Schistosomiasis is closely related to natural environmental factors. The changes of environmental factors such as temperature hydrology vegetation soil etc. all impact the scope and extent of schistosomiasis transmission. Poyang Lake is the largest freshwater lake and one of the major endemic areas with schistosomiasis in China. With global warming the imple-mentation of the Three Gorges Dam operation and the Poyang Lake Ecological Economic Planning the natural environment in Poyang Lake area has been and will continue to change especially the water environment and climate environment which are more closely related to the schistosomiasis transmission. These changes to some extent have affected and will continue to affect the prevalence and transmission of schistosomiasis. This article reviews the relationship between the natural environment and its changes and schistosomiasis transmission in the Poyang Lake region.

This report analyzes the status of schistosomiasis epidemic,surveillance and challenges in transmission?interrupt?ed areas of Jiangxi Province. There are 24 schistosomiasis transmission interrupted counties(cities,districts)among 39 endem?ic counties(cities,districts). Among the 24 counties,there are 6 counties with Oncomelania hupensis snails and 461 villages endemic,with 1.29 million residents. Since 2009,there have not been acute and chronic cases of schistosomiasis and all the pa?tients are historical advanced schistosomiasis cases. The area with snail habitats is 37.02 hm2. Since 2015,the schistosomiasis surveillance has covered the entire transmission interrupted areas. However,there are still many challenges,such as endemic in?stability,weak surveillance capacity,lack of surveillance awareness and other issues. Towards the schistosomiasis elimination, the surveillance should be based on the snail monitoring mainly,supplemented by the mobile population monitoring,and in ad?dition,the capacity building,standardized report of endemic,and snail habitat reform should also be further strengthened.

Objective: Through comparing the hospitalization costs of total knee replacement (TKR) in People’s Hospital of Peking University in 2005 and 2010, to investigate the changing status of hospitalization costs on this operation and the impact of clinical pathway ( CP ) on controlling the hospitalization costs during 5 years , and provide references for controlling medical treatment cost reasonably. Methods: The patients are grouped into undergoing unilateral and bilateral TKR. The total hospitalization cost and cost of each category during 5 years are compared, and SAS 9.2 statistic software is applied to deal the data. Results: Compared with 2005, the total cost for TKR in 2010 decreased. All the charging items decreased, except implant material increased, especially the cost of surgery, hospital room, nursing and pharmacy. Specific to one knee replacement group and both knees replacement, the changing trend of cost is coincident with the total cost. Conclusion: The total cost for TKR in 2010 was lower than that of 2005, which might be the result of adopting CP since 2010. Nevertheless, the implant material cost accounted large proportion of hospitalization cost in 2010, and it has obvious increasing trend compared to 2005. This result is related the increasing application of the new edition of Artificial knee joint prosthesis. Controlling implant material cost is the effective method of decreasing medical costs for TKR.

Objective On the basis of the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ), to establish and appraise a new prognostic evaluation system for elder patients with respiratory failure undergoing mechanical ventilation in order to predict hospital mortality in the respiratory intensive care unit. Methods Two hundred and thirty-eight senile patients with respiratory failure having had mechanical ventilation during their hospitalization were retrospectively analyzed. Patients were randomly divided into 2 groups: model group (n=138) and validation group (n=100). Data of model group were analyzed by monofactorial and multifactorial regression analysis to screen the risk factors. Risk factors were given numerical values according to different grades, and complementary scoring system was then established. APACHE Ⅱ system was combined with complementary scoring system with Logistic multiple regression to form SRFMV system, a special evaluation system for the senile patients with respiratory failure undergoing mechanical ventilation. One hundred patients from validation group were evaluated by both SRFMV system and APACHE Ⅱ system, and the results were then compared to assess the validity and reliability of SRFMV system. Oxygenation index, positive end expiratory pressure (PEEP), tidal volume, phlegm quantity and character, and pulmonary auscultation were selected to serve as standard for complementary scoring system. Mortality equation was set up with logistic multiple regression analysis. Results The predication sensitivity and specificity evaluated by SRFMV system in validation group (0.878 and 0.821, respectively) outstripped that evaluated by APACHE Ⅱsystem (0.818 and 0.771, respectively); the area under ROC curve in SRFMV system and the X2 value in Lemesshow-Hosmer statistic (0.911 and 13.77, respectively) also outstripped that in APACHE Ⅱsystem (0.860 and 11.808, respectively). Conclusions SRFMV system is of better sensitivity and specificity, in which the prediction of mortality is closely consistent with the reality. SRFMV system can be applied to obtain valid predictions of relevant outcomes in senile patients with respiratory failure underwent mechanical ventilation.

The article clarified, according to the recent research results which have been done in Poyang Lake region of Jiangxi province, bovines are the most important animal hosts of Schistosoma japonicum and infected bovines are main infectious sources of Schistosomiasis in Poyang Lake region. Spring (March to June) is the " cross transmission stage" between definitive host and intermediate host, that is, spring is not only the susceptible season of infection for livestock and human, but also is the susceptible season of infection for snails. In flood season (July to August), the transmission of Schistosomiasis between livestock and snails belong to " low level phase" . Autumn (September to Octber) is the second seasonal peak of cercariae and is the susceptible season of infection for livestock and human. Winter(November to Feburary in next year) is the non- susceptible season of infection. Most of the susceptible zones of infection for livestock, human and snails are the marshlands near the endemic villages.

Objective To investigate the testing capabilities of clinical transfusion laboratories in medical institutions in Beijing for the regulatory authorities to formulate administrative policies in this regard.Methods Experts assigned by Beijing Clinical Transfusion Quality Control Center made on-site inspections at the transfusion laboratories in medical institutions using quality control products.They recorded the complete testing process of the operators as well as the instruments,detection reagents in use and the testing results,with statistics and analysis made to the data so collected.Results The pass rate of these on-site inspections was lower than that of the external quality assessment.Some laboratories failed to complete the testing of the quality control products in time and the actual operations in some laboratories were inconsistent to the guidelines.55.9％ of level Ⅰ hospitals and 25.6％ of level Ⅱ hospitals were found with insufficient and inadequate instruments and process layout to meet the needs of clinical blood transfusion.Some of the technicians were found without sufficient trainings in their professional knowledge and basic skills,resulting in their poor competence against emergency cases and weakness in independent problem solving.In addition,the records of detection process and results were found to be substandard.Conclusions Transfusion laboratories in Beijing need to improve their testing capabilities in general.

Objective To construct the prokaryotic expression and purification protocols for Pseudomonas aeruginosa type E flagellin (FlgE) and to study its bioactivity.Methods With analysis of Pseudomonas aeruginosa flagellin FlgE sequences,the whole-length FlgE gene was amplified from Pseudomonas aeruginosa genomic DNA by using PCR and primers with proper restriction enzyme sites.The amplified FlgE fragment and prokaryotic expression plasmid pET24a were digested with Nde Ⅰ and Hind ⅢⅣ respectively.The target fragment and vector were recovered and ligated to obtain the recombinant plasmid pET24a-FlgE.DNA sequencing of positive clone confirmed that the target gene and the junctions with vectors were all correct.The plasmid pET24a-FlgE was transformed into BL21 bacteria.The culture conditions like temperature,rotation speed,inducer concentrations,time length were optimized to achieve maximal expression of the target recombinant FlgE with 6×His tag at C terminal.FlgE-His proteins were purified using His-Trap affinity chromatography columns and identified by SDS-PAGE.The purified proteins were further subjected to endotoxin elimination with proper kits.The purified recombinant FlgE was added to cultured corneal epithelial cells for 4 h and the expression of several inflammation-related molecules was examined by using real-time quantitative PCR.Results The recombinant plasmid pET24a-FlgE was successfully constructed and high level FlgE expression was achieved in BL21 with rotation at 16℃ and 1 mmol/L isopropyl-β-D-glucopyranosyl-galactosidase induction for 20 h.Purified recombinant FlgE-His was obtained and used for primary bioactivity assay.After treatment of corneal epithelial cells with 20 μg/ml FlgE for 4 h,the expression of inflammatory cytokines IL-6,IL-8 were significantly increased.Inactivation of the FlgE with ethanol abolished its stimulatory activity.Conclusion The prokaryotic expression and purification system for recombinant Pseudomonas aeruginosa flagellin FlgE was set up,and the recombinant FlgE stimulated the expression of inflammatory factors in corneal epithelial cells.

Objective To investigate the mechanism of different HLA-G isoform mRNA patterns in different cells alters its cell membrane expression.Methods RT-PCR was used to analyze HLA-G isoform mRNA(HLA-Gl-6)of ovarian cancer cell lines HO-8910,HO-8910PM and OVCAR-3,leukemia cell lines Jurkat,K562,HIJ60,MUTIZ-1,and the chorioeareinoma cell lines JEG-3,JAR.HLA-G between cellular membrane and intracellular expression were analyzed by flow cytometry.Results All HLA-G mRNA isoforms were observed in the positive control cell line JEG-3,but none in the negative control cell line JAR.HLA-G1 isoform mRNA was expressed in HO-8910,HO-8910PM,OVCAR-3,MUTZ-1 and Jurkat cells.HLA-G2 mRNA was not detected in any cell line but JEG-3.HLA-G3 mRNA was found in HO-8910,HO-8910PM,K562,HIJ60,MUTZ-1,OVCAR-3 and Jurkat cells.HO-8910,HO-8910PM,HIJ60,Jurkat cells expre8sed HLA-G4 mRNA.Only the Jurkat cells expressed HLA-G5 mRNA.FACS results showed that JEG3 and HO-8910PM cells membrane expressed HLA-G,however,the intraeellular HLA-G expression was detected in all tested cells except the negative control cell JAR.Conclusion Only the HLA-G1 isoform could be exDressed on cell membrane in particular cell lines. Other isoforms including HLA-C2,-G3,-G4,-G5 and HLA-G6 could not reach cell snrface.

Objective To investigate the status of self-care ability and cognition among disabled elderly,and to analyze the relationship between self-care ability and cognition,then analyze their influencing factors.Methods A total of 813 disabled elderly accepted long-term care at community or facility were recruited by stratified sampling method and investigated by socio-demographic questionnaire,activities of daily living and short portable mental status questionnaire.Results The total scores of self-care ability of the long-term care disabled was 32.01±11.59,and the total points of cognition was 3.77±3.24.Disabled elderly with severe disorders of self-care ability had a higher obstacle rate in every cognition ability than those with mild disabilities (P＜0.001).There were differences in orientation and memory function with different persistent disabled time (x2 =11.875,14.758,P＜0.01).Disabled elderly with cognition obstacles have a higher obstacle rate in every self-care aspect than those with normal cognition (P＜0.01).The multiple regression analysis showed that the educational level (β=-0.067),arital status (β=-0.071),disabled persistence time (β=0.121),orientation ability (β=0.403),the amount of cognition obstacles (β=0.443) were the influence factors of Basic Activities of Daily Living(BADL) among disabled elderly ; and disabled persistence time (β=0.116),orientation ability (β=0.417),recalled ability (β=0.275),memorial ability (β=0.189),calculative ability (β=0.257),the amount of cognition obstacles (β=0.358) were the important factors influence Instrumental Activities of Daily Living(IADL).Conclusion The self-care ability and cognition of the long-term care elderly were declining sharply,and influencing each other.It is advisable to offer them direct long-term care service combined with the laws and characteristics of cognition and self-care ability.

Objective:To observe the clinical efficacy of CAD/CAM all-ceramic onlay in the restoration of molars with extensive defect after root canal therapy(RCT).Methods:260 molars with extensive defect were restored by all-ceramic onlay after RCT.The patients were followed up for 18 months.The restoration effects were assessed using USPHS criteria.Results:The success rate of CAD/CAM all-ceramic onlay was 98％.Restoration exfoliation was found in 3 cases,fractured in 2 cases.Conclusion:CAD/CAM all-ceramic onlay can be applied in restoring extensive postenor tooth-defection after RCT.