Objective To describe the status of prevalence,awareness,treatment,and control of hypertension among the residents in severe historical endemic areas of Keshan Disease in Heilongjiang Province,and to provide scientific evidence for prevention and control of hypertension.Methods In December 2015,Yongjin,Yongli groups of Yongjin Village,and Fengnian,Fengtian,Fengfu groups of Fengnian Village in Fanrong Township,Fuyu County,Qiqihaer City,Heilongjiang Province were selected via the cross-sectional method.The residents aged 18 years or older were surveyed as respondents by cluster sampling.Demography,risk factors,hypertension related information were collected through questionnaire survey.Blood pressure,height and weight were measured through physical examination.Blood pressure measurement was conducted with Omron HEM-1020 electronic sphygmomanometer,the diagnostic criteria was Chinese Guidelines for Prevention and Treatment of Hypertension (revised in 2010).Results Totally 683 residents were surveyed,the valid participants were 669,the prevalence of hypertension was 49.2％ (329/669),the standardized prevalence was 37.9％,the prevalence of men [58.0％ (164/283)] was higher than that of women [42.7％ (165/386),x2 =15.103,P ＜ 0.01],the prevalence increased with increasing age (total,men,women:x2tendency =9.044,4.560,7.789,all P ＜ 0.01).The awareness of hypertensive patients was 60.8％ (200/329),the standardized awareness was 41.2％,the awareness of men [54.3％ (89/164)] was lower than that of women [67.3％ (111/165),x2 =5.836,P ＜ 0.05],the awareness of hypertensive patients increased with increasing age (total,men,women:x2tendency =3.638,2.686,2.419,all P ＜ 0.05).The treatment of hypertensive patients was 51.1％ (168/329),the treatment of men [43.9％ (72/164)] was lower than that of women [58.2％ (96/165),x2=6.711,P ＜ 0.05],the treatment of hypertensive patients increased with increasing age (total,men,women:x2tendency =4.422,2.704,3.633,all P ＜ 0.01).The control rate of hypertensive patients was 5.5％ (18/329),the control rate among the treatment was 10.7％ (18/168).Conclusions The standardized prevalence of hypertension among the residents of the severe historical endemic areas of Keshan disease in Heilongjiang Province is higher than the national average (25.2％),the standardized awareness is lower than the national average (46.5％),the treatment and the control are low.We should pay more attention to the hypertension in the severe historical endemic areas of Keshan disease.

Objective To explore the spatial description of Keshan disease(KD)and to provide a basis for reasonable allocation of health resources and for making precision prevention and control strategies. Methods In 2013 and 2014, the KD's condition, prevention and control measures and their effects were investigated in the diseased affected counties in the provinces through combination of case search and key survey. Results A total of 16(100.0%,16/16)diseased provinces,315(96.0%,315/328)diseased counties were surveyed,and 1 562 people with KD were detected in 281 000 residents, the detection rate was 55.6/10 000. Chronic and latent KD detection rates were 8.9/10 000(250)and 46.7/10 000(1 312),respectively.There were 261(82.9%)diseased counties that had reached the control standards of KD,and 54(17.1%)did not meet the control standards,which mainly distributed in the provinces of Henan, Inner Mongolia, Gansu and Shanxi. Conclusions The detection rate of KD has been at a low level, but in Henan, Inner Mongolia, Gansu, and Shanxi, there are prevalent KD areas that have not yet reached the control level.This part of the areas should be treated as key prevention and control areas of KD.

Objective To explore the spatial distribution clustering and influencing factors of chronic Keshan disease in China,and to provide evidence for prevention and control of Keshan disease.Methods Using non-probability sampling methods,combined with case search and key surveys,data on national detection rate of chronic Keshan disease,on disease influencing factors in 2013-2014 were collected;a spatial database was established,and ArcGIS 9.0 software was used to perform global Moran'sI,local Moran's I,local Getis-Ord Gi and inverse distance weighted interpolation analysis for the detection rate of national chronic Keshan disease.Spatial regression was used to analyze the influencing factors of chronic Keshan disease.Results Global autocorrelation analysis showed that Moran's I =0.03,Z =2.72,P ＜ 0.01,indicating that there was aggregation in the detection rate of Keshan disease.The results of local Moran's Ii showed that there were local high-detection rate clusters in the wards of Keshan disease,and the high-high aggregation areas were mainly concentrated in the wards of Gansu,Inner Mongolia,and Shanxi;the high-low aggregation areas were mainly located in the wards of Heilongjiang,Jilin,Shandong;the low-high aggregation area were mainly located in the wards of Heilongjiang.Getis-Ord Gi autocorrelation results showed that Keshan disease hotspots were mainly located in the wards of Inner Mongolia,Heilongjiang,Gansu,Shandong,Shanxi and Yunnan;the results of reverse distance weighted interpolation showed that the detection rates of the counties in Gansu and Inner Mongolia were higher than that in Heilongjiang,Jilin,Liaoning,Shanxi,Shandong,Shaanxi and Yunnan,the detection rate of wards in other provinces was at a lower level.Spatial regression analysis showed that the spatial distribution of chronic Keshan disease was negatively related to rural per capita net income and annual average temperature in the ward (Z =-2.808,-2.747,P ＜ 0.05).Conclusions Global chronic Keshan disease exists spatial aggregation,the local gathering area is mainly located in the wards of Gansu,Inner Mongolia.The spatial distribution of chronic Keshan disease may be affected by the level of rural per capita net income and annual average temperature in the ward.

Objective To explore the expression and their significance of peripheral Th17 cells and regulatory T cells (Tregs) in idiopathic inflammatory myopathy,and analyze the relationship between the expression and clinical indicators,imaging and pathological changes.Methods Clinical data,laboratory tests,imaging and pathological changes of IIM cases (n=85) and healthy controls (n=70) were enrolled.Clinical data included the classification,age,gender,course of the disease;laboratory tests including erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),creatine kinase (CK),creatine kinase isoenzyme-MB (CKMB),lactate dehydrogenase (LDH),hydroxybutyrate dehydrogenase (HBDH).The level of peripheral Th17,Treg cells and clinical indicators,laboratory tests,imaging and pathological changes were analyzed retrospectively.Since the data was disregarded from the normal distribution,the median four quantile method was used for statistical description.Two samples were compared with Mann-Whitney U test,and the correlation between variables was Spearman rank correlation analysis.Results ①) The levels of Th17 cells in the case group was not significantly different from that in the control group [6.18(3.42,13.65) cell/μl vs 7.42(5.02,11.13) cell/μl,P＞0.05],the levels of Treg cells in patients was significantly lower than that in the control group [21.25(12.48,35.67) cell/μl vs 36.95(30.37,47.12) cell/μl,P＜0.05],the ratio of Th17/Treg was also significantly higher than that in the control group [0.31(0.21,0.47) vs 0.18(0.14,0.31),P＜0.05].② Peripheral Treg cells levels were not correlated with ESR,CRP,CK-MB,LDH and HBDH (P＞0.05).Peripheral Treg cells levels were negatively correlated with CRP (r=-0.279,P＜0.05),but no correlated with ESR,CK-MB,LDH and HBDH (P＞0.05).③ According to the involvement of important organs,patients were classified into two groups:organ involvement group and non-organ involvement group.The levels of Treg cells in the organ involvement group was fewer than that in non-organ involvement group [16.54(8.84,27.34) cell/ul vs 24.87(14.44,43.37) cell/ul,P＜0.05],and the ratio of Th17/Treg in the organ involvement group was significantly higher than that in non-organ involvement group [0.41(0.29,0.68) vs 0.29(0.19,0.39),P＜0.05].④) Peripheral Th17 cells levels in patients with skeletal muscle inflammatory edema was significantly higher than that of non-inflammatory edema patients [10.70 (4.11,14.51) cell/μl vs 3.10 (1.27,5.15) cell/μl,Z=-2.460,P＜0.05].⑤ The levels of Th17,Treg cells and ratio of Th17/Treg did not correlate with pathological features of inflammatory infiltration (P＞0.05).Conclusion The absolute number of peripheral Treg cells decreases significantly in IIM,and correlates with CRP.Patients with organ involvement have fewer Treg cells,and there is imbalance between Th17 and Treg.When muscle MRI presents with inflammatory edema,patients may have high level of Th17 cells.Our results suggest that Treg cells may play an important role in the pathogenesis of IIM.