Objective:To evaluate the effect of different water-improving methods on dental fluorosis of children aged 8 to 12 in drinking-water-borne fluorosis areas in Xi'an City, and provide basis for making fine prevention and control measures.Methods:In 2018, 50 drinking-water-borne fluorosis villages in Xi'an City with water improvement time from 2011 to 2013 were selected as survey sites. The condition and the way of water improvement were surveyed, water fluoride content was determined and the prevalence of dental fluorosis in children aged 8 to 12 was examined, and the rates of dental fluorosis were compared before and after the water improvement in the 50 villages.Results:The water-improving projects were in normal operation in 50 villages. The medians of water fluoride content were 0.31, 0.88 and 1.14 mg/L in villages with municipal water supply, low fluorine well and defluoridation treatment water supply (the villages of different water-improvement methods were 12, 24 and 14, respectively), the differences were statistically significant ( H = 75.54, P < 0.01). The qualification rates of water fluoride in villages with different water-improvement methods were 100.00% (12/12), 79.17% (19/24) and 57.14% (8/14), and the difference was statistically significant (χ 2 = 6.95, P < 0.05). The detection rate of dental fluorosis was 43.17% (218/505) in the 11 villages with excessive water fluoride content, and the detection rate was 20.77% (331/1 594) in the 39 villages with qualified water fluoride content, the difference was statistically significant (χ 2 = 99.66, P < 0.01). After water improvement, the total detection rate of dental fluorosis (26.16%, 549/2 099) in the 50 villages was lower than that before water improvement (41.66%, 959/2 302), the difference was statistically significant (χ 2 = 117.17, P < 0.01). The detection rates of dental fluorosis were reduced after the water improvement in villages with municipal water supply and low fluorine well, the differences were statistically significant (χ 2 = 74.37, 69.36, P < 0.01). The detection rate was declined after water improvement in villages with defluoridation treatment water supply, but the difference was not significant (χ 2 = 0.78, P > 0.05). There was a statistically significant difference in the detection rate of dental fluorosis among children in villages with different water-improvement methods (χ 2 = 72.79, P < 0.01). The detection rate of dental fluorosis in villages with defluoridation treatment water supply [39.53% (200/506)] was higher than that in villages with municipal water supply [17.97% (133/740)] and low fluorine well [25.32% (216/853)], the differences were statistically significant ( P < 0.017); the detection rate of dental fluorosis in villages with municipal water supply was lower than that in villages with low fluorine well ( P < 0.017). Conclusions:The dental fluorosis of children's has been effectively controlled in the villages after water improvement in Xi'an City. The fluoride content in the water and the detection rate of dental fluorosis in children in some endemic areas are still high. It is necessary to further improve the water quality or consolidate the improvement effect as soon as possible.

Objective: To evaluate the dynamic prevalence of dental fluorosis of children and levels of fluoride in drinking water after improvement of water in Xi an City, to provide scientific basis for water fluoridation improvement. Methods: A total of 35 fluorosis endemic villages were selected as fixed monitor sites in 2014-2018, the ways of water improvement were surveyed, water fluorine content were detected and the prevalence of dental fluorosis in children aged 8 to 12 years were examined. Results: Rates of excess fluoride in drinking water from 2014 to 2018 were 22.86%, 14.29%,11.43%, 11.43% and 8.57%, the difference were significant(χ2=16.44, P<0.01).The dental fluorosis detection rates of children aged 8 to 12 years were 20.89%,18.22%,17.46%,18.13% and 16.76% in 2014-2018 which showed a obvious descending trend by year(χ2=10.02, P<0.01). The detection rate of dental fluorosis in children aged 8 and 9 years showed a decreasing trend by year(χ2=6.53, 4.54, P<0.05).The difference of total rate of dental fluorisis,rate of mild cases rate of moderate-to-severe cases were statistically between the villages without qualified water and the villages with normal fluorine water(χ2=179.22, 167.93,10.35, P<0.01). The rate of detection in the villages with the water fluorine exceed standard in 2014-2018 showed a declining trend year by year(χ2=28.50, P<0.01). The detection rate were significant different across water improvement methods(χ2=197.76, P<0.01). Detection rate of dental fluorosis decreased from 2014 to 2018 in the areas with municipal water supply showed a decreasing after year(χ2=12.16, P<0.01). Conclusion The improvement of municipal water supply shows significant effects on water fluorosis control, the detection rate of water fluoride and children s dental fluorosis in some villages with the other ways of water improvement are still higher than expected, the continuously monitor of fluoride content in water and dental fluorosis in children should be strengthened.

Objective: This study aimed to assess the association between hypertension and carotid plaque in a research population in China. Methods: The subjects of this study were selected from a population undergoing physical examination at the Fourth Medical Center of PLA General Hospital in 2017. We collected information on physical examination, physiological index test, blood pressure indicators were analyzed according as continuous variables (systolic blood pressure, diastolic blood pressure, and pulse pressure) and categorical variables (hypertension and quartile of blood pressure pulse pressure). A multivariate logistic regression model was conducted to estimate the correlation between blood pressure and carotid plaque development. Results: A total of 716 individuals were surveyed, including 321 men (44.8%) and 395 women (55.2%), and the prevalence of hypertension and carotid plaque were 40.9%(293 cases) and 40.4% (289 cases), respectively. The prevalence of carotid plaque was higher in individuals aged ≥60 years, diabetes mellitus, hypertension and increased waist circumference, systolic blood pressure, fasting blood glucose and glycosylated hemoglobin. The prevalence of carotid plaque increased with the increase of the quartile of blood pressure and pulse pressure (P_trend<0.05). After adjustment for age, sex, BMI, waist circumference, and total cholesterol, triglyceride, fasting blood glucose, glycosylated hemoglobin, and hemoglobin levels, every 1 mmHg increased systolic blood pressure increases the risk of carotid plaque by 1.4% (95%CI: 1.005-1.024). Compared with the control group, the risk of carotid plaque increased by 86.8% (95%CI: 1.175-2.946) and 84.8% (95%CI: 1.098-3.110) and 119.6% (95%CI: 1.165-4.142) in the group of normal high blood pressure, grade 1 hypertension and grade 2 and grade 3 hypertension, respectively; compared with the control group, the risk of carotid plaque increased by 56.2% in the group of pulse pressure difference≥60 mmHg (95%CI: 1.049-2.326), in which the risk of carotid plaque increased by 73.3% (95%CI: 1.007-2.983) in women with pulse pressure difference≥60 mmHg (1 mmHg=0.133 kPa); in the control group with pulse pressure difference of four categories Q1 (<42 mmHg), the risk of carotid plaque increased by 92.2% (95%CI: 1.173-3.149) and 95.0% (95%CI: 1.147-3.316) in Q3 (50-61 mmHg) and Q4 (≥62 mmHg), respectively. Conclusion Increased blood pressure or pulse pressure are associated with increased prevalence of carotid plaque. Prevention of elevated blood pressure and pulse pressure might be one of the effective precautions for the prevention of carotid plaque development.

Objective:To assess the implementation of control measures and dental fluorosis of children in drinking-water-borne endemic fluorosis areas in Xi'an City, and to evaluate the implementation effects of the prevention and control measures.Methods:All drinking-water-borne endemic fluorosis villages in Xi'an were selected as the investigation sites. The progress and running condition of all water-improved projects were investigated, fluoride concentration in all the water-improved projects and tap water were tested. "Standard Test Method for Drinking Water" (GB/T 5750.5-2006) was used to test the water fluoride. A cross-sectional analytical study was conducted on school children aged 8 - 12 years old, the dental fluorosis was determined according to "Diagnosis of Dental Fluorosis" (WS/T 208-2011).Results:There were 273 drinking-water-borne endemic fluorosis villages, the rate of water improved villages was 91.58% (250/273), and all of the water-improved projects were operating normally (100.00%, 196/196). The rate of water-improved projects with qualified water fluoride was 88.27% (173/196), 237 villages had fluoride safe drinking water and the qualified rate was 86.81% (237/273). The median of water fluoride in the 250 villages with water-improved projects was 0.78 mg/L, the median was 0.83 mg/L in the 23 villages without water-improved projects, and the difference was not significant ( Z = 1.475, P > 0.05) . The overall prevalence of dental fluorosis among children aged 8 - 12 years old was 19.86% (1 960/9 871), and the dental fluorosis index was 0.39. The prevalence of dental fluorosis in the villages with qualified water fluoride was 16.13% (1 377/8 539), and the rate was 43.77% (583/1 332) in the villages with unqualified water fluoride, and the difference was significant (χ 2 = 553.283, P < 0.01). The prevalence of dental fluorosis in children with water fluoride content of 0.00 - 1.20, 1.21 - 1.50, and ≥1.51 mg/L was 16.13% (1 377/8 539), 41.20% (281/682), 46.46% (302/650), and the difference was significant (χ 2 = 559.011, P < 0.01), the severity of the disease was positively correlated with water fluorine concentration ( r = 0.273, P < 0.01). The epidemic situation in 202 villages was effectively controlled and 71 villages did not reach the control standard. Conclusions:The progress of water-improved projects and the rate of qualified water fluoride are not optimistic in Xi'an, the dental fluorosis of children is still higher than the government standard in the high fluoride drinking-water areas. The measures for water improving defluorination and disease surveillance should be strengthened.

Objective: To assess the association and intensity of baseline dyslipidemia with the incidence of carotid plaque in a researchers group in China. Methods: A total of 716 researchers were enrolled in this prospective cohort study. Dyslipidemia was assessed in 2010. Follow-up study on carotid plaque was conducted in 2017. Results: Over 8 years’ follow-up, 289 carotid plaque patients were identified among 716 individuals who did not have carotid plaque at baseline survey, with cumulative incidence of 40.36%. After adjustment of age, gender, BMI, waist circumference, FPG, SBP, DBP, ALT and uric acid, compared with non-dyslipidemia group, HR of carotid plaque for such populations with ≥3 types of dyslipidemia was 1.681 (95%CI: 1.090--2.593). Conclusions Dyslipidemia might be associated with higher risk of carotid plaque, and population with ≥3 types of dyslipidemia had higher risk for carotid plaque. Prevention of dyslipidemia or reduction of types of dyslipidemia might be one of the effective precautions for prevention of carotid plaque.

Objective To assess the effects of defluoridation on prevalence of children's dental fluorosis in Xi'an City and study related influencing factors.Methods In 2017,the survey results of 2013 were collected from the previous investigation of drinking water type fluorosis in Xi'an Center for Disease Control and Prevention,and villages from drinking water type fluorosis areas were divided into five groups:0.0-,0.2-,0.5-,1.0-,and ≥ 1.5 mg/L,according to the fluoride concentrations of water.Four villages were randomly selected from each group,a total of 20 villages were selected as the investigation sites.A cross-sectional analytical study was conducted in the 20 villages,the fluoride in drinking water,the dental fluorosis of children aged 8-12 years and fluoride content in urine were detected,and the survey results were compared with those of 2013.Children were divided into five groups according to urinary fluoride contents as:0.0-(control),0.4-,0.8-,1.2-,and ≥ 1.6 mg/L,and the logistic regression model was used to evaluate the risk of dental fluorosis.Results There were no significant differences in water fluoride content between 2013 and 2017 (P ＞ 0.05).The rates of dental fluorosis among the study population in 2013 and 2017 were 25.35％ (200/789) and 20.58％ (164/797),and the difference was significant (x2 =5.11,P＜0.05).The prevalence rate and severity of dental fluorosis in 2013 [3.52％ (9/256),13.28％ (17/128),31.62％ (43/136),37.82％(45/119),57.33％(86/150)] and 2017[4.02％(10/249),11.82％(13/110),18.05％(24/133),29.13％(37/127),44.94％ (80/178)] were significantly increased with increase of water fluoride concentration (x2 =168.02,117.83,P ＜ 0.01).The prevalence rate of dental fluorosis was higher than 30％ in the three groups with water fluoride content 0.5-,1.0-and ≥ 1.5 mg/L in 2013,and the prevalence rates were decreased in these groups in 2017.The prevalence rate of dental fluorosis was lower than 30％ in the groups with water-fluorine content of 0.5-,1.0-＜1.5 mg/L,while the rate of dental fluorosis in the group with water-fluorine content of higher than 1.5 mg/L was still over 40％.The geometric mean of urinary fluoride of children in 2013 and 2017 were 1.02,0.67 rg/L,and the difference was significant (t =10.24,P ＜ 0.01).There were significant differences in children urinary fluoride between water fluoride groups in 2013 and 2017 (F =85.36,151.14,P ＜ 0.01).The risk of dental fluorosis increased with increase of urinary fluoride content,the odds ratio (OR) values were 5.26,7.83 and 13.28 in the three groups with the urinary fluoride 0.8-,1.2-,≥1.6 mg/L in 2013;the OR values in 2017 were 5.18,7.65 and 13.36,the differences were statistically significant (P ＜ 0.05).Conclusions The situation of water fluoride and dental fluorosis are not optimistic after defluoridation of drinking water.It is necessary to reinforce the measures of water defluoridation,and carry out classified management in endemic fluorosis areas.

Objective: To investigate the current situation and influence factors of perceived professional benefits among nurses working in day-care unit. Methods: Convenience sampling method was adopted, totally 245 nurses working in day-care unit were investigated by nurses' perceived professional benefit questionnaire, psychological capital questionnaire, psychological sub-health questionnaire and a self-designed demographic questionnaire. The data were collected and analyzed statistically. Results: The scores of perceived professional benefit among nurses working in day-care unit were 117.96±14.06. Multiple regression analysis shows that working years, scores of psychological capital questionnaire and psychological sub-health questionnaire were positive factors to perceived professional benefit; while the education level was negative predictors to perceived professional benefit. The regression equation was: the scores of perceived professional benefit among nurses = 70.582-4.882 x the education level + 2.520 x working years+ 0.329 x scores of psychological capital questionnaire + 0.250 x psychological sub-health questionnaire. Conclusions It showed higher level of perceived professional benefit as tested in previous study. Managers can pay more attention to nurses with less working years and higher degree of education, and improve the level of psychological capital and mental health, so as to improve the level of perceived professional benefit.

Objective To investigate the dental fluorosis and intelligence level of children in drinking water-type of endemic fluorosis areas in Xi'an,and to provide a scientific basis for development of prevention and control strategies.Methods In 2016,six drinking water-type of endemic fluorosis villages and one non-diseased village were selected as investigation sites in Xi'an.According to the detection rate and prevalence of dental fluorosis in children,six diseased villages were divided into three groups,the disease light-affected areas were Huidong and Xingnan,the moderate-affected areas were Liulin and Xiazhu,and the serious-affected areas were Hetou and Xiaoyang;and the Deng village was the non-diseased.A cross-sectional survey was conducted to collect 3 tap water samples in each village to test the fluorine content in water.For all children aged 8 to 12 years in diseased villages and 100 children aged 8 to 12 years in non-diseased villages,dental fluorosis examination and intelligence test were carried out.Results Mean value of water fluoride in non-diseased village and endemic fluorosis areas were (0.25 ± 0.01),(0.78 ± 0.43) mg/L,and the water fluoride content in two diseased villages was over 1.20 mg/L.The detection rate of dental fluorosis in children aged 8 to 12 (30.32％,67/221) in diseased areas was significantly higher than that in non-diseased area (2.00％,2/100;x2 =31.32,P ＜ 0.01).Children's IQ scores in the four groups were 108.68 ± 10.83,102.54 ± 12.54,101.70 ± 14.85,93.45 ± 10.84,and the IQ scores were decreased with the severity of dental fluorosis,the difference in IQ scores was significant between the endemic fluorosis areas and non-endemic fluorosis area (P ＜ 0.05);the percentage of children with IQ≤89 in endemic fluorosis areas was significantly higher than that in non-endemic fluorosis area (x2 =22.02,P ＜ 0.01).The IQ scores of children with dental fluorosis was 94.96 ± 13.75,and the IQ was 105.26 ± 10.19 in children with normal condition,the difference was significant (t =5.61,P ＜ 0.01),the mean value of IQ was decreased with the severity of dental fluorosis (F =7.42,P ＜ 0.05),the percentage of children with IQ≤89 in patient was higher than that in normal children,the difference was significant (x2 =45.70,P ＜ 0.01).Conclusion Low level of water fluoride still has negative influence on children's dental health and intelligence,water improving and surveillance should be strengthened to ensure the health of children.

Objective To evaluate the effects of early neck isometrics exercise on relieving neck discomfort in patients after cerebellopontine angle surgeries.Methods The non-synchronous control study was conducted.The control group(40 patients recruited from March to June,2017) received routine nursing,while the intervention group (40 patients recruited from July to November,2017) performed early neck isometrics exercise in addition to routine nursing.Neck discomfort degree,neck rotation range,and Barthel score were measured and compared between two groups on Day 1,Day 3,Day 5,and Day 7 after surgeries.Results The intervention group had a high level of participation and no adverse events occurred.Neck discomfort degree of the intervention group was significantly lower than that of the control group on Day 1,Day 3,and Day 5(P＜0.05).Neck rotation range of the intervention group was improved on Day 1 and Day 3 compared with the control group(P＜0.05).Barthel score of the intervention group on Day 3,Day 5 and Day 7 was significantly better than that of the control group(P＜0.05).Conclusion Early neck isometrics exercise in patients underwent cerebellopontine angle surgeries is safe and feasible,which can alleviate discomfort of neck,and improve patients' early postoperative experience and quality of life.

Objective: To apply and compare two risk assessment methods for occupational lead exposure risk classification in a lead-acid battery enterprise. Methods: In April 2013, an occupational health survey was carried out in a lead-acid battery enterprise. Lead smoke and lead dust were tested in the workplace. The risk assessment index system for occupational chemical hazards that was established and optimized by the research group (referred to as "optimized index system" ) , as well as the Singapore semi-quantitative risk assessment model, was used for occupational lead exposure risk classification in the lead-acid battery enterprise. The two risk classification results were analyzed and compared. Results: In the lead smoke risk classification results, the optimized index system classified the raw material group and foundry group workshops as Class I hazardous and the assembling group workshop as Class II hazardous. The Singapore semi-quantitative risk assessment model classified the raw material group workshop as high risk and foundry group and assembling group workshops as extremely high risk. In the lead dust risk classification results, the optimized index system classified the raw material group workshop as Class I hazardous, while the plate painting group, plate cutting group, and assembling group workshops were classified as Class II hazardous. The Singapore semi-quantitative risk assessment model classified the raw material group workshop as medium risk, the plate painting group and plate cutting group workshops as high risk, and the assembling group workshop as extremely high risk. Conclusion There are some differences in risk assessment of occupational lead exposure between the two risk assessment methods. The optimized index system is comparably more reasonable and feasible, and is highly operable.