Objective To acquire effective clues for identification of environmental risk factors to birth defects. Methods Spatial autocorrelation statistics Moran's I and spatial hotspots detect method Getis's G statistics was used to identify birth defect risk factor. Results The different kinds of birth defects have different spatial distribution. Neural tube birth defects have the properties of spatial autocorrelation and different clustering phenomena in different spatial scales. Two typical spatial patterns were discovered in spatial scales of about 6.84 kilometers and 22.8 kilometers. Conclusion Using spatial autocorrelation probing technique, we find that there may be some common environmental teratogenetic factors which affect birth defects occurring ratio in the study area. By hotspots analysis of the clustering phenomena, the risk factors leading to birth defect were further resolved.

Objective To explore the impact of cardio cerebral vascular diseases (CVD) on life expectancy among residents in Shandong Province,develop effective preventive measures for the high-risk population and provide guidance for the health care resource allocation.Methods Based on the death monitoring data of the disease in Shandong Province in 2012,we calculated the crude mortality and standardized the mortality rate of the disease.We designed life tables with all causes of death and with eliminating causes of CVD death and analysed life expectancy with and without them examined.Results In 2012,crude mortality rate of CVD was 320.16/100 000 (SMR 252.85/100 000) in Shandong Province.The death rate of CVD was of 46.30％ of all deaths reported by monitoring system.The mortality rate of CVD in male and female were 332.99/100 000 and 307.02/100 000,respectively.The mortality rate of CVD in rural and urban areas were 341.84/100 000 and 267.28/100 000,respectively.The mortality of CVD increased with age and growed rapidly after the age of 60.Life expectancy of urban and rural areas was 79.20 years and 78.14 years,respectively.After eliminating causes of CVD death,life expectancy for eliminating causes of CVD death in urban and rural areas increased 8.51 years and 10.02 years,respectively.Life expectancy for eliminating causes of CVD death in male and female increased 8.02 years and 11.10 years,respectively.Conclusions Life expectancy of urban and rural areas,the male and female for eliminating causes of CVD death than that of all causes of death were greatly extended.Reducing the death caused by CVD to increase health life expectancy have important public health significance.

OBJECTIVEOur objective is to build a model that explains the association between the exposure to trace elements in the soil and the risk of neural tube defects.

METHODSWe built a function with different parameters to describe the effects of trace elements on neural tube defects. The association between neural tube defects and trace element levels was transformed into an optimization problem using the maximum likelihood method.

RESULTSTin, lead, nickel, iron, copper, and aluminum had typical layered effects (dosage effects) on the prevalence of neural tube defects. Arsenic, selenium, zinc, strontium, and vanadium had no effect, and molybdenum had one threshold value that affected the prevalence of birth defects.

CONCLUSIONAs an exploratory research work, our model can be used to determine the direction of the effect of the trace element content of cultivated soil on the risk of neural tube defects, which shows the clues by the dosage effect of their toxicological characteristics. Based on our findings, future biogeochemical research should focus on the direct effects of trace elements on human health.

China ; epidemiology ; Dose-Response Relationship, Drug ; Environmental Exposure ; Female ; Humans ; Metals ; chemistry ; toxicity ; Models, Biological ; Neural Tube Defects ; chemically induced ; epidemiology ; Pregnancy ; Prevalence ; Soil Pollutants ; chemistry ; toxicity ; Trace Elements ; chemistry ; toxicity

Objective: To explore the spatial distribution of low birth weight (LBW) and the potential environmental risk factors and provide the evidence for the prevention and intervention of LBW. Methods: Data were from a surveillance system for newly born population and adverse pregnancy outcome between 2007 and 2012 in Pingding county, Shanxi province. The data from 313 villages were analyzed. Spatial hierarchical Bayesian model was used to adjust the risk of LBW at village level, Moran’s I and Getis-Ord Gi* were used to analyze the difference in distribution of LBW risk area. Spatial negative binomial model was used to evaluate the association between the risk of LBW and chemical fertilizer application. Results: A total of 18 749 new births were recorded between 2007 and 2012, including 911 LBW cases, the total incidence of LBW was 4.86%. The result of the spatial hierarchical Bayesian model showed that high-risk area of LBW was in the southeast of Pingding and low-risk area was in the middle west of Pingding. The result of Moran’s I showed that there was a clustering pattern of LBW risk, and Getis-Ord Gi* found a high risk (hot spot) area in the south area. Moreover, the findings of association analysis showed that the risk of LBW increased with the increased chemical fertilizer application at village level. Conclusions There were area specific differences in the risk of LBW, and dose-response relationship between chemical fertilizer application and the risk of LBW. Our findings suggest that maternal exposure to chemical fertilizer during pregnancy might be a potential risk factor for LBW in rural area.

Objective To understand the current status of prenatal health care(PHC) and its related factors for floating women of childbearing age,and to provide evidence for improving the quality of PHC at childbearing age.Methods With data from the reproductive health survey on floating population in five cities,Beijing,Nanjing,Xiamen,Shenzhen and Chongqing,in 2005,the distributions of PHC among floating women were described.Multivariate logistic regression was performed to investigate the factors related to the utilization of PHC.Results In 5 399 cases of valid questionnaires,4 037 floating women who had the history of pregnant,cases who had or did not have PHC services would account for 75.3％ (3 041/4 037) and 24.7％ (996/4 037),respectively.The initial time of using the PHC service was significantly associated with the level of their education (P＜ 0.05) received.Data from the multivariate logistic regression analysis in PHC showed that there were differences between regions (P＜0.05).Proportions of women receiving PHC among those under 30 years and 30-39 were 4.09-folds (95％ CI:3.11-5.39) and 1.98-folds (95％ CI:1.61-2.43),respectively,when compared with that of women over 40-year-old.The proportion of women having received PHC with education levels of senior high school and above or junior high school,were 5.47-folds (95％CI:3.85-7.77) and 2.86-folds (95％CI:2.42-3.39) respectively,compared to that of women with education level of primary school or below.The proportion of married women having PHC was 2.36-folds (95％CI:1.07-5.22) of those unmarried women.The proportions of having PHC of women with one parity and two parities or with family planning certificate were 3.36-fold (95％CI:2.33-4.84) and 1.61-fold (95％CI:1.12-2.30),1.44-folds (95％CI:1.21-1.71) respectively,when compared with those women with three parities or without the certificate.Conclusion Factors as having received higher education,being married,with less parities or having family planning certificate etc.showed protective effects on PHC for floating women of childbearing age.Based on PHC,education should be promoted among the floating women of childbearing age,which would contribute to the prevention and reduction of adverse outcomes related to reproductive health.

Objective To investigate the curative effect and mechanism of α lipoic acid combined with epalrestat and methylcobalamin in patients with type 2 diabetes mellitus (T2DM) complicated with pe-ripheral neuropathy ( DPN) . Methods A total of 160 cases of patients with DPN were randomly divided into the control group ( treated with methylcobalamin and epalrestat) and the observation group ( treated with methylcobalamin, epalrestat and α lipoic acid) , and all patients were treated for 4 weeks. The therapeutic effect, nerve conduction velocity, oxidative stress index and related proteins expression in serum were ob-served in two groups. Results The effective rate of treatment in the observation group was higher than that in the control group (87. 50％ vs 75. 0％) (χ2 = 4. 103,P<0. 05). After treatment, the sensory nerve conduction velocity ( SNCV) and motor nerve conduction velocity ( MNCV) of median nerve and common peroneal nerve were significantly better in the observation group than the control group ( P<0. 05 ) . After treatment, the level of superoxide dismutase ( SOD) was significantly higher in the observation group than the control group, while the level of malondialdehyde ( MDA ) was significantly lower the control group (P<0. 05). After treatment, the level of Bcl-2 protein was significantly higher in observation group than the control group, while the levels of Bax and Caspase-3 proteins were significantly lower than the control group (P<0. 05). Conclusions The application ofαlipoic acid combined to epalrestat and methylcobal-amin in the treatment of DPN can significantly improve the sensory and motor nerve conduction.