood samples were collected from eight rats in each group. Urinary iodine was tested by arseni cerium catalytic spectrophotometry; serum iodine was tested by the method of chloric acid. Histological change of the thyroid gland was observed by transmission electron microscopy and hematoxylin-eosin (HE) staining at the end of 6 months ; apoptosis of thyroid was tested by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) method.At the end of 4, 8, 16, 18, 22 and 24 weeks, the differences of body mass of rats among groups were statistically significant (F = 4.26 , 3.75 , 4.98 , 4.09 , 3.28 , 3.95, all P < 0.05). At the end of 60, 120, 180 days, the differences of iodine concentration in urine and blood among groups were statistically significantly (H = 5.37, 6.03, all P < 0.05). Light microscopy showed that thyroid follicular epithelial cells became flattened, and follicles became distended with colloid following increasing of iodine concentration. Electron microscopy showed increased glial vesicles, condensation of nuclear chromatin, karyopyknosis, and karyolysis with increasing of iodine concentration. The differences of apoptotic indexes among groups were statistically significant (F = 4.59, P < 0.01). The apoptotic indexes of L50HI and L100HI groups [(21.50 ± 5.20)‰, (26.70 ± 6.40)‰] were higher than those of 50HI and 100HI groups[(11.20 ± 4.30)‰, (19.40 ± 4.80)‰, P < 0.01 or < 0.05].Excessiodine and low-protein can cause growth retardation, abnormal iodine metabolism, and thyroid follicular epithelium damage in Wistar rats.


Yun Z.-J.,Shandong Institute for Prevention and Control of Endemic Disease | Chen P.-Z.,Shandong Institute for Prevention and Control of Endemic Disease | Bian J.-C.,Shandong Institute for Prevention and Control of Endemic Disease | Wang Y.-T.,Shandong Institute for Prevention and Control of Endemic Disease | And 2 more authors.
Chinese Journal of Endemiology | Year: 2011

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.


Yun Z.-J.,Shandong Institute for Prevention and Control of Endemic Disease
Chinese Journal of Endemiology | Year: 2011

Objective: To investigate the current status of Kaschin-Beck disease in Shandong province, and to provide a scientific basis for decision-making in controlling the disease. Methods According to the "National Monitoring Program of Kaschin-Beck disease" requirements, historical serious villages of Kaschin-Beck disease in Qingzhou of Shandong province were selected annually; children aged 7 to 16 were chosen to receive clinical examination and children aged 7 to 12 were taken X-ray examination. Clinical and X-ray diagnosis was carried out according to the "Diagnostic Criteria of Kashin Beck Disease"(GB 16003-1995). Results: From 1996 to 2010, in 53 diseased villages, three thousand three hundred and eighteen school children aged 7 to 16 were clinically diagnosed, and child Kaschin-Beck disease of degree I and above were not detected; three thousand and ninety-one school children aged 7 to 12 were examined by X-ray, forty cases were found positive, and the total positive rate was 1.29%(40/3091). The year with the highest positive rate was 2002, and the rate was 3.49%(13/372); the positive rate was 0 in 1996 and 2008. The difference of the X-ray positive rate between each year was statistically significant (χ2 = 31.54, P < 0.01). Conclusions: Child Kashin-Beck disease in Qingzhou is basically under control. Since etiology of Kashin-Beck disease is still unclear, surveillance of the disease still needs to be strengthened.


Yun Z.-J.,Shandong Institute for Prevention and Control of Endemic Disease | Chen P.-Z.,Shandong Institute for Prevention and Control of Endemic Disease | Bian J.-C.,Shandong Institute for Prevention and Control of Endemic Disease | Gao J.,Shandong Institute for Prevention and Control of Endemic Disease | And 2 more authors.
Chinese Journal of Endemiology | Year: 2013

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-Bome 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: Circled digit one 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. Circled digit two In the 10 counties, a total of 86 water-improvement 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. Circled digit three 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 4.50 mg/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. Circled digit four 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.


Yun Z.,Shandong Institute for Prevention and Control of Endemic Disease | Li W.,Shandong Institute for Prevention and Control of Endemic Disease | Yin Y.,Shandong Institute for Prevention and Control of Endemic Disease | Gao J.,Shandong Institute for Prevention and Control of Endemic Disease | And 4 more authors.
Chinese Journal of Endemiology | Year: 2014

Objective: To understand the status quo of the illness situation and the implementation of prevention and control measures on Kashin-Beck disease(KBD) in Shandong Province, and provide a scientific basis for assessment and acceptance of the work on eliminating KBD. Methods: In accordance with the requirements of the national "Implementation Scheme for Endemic Disease Control in 2012" and the "Shandong Provincial Technical Scheme for KBD Control in 2012". In four towns of Qingzhou, three epidemic villages were selected as the surveying villages in each town in order to understand the implementation of measures for prevention and control of KBD; information such as population of investigating villages, per capita income, farming, food and the implementation of control measures,etc were included. In each investigating village, 7-12 years old children were selected to receive clinical and X-ray examination. When fewer than 50 people in a investigating village, one additional endemic village was included near the investigating village, and all children aged 7 to 12 of the village were checked. The number of cases of clinical degree I, II, III and the detection rates, X-ray positive detection rate, the number of cases of metaphysis, epiphysis, distal end of phalanx, carpal bone, triad and the detection. rates were calculated, respectively. Clinical and X-ray diagnosis were based on "The Diagnostic Criteria of Kaschin-Beck disease"(WS/T 207-2010). Results: A total of 14 epidemic villages were selected to survey in four towns of Qingzhou. In the recent three years in the epidemic areas, measures of supplying Se had not been implemented; measures of resettlement and off-site education had not been implemented either. In the epidemic areas, the main crops were wheat and corn; the staple food was flour which accounted for more than 80%, and the foreign food bought accounted for only 11%. The areas of returning farmland to forest(grass) accounted for 0.32%(36/ll 151) of the original arable land, and the areas of replanting economic crops accounted for 1.17%(131/11 151) of the original farmland. A total of 536 children aged 7 to 12 were examined by clinical and X-rays. Patient of KBD was not detected clinically. Six positive patients with metaphyseal changes of KBD were detected by X-rays, and the average X-ray detection rate was 1.12%(6/536). Patients with abnormal epiphysis, distal end of phalanx and carpal bone were not detected by X-rays. Conclusions: KBD in Shandong Province has been effectively controlled. Since the cause of KBD is still unknown, it is necessary to build a sustainable long-term control mechanism of KBD; further improve the monitoring system and dynamic monitoring work still need to be strengthened.


Yun Z.,Shandong Institute for Prevention and Control of Endemic Disease | Yin Y.,Shandong Institute for Prevention and Control of Endemic Disease | Gao J.,Shandong Institute for Prevention and Control of Endemic Disease | Wen Y.,Shandong Institute for Prevention and Control of Endemic Disease | And 3 more authors.
Chinese Journal of Endemiology | Year: 2014

Objective: To understand the schedule and effectiveness of water-improving defluoridation projects comprehensively of control of fluorosis in drinking-water-borne endemic fluorosis areas in Shandong Province, and to provide a scientific basis for making strategies for prevention and control of the disease. Methods: In accordance with the requirements of "Shandong Provincial Survey Scheme for Implementation of Prevention and Control Measures of Endemic Fluorosis", the progress of water-improving defluoridation projects was investigated in Shandong Province. The types of water source, scale and operating conditions for water-improving defluoridation projects in 17 cities of the province were investigated. Water fluoride contents of the normal operating projects were detected by F-ion selective electrode. Results: Circled digit one By the end of 2012, a total of 3 539 water-improving defluoridation projects were built that covered 9 856 fluorosis villages, 113 counties, 17 cities in the province, and the water-improving rate was 91.01% (9 856/10 830). The type of water source of water-improving project was mainly groundwater, accounted for 93.78% (3 319/3 539) of the total projects. As for the scale of the water-improving projects, small centralized water supply projects were the main projects, accounted for 92.96%(3 290/3 3 of the total projects. Circled digit two Of all the water-improving defluoridation projects, normal operating projects accounted for 89.12% (3 154/3 539), intermittent and scrapped projects accounted for 3.25% (115/3 539) and 7.63% (270/3 539), respectively. Circled digit three Among normal operating projects, the number of projects with water fluoride content ≤1.20 mg/L was 1 925, accounted for 72.40% (1 925/2 659). The number of projects with water fluoride content > 1.20 mg/L was 734, accounted for 27.60% (734/2 659); among them water fluoride contents between 2.01-4.00 mg/L and > 4.00 mg/L were 233 and 65, respectively, and the highest water fluoride value was 9.71 mg/L. Conclusions: The progress of water-improving projects in some cities (counties) of Shandong Province is still slow. Some of the water-improving projects can not be operated normally or have been scrapped, and water fluoride content has exceeded the standard seriously. So the prevention and control measures need to be further strengthened, funding should be increased, and the operating conditions and water quality of the water-improving defluoridation projects in Shandong need to be further improved.

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