OBJECTIVE: To investigate the clinical characteristics of Henoch-Schonlein purpura (HSP) patients from different altitudes in Tibet plateau areas of China. METHODS: A retrospective study was used to analyze the 190 HSP patients admitted to Tibet Autonomous Region People ' s Hospital form April 2014 to May 2021. The subjects were divided into 3 groups according to the altitude of long-term residence before onset and the clinical data at different altitudes were compared and analyzed. RESULTS: There were no significant differences in the age of onset and gender in HSP patients at different altitudes (P>0.05). The HSP patients in high altitude areas were more likely to have digestive symptoms (P < 0.01). The patients were more likely to have kidney or joint involvement at higher altitudes. The platelets [(512.1±55.0)×10⁹ /L] and C reactive protein [11.2 (5.7, 19.4) g/L] in high altitude areas were significantly higher than at medium altitudes [(498.3±76.9)×10⁹ /L and 9.5 (4.6, 13.5) g/L] and lower altitudes [(456.4±81.2)×10⁹/L and 3.7 (0.2, 8.9) g/L] respectively. The effective rate of treatment was 98.9%, while there was no significant difference of outcome from different altitudes (P>0.05). The patients who were repeatedly hospitalized all had kidney involvement and no immunosuppressive agents were added in the initial treatment. CONCLUSION HSP is common in high altitude areas. There was little difference in age of onset and gender at different altitudes. Abdominal pain was the most common clinical manifestation. Patients in high altitude areas were more likely to have severe abdominal problems. Kidney involvement may be poor prognostic factor. Early application of glucocorticoid combined with immunosuppressive agents can effectively control the disease and reduce the recurrence of HSP.
Altitude ; China/epidemiology* ; Humans ; IgA Vasculitis/epidemiology* ; Retrospective Studies ; Tibet

Objective: To study the lineages of rabies virus and the epidemic characteristics in different provincial populations of China, to provide information for the development of control and prevention measures in each respective provinces. Methods: Full length N and G genes and full-genome of epidemic strains of rabies virus collected in China were downloaded from GenBank and combined with newly sequenced strains by our lab. Each strain was classified under six lineages of China rabies by constructing phylogenetic trees based on the N or G sequences. Numbers of strains and lineages in each province were counted and compared. Results: Six lineages (China Ⅰ-Ⅵ) were prevalent in China, with 4 found in Yunnan and Hunan. In 6 provinces, including Henan and Fujian, 3 lineages were found. In 8 provinces, including Shanghai and Jiangxi, 2 lineages were found Only 1 lineage, were found in Beijing, Tianjin and other 12 provinces. the China Ⅰ, was the dominant one in 25 provinces. In recent years, China Ⅲ had been found in wild animals and spread over livestock in Inner Mongolia and Xinjiang areas. Qinghai and Tibet had been influenced by China Ⅳ, which also been found in wild animals of Inner Mongolia and Heilongjiang. Conclusion: There had been obvious differences in lineages and strain numbers of rabies virus identified in different provinces in China.
Animals ; China/epidemiology* ; Humans ; Phylogeny ; Rabies/epidemiology* ; Rabies virus ; Tibet

Humans ; Female ; Tibet ; Kashin-Beck Disease/epidemiology* ; China ; Metabolomics

Atherosclerosis ; complications ; epidemiology ; Carotid Artery Diseases ; complications ; epidemiology ; Glucose Metabolism Disorders ; complications ; epidemiology ; Humans ; Tibet ; epidemiology

OBJECTIVETo investigate the relationship between SNPs reported in previous studies and the blood lipid level in the Tibetan population.

METHODSRandom cluster sampling was employed in 5 areas (Lhasa, Shigatse, Shannan, Nagqu, and Nyingchi). The levels of cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) from blood samples were determined and DNA was extracted for genotyping and statistical analyses.

RESULTSAmong 1 318 subjects aged >18 years enrolled in this study, 367 had dyslipidemia with a prevalence of 27.8%, of whom dyslipidemia males accounted for 33.1% and dyslipidemia females -24.5%. Results of the correlation analysis between all SNPs and TG showed that the SNPs of rs714052 and rs964184 were related to the serum TG level. Subjects with rs714052 CC genotype had the lowest TG level, and the highest TG level was found in those with rs714052 TT genotype. The serum TG level in individuals with TC genotype lied in between the above two population groups. Subjects with rs964184 CC genotype had the lowest TG level, and the highest serum TG level was noted in those with rs964184 GG genotype.

CONCLUSIONSeveral SNPs were found to be related to the serum TG level in the Tibetan population. The APOA5 gene and MLXIPL gene may be closely associated with the serum TG level in this ethnic population group.

Dyslipidemias ; epidemiology ; genetics ; Female ; Genotype ; Humans ; Lipids ; blood ; Male ; Polymorphism, Single Nucleotide ; Tibet ; epidemiology

OBJECTIVETo understand the prevalence of vitamin A deficiency (VAD) among children under six years of age in Tibet, China.

METHODSTotally, 1 257 children under six years of age were selected from two cities, two farming counties, two semi-farming counties and two livestock farming counties with stratified cluster sampling to asses VAD status in Tibet. Family information, children's feeding and disease history in the previous two weeks were collected by questionnaire. Blood specimen was collected from each child and serum was separated for detection of vitamin A concentration with microfluorescent spectrophotometry.

RESULTSTotally, 1 257 children under six years of age were surveyed, with 635 boys, 622 girls, 862 aged over two years, and 98.5% of Tibet nationality. Six cases of night blindness and two cases of xerophthalmia were detected from them, with prevalence of clinical VAD of 0.96%. Eighteen of 1071 mothers with children under six years of age were found suffering from night blindness, accounting for 1.7%. Clinical cases of VAD both in children and mothers came from all four sampling strata. Average serum concentration of vitamin A and prevalence of subclinical VAD (serum vitamin A lower than or equal to 0.70 micromol/L) was 1.15 micromol/L and 5.4% and 1.12 micromol/L and 4.7% in cities and livestock farming counties, respectively, significantly higher than those in farming (1.04 micromol/L and 11.0%) and semi-farming counties (1.05 micromol/L and 12.3%), respectively, as compared to average levels of 1.09 micromol/L and 8.4% in the autonomous region as a whole. Prevalence of subclinical VAD in children under six months and those aged six to eleven months were 22.2% and 13.3%, respectively, significantly higher than those in children aged one year (8.5%), two to three years (5.4%) and four to five years (7.9%), respectively. There was also significant difference in serum level of vitamin A between children at varied ages, but no significant difference both in serum level of vitamin A and prevalence of subclinical VAD between gender was found.

CONCLUSIONSIn general, status of VAD in children of Tibet was milder than that at national level. But, moderate subclinical VAD in some areas, such as farming and semi-farming counties, did exist, so vitamin A supplementation aiming to children, especially those under one year of age, in those areas should be urged.

Age Factors ; Child, Preschool ; Female ; Humans ; Male ; Sex Factors ; Tibet ; epidemiology ; Vitamin A ; blood ; Vitamin A Deficiency ; epidemiology

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Male ; Osteoarthritis ; epidemiology ; Tibet ; epidemiology

Altitude ; China/epidemiology* ; Community-Acquired Infections/epidemiology* ; Humans ; Pneumonia/etiology* ; Tibet

OBJECTIVES: To study the molecular epidemiological characteristics of the virus in children with acute viral diarrhea in Changdu of Tibet, China. METHODS: Fecal specimens were collected from 96 children with acute diarrhea who visited the People's Hospital of Changdu, Tibet, from November 2018 to November 2020 and were tested for adenovirus, norovirus, astrovirus, sapovirus, and rotavirus. Gene sequencing was performed for the genotypes of these viruses. RESULTS: The overall positive rate of the five viruses was 39% (37/96), among which astrovirus had the highest positive rate of 17%, followed by norovirus (9%), rotavirus (8%), adenovirus (7%), and sapovirus (5%). There was no significant difference in the positive rate of the five viruses among different age groups (P>0.05). Only the positive rate of astrovirus was significantly different among the four seasons (P<0.05). For adenovirus, 6 children had F41 type and 1 had C2 type; for norovirus, 6 had GⅠ.3 type, 1 had GⅠ.7 type, 1 had GⅡ.3 type, and 2 had GⅡ.4 Sydney_2012 type; HAstrV-1 type was observed in all children with astrovirus infection; for sapovirus, 1 child each had sporadic GⅠ.2, GⅠ.6, and GⅡ.1 sapovirus and 2 children had unknown type; 6 children had rotavirus G9[P8]. CONCLUSIONS Astrovirus and norovirus are important pathogens in children with acute diarrhea in Changdu, Tibet. The positive rate of adenovirus, norovirus, astrovirus, sapovirus, and rotavirus is not associated with age, and only the positive rate of astrovirus has obvious seasonality. F41 type is the dominant genotype of adenovirus; GⅠ.3 is the dominant genotype of norovirus; HAstrV-1 is the dominant genotype of astrovirus; sporadic GⅠ.2, GⅠ.6, and GⅡ.1 are the dominant genotypes of sapovirus; G9[P8] is the dominant genotype of rotavirus.
Child ; China ; Diarrhea/epidemiology* ; Feces ; Gastroenteritis ; Humans ; Tibet/epidemiology* ; Viruses/genetics*

BACKGROUNDCongenital heart disease (CHD) is a common heart condition which does considerable harm to the health of children and adolescents. CHD epidemiological characteristics of Tibetan children whose ages ranged from 4 to 18 years were investigated in Qinghai Province.

METHODSA total of 32 578 Tibetan children, living at altitudes of 2535 m, 3600 m and 4200 m, were examined using a three-stage protocol: prescreening, rechecking and diagnosis using a color Doppler. The distribution of CHD at different altitudes was analyzed together with differences in occurrence according to age and gender.

RESULTSA total of 235 CHD cases were discovered. The total prevalence of CHD was 7.21 per thousand. Prevalence of CHD has been shown to increase along with increase in altitude with 5.45 per thousand at an altitude of 2535 m, 6.80 per thousand at 3600 m and 9.79 per thousand at 4200 m. There were no statistically significant differences between the prevalence at 2535 m and 3600 m (chi(2) = 1.594, P > 0.05). However, there was a significant difference between the prevalence at 2535 m and 4200 m (chi(2) = 7.002, P < 0.01). Also, apparent differences existed between the prevalence at 3600 m and at 4200 m (chi(2) = 5.540, P < 0.05). There was no statistically significant difference in prevalence according to age at an altitude of 2535 m, but the rate of CHD increased significantly along with increasing age at 3600 m and 4200 m. The total prevalence ratio of children aged from 16 to 18 years was significantly higher than that of children from 4 to 7, and from 8 to 12 with chi(2) values of 10.79 (P < 0.005), and 5.60 (P < 0.05) respectively. Within the constituent ratio of CHD, the prevalence of atrial septal defect (ASD) was the highest at 39.10%, followed by the prevalence of ventricular septal defect (VSD) at 32.8% and patent ductus arteriosus (PDA) at 24.7%. Furthermore the proportion of the four categories of CHD varied at different altitude levels: at 2535 m, of those diagnosed with CHD, the prevalence rate of VSD was the highest at 43.5%, at 3600 m ASD was the highest at 42.8% and at 4200 m, PDA was the highest at 50.8%.

CONCLUSIONThe epidemiological characteristics of CHD in Tibetan children may be associated with altitude levels.

Adolescent ; Altitude ; Child ; Child, Preschool ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Heart Defects, Congenital ; epidemiology ; Humans ; Male ; Tibet ; epidemiology