Value of pseudopod sign on high-frequency ultrasound in predicting the pathological invasion of extramammary Paget's disease lesions

BACKGROUND

Vertical invasion of extramammary Paget's disease (EMPD) is associated with poor prognosis. The usual vertical invasion route is directly downward or along the skin appendages. High-frequency ultrasound (HFUS) can be used to measure the EMPD lesion thickness, and visualize the pseudopod extensions due to skin appendage involvement. It is a non-invasive method for evaluating the extent of vertical invasion in EMPD.

OBJECTIVE

To investigate the value of HFUS in predicting the extent of vertical invasion in EMPD.

METHODS

In this retrospective study, 85 patients with EMPD were divided into two groups based on the pathology: invasive EMPD (iEMPD) group (n = 13) and in situ EMPD group (n = 72). The clinical and HFUS features of both the groups were analyzed. The different types of pseudopodia morphology on HFUS were as follows: no pseudopodia, irregular bottom, small sphere, short strip, long strip, vase shape, and nodular convex. These were further stratified into low-risk and high-risk levels.

RESULTS

The clinical features were comparable between the two groups (P > .05). There were significant differences between the two groups in the HFUS features (lesion thickness, lesion shape, bottom shape, layer involvement, pseudopodia morphology, and color Doppler blood flow signal; all P < .05). The distribution of the pseudopodia morphology types in the in situ EMPD and iEMPD groups, was as follows: no pseudopodia, 30/72 and 0/13; irregular bottom, 5/72 and 0/13; small sphere, 5/72 and 0/13; short strip, 21/72 and 0/13; long strip, 8/72 and 3/13; vase shape, 3/72 and 3/13; and nodular convex, 0/72 and 7/13 (P < .05 for all). The sensitivity and specificity of high-risk pseudopodia in identifying iEMPD were 100% and 84.7%, respectively.

CONCLUSIONS

HFUS provides morphological information regarding EMPD lesions. Risk stratification for pseudopodia can help to distinguish between iEMPD and in situ EMPD lesions.

The new-generation proteasome inhibitor oprozomib increases the sensitivity of cervical cancer cells to cisplatin-induced apoptosis

This study aimed to evaluate the anti-tumor effect of a new generation of protease inhibitor, oprozomib (OPZ), used alone and in combination with cisplatin, also called CDDP, on cervical cancer. Five different types of cervical cancer cell lines - HeLa, Caski, HeLa-CDDP, C33a, and SiHa - and one nontransformed cervical cell line - HaCaT -were treated with OPZ alone or in combination with cisplatin. The inhibitory effects of OPZ and cisplatin on the proliferation of cervical cancer cells were then analyzed using cytotoxicity tests, flow cytometry, and Western blotting. It was found that OPZ alone or in combination with cisplatin can reduce the proliferation of the five types of cancer cells by enhancing the lysis of caspase-3 and PARP and inducing cancer cell apoptosis. In the combined treatment, OPZ was found to inhibit the degradation of inhibitory factor κB alpha induced by cisplatin, thereby inhibiting the activation of NF-κB, which causes cisplatin resistance, and enhancing the sensitivity of the tumor cells to cisplatin. Moreover, OPZ promoted the phosphorylation of the apoptosis signaling pathway JNK that was activated by cisplatin, thereby inducing tumor cell apoptosis. These findings provide a theoretical basis for the clinical use of OPZ alone and in combination with cisplatin in the treatment of cervical cancer.

[Efficacy and safety of segmental radiofrequency ablation for isolation of the superior vena cava in patients with atrial fibrillation]

Objective: To analyze the three-dimensional distribution of functional sinus node, right phrenic nerve and superior vena cava(SVC)-right atrial muscle sleeves by three-dimensional electrophysiological technique in patients with atrial fibrillation (AF), and to investigate the efficacy and safety of segmental radiofrequency catheter ablation (RFCA) for isolation of superior vena cava in these patients. Methods: In this retrospective study, we enrolled 136 AF patients who underwent first RFCA in the First Affiliated Hospital of Zhengzhou University from July 2018 to June 2019 and all patients underwent SVC isolation under sinus rhythm. Baseline clinical data of patients were collected. The functional sinus node was defined by activation mapping, pacing was guided by three-dimensional mapping (Carto) system, localization of the right phrenic nerve was defined by pacing map, the superior vena cava-right atrial muscle sleeves was determined according to the change of potential during SVC isolation, segmental RFCA was performed for SVC isolation, the three-dimensional distribution of functional sinus node, right phrenic nerve and superior vena cava(SVC)-right atrial muscle sleeves was determined by three-dimensional electrophysiological technique. Immediate SVC isolation was achieved in all patients. Patients were evaluated immediately after RFCA and patients were followed at 3, 6, 9, and 12 months after RFCA. Holter monitoring was performed every 3 months, the chest radiograph and the SVC ultrasonic examination were performed every 6 months after RFCA. Postoperative complications were assessed. Results: The mean age of the 136 patients with AF was (51.6±14.2) years, 86 (63.2%) were male, 98 cases (72.1%) were paroxysmal AF and 38 cases (27.9%) were persistent AF. Right atrium activation mapping revealed that 17 (12.5%) functional sinus node were located in the SVC, 78 (57.4%) were located at the SVC-right atrium junctions, 41 (30.1%) were located below the junction level. From the head to foot view, 83 (61.0%) functional sinus node were located at the anterior lateral segment of the SVC-right atrium three-dimensional reconstruction model, 34 (25.0%) located at the posterior lateral segment, 15 (11.0%) located at the anterior wall, 4 (2.9%) located at posterior wall or anterior septum. A total of 294 SVC muscle sleeves were detected among all patients, 94 (32.0%) SVC muscle sleeves were located at the anterior septum of the SVC-right atrium three-dimensional reconstruction model, 76 (25.9%) were located at the posterior septum, 21(7.1%) were located at the posterior free wall, 11 (3.7%) were located at the posterior lateral, 27 (9.2%) were located at anterior lateral wall and 65 (22.1%) were located at the anterior free wall. Right phrenic nerve positioned relatively fix, 133 (97.8%) were located at the lateral segment of the SVC-right atrium three-dimensional reconstruction model, 3 (2.2%) were located at the anterior free wall. Sinus rhythm and SVC isolation were successfully restored immediately after RFCA, no significant SVC stenosis, right phrenic nerve palsy and functional sinus node injury occurred immediately post procedure. All patients were followed up for (11.2±3.6) months and none had postoperative complication. Conclusions: Three-dimensional electrophysiological can determine the spatial location of functional sinus node, right phrenic nerve and SVC-right atrial sleeves. On this basis, segmental RFCA is a safe and effective method to achieve complete isolation of SVC.

Association of body mass index with immune recovery, virological failure and cardiovascular disease risk among people living with HIV

OBJECTIVES

We conducted a longitudinal cohort analysis to evaluate the association of pre-treatment body mass index (BMI) with CD4 recovery, virological failure (VF) and cardiovascular risk disease (CVD) markers among people living with HIV (PLHIV).

METHODS

Participants who were enrolled between January 2003 and March 2019 in a regional Asia HIV cohort with weight and height measurements prior to antiretroviral therapy (ART) initiation were included. Factors associated with mean CD4 increase were analysed using repeated-measures linear regression. Time to first VF after 6 months on ART and time to first development of CVD risk markers were analysed using Cox regression models. Sensitivity analyses were done adjusting for Asian BMI thresholds.

RESULTS

Of 4993 PLHIV (66% male), 62% had pre-treatment BMI in the normal range (18.5-25.0 kg/m² ), while 26%, 10% and 2% were underweight (< 18.5 kg/m² ), overweight (25-30 kg/m2) and obese (> 30 kg/m² ), respectively. Both higher baseline and time-updated BMI were associated with larger CD4 gains compared with normal BMI. After adjusting for Asian BMI thresholds, higher baseline BMIs of 23-27.5 and > 27.5 kg/m² were associated with larger CD4 increases of 15.6 cells/µL [95% confidence interval (CI): 2.9-28.3] and 28.8 cells/µL (95% CI: 6.6-50.9), respectively, compared with normal BMI (18.5-23 kg/m² ). PLHIV with BMIs of 25-30 and > 30 kg/m² were 1.27 times (95% CI: 1.10-1.47) and 1.61 times (95% CI: 1.13-2.24) more likely to develop CVD risk factors. No relationship between pre-treatment BMI and VF was observed.

CONCLUSIONS

High pre-treatment BMI was associated with better immune reconstitution and CVD risk factor development in an Asian PLHIV cohort.

[Electrophysiological characteristics and therapeutic efficacy of radiofrequency ablation of focal atrial tachycardia originating from the right atrial appendage during pregnancy]

Objective: To analyze the electrophysiological characteristics and the therapeutic efficacy of irrigated-tip catheter radiofrequency ablation(RFA) without radiation for pregnant women with focal atrial tachycardia(AT) originating from the right atrial appendage (RAA). Methods: Data from 55 women with focal AT, who underwent radiofrequency ablation (RFA) in the First Affiliated Hospital of Zhengzhou University from October 2016 to March 2019, were screened. 2 non-pregnant women with right atrial appendage tachycardia (RAAT) and 4 pregnant women with non-RAAT were excluded. The remaining 49 cases were divided into RAAT during pregnancy group (n=6, including 4 cases of tachycardia-induced cardiomyopathy) and non-pregnant and non-RAAT group (control, n=43). Under the guidance of three-dimensional mapping system, the earliest activation site was identified, RFA with the irrigated catheter without x-ray fluoroscopy was performed in RAAT patients during pregnancy, all patients in control group underwent non-zero-ray ablation. Patients were followed up at 3, 6, 12 months post procedure, and yearly follow up thereafter in outpatient clinic. Electrocardiogram or Holter monitoring was performed during follow up. AT recurrence and surgical complications were recorded during follow up. At 6 months after RFA, echocardiography examination and laboratory examination including N-terminal B-type brain natriuretic peptide measurement were performed in the pregnant patients, delivery results were also recorded in the pregnant patients. The electrophysiological characteristics of RAAT during pregnancy were analyzed, the therapeutic efficacy of RFA was compared between the two groups. Results: This study is a retrospective study. Age ((30.7±6.2)years vs. (57.2±11.7)years), left ventricular ejection fraction ((46.0±12.8)% vs. (60.1±5.9)%), proportions of organic heart disease (0% vs. 58%) were significantly lower in the RAAT patients during pregnancy group than in control group (P<0.05), while proportions of patients with persistent tachycardia (100% vs. 7%), symptoms of chest distress and palpitation (6/6 vs. 49%) and left ventricular ejection farction≤50% (4/6 vs. 9%) were significantly higher in RAAT group than in control group (P<0.05), heart rate was similar between the two groups ((163.7±11.1)beats/minutes vs. (153.7±15.2)beats/minutes, P>0.05). The characteristic P-wave morphology was observed in RAAT patients during pregnancy, i.e, P wave was mostly upright (5/6) in inferior-leads (Ⅱ, Ⅲ, aVF) and in lead I and aVL, deep and wide negative P wave was found in V₁ lead (5/6), and gradually became positive from V₂-V₆. The mean tachycardia cycle length was (361.7±38.5) ms. Three-dimensional mapping showed that the origin points of the 6 RAAT pregnant patients were all scattered in the local region, the local region was ablated accordingly, 2 patients (2/6) received extensive ablation of local areas. Immediate successful rate was similar between the two groups (6/6 vs. 93%). During follow up ((15.3±4.0) months), no complications were observed after RFA, postoperative recurrence rate was similar (1/6 vs. 12%). Uncomplicated delivery was reported in all 6 pregnant RAAT post ablation. Normal cardiac structure and function was observed in the 4 pregnant patients with tachycardia-induced cardiomyopathy post ablation. Compared to pre-ablation phase, reduced left atrial dimension ((30.3±1.3) mm vs. (36.8±6.7) mm, P>0.05), increased left ventricular ejection fraction ((64.0±2.9)% vs. (39.8±10.7)%), reduced left ventricular end-diastolic dimension ((44.8±4.0) mm vs. (60.0±2.9) mm) and reduced N-terminal B-type natriuretic peptide value ((136.2±47.5) ng/L vs. (3 408.4±901.3) ng/L) were observed at 6 months post ablation (P<0.05). Conclusion: The electrophysiological characteristics are suggestive for focal AT originating from RAA during pregnancy. Under the guidance of 3-dimension activation mapping, no fluoroscopic RFA with irrigated-tip catheter is a safe and effective strategy for the treatment of focal RAAT during pregnancy.

Effects of interchange ratio on sludge reduction and microbial community structures in an anaerobic/anoxic/oxic process with combined anaerobic side-stream reactor

Oxic-settling-anaerobic (OSA) process is effective in minimizing sludge production, by inserting an anaerobic side-stream reactor (ASSR) in the recycling bypass. Interchange ratio (IR), the quantity ratio of sludge entering the ASSR to the sludge in the main stream reactors, is one of the most important parameters for OSA process. In the present study, a laboratory-scale anaerobic/anoxic/oxic (A²/O) process combined with an ASSR (A²/O-ASSR) was operated for 366 days in parallel with a conventional A²/O process to investigate the effects of IR on sludge reduction. IR was assigned values of 5%, 8%, 10%, and 15%, and the A²/O-ASSR process achieved 14.0%, 16.0%, 24.1%, and 13.7% of sludge reduction, respectively. At the optimum IR of 10%, high through-put sequencing analysis showed that the microbes responsible for pollutant removal and ubiquitous in wastewater treatment remained predominant in the two systems, and slow-growing microbes related to hydrolysis, nitrogen and phosphorus removal increased in the A²/O-ASSR process, which probably played a key role in sludge reduction. 40.6-58.6% of sludge reduction was caused by sludge decay in the ASSR. The tiny amount of extracellular polymeric substance released in the A²/O-ASSR process was subthreshold to cause remarkable sludge reduction.

Diagnostic performance of two specific schistosoma japonicum immunological tests for screening schistosoma haematobium in school children in Zambia

Dipstick Dye Immunoassay (DDIA) and Indirect Haemagglutination Assay (IHA), are two commercially available kits which have been widely used for screening Schistosoma japonicum in P.R. China. Whether they can be used for screening of Schistosoma haematobium are not clear. In order to evaluate the diagnostic efficiency of DDIA and IHA for screening Schistosoma haematobium, serum samples were collected from pupils in endemic areas in Zambia, Southern Africa, and tested by DDIA and IHA by single-blind manner. Meanwhile, the pupils were microscopically examined by infection with Schistosoma and soil-transmitted helminths, visually observed for parasite eggs. Of the enrolled 148 pupils, 61% tested positive for S. haematobium infection, while 31% and 36% of pupils were infected with hookworm and Ascaris respectively. Regarding the parasitological tests as reference standard, for the diagnosis of S. haematobium infection, IHA performed higher sensitivity (74%, 95% CI: 65%-83%) than that of DDIA (60%, 95%CI: 49%-70%). The sensitivities of IHA and DDIA are significant higher in 10-14 years old students than those of 7-9 years old group. The specificity of DDIA and IHA were 61% (95%CI: 49%-74%) and 72% (95%CI: 60%-84%), respectively. The co-infection with STHs decreased the specificity of DDIA but had no impact on that of IHA. Our study indicated that IHA has more potential as an alternative diagnostic tool for identifying schistosomiasis haematobium but need further improvement.

Population structure and genetic diversity of Setosphaeria turcica from corn in Heilongjiang province, China

AIM

The aims of this study were to identify races and mating types of Setosphaeria turcica causing northern corn leaf blight in Heilongjiang province of China and analyse the genetic diversity of S. turcica isolates using SSR markers.

METHODS AND RESULTS

Based on gene-for-gene interactions, 13 races of S. turcica (races 0, 1, 2, 3, 12, 13, 23, 123, N, 1N, 12N, 3N and 23N) were isolated from infected corn plants in Heilongjiang province. Races 0 and 1 were the predominant races, and race 23N was identified for the first time in the region. Using two pairs of specific primers, three mating types, 'a', 'Aa' and 'A', were identified, with 'a' being the predominant mating type. SSR markers were used to analyse genetic diversity of 60 S. turcica isolates. Five SSR primers were polymorphic, which resulted in 45 reproducible bands with 2-15 bands for each primer. Cluster analysis separated the isolates into five groups at a similarity coefficient of 0·84. Analysis of molecular variance showed that there was significant correlation between SSR groups and mating type of the isolates. No significant correlation was found between SSR groups and physiological races or geographical location of the isolates.

CONCLUSIONS

The work reported that races 0 and 1 were the predominant races, and race 23N was identified for the first time in Heilongjiang province with 'a' being the predominant mating type. There was significant correlation between SSR groups and mating type of S. turcica isolates.

SIGNIFICANCE AND IMPACT OF THE STUDY

Our results provide information on population structure and genetic diversity of S. turcica causing Northern corn leaf blight, which will facilitate the development of effective disease management programs.

Corrections to: Molluscicidal effectiveness of Luo-Wei, a novel plant-derived molluscicide, against Oncomelania hupensis, Biomphalaria alexandrina and Bulinus truncatus

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Molluscicidal effectiveness of Luo-Wei, a novel plant-derived molluscicide, against Oncomelania hupensis, Biomphalaria alexandrina and Bulinus truncatus

BACKGROUND

Control of snail intermediate hosts has been proved to be a fast and efficient approach for interrupting the transmission of schistosomiasis. Some plant extracts have shown obvious molluscicidal activity, and a new compound Luo-Wei, also named tea-seed distilled saponin (TDS), was developed based on the saponins extracted from Camellia oleifera seeds. We aimed to test the molluscicidal activity of 4% TDS against the intermediate host snails in China and Egypt, and evaluate its environmental safety to non-target organisms.

METHODS

In the laboratory, Oncomelania hupensis, Biomphalaria alexandrina and Bulinus truncatus were exposed to 4% TDS, and the median lethal concentration (LC₅₀) was estimated at 24, 48 and 72 h. In the field, snail mortalities were assessed 1, 2, 3 and 7 d post-immersion with 2.5 g/m³ 4% TDS and 1, 3, 7 and 15 d post-spraying with 5 g/m² 4% TDS. In addition, the acute toxicity of 4% TDS to Japanese quail (Coturnix japonica), zebrafish (Brachydanio rerio) and freshwater shrimp (Macrobrachium nipponense) was assessed by estimations of LC₅₀ or median lethal dose (LD₅₀).

RESULTS

In the laboratory, the LC₅₀ values of 4% TDS for O. hupensis were 0.701, 0.371 and 0.33 mg/L at 24, 48 and 72 h, respectively, and 4% TDS showed a 1.975 mg/L [corrected] 24 h LC₅₀ against B. alexandrina, and a 1.396 mg/L 24 h LC₅₀ against B. truncatus. Across all study regions, the pooled mortalities of O. hupensis were 72, 86, 94 and 98% at 1, 2, 3 and 7 d, following field immersion of 4% TDS at a dose of 2.5 g/m³, and were 69, 77, 85 and 88% at 1, 3, 7 and 15 d, following field spraying at 5 g/m², respectively. 4% TDS had moderate toxicity to Japanese quail (7 d LD₅₀ > 60 mg/kg) and to shrimp (96 h LC₅₀ = 6.28 mg/L; 95% CI: 3.53-11.2 mg/L), whereas its toxicity to zebrafish was high (96 h LC₅₀ = 0.15 mg/L; 95% CI: 0.14-0.17 mg/L).

CONCLUSIONS

4% TDS is active against O. hupensis, B. alexandrina and B. truncatus under laboratory and field conditions, and it may be a candidate molluscicide of plant origin.

Cardiovascular disease-related mortality and factors associated with cardiovascular events in the TREAT Asia HIV Observational Database (TAHOD)

OBJECTIVES

With aging of the HIV-positive population, cardiovascular disease (CVD) increasingly contributes to morbidity and mortality. We investigated CVD-related and other causes of death (CODs) and factors associated with CVD in a multi-country Asian HIV-positive cohort.

METHODS

Patient data from 2003-2017 were obtained from the Therapeutics, Research, Education and AIDS Training in Asia (TREAT Asia) HIV Observational Database (TAHOD). We included patients on antiretroviral therapy (ART) with > 1 day of follow-up. Cumulative incidences were plotted for CVD-related, AIDS-related, non-AIDS-related, and unknown CODs, and any CVD (i.e. fatal and nonfatal). Competing risk regression was used to assess risk factors of any CVD.

RESULTS

Of 8069 patients with a median follow-up of 7.3 years [interquartile range (IQR) 4.4-10.7 years], 378 patients died [incidence rate (IR) 6.2 per 1000 person-years (PY)], and this total included 22 CVD-related deaths (IR 0.36 per 1000 PY). Factors significantly associated with any CVD event (IR 2.2 per 1000 PY) were older age [sub-hazard ratio (sHR) 2.21; 95% confidence interval (CI) 1.36-3.58 for age 41-50 years; sHR 5.52; 95% CI 3.43-8.91 for ≥ 51 years, compared with < 40 years], high blood pressure (sHR 1.62; 95% CI 1.04-2.52), high total cholesterol (sHR 1.89; 95% CI 1.27-2.82), high triglycerides (sHR 1.55; 95% CI 1.02-2.37) and high body mass index (BMI) (sHR 1.66; 95% CI 1.12-2.46). CVD crude IRs were lower in the later ART initiation period and in lower middle- and upper middle-income countries.

CONCLUSIONS

The development of fatal and nonfatal CVD events in our cohort was associated with older age, and treatable risk factors such as high blood pressure, triglycerides, total cholesterol and BMI. Lower CVD event rates in middle-income countries may indicate under-diagnosis of CVD in Asian-Pacific resource-limited settings.

SUMOylation of Alpha-Synuclein Influences on Alpha-Synuclein Aggregation Induced by Methamphetamine

Methamphetamine (METH) is an illegal and widely abused psychoactive stimulant. METH abusers are at high risk of neurodegenerative disorders, including Parkinson’s disease (PD). Previous studies have demonstrated that METH causes alpha-synuclein (α-syn) aggregation in the both laboratory animal and human. In this study, exposure to high METH doses increased the expression of α-syn and the small ubiquitin-related modifier 1 (SUMO-1). Therefore, we hypothesized that SUMOylation of α-syn is involved in high-dose METH-induced α-syn aggregation. We measured the levels of α-syn SUMOylation and these enzymes involved in the SUMOylation cycle in SH-SY5Y human neuroblastoma cells (SH-SY5Y cells), in cultures of C57 BL/6 primary mouse neurons and in brain tissues of mice exposure to METH. We also demonstrated the effect of α-syn SUMOylation on α-syn aggregation after METH exposure by overexpressing the key enzyme of the SUMOylation cycle or silencing SUMO-1 expression in vitro. Then, we make introduced mutations in the major SUMOylation acceptor sites of α-syn by transfecting a lentivirus containing the sequence of WT α-syn or K96/102R α-syn into SH-SY5Y cells and injecting an adenovirus containing the sequence of WT α-syn or K96/102R α-syn into the mouse striatum. Levels of the ubiquitin-proteasome system (UPS)-related makers ubiquitin (Ub) and UbE1, as well as the autophagy-lysosome pathway (ALP)-related markers LC3, P62 and lysosomal associated membrane protein 2A (LAMP2A), were also measured in SH-SY5Y cells transfected with lentivirus and mice injected with adenovirus. The results showed that METH exposure decreases the SUMOylation level of α-syn, although the expression of α-syn and SUMO-1 are increased. One possible cause is the reduction of UBC9 level. The increase in α-syn SUMOylation by UBC9 overexpression relieves METH-induced α-syn overexpression and aggregation, whereas the decrease in α-syn SUMOylation by SUMO-1 silencing exacerbates the same pathology. Furthermore, mutations in the major SUMOylation acceptor sites of α-syn also aggravate α-syn overexpression and aggregation by impairing degradation through the UPS and the ALP in vitro and in vivo. These results suggest that SUMOylation of α-syn plays a fundamental part in α-syn overexpression and aggregation induced by METH and could be a suitable target for the treatment of neurodegenerative diseases.

An integrated environmental improvement of marshlands: impact on control and elimination of schistosomiasis in marshland regions along the Yangtze River, China

BACKGROUND

Schistosomiasis is a global snail-transmitted infectious disease of poverty. Transmission control had been achieved in China in 2015 after the control efforts for over 60 years. Currently, the remaining core regions endemic for Schistosoma japonicum are mainly located in the marshland and lake regions along the Yangtze River basin.

METHODS

During the period from 2001 through 2015, an integrated environmental improvement of the marshlands was carried out through the implementation of industrial, agricultural and resources development projects in Yizheng County along the Yangtze River. S. japonicum infection in humans, livestock and snails was estimated by serology, stool examination, hatching technique and microscopy during the 15-year study period to evaluate the effect of the integrated environmental improvement on control and elimination of schistosomiasis.

RESULTS

A 0.05% overall rate of S. japonicum infection was observed in snails during the 15-year study period, and no infected snails were detected since 2012. The overall prevalence of S. japonicum infection was 0.09% in humans during the study period, and no human infection was found since 2012. In addition, only 13 bovines were identified with S. japonicum infection in 2003 during the 15-year study period, and since 2004, no infection was found in livestock.

CONCLUSION

The results of the present study demonstrate that the implementation of industrial, agricultural and water resources development projects, not only alters snail habitats in marshland regions, and promotes local economic development, which appears a win-to-win strategy to block the transmission of S. japonicum and accelerate socio-economic development along the Yangtze River.

Approaches being used in the national schistosomiasis elimination programme in China: a review

Schistosomiasis japonica, caused by the human blood fluke Schistosoma japonicum, remains a major public health problem in China, although great success has been achieved. The control efforts during the past half-decade, notably the wide implementation of the new integrated strategy with emphasis on control of the source of S. japonicum infection across the country since 2004, has greatly reduced S. japonicum in humans, livestock, and intermediate host Oncomelania hupensis snails, and transmission control of schistosomiasis was achieved in China in 2015. A two-stage roadmap was therefore proposed for schistosomiasis elimination in 2015, with aims to achieve transmission interruption by 2020 and achieve disease elimination by 2025 in the country. During the last two decades, a variety of approaches, which target the epidemiological factors of schistosomiasis japonica have been developed, in order to block the transmission cycle of the parasite. These approaches have been employed in the national or local schistosomiasis control activities, and facilitated, at least in part, the progress of the schistosomiasis elimination programs. Here, we present an approach to control the source of S. japonicum infection, three new tools for snail control, three approaches for detecting and monitoring S. japonicum infection, and a novel model for health education. These approaches are considered to play a great role in the stage moving towards transmission interruption and elimination of schistosomiasis in China.

A multidisciplinary, integrated approach for the elimination of schistosomiasis: a longitudinal study in a historically hyper-endemic region in the lower reaches of the Yangtze River, China from 2005 to 2014

BACKGROUND

Although great success has been achieved, schistosomiasis remains a major public health concern in China, and the remaining core endemic regions are concentrated along the middle and lower reaches of the Yangtze River. In this longitudinal study, we evaluated the effectiveness of a multidisciplinary, integrated approach for schistosomiasis elimination in a historically hyper-endemic region in the lower reaches of the Yangtze River, China over the 10-year period from 2005 through 2014.

METHODS

A three-step roadmap for schistosomiasis elimination was designed in the study site, and multidisciplinary, integrated interventions were implemented by the health, agriculture, water resources development, land and resources, and forestry sectors from 2005 to 2014, including chemotherapy for infected individuals, health education, management of the source of Schistosoma japonicum infection, and intermediate host snail control. The annual number of schistosomiasis patients, S. japonicum infection in humans, bovines and Oncomelania hupensis snails, and water infectivity were observed to assess the effectiveness of the multidisciplinary, integrated approach for the elimination of schistosomiasis.

RESULTS

There was a tendency towards a gradual decline in both the number of schistosomiasis cases and the prevalence of S. japonicum human infection across the study period from 2005 through 2014. No S. japonicum human infection was detected since 2012, and no acute infection was seen since 2006. During the study period, no infection was found in bovines, and a 0.03% overall infection rate was observed in O. hupensis snails. Since 2009, no infected snails were identified, and the area of both snail habitats and infected snail habitats appeared a reduction over the study period. Following the 3-year multidisciplinary, integrated control, infection control was achieved, and transmission control was achieved after 6-year implementation, with all infected snails and water infectivity eliminated; in addition, the 10-year implementation resulted in interruption of schistosomiasis transmission in the study site in 2014.

CONCLUSIONS

The results of the present 10-year longitudinal study demonstrate that the multidisciplinary, integrated approach is effective for the elimination of schistosomiasis as a public health problem in the lower reaches of the Yangtze River, China.

Quantitative trait loci mapping of the stigma exertion rate and spikelet number per panicle in rice (Oryza sativa L.)

The stigma exertion rate is a polygenic inherited trait that is important for increased seed yield in hybrid rice breeding. To identify quantitative trait loci (QTL) associated with high stigma exertion rate, we conducted QTL mapping using 134 recombinant inbred lines derived from XieqingzaoB and Zhonghui9308, which have high and low stigma exertion rates, respectively. A total of eight QTLs (qSES6, qSSE11, qDSE1a, qDSE1b, qDSE10, qDSE11, qTSE1, and qTSE11) for single stigma exertion, double stigma exertion, and total stigma exertion were detected. The locations of qSSE11 and qTSE11 have not been previously reported, and the qDSE11 allele from parent XQZB exhibited a positive additive effect. In addition, three QTLs (qSNP1, qSNP3a, and qSNP3b), for spikelet number per panicle were identified. Of note, one QTL (qSNP1) was detected in two different environments (Hainan and Zhejiang). To evaluate the advantage of exerted stigma for cross-pollination, single, dual, and total stigma exertion should be considered separately for future genetic improvement in the production of rice hybrid seeds. In addition, this study provides information for fine mapping, gene cloning, and marker assisted selection, with emphasis on the latter.

Ultrasound Findings of Intraductal Papillary Neoplasm in Bile Duct and the Added Value of Contrast-Enhanced Ultrasound

PURPOSE

To investigate the imaging features of intraductal papillary neoplasm in bile duct (IPNB) on baseline ultrasound and contrast-enhanced ultrasound (CEUS).

MATERIALS AND METHODS

The imaging features on baseline ultrasound and CEUS in 16 pathologically proven IPNB lesions in 15 patients were retrospectively analyzed. Real-time contrast specific modes and contrast agent of SonoVue were used for CEUS.

RESULTS

Bile duct dilation was present in all patients. The mean lengths for the intraductal papillary adenomas and adenocarcinomas were 2.5 ± 1.1 (range, 1.2 - 4.2 cm) and 5.6 ± 2.0 cm (range, 3.3 - 9.8 cm) (P = 0.004). Three imaging types of IPNB on ultrasound were depicted: bile duct dilation with intraductal mass (n = 8), bile duct dilation without intraductal mass (n = 3), and cystic-solid mixed type (n = 5). On CEUS, solid components of 13 lesions appeared hyper- (n = 12) or iso-enhancement (n = 1) in the arterial phase whereas all showed hypo-enhancement in the portal and late phases. For 3 lesions of bile duct dilation without intraductal mass, CEUS showed non-enhancement during all phases. Pre-surgical CEUS and conventional ultrasound made correct diagnoses in 12 (75.0 %) and 5(31.3 %) of 16 IPNBs respectively (P = 0.04). For CECT, correct diagnosis was also achieved in 12 (75.0 %) of 16 lesions (P = 1.00, in comparison with CEUS).

CONCLUSIONS

IPNB should be taken into consideration when intraductal mass or cystic-solid mass with bile duct dilation, or remarkable bile duct dilation without intraductal mass, are found on US. Intraductal mass length > 3.0 cm is more commonly found in malignant IPNB. CEUS might facilitate the diagnosis of IPNB by easily excluding the possibility of commonly found sludge, nonshadowing stones, or blood clots.

Differential expression of luteinizing hormone receptor, androgen receptor and heat-shock protein 70 in the testis of long-distance transported mice

Spermatogenesis, is a complex process of precisely regulated intracellular events, where it is affected by many factors. Long-distance transport of animals is one of the stressors that may influence spermatogenesis and sperm quality. The present study chose luteinizing hormone receptor (LHR), androgen receptor (AR), and heat-shock protein 70 (HSP70) as our target genes to investigate their mRNA and protein expression in the testes of long-distance transported (about 1000 km) mice. Histological analysis showed that there was a reduction in the thickness of the seminiferous epithelium in the transported mice, and a significant decrease in body weight and sperm count in the epididymis was also observed. mRNA expression was determined by QPCR in the testis of transported and control mice. The levels for AR decreased significantly in transported mice. LHR and HSP70 expression in the testes of the transported mice was slightly higher than that of control mice but did not reach a significant level. A similar tendency of protein expression was also observed by Western blot analysis. The levels of LHR and HSP70 increased slightly after transportation. However, none of the changes were statistically significant compared with the control mice. In conclusion, long-distance transport has an adverse effect on reproductive organs and spermatozoa in adult mice.

Study of the sludge reduction in an oxic-settling-anaerobic activated sludge process based on UNITANK

An oxic-settling-anaerobic process (OSA) can effectively reduce sludge production, but most of the research studies on the OSA process have been either under laboratory test conditions or based on synthetic wastewater, which cannot fully reflect the performance and sludge reduction efficiency in existing OSA process. Thus, aiming at examining the sludge reduction efficiency and the stability of the OSA process, UNITANK and UNITANK-OSA processes were performed in a 120 m(3)/d pilot-scale system using actual sewage. The results indicate that UNITANK-OSA achieved a 48% reduction of the sludge compared to the reduction due to UNITANK, not considering the accumulation of the effluent-suspended solids. The effluent quality was not found to change significantly, except that the total phosphorus concentration increased slightly. The extracellular polymeric substances metal floc theory may, to some extent, explain this reduction in this study. The OSA process could be used to reform the classic wastewater treatment process to get lower sludge mass.

[Surveillance and risk assessment system of schistosomiasis in Jiangsu Province. II. Surveillance pattern and effect of Oncomelania hupensis snail status in Dongtai City, Jiangsu Province]

OBJECTIVE

To explore the method of Oncomelania hupensis snail surveillance in transmission-interrupted regions of schistosomiasis, so as to provide a new pattern for the surveillance of snail status in the transmission-interrupted areas.

METHODS

In Dongtai County, north of Jiangsu Province where the transmission of schistosomiasis was interrupted, the surveillance of snail status was performed by means of the village-level general survey, village-level sampling survey, snail survey in key settings of township and county, and snail reporting by residents. In addition, quality-control snail sites were set up for quality control. The effectiveness and cost of the four methods of snail surveillance was compared.

RESULTS

A total of 163 079 settings and 22 785.62 hm2 were surveyed in Dongtai County from 2008 to 2013, and 89 residual snail breeding sites were found, with a snail area of 1.48 hm2. The patterns of village-level general survey, village-level sampling survey, and snail survey in key settings of township and county were employed for investigation of 94 550, 45 033 and 23 496 settings, consisting of 57.98%, 27.61% and 14.41% of total settings, and 2, 0 and 6 settings were found with snails, with 0.021/thousand, 0, and 0.255/thousand detection rates of settings with snail breading sites, respectively. The pattern of snail survey in key settings of township and county was more effective than that of village-level survey to detect-snail breeding sites (χ2 = 19.158, P = 0). The recovery rate of quality-control snail breeding sites was 52.56%, 38.27% and 73.62% for the three patterns of snail survey, respectively, and the pattern of snail survey in key settings of township and county showed a higher quality for snail survey than that of village-level survey (χ2 = 111.597 and 85.991, both P = 0). During the period from 2008 to 2013, 289 person-times reported 279 suspected snail habitats and 1 501 living snails, and no Oncomelania snails were found. During the 6-year period, there were 1617.5, 964.7 and 527.7 thousand RMB invested for village-level general survey, village-level sampling survey, and snail survey in key settings of township and county, and the cost of snail survey per hm2 was 129.88, 133.6 and 162.57 RMB/hm2, respectively. The cost of village-level general survey and snail survey in key settings of township and county to detect a snail-breeding site was 808 800 and 88 000 RMB, respectively (t = 12.850, P = 0.000), and the cost of snail survey in key settings of township and county was 10.88% of that of village-level general survey.

CONCLUSION

The snail survey in key settings of township and county is a highly effective and high-quality method for snail surveillance, which miay serve as a prior way for the surveillance of snail status in the transmission-interrupted areas of schistosomiasis.

[Comparison of molluscicidal effects of two snail control methods with plastic film covering in hilly regions]

OBJECTIVE

To evaluate and compare the molluscicidal effects of colorless and black plastic film covering methods against Oncomelania hupensis snails in hilly regions.

METHODS

A hilly setting with high snail density was selected as the study area, and three groups including the colorless plastic film covering method, black plastic film covering method and control were designed. The snail surveys were conducted 1, 3, 7, 15 days and 30 days in each group following plastic film covering, and the mortality of snails and reduction of snail density were investigated. The air temperature, soil surface temperature in the control group, as well as the soil surface temperature and the temperatures 5 cm and 15 cm under the soil within the film were recorded.

RESULTS

The mortality rates of snails were 36.84%, 78.94%, 95.92%, 100.00% and 99.45% 1, 3, 7, 15 days and 30 days following colorless plastic film covering, respectively, and the snail density after 30 days of covering reduced by 99.36% as compared to that before covering, while the mortality rates of snails were 10.08%, 8.94%, 6.11%, 26.15% and 49.32% 1, 3, 7, 15 days and 30 days following black plastic film covering, respectively, and the snail density after 30 days of covering reduced by 58.10% as compared to that before covering. There were significant differences in the 1-, 3-, 7-, 15-day and 30-day snail mortality rates between the colorless and black film covering groups (all P values <0.01), and a significant difference was detected in the snail density between the two groups 30 days after the film covering (P < 0.001). In addition, the speed, amplitude and duration of the rise in the soil surface temperature within the colorless film were all greater than those within the black film.

CONCLUSION

The short-term molluscicidal effect of the colorless plastic film covering method is significantly superior to that of the black plastic film covering method in summer in hilly regions.

[Field evaluation of a novel plant molluscicide "Luo-wei" against Oncomelania hupensis IV molluscicidal effect in field of river beach in Dongzhi County, Anhui Province]

OBJECTIVE

To evaluate the field effect of the plant molluscicide "Luo-wei" (tea-seed distilled saponins, TDS) against the snail Oncomelania hupensis in the river beach in Anhui Province.

METHODS

The immersing and spraying experiments were carried out in the river beach in Dongzhi County, Anhui Province, to assess the molluscicidal effect of 4% TDS comparing with 50% wettable powder of niclosamide ethanolamine salt (WPN). The chi(2) test or Fish's exact test was used to examine the differences between or among the molluscicidal effects by different environments, molluscicides, application methods, or days after the intervention. Meanwhile, the cost-effectiveness of the two molluscicides was analyzed.

RESULTS

After 1, 2 , 3 d and 7 d of the immersion, the snail death rates in both TDS group and WPN group increased gradually, the snail death rates in the two groups after immersing for 7 d were 94.62% and 99.24%, respectively, and there was no significant difference between them ( chi(2) = 3.30, P > 0.05). After 1 , 3 , 7 d and 15 d of spraying, the snail death rates were 70.82%, 79.75%, 85.11% and 91.65% in the TDS group, and 77.71%, 84.27%, 91.90% and 95.58% in the WPN group, respectively, and the differences among the snail death rates of the two groups at each time point were statistically significant (all P values < 0.05). The costs of spraying were 316.71 yuan per 100 m2 for TDS and 309.71 for WPN.

CONCLUSIONS

The molluscicidal effect of TDS has reached the requirements of national standard on nature source pesticides in the river beach of the middle and lower reaches of the Yangtze River. It is necessary to further evaluate its cost-effectiveness in large-scale field experiments in the future.

[Surveilance and response for Schistosomiasis japonica based on sentinel mice examination for cercariae-infested water in risk region, 2012]

OBJECTIVE

To monitor water body infestation in schistosomiasis high-risk areas with sentinel mouse technique.

METHODS

A total of 72 surveillance sites from 47 counties were selected in Hunan, Hubei, Jiangxi, Anhui, Jiangsu, Yunnan, and Sichuan. The water infectivity of Schistosoma japonicum was determined in the surveillance sites by using sentinel mice during June-July and September, 2012.

RESULTS

Among the 3,283 sentinel mice which were placed in 72 sites, 3,062 (93.3%) were recovered and dissected. Infected sentinel mice were found in six sites accounting for 8.3% (6/72) of the total surveillance sites, with an occurrence rate of sites with infected mice of 8.3% in June-July and 2.8% in September. 33 infected mice were discovered with a total infection rate of 1.08% (33/3,062). 1,085 adult worms were collected, with a mean worm burden of 32.9 worms per mouse in infected sentinel mice. 4 positive sites were in Hunan and 2 were in Jiangxi. Local acute schistosomiasis or suspected local acute cases which detected elsewhere were reported in 2 positive sites. Some follow-up activities were conducted in the 6 positive sites.

CONCLUSION

Compared with those in 2010, the schistosomiasis risk areas are shrinking in 2012. However, some regions are still the schistosomiasis high-risk areas.

Schistosoma japonicum risk in Jiangsu province, People's Republic of China: identification of a spatio-temporal risk pattern along the Yangtze River

The risk for Schistosoma japonicum infection in Jiangsu province, People's Republic of China, was investigated by a mouse bioassay. Various investigations were conducted in the period 2009-2011 with the presentation here representing the summary of the results from 45-50 sites in the marshlands along the Yangtze River's course through the province. Indices representing three aspects of the infection were collected to assess risk: (i) the proportion of sentinel points where at least one mouse infection was recorded; (ii) the proportion of infected mice at each of these sites; and (iii) the average worm burdens. Directional distribution analysis and scan statistics were used to explore the spatio-temporal risk pattern. The spatial distribution was oriented along the Yangtze River and the directional distributions for the proportion of infected mice and mean worm burdens were similar for the positive sentinel sites. Four statistically significant clusters were detected in 2009, but only one in 2010 and 2011, respectively. Temporal windows for infection risk were seen in June and September. The study illustrates the utility of spatio-temporal analysis in assessing the risk for schistosomiasis. This approach should be useful with respect to surveillance and response that can be expected to be increasingly applied when moving from morbidity control to transmission control.

Spatio-temporal analysis to identify determinants of Oncomelania hupensis infection with Schistosoma japonicum in Jiangsu province, China

Background

With the successful implementation of integrated measures for schistosomiasis japonica control, Jiangsu province has reached low-endemicity status. However, infected Oncomelania hupensis snails could still be found in certain locations along the Yangtze river until 2009, and there is concern that they might spread again, resulting in the possible re-emergence of infections among people and domestic animals alike. In order to establish a robust surveillance system that is able to detect the spread of infected snails at an early stage, sensitive and reliable methods to identify risk factors for the establishment of infected snails need to be developed.

Methods

A total of 107 villages reporting the persistent presence of infected snails were selected. Relevant data on the distribution of infected snails, and human and livestock infection status information for the years 2003 to 2008 were collected. Spatio-temporal pattern analysis including spatial autocorrelation, directional distribution and spatial error models were carried out to explore spatial correlations between infected snails and selected explanatory factors.

Results

The area where infected snails were found, as well as their density, decreased significantly between 2003 and 2008. Changes in human and livestock prevalences were less pronounced. Three statistically significant spatial autocorrelations for infected snails were identified. (i) The Moran’s I of infected snails increased from 2004 to 2007, with the snail density increasing and the area with infected snails decreasing. (ii) The standard deviations of ellipses around infected snails were decreasing and the central points of the ellipses moved from West to East. (iii) The spatial error models indicated no significant correlation between the density of infected snails and selected risk factors.

Conclusions

We conclude that the contribution of local infection sources including humans and livestock to the distribution of infected snails might be relatively small and that snail control may limit infected snails to increasingly small areas ecologically most suitable for transmission. We provide a method to identify these areas and risk factors for persistent infected snail presence through spatio-temporal analysis, and a suggested framework, which could assist in designing evidence based control strategies for schistosomiasis japonica elimination.

[Field evaluation of a novel plant molluscicide "Luo-Wei" against Oncomelania hupensis I molluscicidal effect by the spraying method in lake and marshland regions]

OBJECTIVE

To evaluate the field effect of a novel plant molluscicide "Luo-wei" (Tea-seed distilled saponins, TDS) against Oncomelania hupensis in the lake and marshland regions.

METHODS

A spraying experiment was carried out in the grassland of two schistosomiasis endemic counties, including Xingzi in Jiangxi Province and the Huarong in Hunan Province, to assess the molluscicidal effect of 4% TDS comparing with 50% wettable powder of niclosamide ethanolamine salt (WPN). The chi2 test was used to examine the differences between regions, molluscicides, or days after spraying.

RESULTS

Following 1, 3, 7, and 15 days of test, the snail mortality showed a simultaneous increase both in TDS group (70.43%-86.88%) and WPN group (70.21%-85.35%). There is no significant difference between TDS and WPN of day 1, 7 and 15 (all P values > 0.05), but except for day 3 (chi2 = 3.910, P = 0.048). By the end of day 15, the snail mortality for TDS was 86.53% in Xingzi and 88.28% in Huarong, while for WPN was 83.04% in Xingzi and 93.69% in Huarong respectively; the decline rate of snail density for TDS was 85.29% in Xingzi and 93.53% in Huarong, while for WPN was 85.29% in Xingzi and 93.53% in Huarong respectively. The adjusted mortality of different days ranged from 69.63% to 86.54% in the the TDS group, and 69.41% to 86.54% in the WPN group.

CONCLUSION

The molluscicidal effect of TDS by spraying is similar to that of WPN. It is time to popularize this new plant molluscicide (TDS) in a wider field.

Optimizing molluscicide treatment strategies in different control stages of schistosomiasis in the People's Republic of China

BACKGROUND

The application of chemical molluscicides is still one of the most effective measures for schistosomiasis control in P. R. China. By applying diverse molluscicide treatment scenarios on different snail densities in the field, we attempted to understand the cost-effectiveness of molluscicide application so as to prescribe an optimal management approach to control intermediate host snail Oncomelania hupensis under acceptable thresholds based on the goal of the National Schistosomiasis Control Programme.

METHODS

The molluscicidal field trial was carried out in the marshland of an island along the Yangtze River, Jiangsu province, P.R. China in October 2010. Three plots in the island representing low-density, medium-density and high-density groups were identified after the baseline survey on snail density. Each snail density plot was divided into four experimental units in which molluscicide (50% niclosamide ethanolamine salt wettable powder) was applied once, twice, trice and four times, respectively. The logistic regression model to correlate snail mortality rate with the covariates of number of molluscicidal treatment and snail density, and a linear regression model to investigate the relationship between cost-effectiveness and number of molluscicidal treatment as well as snail density were established.

RESULTS

The study revealed that increase in the number of molluscicide treatments led to increased snail mortality across all three population density groups. The most cost-effective regimen was seen in the high snail density group with a single molluscicide treatment. For both high and low density groups, the more times molluscicide were applied, the less cost-effectiveness was. However, for the median density group, the level of cost-effectiveness for two applications was slightly higher than that in one time.

CONCLUSIONS

We concluded that different stages of the national schistosomiasis control/elimination programme, namely morbidity control, transmission control and transmission interruption, should utilize different molluscicide treatment strategies to maximize cost-effectiveness.

[Surveillance of schistosomiasis in Jiangsu Province, China, 2005-2010]

OBJECTIVE

To understand the endemic situation of national surveillance sites in Jiangsu Province from 2005 to 2010, so as to provide the evidence for the prevention and control of schistosomiasis.

METHODS

According to the national surveillance protocol, a longitudinal surveillance on endemic situation of schistosomiasis was carried out in 8 national surveillance sites from 2005 to 2010.

RESULTS

In general, the positive rates of blood tests and infection rates of Schistosoma japonicum decreased from 9.04% and 0.22% in 2005 to 4.34% and 0.02% in 2010, and the rates of decline were 51.99% and 90.91%, respectively. The endemic situation of farmers, fishermen and business men were relatively serious, and the infection degree of the low-aged group of students was relatively serious. No local acute schistosomiasis case was detected. A total of 7 466.46 hm2 of environmental sites were investigated, and the areas with living Oncomelania hupensis snails and infected snails were 2 213.98 and 247.91 hm2, respectively, the densities of living snails and infected snails decreased gradually, and no infected snail was found in 2010. However, the total areas with living snails and infected snails still keep a relative high level, and the density of infected snails rebounded in special sites.

CONCLUSION

The endemic situation of the national surveillance sites is under control, and the infection rate of human keeps at a low level in Jiangsu Province. The surveillance and control of snails and infection source should still be strengthened.

[Engineering management mode of mollusciciding and assessment of its field application]

OBJECTIVE

To establish the engineering management mode of mollusciciding, and assess its snail control effect in field application, so as to provide the effective management interventions for improving the quality of mollusciciding in the field.

METHODS

Engineering management of mollusciciding was performed. The snail distribution was surveyed before and after snail control with molluscicides and environmental modification, and the database was established. The snail control effect of the engineering management mode of mollusciciding was assessed.

RESULTS

Engineering management mode of mollusciciding was conducted in 96.27% (1 033/1 073) of the total snail habitats in 6 counties (districts) of Yangzhou City from 2006 to 2011. After the implementation of engineering management mode, the mortality of snails increased from 65.07% before implementation to 87.16% (80.65%-89.38%), and significant difference was observed (chi2 = 4 623.297, P = 0). The reductions in occurrence rate of frames with snails and snail density and the corrected mortality of snails were 57.67% (49.27%-66.98%), 76.67% (76.13%-83.66%) and 86.58% (79.89%-88.89%), respectively, which were 1.45, 1.63 times and 1.37 times more than those before implementation. After the implementation of engineering management mode of mollusciciding for 3 years in Yangzhou City, all infected snails were eliminated. After 6 years of implementation, the number of settings with snails, snail areas, occurrence rate of frames with snails, means snail density decreased by 56.27%, 76.40%, 67.99% and 66.67%, respectively.

CONCLUSIONS

High-quality molluscicide is the essential factor to ensure the molluscicidal effect, and engineering management mode of mollusciciding is an effective approach to improve the quality of snail control with molluscicides in the field.

A real-time platform for monitoring schistosomiasis transmission supported by Google Earth and a web-based geographical information system

A basic framework for the rapid assessment of the risk for schistosomiasis was developed by combining spatial data from Google Earth® with a geographical information system (GIS) package, bundling the modules together with an Internet connection into a WebGIS platform. It operates through functions such as "search", "evaluation", "risk analysis" and "prediction" and is primarily aimed to be a dynamic, early-warning system (EWS) providing user-friendly, evidence-based, near real-time awareness of the status of an important endemic disease. It contributes to rapid information-sharing at all levels of decision-making, facilitating "point-of-care" response, i.e. treatment provided at newly discovered transmission sites. The experience using the platform is encouraging and it has the potential to improve support systems and strengthen schistosomiasis control activities, in particular with regard to surveillance and EWS. It can quickly and intuitively locate early, high-risk areas, retrieve all important data needed as well as provide detailed, up-to-date information on the performance of the control programme. This WebGIS, the first of its kind in the People's Republic of China, is not only applicable for schistosomiasis but can easily be adapted for improving control of any endemic disease in any geographical area.

[Novel strategies and technologies to achieve the transmission control of schistosomiasis in Jiangsu Province]

According to the requirements of the Mid- and Long-term Plan for Prevention and Control of Schistosomiasis in China and based on the actual situation of schistosomiasis control in Jiangsu Province, this paper demonstrates the new technologies achieved by the scientific innovation and the novel control strategies including integrated control in key regions and control of key populations and surveillance and forecast of key water regions since 2004, with the emphasis on the control and elimination of infected Oncomelania snails. Such strategies and technologies implemented the result in continuous decrease in the endemic situation of schistosomiasis in the province, and the whole province achieved the goal of schistosomiasis transmission control in late 2010.

[Surveillance and forecast of Schistosoma japonicum-infected sentinel mice in key water regions of China in 2010]

OBJECTIVE

To explore the approach and tool for surveillance and forecast of schistosomiasis, so as to provide scientific evidence for improving the sensitivity of the surveillance and forecast system of schistosomiasis.

METHODS

Two field detections were carried out in June and September by using the determination of sentinel mice in key high-risk water regions of 7 provinces of Hunan, Hubei, Jiangxi, Anhui, Jiangsu, Yunnan and Sichuan, and the sentinel mice were raised in laboratory and dissected for observation of schistosome infections. The database regarding schisosome infections in key water regions of China was established, and the tempo-spatial distribution and environmental features of the national surveillance and forecast sites with positive sentinel mice were analyzed.

RESULTS

A total of 72 surveillance and forecast sites were detected in 34 counties (cities, districts) of 7 provinces. Of the 2 667 sentinel mice placed, 2 613 were recovered, with a recovery rate of 97.98%. Among the 72 sites detected, 17 were detected with positive sentinel mice, and the occurrence rate of positive sites was 23.61%. The occurrence rate was 17.24% (10/58) in June and 14.71% (10/68) in September, and no significant difference was observed between two batches (chi2 = 0.151, P = 0.698). Of the 2 436 sentinel mice dissected, 90 were positive, and 459 schistosome worms were collected, with a total infection rate of 3.69%, and the mean worm burdens of positive mice were 5.10 worms per mouse. The infection rate of sentinel mice was 2.82% (31/1 099) in June and 4.41% (58/1 337) in September, the infection rate of sentinel mice was significantly higher in September than that in Juen (chi2 = 14.681, P < 0.01), and the mean worm burdens of infected sentinel mice were 2.45 worms per mouse in June and 6.49 worms per mouse in September. The occurrence rates of the positive sites with infected snails detected in the study year, last year and without infected snails detected in recent 3 years were 29.63%, 41.67% and 12.12%, respectively, and no significant differences were detected (chi2 = 5.227, P = 0.071). The infection rates of sentinel mice in the aforementioned 3 settings were 9.38%, 3.98% and 0.59%, respectively, and there was significant difference observed (chi2 = 20.489, P < 0.01).

CONCLUSIONS

The monitoring results of sentinel mice infections in key water regions can almost reflect the endemic situation of schistosomiasis in local areas. Notably, many infections are detected in settings without infected snails detected in recent years. The monitoring of sentinel mice infections could significantly improve the sensitivity of the surveillance and forecast system of schistosomiasis.

[Effect evaluation of transmission control of schistosomiasis in 14 counties (cities, districts) of Jiangsu Province]

OBJECTIVE

To assess the control effect of transmission control of schistosomiasis in 14 counties (cities, districts) of Jiangsu Province.

METHODS

According to the requirement of the national assessment scheme of schistosomiasis, the effect of schistosomiasis control was evaluated. The schistosomiasis morbidity and changes in Oncomelania snail status in recent 2 years were assessed. The field survey was done by using the stratified sampling method. A heavy-endemicity administrative village was randomly sampled from the townships with low, moderate and heavy endemicities in each county, respectively as the assessment villages. The morbidity in resident populations and free-grazing domestic animals and the snail infections in the settings where snails were detected and frequent human and domestic animal activities were observed in recent 3 years.

RESULTS

During the period from 2007 through 2010, the transmission control effect of schistosomiasis was assessed in 14 counties (cities, districts) of Jiangsu Province, and field surveys were performed in 42 villages of 39 townships. A total of 264 settings, 1 679.73 hm2 and 39 894 frames were surveyed, and 2 179 snails were collected. Of the 405 living snails dissected, no infected snails were detected, and the snail infection rate was 0. Totally 22 147 residents were investigated. The serum examination of schistosome infection was performed in 22 147 residents, and 300 were sero-positive, with a sero-positive rate of 1.35% (0.30%-4.26%). The stool examination was done in 297 sero-positive cases, and no cases were stool-positive, with a stool-positive rate of 0. A total of 2 931 domestic animals were investigated, including 230 head of cattle, 2 333 pigs and 368 sheep, and no infections were detected. The files regarding the schistosomiasis morbidity and snail status have been established in 14 counties (cities, districts). All infected snails were killed in the 14 counties (districts, cities) 2 years prior to the assessment, and the mean time that no infected snails were detected was 2.71 years (2-4 years). No acute schistosomiasis patients were found in all 14 counties (districts, cities) more than 3 years prior to the assessment.

CONCLUSION

According to the Criteria for Control and Elimination of Schistosomiasis in China (GB 15976-2006), the transmission of schistosomiasis in 14 countries (cities, districts) of Jiangsu Province has been controlled.

[Burden of disease in Schistosomiasis japonica. IV. Community socioeconomic determinants of chronic schistosomiasis]

OBJECTIVE

To explore the socioeconomic determinants of chronic schistosomiasis japonica at a community (village) level.

METHODS

The socioeconomic and epidemiological data (Years lived with disability, YLDs) came from the thematic research carried out in two schistosome-endemic counties, Dangtu and Hanshou, in lake areas between 2004 and 2005. A concentration index was calculated and used to assess the health inequalities between socioeconomic statuses. The community risk factors relating to chronic schistosomiasis were explored by the multiple regression model.

RESULTS

The concentration index was -0.12 of Dangtu County and 0.03 of Hanshou County which indicated that there were no health inequalities due to schistosomiasis between communities with different socioeconomic statuses. There was no linear relationship between the economic levels and YLDs of chronic schistosomiasis. The results of multiple regression model showed that the distance from village to schistosome-infested water (P < 0.01) and wet land area per capita (P < 0.05) were significantly related to YLDs of chronic schistosomiasis.

CONCLUSION

There is non-linear relationship between socioeconomic levels and YLDs of chronic schistosomiasis, but the distance from village to schistosome-infested water and wet land area per capita are significantly related to the latter.

Effect of an integrated control strategy for schistosomiasis japonica in the lower reaches of the Yangtze River, China: an evaluation from 2005 to 2008

Background

Schistosomiasis japonica remains a major public health concern in China. There are many interventions implemented to control the transmission of the disease. The purpose of the present study was to investigate the effects of an integrated control strategy for schistosomiasis control.

Methods

An integrated control strategy for schistosomiasis japonica with emphasis on removing cattle from snail-infested grasslands, providing farmers with mechanized farm equipment, improving sanitation by supplying tap water and building lavatories and latrines and providing boats with fecal-matter containers was implemented in 107 villages of the lower reaches of the Yangtze River, Jiangsu Province, China, during a 32-month period from May 2005 to 2008, and the effectiveness was investigated.

Results

Following the effects of the comprehensive control, the snail habitat, infected snail habitat, snail infection rate, and S. japonicum prevalence in both humans and livestock all appeared a declining trend year by year, with reductions of 47.88%, 94.29%, 92.55%, 96.94%, and 100% compared with those before the comprehensive control. In addition, all of the 17 counties achieved the infection control in 2007, and 7 reached the criteria of transmission control in 2008. The confirmed snail habitats reduced from 107 to 20, and the acute infections have also been controlled for 2 successive years since 2007.

Conclusions

The integrated control strategy for schistosomiasis japonica is effective to control the transmission of S. japonicum.

[Strategy of comprehensive control for schistosomiasis and its effect in key areas of Jiangsu Province]

OBJECTIVE

To evaluate the effect of comprehensive control for schistosomiasis in key areas of Jiangsu Province.

METHODS

The basic data and the data of implementation of comprehensive control measures were collected from the key areas of Jiangsu Province, including 30 townships, 87 marshlands and 78 anchor points. A field survey was carried out to investigate the Oncomelania snail status by using the systematic sampling method and schistosomiasis morbidity in humans and animals in the 12 key counties (districts). The changes of snail status and morbidity of humans and animals were statistically analyzed in key counties (districts) where comprehensive control measures was implemented, and the effects of schistosomiasis control before and after the implementation of the comprehensive control were compared.

RESULTS

From 2008 to 2010, a total of 84 100 harmless latrines were constructed, 339 600 persons were examined, 2.6938 million people received health education, 112 000 protective creams and 798 000 publicity materials were allocated, 9 085 domestic animals were reared in pens, 11 800 domestic animals were examined, 130 high-risk cattle were eliminated in 30 key townships of 12 countries (districts), Jiangsu Province. A total of 19 640.78 hm2 were controlled with molluscicides, 798 warning tablets were placed, 116.07 hm2 of farmlands were ploughed up and planted, 306.80 hm2 were dug for fish culture, and 506.74 hm2 were planted with trees for snail control in 87 high-risk marshlands. A total of 118.83 million Yuan were invested into the water resources development projects, 39.82 km-long rivers were dredged, 70.04 km-long bank were concreted, 30 culvert gates were re-constructed, and 22 snail sedimentation tanks were built. In the 78 anchor points, 95 harmless public toilets were built, 3 192 stool container were allocated, 28 700 boatmen were examined, 71 600 protective creams and 53 200 publicity materials were allocated, and 46 600 persons received health education. Following the implementation of comprehensive control, the settings with infected snails, infected snail areas, infection rates of snails reduced from 75, 802.73 hm2 and 0.10% before the comprehensive control in 2007 to all 0 in 2010, with reduction rates of all 100%. The infection rates of schistosome in both humans and domestic animals appeared declining trends in 12 counties (districts) from 2005 to 2010, and the human infection rates were 0.16%, 0.04%, 0.02%, 0.02%, 0.01% and 0.01%, respectively, while being 0.11%, 0.05%, 0, 0, 0 and 0, respectively in domestic animals. During the period of comprehensive control, totally 45 transmission-controlled townships and 183 villages were newly added. In 2010, all of the 12 counties (districts) reached the criteria of schistosomiasis transmission control.

CONCLUSIONS

The comprehensive control with emphasis on the key areas where infected snails are found, is an effective measure to further facilitate schistosomiasis control and rapidly control the transmission of schistosomiasis.

[Burden of disease in schistosomiasis japonica III household socioeconomic determinants of chronic schistosomiasis]

OBJECTIVE

To explore the socioeconomic determinants of chronic schistosomiasis japonica at household level.

METHODS

The socioeconomic status of case and control families in lake and marsh schistosomiasis endemic areas were investigated by questionnaire, socioeconomic factors were analyzed by the principle components analysis, and the wealth index were calculated to evaluate the economic status at household level. Then the relation between schistosome infection and some influencing factors were analyzed by two-level Logistic regression model.

RESULTS

A total of 2 716 households in 91 villages were investigated, among which 1 050 were case families and 1 666 were control families. The values of the first eigenvector of stone/brick house, house with > or = 2 floors, black/white TV, colour TV, washing machine, refrigerator, side occupation were -0.42, 0.46, -0.45, 0.46, 0.32, 0.24 and 0.16, respectively, which suggested that the first eigenvector was the comprehensive index reflecting family wealth. The results of Logistic regression model showed that there were 4 household factors significantly relating to chronic schistosomiasis, namely, the distance from residence to schistosome-infested water, source of washing water, economic status, and wet land area per capita, among which the factor that the distance from residence to schistosome - infested water < 100 m with the highest (OR = 12.590, P = 0).

CONCLUSION

In the lake and marsh endemic areas, health education and other intervention to the poor family living along river or lake without safe water supply should be strengthened to control schistosomiasis.

A Google Earth-based surveillance system for schistosomiasis japonica implemented in the lower reaches of the Yangtze River, China

BACKGROUND

Due to the success of the national schistosomiasis control programme in China, transmission has been sufficiently reduced in many areas to severely limit identification of areas at risk by conventional snail surveys only. In this study, we imported Google Earth technology and a Global Positioning System (GPS) into the monitoring system for schistosomiasis surveillance of the banks of the Yangtze River in Jiangsu Province, China.

METHODS

A total of 45 sites were selected and the risk was assessed monthly by water exposure of sentinel mice at these sites from May to September in 2009 and 2010. The results were assembled and broadcast via the Google Earth platform.

RESULTS

The intensity of schistosomiasis transmission showed peaks of risk in June and September of 2009, while there was only one small peak in June in 2010 as the number of detected positive transmission sites dropped dramatically that year thanks to improved mollusciciding. River ports were found to be areas of particular risk, but ferry terminals and other centres of river-related activities were also problematic.

CONCLUSIONS

The results confirm that the surveillance system can be rapidly updated and easily maintained, which proves the Google Earth approach to be a user-friendly, inexpensive warning system for schistosomiasis risk.

Optimization of complex conditions by response surface methodology for APAM-oil/water emulsion removal from aqua solutions using nano-sized TiO2/Al2O3 PVDF ultrafiltration membrane

This paper studies the cumulative effect of various parameters, namely anionic polyacrylamide (APAM) concentration, oil concentration, pH, trans-membrane pressure (TMP), and total dissolved solid (TDS), and obtains optimal parameters for the minimum relative flux (J/J(0)) declining in aqueous solutions with response surface methodology (RSM). In order to analyze the mutual interaction and optimal values of parameters affecting ultrafiltration, a central composite rotatable design (CCRD), one method of RSM, was employed. The analysis of variance (ANOVA) of the cubic polynomial model demonstrated that this model was highly significant and reliable. The results show that the effect of APAM and oil on J/J(0) has an inverse trend with pH value increasing. Moreover, the mutual interaction of initial APAM (oil) concentration (C(APAM(oil))) and pH (TMP) were negligible, while the mutual interaction of C(APAM) and C(oil) has an obvious effect, i.e. the effect of initial feed C(APAM) became more important at higher values of initial feed C(oil), and the J/J(0) was only about 4%. The favorable operate conditions in this ultrafiltration process were at low C(APAM), C(oil), pH, and TMP, which agreed with the conclusions of many authors, while considering water production, C(APAM) and C(oil) < 50 mg/L, pH < 4, and TMP < 0.075 MPa could be accepted.

[Burden of disease in schistosomiasis japonica. II. Measurement of health inequalities due to chronic schistosomiasis]

OBJECTIVE

To measure and evaluate the health inequalities due to chronic schistosomiasis japonica.

METHODS

Based on years lived with disability (YLD) caused by chronic schistosomiasis, a concentration index and Gini index, along with a concentration curve and Lorenz curve, the health inequalities between sexes, age groups or endemicities were identified and quantified.

RESULTS

The age concentration index was 0.395 of females and 0.380 of males, with no significant difference between them. More than 60% of YLD was contributed by those aged > or = 45 years old who accounted for about a third of total population in both sexes. Gini index was 0.666 of Dangtu County and 0.451 of Hanshou County, and 60% of YLD was contributed by the highly endemic villages.

CONCLUSIONS

The concentration index and Gini index could quantify the magnitude of health inequalities well. The priority of morbidity control should be given to those aged > or = 45 years old and living in highly endemic villages.

Compensatory density feedback of Oncomelania hupensis populations in two different environmental settings in China

Background

The most recent strategy for schistosomiasis control in the People's Republic of China aims to reduce the likelihood of environmental contamination of schistosome eggs. Despite considerable progress, it is believed that achievements would be further consolidated with additional intermediate host snail control measures. We provide an empirical framework for discerning the relative contribution of intrinsic effects (density feedback) from other extrinsic drivers of snail population dynamics.

Methods

We set up experiments in two study locations to collect reproduction data of Oncomelania hupensis, the intermediate host snail of Schistosoma japonicum. We applied a set of four population dynamic models that have been widely used to study phenomenological time-series data to examine the properties of demographic density feedback patterns from abundance data. We also contrasted the obtained results with the component feedback of density on survival rate to determine whether adult survival was the principal driver of the demographic feedback observed.

Results

Demographic density feedback models (Ricker- and Gompertz-logistic) accounted for > 99% of Akaike's information criterion model weight, with the Gompertz ranking highest in all O. hupensis population groups. We found some evidence for stronger compensatory feedback in the O. hupensis population from Sichuan compared to a Jiangsu population. Survival rates revealed strong component feedback, but the log-linear relationships (i.e. Gompertz) had less support in the demographic feedback analysis.

Conclusions

Our findings indicate that integrated schistosomiasis control measures must continue to reduce parasite abundance further because intermediate host snail populations tend to grow exponentially at low densities, especially O. hupensis populations in mountainous regions. We conclude that density feedback in adult survival is the principal component contribution to the demographic phenomenon observed in the population fitness (r)-abundance relationship.

[Burden of disease in schistosomiasis japonica. I. Calculation and evaluation of years lived with disability of chronic schistosomiasis]

OBJECTIVE

To discuss the evaluation index of the disease burden of chronic schistosomiasis and its calculation methods.

METHODS

The epidemiological data came from the thematic research carried out in two schistosome-endemic counties in lake areas between 2004 and 2005. The specific prevalence rates by age group, gender and endemic type were calculated. According to the age-specific disability weight obtained in the thematic research, the years lived with disability (YLDs) and the rates of YLD of stratified samples by age and gender, and the total YLDs of the two counties were calculated.

RESULTS

The total YLDs were 1 056.26 and 3 967.43 person-years in Dangtu and Hanshou counties, respectively. The contributing rate of Grade I type village to the total YLDs of two counties was 37.95% (40.08% in Dangtu and 37.39% in Hanshou). For different stratums by age and gender, the older ones and male tended to have larger YLDs. Compared to the non-endemic areas, chronic schistosomiasis brought an average extra of 4.398 and 1.505 years per 1 000 person to population in Dangtu and Hanshou counties, respectively.

CONCLUSION

The evaluation to YLDs of chronic schistosomiasis is helpful for prioritizing intervention areas and population, as well as providing a new index for the evaluation of effectiveness of control measures.

[Surveillance and forecast system of schistosomiasis in Jiangsu Province V monitoring of infectivity of Schistosoma japonicum miracidia of Yangtze River]

OBJECTIVE

To establish an approach to monitor the Schistosoma japonicum miracidia in waterbody of the Yangtze River, and monitor the infectivity of water body, so as to provide the evidence for tracing and controlling infection source and interrupting the transmission of schistosomiasis, and Oncomelania snail control.

METHODS

The floating bottle-nylon bag sentinel snails method was employed. A total of 45 surveillance sites were selected along the Jiangsu section of the Yangtze River, 500 snails were placed into each site from May to September, once every month. Twenty-eight hours later, all the snails were transferred and raised in an incubator at 25 degrees C. Two months after the first recovery, the snail infection was detected each month by using the cercaria-shedding test. Three months after the final placement, all the snails were dissected for observation of the infection. The activities of humans and domestic animals were surveyed in the settings where infected snails were found. The database of surveillance results of sentinel snails in the Yangtze River, Jiangsu Province was established, and the geographical distribution map of site with infected snails was drawn, and the probability that snails were infected with S. japonicum was estimated.

RESULTS

A total of 44 717 sentinel snails were placed in 45 sites during the period of 5 months, and 43 477 recovered, with a recovery rate of 97.23%. A total of 81 410 snails were detected by the cercaria-shedding test, no infections were found. A total of 13 033 snails were dissected, and 5 were infected, with an infection rate of 0.038%. The probability of snail infection in water was 4.11 out of a million. Five sites with infected snails were found in 45 sites, with an occurrence rate of 11.11%. The sites with infected sentinel snails were distributed in south bank (3, 21.43%), north bank (1, 5.56%) and river center (1, 7.69%), respectively. The occurrence rate of sites with infected snails in south bank was 3.8 times more than that in north bank. Among the 5 sites, 3 were anchor points of boat fishermen.

CONCLUSIONS

The contamination of S. japonicum eggs in south bank of the Yangtze River is higher than that in north bank in Jiangsu Province, and the anchor point of boat fisherman is one of the important contamination regions. The floating bottle-nylon bag sentinel snails testing method is an effective approach to monitor the contamination of S. japonicum eggs in water.

[Surveillance and forecast system of schistosomiasis in Jiangsu Province. IV. Establishment of Schistosoma japonicum cercaria-killing method by spraying niclosamide suspension on water surface]

OBJECTIVE

To investigate the effect of suspension concentrate of niclosamide (SCN) on killing cercariae of Schistosoma japonicum on water surface, optimization and impact on fish, so as to establish an emergency-treatment intervention for rapidly killing cercariae and eliminating water infectivity.

METHODS

SCN was formulated into different concentrations of solutions, and then the solutions were sprayed on the surface of water containing S. japonicum cercariae. The water infectivity was determined by using mice at 0, 10, 30 min after spraying SCN. SCN was formulated into a solution of 100 mg/L and then sprayed on the surface of the water by using the spraying values of 0.01, 0.02, 0.03 g/m2 and 0.04 g/m2. At 30 min and 60 min after spraying, the water infectivity was determined by using mice. Zebra fish were transferred into the static water, then 100 mg/L SCN (s), using spraying values of 0.01, 0.02, 0.03 g/m2 and 0.04 g/m2, were sprayed on water surface. At 0, 10, 30, 60 min after spraying, the samples were collected at water depths of 0, 10, 20, 30, 40 cm, and niclosamide was determined by using high-performance liquid chromatography. The death of zebra fish was continually observed within 96 h after spraying SCN.

RESULTS

At 0, 10, 30 min after spraying 1 000, 100, 10, 1, 0.1 mg/L SCN on water surface, the infectivity of water significantly decreased. At 30 min after spraying 1 000 mg/L and 100 mg/L SCN, no schistosome infectivity was detected in the water. At 30 min after spraying 100 mg/L SCN, with spraying values of 0.01, 0.02, 0.03, 0.04 g/m2, the water infectivity significantly reduced, and no infectivity was found 60 min after spraying SCN. After the surface of static water was sprayed with 100 mg/L SCN, the peak concentration was found at 0 min, and the solution diffused to site with a water depth of 10 cm after 10 min, and 30 min later, SCN diffused to the whole water body, and distributed evenly. After spraying 100 mg/L SCN on the surface of water with a volume of (3.14 x 20(2) x 50) cm3, by using the spraying value of 0.02 g/m2, 96 h later, no death of zebra fish was found.

CONCLUSIONS

From 30 to 60 min after spraying 100 mg/L SCN, with the value of 0.02 g/m2, on the surface of S. japonicum-infested water, the water infectivity can be eliminated, and there is no evident toxicity to fish. This cercaria-killing method, as an emergency-treatment intervention for infested water, can be applied in those surveillance and forecast sites.

Molluscicidal efficacies of different formulations of niclosamide: result of meta-analysis of Chinese literature

The control efforts on Oncomelania hupensis, the intermediate snail host of Schistosoma japonicum, cannot be easily excluded from the integrated approach of schistosomiasis control in China. Application of chemical compounds, molluscicides, in snail habitats is a common method for snail control in addition to environmental modification. We conducted a systematic review and meta-analysis to assess the molluscicidal effects of the currently recommended 50% niclosamide ethanolamine salt wettable powder and a new 4% niclosamide ethanolamine salt powder developed by Chinese researchers. Literature was searched from three Chinese databases, i.e. Chinese Biomedical Database, VIP Database and Wanfang Database, on field mollusciciding trials of niclosamide in China (from January 1, 1990 to April 1, 2010). Molluscicidal effects on reduction of snail population of the 50% or 4% niclosamide formulations in field trial were evaluated 3 days, 7 days or 15 days post-application. Out of 90 publications, 20 papers were eventually selected for analysis. Publication bias and heterogeneity tests indicated that no publication bias existed but heterogeneity between studies was present. Meta-analysis in a random effect model showed that the snail mortality of 3, 7 and 15 days after spraying the 50% niclosamide ethanolamine salt wettable powder were 77% [95%CI: 0.68-0.86], 83% [95%CI: 0.77-0.89], and 88% [95%CI: 0.82-0.92], respectively. For the 4% niclosamide ethanolamine salt powder, the snail mortality after 3, 7 and 15 days were 81% [95%CI: 0.65-0.93], 90% [95%CI: 0.83-0.95] and 94% [95%CI: 0.91-0.97], respectively. Both are good enough to be used as molluscicides integrated with a schistosomiasis control programme. The 4% niclosamide ethanolamine salt powder can be applied in the field without water supply as the surrogate of the current widely used 50% niclosamide ethanolamine salt wettable powder. However, to consolidate the schistosomiasis control achievement gained, it is necessary to continuously perform mollusciciding more than twice annually in the field.

Comparative study of serology and histology based detection of Helicobacter pylori infections: a large population-based study of 7,241 subjects from China

Two detection methods for H. pylori infections, i.e. serological antibody titer measurements by Hp-ELISA and histological scoring by HE staining, have been compared to investigate the relationship between the diagnosis methods, to clarify the application scope of each diagnosis method and to determine its influencing factors. In the 7,241 subjects who participated in gastric cancer screening, H. pylori infection rate was 70.14% by the Hp-HE method and 41.87% by the Hp-ELISA method when 34EIU was recognized as the cut-off value. The IgG titers increased with the elevation of HE scores; however, the two methods were not closely correlated among those in different gastric disease status. Age, gender and drinking status did not have significant impact on the relationship between the two methods; however, smoking status seemed to significantly influence the correlation of the two diagnosis methods. In conclusion, it was necessary to reevaluate the cut-off value when using ELISA test kits in different population groups. In most cases, the results of two H. pylori infection diagnosis methods show high correlation. However, this relationship can be affected by smoking and gastric diseases status. Additionally, the dynamic change of H. pylori antibody titers is an indicator of gastric disease development.

Biological evaluation of collagen-chitosan scaffolds for dermis tissue engineering

Three-dimensional collagen-chitosan scaffolds were fabricated with type I collagen and chitosan through freeze drying and glutaraldehyde cross-linking. Dermal fibroblasts were isolated from neonatal Sprague-Dawley rat skin by dispase II/collagenase I digestion. The fibroblasts were then seeded into the scaffolds to construct tissue-engineered dermis. The microstructure of the scaffolds as well as the fibroblasts' proliferation, cytokine secretion and cell cycle were investigated. Flow cytometry analysis indicated that cells in the scaffolds proliferated steadily. IL-6 concentration measurement by the ELISA test suggested that the scaffolds could promote secretion of the fibroblasts' cytokine. These results show that the fibroblasts and the scaffolds interact well with each other, and the fibroblasts have better proliferation ability and biological activity in the scaffolds than in monolayer culture. The scaffolds are a promising candidate for tissue repair and regeneration with enhanced biostability and good cytocompatibility.

Potential impact of climate change on schistosomiasis transmission in China

Appraisal of the present and future impact of climate change and climate variability on the transmission of infectious diseases is a complex but pressing public health issue. We developed a biology-driven model to assess the potential impact of rising temperature on the transmission of schistosomiasis in China. We found a temperature threshold of 15.4 degrees C for development of Schistosoma japonicum within the intermediate host snail (i.e., Oncomelania hupensis), and a temperature of 5.8 degrees C at which half the snail sample investigated was in hibernation. Historical data suggest that the occurrence of O. hupensis is restricted to areas where the mean January temperature is above 0 degrees C. The combination of these temperature thresholds, together with our own predicted temperature increases in China of 0.9 degrees C in 2030 and 1.6 degrees C in 2050 facilitated predictive risk mapping. We forecast an expansion of schistosomiasis transmission into currently non-endemic areas in the north, with an additional risk area of 783,883 km(2) by 2050, translating to 8.1% of the surface area of China. Our results call for rigorous monitoring and surveillance of schistosomiasis in a future warmer China.

Effect of temperature on the development of Schistosoma japonicum within Oncomelania hupensis, and hibernation of O. hupensis

The objectives of this investigation were to assess the effect of temperature on the development of Schistosoma japonicum harboured in Oncomelania hupensis and to determine the lowest temperature threshold at which the hibernation of O. hupensis occurs. In the first experiment, adult infection-free O. hupensis, collected from Jiangsu province in eastern China, were infected with S. japonicum miracidia and raised at different temperatures under laboratory conditions. The development of miracidia until the release of cercariae was monitored employing the cercarial shedding method. In the second experiment, batches of O. hupensis were kept at temperatures below 13 degrees C with the temperature gradually reduced. Snail activity was assessed by a pin puncture method. We found a positive relationship between the development of S. japonicum within O. hupensis and temperature. In snails kept at 15.3 degrees C, S. japonicum arrested their development, while the fastest development occurred at 30 degrees C. The temperature at which half of the snails were in hibernation (ET(50)) was 6.4 degrees C. Our results underscore the pivotal role temperature plays on the biological activity of O. hupensis and the development of S. japonicum within the intermediate host. These findings are likely to have implications for the transmission of schistosomiasis in a warmer future China.