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Context: This paper reports a detailed epidemiological investigation of a large Haff disease outbreak in Nanjing, China, including laboratory analysis of water, river sediment, and fish. Methods: Structured questionnaires were administered to all case-patients. An unmatched case-control study was conducted to identify the factors affecting the incidence of Haff disease. Thirteen samples of crayfish, together with four samples of water and four samples of sediment were collected and sent for laboratory analysis. Results: The disease onset of 494 patients occurred between 2 am on 30 June 2016 and 3 am on 29 August 2016. The median incubation time for onset of symptoms after crayfish ingestion was 7.1 hours (range: 1–20 hours). All patients presented with or developed local or diffuse myalgia. However, no kidney injury was observed. Serum creatinine kinase was elevated in all patients (mean: 4614 U/L, median: 2000 U/L, range: 81–55200 U/L). The average number of crayfish consumed by patients on the day of illness was 20 (2–80). The case-control study revealed that eating a large quantity of crayfish, drinking alcohol, and eating the crayfish head and/or intestines were associated with an increased risk of disease. Chemical analysis of crayfish, river water and sediment did not identify known or novel toxins including anticoccidiosis drugs, niclosamide, organophosphorus pesticides, and microcystins. Conclusion: An outbreak of Haff Disease was associated with consumption of crayfish from the Yangtze River and its surrounding water system. Eating a large quantity of crayfish, eating the head and/or intestines, and consuming alcohol with the crayfish were associated with the development of Haff Disease. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the potential risk of lead and cadmium through vegetables and edible fungus in Nanjing City from 2014 to 2018., Methods: Based on the survey of dietary consumption of residents in Nanjing City, combining with the concentration data of lead and cadmium in vegetables and edible fungus, using @Risk software to simulate and analyze the cumulative dietary exposure in a probabilistic way, and compared with the health guidance value or benchmark dose(BMD) to assess the potential health risks of lead and cadmium for Nanjing residents., Results: The average exposure of lead and cadmium was 0.237 and 0.090 μg/kg, the exposure of cadmium in the general population were lower than the corresponding health guidance value, meanwhile the margin of exposure(MOE) for lead was higher than 1 in 18-49 years old group and over 50 years old group respectively, except for the high-end exposure(P95) in 6-17 years group the MOE for lead was 0.9. The pollution level and the consumption of leafy vegetables, edible fungus and artemisia selengensis were the main factors affecting the exposure of lead and cadmium through vegetables and edible fungus., Conclusion: The exposure to lead and cadmium through vegetables is at a relatively safe level, but more attention should be paid to the risk of lead and cadmium exposure in 6-17 years old and over 50 years old group of high-end exposure population.

Objective: To evaluate the potential risk of dietary exposure to sodium saccharin among residents in Nanjing City, and provide scientific evidence for safety surveillance and risk management in processed foods., Methods: Based on the survey of dietary consumption of residents in Nanjing City, combining with the limits of sodium saccharin in processed foods(GB 2760-2014), using @Risk software to establish the cumulative dietary exposure in a probabilistic way, and compared with the acceptable daily intake(ADI) for risk assessment., Results: The average exposure of sodium saccharin of residents was 0. 69 mg/kg, accounted for 13. 80% of ADI, while high exposure(P97. 5) was 5. 37 mg/kg, and accounted for 107. 36% of ADI. The exposure of sodium saccharin of residents in all age groups exceeded ADI were ranged from 20. 60% to 132. 80%. The intake of sodium saccharin exposure of high exposures(P97. 5) exceeded ADI was 132. 80% and 110. 75% in 18-49 years and 11-17 years people respectively. Cooked nuts, candied fruit and bean products were the main sources of sodium saccharin exposure compared with others., Conclusion: Dietary exposure assessment shows that the risk dietary exposure to sodium saccharin is generally safe. Residents who intake these processed foods higher should be paid more attention to reduce the level of sodium saccharin exposure.

Objective: To understand the prevalence and epidemic characteristics of metabolic syndrome(MS) among adult residents in Nanjing City., Methods: In 2010-2013, a total of 4918 adult residents in Nanjing City were surveyed using a multi-stage stratification and population proportional clustering random sampling method. Questionnaires, physical examinations and laboratory examinations were conducted to collect the basic conditions, health history of the subjects and related indicators including height, weight, waist circumference, blood pressure, fasting blood glucose, total cholesterol, triglycerides, high-density lipoprotein cholesterol, etc. The 2009 International Joint Interim Statement(JIS) was used to filter patients with metabolic syndrome., Results: Among the 4918 surveyed subjects, 1627 were MS, with a crude prevalence rate of 33. 1% and an age-standardized prevalence rate of 26. 3%, the standardized prevalence rate of MS was 29. 0% in males and 24. 8% in females. Age-standardized prevalence rates between different genders had no significant statistical difference(χ~2=1. 352, P=0. 245). There were significant statistical differences between the crude prevalence rate of MS among subjects of different ages(χ~2=132. 557, P<0. 001), occupations(χ~2=87. 572, P<0. 001)and educational level(χ~2=26. 077, P<0. 001). Patients with a family history of hypertension(χ~2=26. 582, P<0. 001) and a family history of diabetes(χ~2=16. 013, P<0. 001)had a higher prevalence of MS., Conclusion: The prevalence of metabolic syndrome in adult residents in Nanjing City in 2010-2013 was relatively high.

Group-A rotaviruses are recognized as the most common cause of acute diarrhea. Phylogenetic analyses of the VP7 genes of rotaviruses circulating in Nanjing (China) could aid in the development of rotavirus vaccines. A total of 908 stool specimens were collected from patients suffering from acute diarrhea in Nanjing between October 2012 and December 2013, and were tested further for rotaviruses. Fifty rotavirus isolates selected randomly were typed by reverse transcription-polymerase chain reaction using serotype-specific primers for G genotyping. VP7 genes of 19 G9 strains were sequenced for further genetic characterization. Among the 908 stool specimens examined during the surveillance period, 103 (11.34%) were rotavirus-positive. G9 was the most predominant genotype (78.0%), followed by G2, G1 and G3. Sequence and phylogenetic analyses of the VP7 genes of serotype G9 rotaviruses revealed these strains to comprise two lineages (G9-VI, G9-III) and to be dominated by the G9-VI lineage (which belonged to a unique subcluster of Japanese and Chinese G9 strains). Amino-acid sequences of the four antigenic regions (A, B, C or F) were variant among a portion of strains, which may have contributed to the prevalence of G9 rotaviruses in this area.

Objective: To investigate the health and nutrition status of children in rural area of Lishui District, Nanjing City., Methods: Cluster random sampling and the stratified sampling methods were used to recruit participants. Refer to the WHO child growth standards, Z score method was used to evaluate physical growth of the group. Dietary research was conducted by the food frequency questionnaire(FFQ), and referring to the 2002 food composition tables of China to evaluate the daily dietary intakes., Results: BAZ scores showed 0 - 17 years old children obesity prevalence rate was 9. 0%, overweight was 18. 2%, angular and malnutrition were co-existed with the prevalence rates were 9. 1%, 1. 9% respectively. The average cooking oil was (27 ± 7. 3) g, and children daily intakes of vitamin A, vitamin B1, vitamin B2, vitamin C and calcium suitable rates were less than 50% according to the recommendation of Chinese DRIs., Conclusion: Rural children suffered from the problems of obesity and emaciated dietary structure is irrational and dietary nutrients intakes do not reached the demands of Chinese DRIs.

Objective: To find out the prevalence of hyperlipemia, hypertension and diabetes, and explore the primary influence factors., Methods: The survey consists of questionnaire and health examination on 2120 elderly adults aged above 45 year old. The possible influence factors and the primary factors in 19 factors were analyzed and screened by case-control study and logistic regression analysis., Results: This investigation showed that the prevalence rates of hyperlipemia, hypertension, and diabetes were 50.12%, 44.26% and 8.74% respectively. For hyperlipemia: monthly income, BMI, WHR, coarse food grain were primary factors. For hypertension: age, smoke, intensity, BMI, WHR were primary factors. For diabetes: family history of disease, BMI, WHR, coarse food grain, exercises were primary factors., Conclusion: The risk factors of the three chronic diseases were obesity and unhealthy life styles, and the protective factors were coarse food grian and exercises. It's important to decrease prevalence of chronic diseases in community by controlling these risk factors.