Objective:To investigate the current situation of water-borne endemic fluorosis in Anhui Province, and provide basic data for the adjusting the prevention and control measures.Methods:Using cross-sectional survey method, all villages in the water-borne endemic fluorosis areas were investigated in Anhui Province from 2019 to 2022. In water-borne endemic fluorosis village, the situation of water improvement project and the fluoride level of drinking water were investigated, and dental fluorosis of all children aged 8 - 12 was examined. The criteria for determining the achievement of control targets for water-borne endemic fluorosis in affected counties were based on the "Evaluation Measures for Control and Elimination of Key Endemic Diseases (2019 Edition)".Results:From 2019 to 2022, the rate of water improvement village in water-borne endemic fluorosis areas were 88.47% (1 527/1 726), 100% (1 726/1 726), 100% (1 726/1 726) and 100% (1 726/1 726), respectively. The qualified proportion of water fluoride in water-borne endemic fluorosis villages was 33.84% (584/1 726), 63.09% (1 089/1 726), 70.74% (1 221/1 726) and 74.33% (1 283/1 726), respectively. The prevalence rates of dental fluorosis in children aged 8 - 12 were 25.48% (45 461/178 440), 15.78% (27 959/177 200), 13.68% (23 505/171 880) and 12.66% (23 315/184 200), respectively. The proportion of affected counties that had achieved the control target of water-borne endemic fluorosis was 16% (4/25), 60% (15/25), 36% (9/25) and 40% (10/25), respectively.Conclusions:The water-borne endemic fluorosis areas in Anhui Province have improved the water fluoride qualification rate and reduced the incidence of fluorosis in children through prevention and control measures such as water improvement and fluoride reduction. However, the prevention and control efforts in key areas and counties need to be further improved.

Objective:To investigate the current prevalence and control status of coal-burning-borne endemic fluorosis in key areas of the disease in Zhenxiong County of Yunnan Province, thereby providing scientific basis for formulating subsequent prevention strategies and measures.Methods:From October to November 2023, a simple random sampling method was used to conduct a survey in three key townships (towns) in Zhenxiong County, Chishuiyuan Town, Yanyuan Town, and Linkou Yi and Miao Ethnic Township. Three administrative villages were selected from each township (town) as survey sites, and dental fluorosis examination on children aged 8 - 12 years who were born and lived in the local area was conducted. Thirty households were selected from each survey site, the use of household stoves and the formation of related healthy living behaviors were investigated. At the same time, a survey was conducted among primary school students and housewives to investigate their knowledge of coal-burning-borne endemic fluorosis prevention and control. The control and elimination of endemic areas were evaluated according to the "Assessment Protocol for Control and Elimination of Key Endemic Diseases (2019 Edition)".Results:A total of 1 172 children were examined, and the detection rate of dental fluorosis was 7.76% (91/1 172), with a dental fluorosis index of 0.11. A total of 295 households were investigated, and the qualified improved stoves rate and the correct use rate of qualified improved stoves were 95.59% (282/295) and 100% (282/282), respectively. The correct drying rate of edible corn and chili peppers was 79.66% (235/295). The awareness rates of coal-burning-borne endemic fluorosis prevention and control knowledge among housewives and primary school students were 46.69% (409/876) and 82.49% (440.5/534), respectively. Among the 9 villages investigated, two villages had met the criteria for eliminating endemic disease areas, two villages had met the criteria for controlling endemic disease areas, and the remaining 5 villages were uncontrolled.Conclusions:After implementing the comprehensive prevention and control measures mainly based on changing stoves, coal-burning-borne endemic fluorosis condition in Zhenxiong County has been effectively controlled, but there is still a significant gap between the elimination goals of some endemic fluorosis areas. Therefore, it is necessary to continue to strengthen prevention and control measures and promote health education.

Objective:To investigate the iodine nutritional status of children aged 8-10 years in Jilin Province.Methods:From March 2021 to September 2023, in accordance with the requirements of the "Monitoring Plan for Iodine Deficiency Disorders in Jilin Province", monitoring for iodine deficiency disorders was carried out among children aged 8-10 years in 60 counties (cities, districts) of Jilin Province. Salt samples from children's homes and one random urine sample were collected to test salt iodine and urinary iodine. Thyroid B-ultrasound examination was performed on children to calculate the goiter rate.Results:From 2021 to 2023, a total of 36 028 household salt samples were tested, with a median salt iodine of 23.9 mg/kg and a consumption rate of qualified iodized salt of 96.3% (34 705/36 028). A total of 36 028 children's urine samples were tested, with a median urinary iodine level of 179.3 μg/L. The median urinary iodine levels of children in each year were 180.0, 177.2 and 181.2 μg/L, respectively ( n = 12 014, 12 006, 12 008). The median urinary iodine levels of children aged 8, 9 and 10 years were 182.2, 182.1 and 172.8 μg/L, respectively ( n = 10 238, 16 343, 9 447). The median urinary iodine levels of boys and girls were 182.8 and 176.3 μg/L, respectively ( n = 18 227, 17 801). A total of 12 006 children underwent thyroid examination, 41 children were detected with goiter, with a goiter rate of 0.34%. Conclusion:From 2021 to 2023, the consumption rate of qualified iodized salt ( > 90%), urinary iodine (100-< 200 μg/L) and goiter rate ( < 5%) of children in Jilin Province meet the national iodine deficiency disorders elimination standards.

Objective:To compare the efficacy of two surgical approaches for lumbar Brucellar spondylitis: one-stage posterior approach debridement with intervertebral bone graft fusion and pedicle screw-rod internal fixation (simple posterior group) versus one-stage anterior approach debridement with intervertebral bone graft fusion combined with posterior pedicle screw-rod internal fixation (combined anterior-posterior group).Methods:A systematic search was performed in the Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), VIP, and Wanfang Data from the time of database establishment to May 2024 to identify randomized controlled trial (RCT) and controlled clinical trial (CCT) comparing the two surgical approaches (simple posterior group and combined anterior-posterior group) in the treatment of lumbar Brucellar spondylitis. Meta-analysis was conducted by two researchers using RevMan 5.4.0 and Stata 13.1 software.Results:A total of 8 studies (2 RCTs, 6 CCTs studies) were included, including 669 patients (344 in the simple posterior group and 325 in the combined anterior-posterior group). Meta-analysis results revealed that the simple posterior group demonstrated shorter surgical time [ WMD = - 125.68, 95% CI ( - 186.84, - 64.53), P < 0.001], less intraoperative bleeding [ WMD = - 385.76, 95% CI ( - 572.40, - 199.11), P < 0.001], shorter hospital stay [ WMD = - 5.60, 95% CI ( - 8.30, - 2.91), P < 0.001], earlier postoperative ambulation time [ WMD = - 6.15, 95% CI ( - 10.72, - 1.59), P = 0.008], and a smaller Cobb angle at 3 months after surgery [ WMD = - 0.66, 95% CI ( - 1.23, - 0.09), P = 0.020]. However, there was no statistically significant differences in erythrocyte sedimentation rate [ WMD = 0.01, 95% CI ( - 0.90, 0.93), P = 0.980], visual analogue scale scores [ WMD = - 0.19, 95% CI ( - 0.40, 0.01), P = 0.070], Oswestry disability index score [ WMD = 0.02, 95% CI ( - 0.61, 0.66), P = 0.950] at 3 months after surgery, and postoperative complication rate [ OR = 0.57, 95% CI (0.17, 1.94), P = 0.370]. Conclusions:Compared with the combined anterior-posterior approach, the simple posterior approach has the advantages of shorter surgical time, less bleeding, and faster postoperative recovery. However, there is no significant difference between the two in terms of symptom improvement, functional recovery, and incidence of complications. Simple posterior approach surgery is an effective choice for treating lumbar Brucellar spondylitis.

Objective:To investigate the distribution of iodine in drinking water and the iodine nutrition status of key populations in Boxing County of Shandong Province, and to provide a basis for continuous elimination of iodine deficiency disorders and scientific iodine supplementation.Methods:In 2021, in the historical iodine deficiency towns (districts, referred to as towns) in Boxing County, one water sample of centralized water supply terminal water of each administrative village (neighborhood committee) was collected for water iodine testing. Using stratified cluster sampling method, the historical iodine deficiency areas in Boxing County were divided into 5 areas according to east, west, south, north and center. One town was randomly selected from each area, 20 pregnant women and 40 non-boarding students aged 8 - 10 from a primary school were randomly selected from each town. Thirty pregnant women and 100 students were selected from each of the two historical high iodine towns, and random urine samples were collected from the above-mentioned population for urinary iodine detection and analysis.Results:A total of 329 water samples were collected, and the median water iodine was 10.9 μg/L. Of these, 267 samples (81.2%) were < 40 μg/L, 33 samples (10.0%) were among 40 - 100 μg/L, and 29 samples (8.8%) were > 100 μg/L. A total of 410 urine samples were collected from children, and the median urinary iodine was 162.0 μg/L. The median urinary iodine of children in different towns was compared, and the difference was statistically significant ( H = 86.34, P < 0.001). A total of 109 urine samples were collected from pregnant women, and the median urinary iodine was 57.4 μg/L. The median urinary iodine of pregnant women in different towns were compared, and the difference was statistically significant ( H = 38.35, P < 0.001). Conclusions:The distribution of iodine in drinking water in Boxing County is complex, with areas with high iodine, iodine deficiency, and suitable iodine sources coexisting. Children's iodine nutrition is at an appropriate level, but pregnant women's iodine nutrition is at a deficiency level. Relevant departments should strengthen health promotion, and each region should formulate iodized salt supply strategies based on actual conditions. At the same time, special attention should be paid to the iodine nutrition status of pregnant women.

Objective:To investigate the iodine nutrition level of different populations in Daxing District of Beijing, and to provide a basis for implementation of "tailored measures, classified guidance, and scientific iodine supplementation" for prevention and control of iodine deficiency disorders.Methods:From 2020 to 2023, Daxing District of Beijing was divided into 5 districts from April to September each year based on east, west, south, north, and center. One township (street) was selected from each district, and 20 pregnant women, 40 women of childbearing age, 40 adult males, and 40 non boarding children aged 8 to 10 from one primary school were selected from each township (street). At the same time, 100 pregnant women with current addresses in Daxing District, Beijing were selected from one obstetrics hospital in Daxing District every year. Once random urine sample was collected from all survey subjects, and the household edible salt samples were collected from children and 400 pregnant women for determination of urinary iodine and salt iodine levels.Results:From 2020 to 2023, a total of 3 022 urine samples were collected, including 920, 700, 702, and 700 samples from children aged 8 - 10, pregnant women, women of childbearing age, and adult males, respectively. The median urinary iodine levels were 181.1, 135.0, 144.0, and 140.0 μg/L, respectively. There were statistically significant differences in urinary iodine levels among children aged 8 - 10, pregnant women, and women of childbearing age in different years ( H = 77.88, 9.40, 22.11, P < 0.05). A total of 1 320 household edible salt samples were collected from children aged 8 - 10 and pregnant women. Among them, 920 salt samples were collected from children, the median salt iodine was 21.3 mg/kg, the iodized salt coverage rate was 88.48% (814/920), and the qualified iodized salt consumption rate was 80.76% (743/920). Four hundred salt samples were collected from pregnant women, the median salt iodine was 21.8 mg/kg, the coverage rate of iodized salt was 90.25% (361/400), and the consumption rate of qualified iodized salt was 77.50% (310/400). The results of correlation analysis showed there was no correlation between urinary iodine level of children aged 8 to 10 and pregnant women with their salt iodine level ( r = 0.06, 0.07, P = 0.055, 0.142). Conclusions:Pregnant women in Daxing District, Beijing are at a deficiency level in iodine nutrition, with children aged 8 - 10, women of childbearing age, and adult males all at an appropriate level of iodine nutrition. We should strengthen health education for pregnant women and ensure that they receive sufficient iodine nutrition. At the same time, relevant departments should increase the supervision and management of iodized salt.

Objective:To study the current prevalence and temporal patterns of Keshan disease in Gansu Province, thereby establishing a scientific foundation for development of targeted prevention and control strategies.Methods:From March 2019 to October 2021, monitoring of Keshan disease was conducted in all affected townships (towns) across 28 counties (districts, cities) in Gansu Province. Demographic data were collected from affected villages, and suspected chronic Keshan disease cases were identified through village clinics, township health centers, county hospitals, and other medical institutions. These suspected cases were diagnostically verified according to the "Diagnosis of Keshan Disease" (WS/T 210-2011). Current chronic Keshan disease cases underwent re-examination and follow-up monitoring.Results:There were a total of 254 endemic townships (towns) and 2 611 endemic villages across the province, with a permanent resident population of 3.667 1 million in the affected areas. New cases of chronic Keshan disease continued to emerge throughout the study period, totaling 6 cases. From 2020 to 2021, among the total number of chronic Keshan disease cases, 88.92% (923/1 038) remained stable in condition, while mortality cases accounted for 9.54% (99/1 038). Over the past three years, there were 886 males and 687 females with current chronic Keshan disease, mainly aged between 50 and 60 years old, accounting for 38.78% (610/1 573).Conclusions:While Keshan disease in Gansu Province maintains a sustained level of elimination, new chronic cases continue to emerge. It is essential to enhance disease surveillance efforts, and effectively consolidate the achievements in Keshan disease prevention and control measures.

Objective:To investigate the changes and characteristics of human brucellosis epidemic in Ningxia Hui Autonomous Region (Ningxia), and provide reference for development of brucellosis prevention and control measures in the future.Methods:The data of reported cases of brucellosis in Ningxia in 2022 and 2023 were collected from the "Infectious Disease Reporting Information Management System of China Disease Prevention and Control Information System". Descriptive epidemiological methods were used to compare and analyze the epidemic data.Results:A total of 10 891 cases of human brucellosis were reported in Ningxia in 2022 and 2023, with an average annual incidence rate of 74.94/100 000, and no death cases. The incidence rate of brucellosis decreased from 86.76/100 000 in 2022 to 63.17/100 000 in 2023, with a statistically significant difference (χ 2 = 269.96, P < 0.001). In 2022 and 2023, 22 counties (cities, districts) in Ningxia had reported brucellosis cases, and the incidence rate of brucellosis in each county (city, district) had decreased by 7.88% to 58.43%. There were reports of brucellosis cases in every month of the year. The incidence rates of brucellosis in males were higher than those in females (χ 2 = 831.79, 715.24, P < 0.001). There were statistically significant differences in incidence rates among different age groups (χ 2 = 2 113.28, 1 455.83, P < 0.001), the age distribution were mainly concentrated in the 45 - 59 year old age group [41.62% (2 618/6 290), 41.84% (1 925/4 601)]. The occupational distribution were mainly dominated by farmers and herdsmen [88.71% (5 580/6 290), 89.52% (4 119/4 601)]. Compared with those in 2022, the incidence rates of brucellosis in males and females and all age groups in 2023 were significantly lower (χ 2 = 163.23, 108.56, 14.83, 27.10, 106.81, 110.89, 37.22, P < 0.001). The outbreak of brucellosis had decreased from 6 cases in 2022 to 1 case in 2023. Conclusions:In 2023, the incidence rate of human brucellosis in Ningxia is significantly decreased compared to 2022, the epidemic still affects various regions, with cases occurring in every month of the year. The affected population is mainly male, middle-aged, and farmers and herdsmen.

Objective:To analyze the surveillance results of brucellosis in Shanxi Province, to gain a understanding of the epidemic characteristics and changing trend of brucellosis in Shanxi Province, and to provide scientific basis for formulating prevention and control strategies and measures for brucellosis.Methods:The surveillance data of brucellosis in Shanxi Province from Infectious Disease Reporting Information Management System of China Disease Prevention and Control Information System, and the active surveillance results of 5 national brucellosis surveillance sites from 2018 to 2023 were collected for descriptive analysis.Results:From 2018 to 2023, a total of 24 041 cases of human brucellosis were reported in Shanxi Province, with the number of cases increased from 2 800 in 2018 to 5 131 in 2023. The annual reported incidence was 11.22/100 000, ranging from 7.56/100 000 to 14.74/100 000, showing an overall upward trend (χ 2trend = 1 377.43, P < 0.001). The epidemic had affected all counties (cities and districts) in the province, mainly concentrated in Linfen City, Jinzhong City, Datong City, and Shuozhou City, with a total of 13 489 cases of human brucellosis reported, accounting for 56.11%. The population distribution was mainly composed of individuals aged 40 - 69 (17 682 cases), males (18 513 cases), farmers (20 295 cases), and household and unemployed individuals (1 017 cases). The onset of the disease showed obvious seasonality, with the peak time from March to August, accounting for 66.39% (15 961/24 041). A total of 14 130 occupational individuals were investigated at the surveillance sites, and 11 141 underwent serological tests, with a positive rate of 5.25% (585/11 141), including 299 new cases. The positive rate of serological tests was relatively high in Qinyuan County, at 8.51% (241/2 832). Etiological culture was conducted on 338 human blood samples, and 43 strains of Brucella were isolated, with a detection rate of 12.72%. All strains were Brucella melitensis, including 42 strains of Brucella melitensis biovar 3. Conclusions:The overall trend of human brucellosis epidemic in Shanxi Province from 2018 to 2023 is on the rise, and it is still at a high level. It is suggested to continue strengthening monitoring, study the epidemic situation in a timely manner, take comprehensive prevention and control measures, and effectively control the spread of brucellosis.

Objective:To analyze the epidemic characteristics and changing trends of human brucellosis in Tangshan City, providing a basis for brucellosis prevention and control.Methods:Brucellosis surveillance data and historical surveillance data of Tangshan City reported from 2007 to 2022 in China Disease Prevention and Control Information System were collected. A descriptive analysis using retrospective methods was conducted to summarize the epidemic situation, distribution of three (population, time, region) and pathogenic monitoring results of brucellosis. Joinpoint regression was used to analyze the trend of brucellosis incidence.Results:From 2007 to 2022, a total of 3 949 cases of brucellosis were reported in Tangshan City, with the annual incidence ranging from 0.24 per 100 000 to 7.17 per 100 000, showing an upward trend (AAPC = 18.42%, 95% CI: 10.16% - 24.67%, P < 0.001). The affected population was mainly composed of those aged 40 - 69 years old (3 582 cases, accounting for 90.71%), male (2 957 cases, accounting for 74.88%), and farmers (3 432 cases, accounting for 86.91%). The onset time was mainly concentrated from March to August. The average annual incidence rates of brucellosis in the eastern region, western region and the central urban area were 5.31 per 100 000, 1.84 per 100 000, and 1.42 per 100 000, respectively. There were statistically significant differences among different regions (χ 2 = 1 049.17, P < 0.001). Pathogenic monitoring results revealed that 12 Brucella strains were isolated, all identified as sheep type 3. Conclusions:The incidence of brucellosis in Tangshan City is on the rise from 2007 to 2022. The incidence is mainly among middle-aged and elderly male famers, and it shows s distinct seasonal pattern. It is suggested to strengthen the prevention and control of brucellosis in the whole city.