Objective To investigate the status of the disease of the fluorosis and arsenism caused by coal-burning in Ankang city of Shaanxi. Methods Nine survey spots were chosen to carry out the epidemiological investigation of adult skeletal fluorosis and arsenism in the coal-polluted areas of Ankang, respectively using Determination of Fluorine in Coal (GB/T 4633-1997) to determine the coal fluorine and using hydride generation atomic fluorescence spectrophotometry(HCAFS) to determine coal arsenic. The diagnose of the adult skeletal fluorosis followed the Diagnosis of Clinical Classification for Endemic Skeletal Fluorosis Standard(GB 16396-1996), that of arsenism using Standard of Diagnosis for Endemic Arsensim (WS/T 211-2001). Results Totally 569 adults were investigated over the age of 16, among which 121 cases were skeletal fluorosis, with a total detection rate of 21.27%. Four cases of II degree and higher skeletal fluorosis patients were identified, accounting for 0.70% of the number of subjects. One hundred and thirty-two cases of arsenic poisonin were detected, in a rate of 23.20%. Ninety-five patients were identified with moderate or severe arsenic poisoning, accounting for 16.69% of subjects. A positive correlation was found between the detection rates of the skeletal fluorosis and the arsenism(r = 0.816, P < 0.01), as well as between the detection rate of skeletal fluorosis and fluoride content of coal(r = 0.775, P < 0.05). The detection rate of arsenism and arsenic content of coal also had close relationship (r = 0.761, P < 0.05). The detection rate of skeletal fluorosis in the group aged 40 - ,50 - , and 60 - [27.20%(34/125) ,29.27%(36/123), 28.13%(36/128)] was increased, compared the group of less than 40 years age[7.77%( 15/193), X~2 = 21.969,25.648,23.856,P<0.01].For the detection rate of arsenism,male[33.67%(99/294)]was obviously higher than female[12.00%(33/275),)(X~2=37.162,P<0.01].Conclusions A high detection rate of fhorosis is correlated with arsenic poisoning,but the probability of the two diseases simultaneously occurred in a person is not high.In this polluted area.when fluoride accumulates to a certain level as in aduh,the detection rates no longer varies obviously;however,that of arsenism increases along with the age.

Objective To know the condition and feature of water-born endemic arsenism in Shaanxi province, and to provide scientific evidences for prevention and treatment of the disease. Methods In 2009, 8 villages of Duhe, Miaogou, Sanhe, Caiyuan in Shanyang county and Shuanglong, Guangming, Donghekou in Zhen'an county and Guojiawan in Mian county as monitoring sites from both the found water-born arsenic poisoning areas and potential ones of drinking water arsenic ＞ 0.15 mg/L were selected. The disease conditions of residents who lived for more than six months of continuous residence, were investigated according to "Endemic Arsenism Diagnostic Criteria" (WS/T 211-2001 ) and arsenic level in the drinking water were determined. Results Seven thousand six hundred and ninety-three individuals were investigated and 612 cases of arsenism were diagnosed in the 8 villages, the prevalence rate was 7.96%(612/7693). Mild patients accounted for 33.17%(203/612), moderate patients accounted for 50.16%(307/612), and severe patients accounted for 16.67%(102/612). The detection rate for male was 9.99%(408/4085), for female was 5.65%(204/3608), the former was higher than the latter(x2 = 49.138,P ＜ 0.01 ). The older the age was, the higher the rate was(x2 = 770.708, P ＜ 0.01 ). Main clinical manifestation of the patients was depigmentation and pigmentation in skin. Patients with one symptom accounted for 43.30% (265/612), with two symptoms accounted for 56.70% (347/612). Three hundred and seventy drinking water samples were detected, the median of arsenism content was 0.005 mg/L, ranged 0 - 1.660 mg/L. The over-limit rate of arsenic level in the drinking water were 11.62% (43/370). Conclusion Water-born endemic arsenism is mildly prevailing in Shaanxi province, however, great attention should be given to control and monitoring of the disease.

Objective To investigate the current situation of endemic fluorosis associated with drinking water in Shaanxi province in 2008, providing prevention and control work with scientific evidence. Methods According to data of drinking water endemic fluorosis in Shaanxi, 15 counties in Yulin, Weinan and Xianyang city were divided into mild, moderate and severe diseased areas according to fuoride level in the drinking water or the fluorosis severity, and 12,39,45 endemic fluorosis villages were selected respectively from each area. Dental fluorosis for all the children aged 8 - 12 years old and clinical skeletal fluorosis for the people over the age of 16 were examined. In mild, moderate and severe areas, 30% of the survey villages received X-ray to examine skeletal fuorosis. Five water samples were collected from villages with unimproved water respectively from the east, the west, the south, the north, the middle; if there was less than 5 that could be sampled, then all were collected, moreover 3 peripheral and 1 central water samples were collected from villages with improved water. Also in mild, moderate and severe illness areas, 50% of the surveyed villages were selected; in each village, 30 urine samples of the children aged 8 - 12 were collected, 6 portions in each age group. If Less than 30 children in all the age groups or less than 6 in each age group, all their urine samples were collected to determine fluoride. Results Totally 3652 children aged 8 - 12 years old were examined and 1930 cases of dental fluorosis were diagnosed, the rate was 52.85% and the index was 1.22. The rates in Dinghian, Jingbian and Pucheng village were higher, being 90.43% (170/188) ,82.89%(126/152),80.65% (325/403) respectively. A total of 40 543 adults over the age of 16 were examined and 5935 cases of skeletal fluorosis were diagnosed, in a rate of 14.64%. The rates of the mild, moderate, severe skeletal fluorosis were respectively 9.17%(3717/40 543),4.36%(1769/40 543),1.11%(449/40 543).All 706 adults were taken X-ray films.and 280 cases of positive change were diagnosed,the positive rate was 39.66%. The rates of the mild,moderate,severe change were respectively 17.28%(122/706),17.00%(120/706),5.38%(38/706).All 427 water samples were collected,the fluoride content waS(2.22±1.41)ms/L,and the abnormal rate was 85.01%(363/427).All 1393 portions of urine sample were collected in children and the median of fuoride was 2.37 mg/L Conclusions The endemic fluorosis associated with drinking water is still comparatively serious in Shaanxi.The preventive measures for improving water must be improved.

Objective To learn the pain status in the patients of emergent hand injury and analyze the relative factors which influenced the pain. Methods A total of 210 patients of emergent hand injury were investigated with short McGill pain questionnaire and anxious status scale. Results The VAS at the injury happened and at the visit in 210 emergent hand injury patients were (4.87±2.42 ) and (4.70±2.31 ). During the visit, the PRI was ( 3.34±2.35 ), feeling PRI was ( 3.17±2.26 ), emotional PRI was (0. 17±0.67 ),PPI was (2.80±0.26) ,The variance analysis found the VAS of patients had different degree injury in the past had different VAS of this visit ( F=2. 29, P < 0. 05 ). Relative analysis found the severity of this hand injury ( r = 0. 262, P < 0. 01 ) and the S-AI of this visit ( r = 0.390, P < 0.01 ) had positive correlation with the VAS of this visit. The education ( r = - 0. 172, P < 0. 05 ) had negative correlation with the VAS. Conclusions The pain in the patients of emergent hand injury was medium, releasing the anxiety of the patients at the visit could reduce the pain at that time.

Abstract: Objective　To detect and analyze the antiserum of Yersinia pestis phage in Marmota himalayana blood from the natural plague foci of Qinghai-Tibet Plateau by micro-bolus technique, to provide a theoretical basis for interaction between phages and mammalian immunology, phage therapy and interaction between bacteriophage and ecology in future. Methods　Using diagnostic Yersinia pestis phage and 3 wild plague phages from Qinghai-Tibet Plateau Natural Plague Foci as antigens, 847 serums of Marmota Himalayana blood, from Tongde, Guinan, Gonghe, Xinghai, Tianjun foci counties in Qinghai Plateau, were collected from July to September in 2020, 2021 and determined on antiserum of Yersinia pestis phage by microplate method and double agar plate method. Results　The neutralization reaction experiment lasted for 24 hours between 4 phage and 847 serums by microplate method independently. These mixtures were tested by double agar plate method. All results were negative on antiserum of Yersinia pestis bacteriophage. Conclusions　The positive antiserum of Yersinia pestis phage in Marmota himalayana were not found the natural plague foci of Qinghai-Tibet Plateau, which agreed with plague epidemiology in 5 foci counties in Qinghai plateau from 2020-2021, that was a characteristic of the resting period. In other words, it was in the absence of plague pathogen. It also showed indirectly that the absence or weak presence of Yersinia pestis bacteriophage in the plague foci. It showed a lower frequency on host animals coming into contact with phages naturally. The antiserum of Yersinia pestis phage may be related to the form of plague infection and the intensity of the disease.

Objective To analyze the outcome of the epidemiological investigation on an animal plague in Dingbian County of Shaanxi Province.Methods The region of 25 square kiolmeters(km2)in Hongliugou Town was selected as monitoring point of plague to investigate on host animals,etiology and serology.The epidemic area was classified,deratization and depulization were correspondingly adopted.Health education was carried out for prevention knowledge of plague,and questionnaire survey was conducted among residents and medical staff in the epidemic area.Result The average rat density in monitoring site was 8.38 rats per hectare in Hongliugou Town.Average rate infected with flea and flea index were 50.4%(56/111)and 1.81,respectively.The epidemic area was classified 3 types,and came up to the demand after corresponding measures adopted.In the epidemic area,the pass rate of the prevention and control knowledge were 62.00%(31/50)in residents and 92.98%(53/57) in medical staff.Conclusions Plague epizootic can be discovered by exercising regular monitoring and controlledimmed iately and effectively by taking the appropriate control measures.

Objective To explore the current status of the family function and the influential factors in the community, Methods A questionnaire survey including the general data questionnaire and APGAR scale developed by Smikstein was conducted in 94 families of three communities of Wuhan City. Results 46.8% of the surveyed family showed good function, 51. 1% showed moderate dysfunction and 2.1% in severe dysfunction. The multinomial regression revealed that education level and whether the family members had chronic diseases had influence to the family function level (P<0.05). Conclusions More than 50% of the families exist moderate or severe family dysfunction. The higher education level, the better family function; meanwhile compared with the family whose members experience chronic diseases, the family without experiencing chronic dieseases shows much better family function.

ObjectiveTo investigate the current situation of coal-burning borne endemic fluorosis in the infected area,the usage of defluoridation stove and the formation of related behavior; to evaluate the control effect,so as to provide a theoretical basis for superiors' policy-making.MethodsNine villages in three counties of Ankang city and Hanzhong city Shanxi province were monitored in 2010.Choose five disease infected villages with oven changed in the three monitoring counties,and 10 families were randomly selected in each of the nine monitoring points and every chosen village,and a survey on the stove using and related behavior changes was carried out.By using Dean method,the dental fluorosis of every child aged 8 - 12 in the monitoring villages was examined.Meanwhile 10 copies of urine samples were randomly collected in each age group in the above-mentioned villages.The content of fluoride in urine was determined by F-ion selective electrode(WS/T 30-1996) and evaluated according to “The Normal Concentration of Urinary Fluoride of Population” (WS/T 256-2005).Twenty men over 25years old in the monitoring counties were randomly selected in each age group to be examined skeletal fluorosis by X-rays,and diagnosis was based on “The Endemic Skeletal Fluorosis Standard”(WS 192-2007).ResultsThe proper utilization rate and the qualified households of iron stoves and improved stoves,the correct drying rate and the correct storage rate of peppers and coms were all low.The washing rate of corns and peppers before eating was higher than 95％.Of the 350 children being examined of dental fluorosis in the 9 monitoring villages,the detection rate of dental fluorosis was 59.71％ (209/350).A total of 871 adults over the age of 25 were examined,and the detection rate of skeletal fluorosis was 17.22％ (150/871).A total of 350 copies of children urine samples were tested and the fluoride content were between 0.07 - 2.02 mg/L,the geometric mean value of fluoride content was 0.66 mg/L.ConclusionsThe coal-burning borne endemic fluorosis in Shanxi is in a growth phase,many defluoridation stoves are out of order,and the formation of healthy behaviors is low.To strengthen the disease surveillance,health education and management of defluoridation stoves are keys to prevent coal-burning borne endemic fluorosis in the future.

Objective To investigate the running conditions of the water improvement projects and the role of these projects in reducing fluoride in drinking-water type of fluorosis in Shaanxi province, and provide a scientific basis for prevention and control of the disease. Methods Forty-eight villages of 16 counties in Xi'an, Baoji, and Yulin cities of Shaanxi province were monitored in 2009. Five water samples were collected randomly in water unimproved monitoring villages by the position of east, west, south, north, and center parts. In water improved monitoring villages, 3 tap water and one source water samples were collected. Water fluoride was tested using fluoride ion selective electrode method according to the "Standard Testing Methods for Drinking Water" (GB/T 5750-2006). All school children aged 8 to 12 in monitored villages were examined their dental fluorosis using Dean criteria. All people over 16 years old were examined clinical skeletal fluorosis, and 30% of the project counties were randomly selected, then randomly selected one village among these counties, clinically diagnosed patients with skeletal fluorosis were examined again by X-ray using "Diagnostic Criteria of Endemic Skeletal Fluorosis"(WS 192-2007). Urine samples of 30 children aged 8 to 12 and of 20 adults over the age of 16 were randomly collected, urinary fluoride was tested according to "the Determination of Urinary Fluoride by Ion Selective Electrode Method" (WS/T 89-19%). Results Of the 22 water improvement projects that in normal operation, fluoride level of 8 source waters exceeded the standard, accounting for 36.36%(8/22), and projects scrapped 5. Two hundred and two water samples were tested. In water improved historical diseased areas, the median of water fluoride of source water and tap water were 0.72,0.62 mg/L, respectively, and the average rate of water fluoride exceeded the standard ere 36.36%(8/22) and 31.94%(23/72), respectively. In water unimproved historical diseased areas, the median of water fluoride was 1.00 mg/L, and the average rate of water fluoride exceeded the standard was 39.81%(43/108). Detection rate of dental fluorosis among children aged 8 to 12 was 16.06% (367/2285), dental fluorosis index was 0.30, and the prevalence was negative. Detection rate of clinical skeletal fluorosis among adults over 16 years old was 5.09%(1542/30 272), a totally of 198 people had X-ray film taken, positive 68, the positive detection rate was 34.34%(68/198). One thousand and fifty-one copies of children's urine samples were tested, geometric mean of urinary fluoride was 0.95 mg/L; nine hundred and fourteen copies of adults urine samples were tested, geometric mean of urinary fluoride was 1.16 mg/L Conclusions Drinking-water type of fluorosis affects a large area in Shaanxi province, the disease is still serious, and the task of prevention remains very arduous. Further intensify the water improvement project in diseased areas, and strengthen disease monitoring, health education and water improvement project management is the key to prevention and control of endemic fluorosis.

We wished to understand the genetic recombination and phylogenetic characteristics of human en- terovirus A71 (EV-A71) and to explore its potential virulence-related sites. Full-length genomes of three EV-A71 strains isolated from patients in Chenzhou City (China) were sequenced and analyzed. Possible re- combination events and crossover sites were analyzed with Recombination Detection Program v4. 1. 6 by comparison with the complete genome sequences of 231 strains of EV-A71. Similarly, plot and bootscanning analyses were undertaken with SimPlot v3. 5. 1. Phylogenetic trees based on the sequences of VP1 regions were constructed with MEGA v5. 2 using the Kimura two-parameter model and neighbor-joining method. Results suggested that recombination events were detected among the three EV-A71 isolates from Chenzhou City. The common main parent sequence was from JF799986 isolated from samples in Guang- zhou City (China) in 2009, and the minor parent sequence was TW/70516/08. Intertypic recombination e- vents were found in the C4b strain (strain SHZH98 isolated in 1998) and C4a strain (Fuyang strain isola- ted in 2008) with the prototype strains of CVA4 and CVA14 in the 3D region. The chi-square test was used to screen-out potential virulence-related sites with nucleotide substitutions of different types of hand, foot, and mouth disease (HFMD) cases using SPSS v19.0. Results suggested that there were no significant nucleotide substitutions between death cases and severe-HFMD cases. Eighteen significant nucleotide substitutions were found between death/severe-HFMD cases and mild-HFMD cases, and all these 18 substitutions were distributed only in P2 and P3 regions. Intertypic recombination among the predominant circulating EV-A71 strains in the Chinese mainland and other EV-A strains probably dates before 1998, and intratypic recombination might have occurred frequently in the HFMD outbreak from 2008 to 2012. Substitutions in the non-capsid region may be correlated with the changes in virulence of EV-A71. These data suggest that researchers should pay more attention to the relationships between substitutions in the noncapsid region and the virulence of the virus.
Enterovirus A, Human ; genetics ; pathogenicity ; Mutation ; Phylogeny ; Recombination, Genetic ; Virulence