Objective To explore the relationship between prevalence of Kashin-Beck disease (KBD) and ecological environment, and to broaden the perspective of KBD etiology. Methods In 37 counties of KBD areas in Gansu Province, information about the ecological environment and implementation situation of control measures (altitude, temperature, rainfall, evapo ration, frost free period, annual sunshine hours, population density, per capita income, the proportion of staple food, returning farmland to forest, to forestry and replant crops) and X-ray detection rate of KBD of 7-12-year-old children in 2012 - 2014 was collected. Using four quantile regression method, the regression model was introduced to analyze the 11 ecological factors which related to the pathogenesis of KBD. The effect of three points on X-ray detection rate of KBD was estimated. Results The X-ray detection rate of KBD was independent of altitude, temperature, evaporation, population density, per capita income and cash crops, and was dependent of rainfall, frost free period, annual sunshine hours, the staple food purchase ratio, and returning farmland to forest and grassland. No matter where in any place numbered, the higher rainfall (measure value:0.003 3 to 0.006 4), the longer frost free period (measure value: 0.029 2 to 0.043 8), the longer annual sunshine hours (measure value:0.001 6 to 0.001 8), and the higher staple food purchase ratio (measure value:0.019 7 to 0.027 6), the higher risk of X-ray detection rate of KBD; the higher returning farmland to forest and to grassland, the lower risk of X-ray detection rate of KBD (measure value: - 0.037 2 to - 0.013 3). Conclusion The X-ray detection rate of KBD is closely related to local ecological environment.

Objective Assessment of short?term and mid?term changes of knee cartilage in non?professional long?distance runners before and after marathon using T2 mapping imaging. Methods Twenty?four knee joints of 12 healthy volunteers (5 males and 7 females) who participated in the marathon were examined by 3.0 T MRI one week before the race, within 12 hours after the race and two months after the race, respectively. The age ranged from 21.0 to 37.0 years. Athletes run more than three times a week, and each time was about 30 minutes. From T2 mapping we can obtain T2 value of 6 cartilage subregions of knee joint. Paired t?test was used to compare the T2 values of cartilage before and after the marathon. The comparison between the superficial and deep T2 values of cartilage was performed by independent sample t test. Results T2 mapping imaging showed that the T2 value of the superficial articular cartilage was higher than that of deep articular cartilage in pre?competition, within 12 hours after competition and 2 months follow?up, respectively (t=11.095, 10.385 and 10.102, P<0.01). The T2 value of superficial articular cartilage decreased after the competition compared with that of pre?competition (t=2.18,P<0.05), while the T2 value of deep articular cartilage showed no significant difference compared with that of pre?competition (t=1.832, P> 0.05). Except for the MTP?DZ, the T2 value of the remaining cartilage subregions showed a trend of decrease within 12 hours after the competition. There were significant differences in the subregion of MFC?DZ (t=2.110,P<0.05). At the follow?up of 2 months, cartilage T2 values of the MTP?SZ,LTP?SZ,LTP?DZ,MFC?DZ, Patella?SZ, Patella?DZ, Trochlea?SZ, Trochlea?DZ subregions showed a trend of recovery, and there was no significant difference compared with pre?competition(t=0.857,0.573, 0.146, 0.510,-0.594,-1.135,-0.812,-0.679; P>0.05). The T2 values of the LFC?SZ and LFC?DZ were lower than those before the race, with statistical significance (t=2.378, 3.147,P<0.05). Conclusion T2 value could reflect the change process of articular cartilage tissue composition in marathon runners from T2 mapping imaging. Under stress, the changes of superficial T2 value are more significant. The T2 value of knee cartilage can gradually recover to the pre?run level 2 months after running.

Objective: Assessment of short-term and mid-term changes of knee cartilage in non-professional long-distance runners before and after marathon using T₂ mapping imaging. Methods: Twenty-four knee joints of 12 healthy volunteers (5 males and 7 females) who participated in the marathon were examined by 3.0 T MRI one week before the race, within 12 hours after the race and two months after the race, respectively. The age ranged from 21.0 to 37.0 years. Athletes run more than three times a week, and each time was about 30 minutes. From T₂ mapping we can obtain T₂ value of 6 cartilage subregions of knee joint. Paired t-test was used to compare the T₂ values of cartilage before and after the marathon. The comparison between the superficial and deep T₂ values of cartilage was performed by independent sample t test. Results: T₂ mapping imaging showed that the T₂ value of the superficial articular cartilage was higher than that of deep articular cartilage in pre-competition, within 12 hours after competition and 2 months follow-up, respectively (t=11.095, 10.385 and 10.102, P<0.01). The T₂ value of superficial articular cartilage decreased after the competition compared with that of pre-competition (t=2.18,P<0.05), while the T₂ value of deep articular cartilage showed no significant difference compared with that of pre-competition (t=1.832, P> 0.05). Except for the MTP-DZ, the T₂ value of the remaining cartilage subregions showed a trend of decrease within 12 hours after the competition. There were significant differences in the subregion of MFC-DZ (t=2.110,P<0.05). At the follow-up of 2 months, cartilage T₂ values of the MTP-SZ,LTP-SZ,LTP-DZ,MFC-DZ, Patella-SZ, Patella-DZ, Trochlea-SZ, Trochlea-DZ subregions showed a trend of recovery, and there was no significant difference compared with pre-competition (t=0.857,0.573, 0.146, 0.510, -0.594, -1.135, -0.812, -0.679; P>0.05). The T₂ values of the LFC-SZ and LFC-DZ were lower than those before the race, with statistical significance (t=2.378, 3.147,P<0.05). Conclusion T₂ value could reflect the change process of articular cartilage tissue composition in marathon runners from T₂ mapping imaging. Under stress, the changes of superficial T₂ value are more significant. The T₂ value of knee cartilage can gradually recover to the pre-run level 2 months after running.

Objective To evaluate the efficacy of telephone interviews on the quality of life of patients with chronic Keshan disease.Methods Totally 120 cases of chronic Keshan disease patients with chronic heart failure and NYHA classification of Ⅱ-Ⅳ were enrolled among the 181 patients with chronic Keshan disease,which confirmed by case search in Heshui County and Zhengning County in Qingyang City,Gansu Province in 2015,general demographic and clinical data were collected.According to the principle of random number table grouping,these 120 patients were randomly divided into a intervention group (n =60) and a control group (n =60).Both groups were given the conventional therapy and encouraged to inquiry or given regular outpatient medical follow-up.The patients in the intervention group received telephone interviews regularly for 6 months,with a interview frequency once a week in the first month,once every two weeks in the second and third months and once a month in the fourth,the fifth and the sixth months,with about 15 to 20 minutes interviews each time.Meanwhile there was no telephone interviews in the control group.At the begining of study,and after 3 months and 6 months of study,quality of life scores were scored according to the Minnesota Heart Insufficiency Scale (MLHFQ).The scores included total quality of life,physical field scores,emotional field scores,and other field scores.The lower the score,the higher the quality of life.Results After 3 months of telephone interviews,the emotional domain score of the intervention group (10.16 ± 4.58) was lower than that of the control group (13.10 ± 5.37,P ＜ 0.05).After 6 months of telephone interviews,the patients in the intervention group (35.60 ± 16.07,6.67 ± 4.01,13.16 ± 4.13) had significantly better quality of life than those in the control group (57.19 ± 14.97,12.43 ± 5.29,18.94 ± 6.68),with lower total points of life quality,emotion area and other area scores.The differences between the two groups were statistically significant (P ＜ 0.05).Conclusions Telephone interviews may promote the quality of life for patients with chronic Keshan disease.It is an effective way in enhancing the ability of chronic Keshan disease management.

Objective:To explore the effect of health education on drinking-water-borne endemic fluorosis in Gansu Province, and provide evidence for further development of health education measures.Methods:In 2011-2013, 2016 and 2017, using prospective method, 16-19 drinking-water-borne endemic fluorosis counties (cities, districts) were selected as project counties in Gansu Province each year, and 3 townships (towns) were selected in each project county. To carry out public health education activities on prevention and treatment of drinking-water-borne endemic fluorosis, school health education activities 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 health education of drinking-water-borne endemic fluorosis prevention knowledge were conducted among 30-50 students of grade 5 in the central primary school and 15-30 housewives lived near the schools in each township (town). Comparative analysis of the effects of health education activities was carried out.Results:The total awareness rates of prevention and treatment of drinking-water-borne endemic fluorosis in students of grade 5 and housewives were 89.55% (28 164/31 452) and 86.61% (14 976/17 292) after the intervention, respectively, which were significantly higher than those before the intervention [53.40% (16 518/30 933) and 51.88% (8 925/17 202)], and the differences were statistically significant (χ 2=1 586.16, 4 886.16, P < 0.05). Among the primary school students and housewives, the knowledge awareness rates of prevention and treatment of drinking-water-borne endemic fluorosis were increased by 36.15% and 34.73%, respectively. Conclusions:After implementation of drinking-water-borne endemic fluorosis health education intervention, the awareness rates of prevention and treatment knowledge in primary school students and housewives in Gansu Province are significantly increased. However, there are still weakness such as shortage of primary health education staff and insufficient investment in work funds, which means we can further expand the scope of health education.

Objective:To spread the knowledge of Keshan disease prevention and control, enhance the awareness of disease prevention among the population in the diseased areas, and provide the basis for formulating scientific intervention strategies for health education of Keshan disease.Methods:From October 2017 to April 2018, 10 counties (districts) with Keshan disease were selected as project counties(districts) in Gansu Province, and 3 towns were selected in each project county (district). To carry out Keshan disease health education activities in grade 4 - 6 of each township (town) central primary school, 3 villages were selected in each township to carry out community health education activities. We carried out 6-month propaganda on knowledge of Keshan disease prevention and control among pupils and residents, distributed health education materials and held lectures. Before and after the intervention, we conducted a questionnaire survey on health education among the target population (residents under 50 and primary school students in Grade 5), evaluated the improvement level of knowledge about keshan disease, and made statistical analysis.Results:Four hundred and fifty residents were investigated pre intervention and 451 residents post intervention, the awareness rate of Keshan disease prevention and control knowledge among residents in the diseased areas increased from 45.4% (2 041/4 500) before intervention to 79.5% (3 584/4 510) after intervention (χ 2 = 1 115.9, P < 0.05). Nine hundred and forty-eight pupils were investigated before intervention and 906 pupils (primary school students in Grade 5) after intervention, the awareness rate of Keshan disease prevention and control knowledge among pupils increased from 50.8% (4 818/9 480) before intervention to 84.2% (7 631/9 060) after intervention (χ 2 = 2 343.3, P < 0.05). Conclusion:The comprehensive intervention mainly based on health education can significantly improve the awareness rate of prevention and treatment knowledge of Keshan disease among primary school students and residents, and improve their bad life style, which is of great significance to the prevention and treatment of Keshan disease.