A total of 785 individuals from an endemic area of schistosomiasis japonica had parasito-logical and physical examination done. A morbidity questionnaire about symptoms of schisto-somiasis within the past 2wk was also administered to each participant. Among those infected people,there was a significant increase in diarrhea,bloody stool and weakness during the pre-vious two weeks. Hepatomegaly and splenomegaly were related to the history of schistosomi-asis japonica.

Objective To explore the application of amplified fragment length polymorphism (AFLP) in the study of genetic diversity of Oncomelania hupensis. Methods A snail was taken at random from Dali region, Yunnan Province and Yueyang City, Hunan Province respectively, and DNA was drawn with guanidinium thiocyanate and resin et al. Genomic DNA was amplified selectively by the AFLP technique with 64 pairs of primers, and the polymorphism of PCR products was examined by SDS-PAGE. Results The number of AFLP markers was between 5 and 55 for a pair of primers. The average number of a pair of primers was 38.30 (95% CI 36.03-40.57) for the snail from Yunnan Province, and 39.14 (95% CI 36.71-41.57) for the one from Hunan Province. For a pair of primers, the number of amplified polymorphic markers was between 3 and 37, and the polymorphic rate was between 28.6% and 76.2%, the average, 23.67 (95% CI 22.12-25.22) and 47.36%(95 %CI 45.22%-49.50%), respectively. The average similarity between the two populations was 0.69 (95% CI 0.67-0.70). Conclusion The AFLP technique is a new path for classifying Oncomelania hupensis and studying the genetic diversity of it.[

Objective: To evaluate the project performance of public health service system in rural areas during the implementation of China Rural Health Project ( hereinafter referred to asHealth XI Project) . Methods: In this paper, all 40 counties covered by the Health XI Project are selected as case study. This paper uses the performance evaluation index system for rural public health system developed for the project and continuously collect input and out-put indexes between 2008 and 2013 in order to conduct a comprehensive analysis and evaluation. Results: During the implementation of the Health XI Project, the inputs and outputs of the rural public health service system had gradual-ly increased in all the countries covered by the project. The score for inputs and outputs increased from 22. 73 and 39. 05 in 2008 to 32. 62 and 57. 60 in 2013, with a growth rate of 43. 15% and 47. 50%, respectively. The input scores significantly grew faster than output scores in some provinces. The input-output ratio increased from 1. 72 to 1. 77, with slight fluctuations between different years. Conclusion: The application of the performance evaluation index system for public health service system in monitoring project implementation process can help to timely discover the weak links associated with the implementation of rural public health service system, and thus take effective measures to promote the improvement of the system. . When increasing investment in public health, how to efficiently use re-sources and improve the service effectiveness is still an urgent problem.

Objective To study current situation and existed problems in the public health emergency alert and response system so as to formulate more advices to consummate it and help to establish a more reasonable system adapting to our country. Methods A qualitative study was carried out among CDC working staff including two focus group discussions(FGD). Results Although government had put more emphasis on public health,increasing its devotion and strengthening the alert and response capability after SARS outbreak, some problems still existed, such as ① absence of correlative laws and rules; ② lack of government devotion; ③ insufficient utilization of surveillance information; ④ lack of the canonical response guidance. Conclusions With regard to the building up of the public health emergency alert and response system, the following proposals are put forward: increasing payout on public health; consummating the construction of disease surveillance network; affording more education and training to correlative staff engaged in the disease control to improve their abilities.

In order to acquire the information on the changes and improvement after the implementation of National Schistosomiasis Control and Prevention Regulation, a survey was performed. The awareness of schistosomiasis and the regulation, stool management and other related contents were carried out in the rural areas of Jiangsu, Anhui, Jiangxi, Hubei, Hunan, Sichuan and Yunan provinces. The results showed 98.9% of the residents knew about schistosomiasis, 89. 8% knew the regulation, 95. 1% supported the management of drinking water and lavatory, 45.3% used tap water as their ordinary drinking water supply, but there were 47.6% still drank well water, 51.1% used water closet and 40.0% used simple toilet. The work on improving water and sanitary conditions in mountain areas was left behind that in lake areas. It is indicated that there is still a lot we must do to promote the propaganda of the regulation.

Objective To analyze the clinical features of the hospitalized children with laboratory-confirmed influenza in Suzhou. Methods The demographic information, laboratory test results, clinical features, treatments and outcomes of the hospitalized children with laboratoryconfirmed influenza were collected retrospectively. The data were analyzed using chi square test,Cochran-Armitage trend test. Results Four hundred and eighty hospitalized children were diagnosed with laboratory-confirmed influenza during the period of 2005 to 2009. Among these cases, 414 were subtype A and 66 were subtype B. The positive rate was 2.66%. Four hundred and nineteen cases (87.29 %) were ≤ 5 years old. Most of the cases developed during winter (from December to April the next year) and summer (from July to August). The age and sex distribution didn't vary from year to year (x2=9. 7768,x2 = 8. 7573; both P＞0.05). The mean disease course was (16.22± 9.41)days, and the mean hospitalization duration was (7.89 ±2.97) days. The percentages of patients with symptoms of fever, dyspnea and diarrhea or requiring oxygen treatment decreased with age (Z =4. 9430, Z=2. 1021, Z=3. 2073 and Z=2. 3277, respectively; all P＜0.05). The percentages of cases with concomitant pneumonia and upper respiratory infection also decreased with age (Z =-3. 8762 and Z=-3. 5095, respectively; both P＜0.01). Fifteen point five percent (60/387 cases)of the cases were co-infected with pneumococcus and 15. 0% (72/480 cases) were co-infected with respiratory syncytial virus (RSV). The level of C-reactive protein was significantly higher in cases with bacterial co-infection than those with viral co-infection (Z= -3.1290, P ＜ 0. 01 ).Conclusions Hospitalized children with influenza are more common in winter and summer in Shuzhou.Many patients are co-infected with pneumococcus or RSV. The symptoms are more severe in younger children.

With the support of World Bank ( WB ) and UK Department for International Development ( DFID) , China Rural Health Project ( hereinafter referred asHealth XI Project) has successfully covered 40 coun-ties in 8 provinces. With the establishment of community diagnosis and health records as the entry point, hyperten-sion, diabetes and other major chronic diseases as the starting point, and focus on the needs of healthy people, high-risk groups and patients, the project mainly adopts health education and promotion, health management, disease management and other measures to explore the establishment of a new model of rural chronic disease management. By analyzing the monitoring data of chronic diseases in the project zones, this study found that the number of registered and managed patients with hypertension and diabetes increased significantly, from 397,113 and 136,326 in 2009 to 1,500,252 and 388,846 in 2013, respectively. The management rate also increased from 60. 8% and 32. 2% in 2009 to 92. 2% and 88. 8% in 2013, respectively. The results of the 5th National Health Service Survey show that, the control rates for self-reported hypertension and diabetes ((53. 8% and 50. 2%, respectively) in the project zones were significantly higher than the national average in rural areas ( 54 . 9% and 38 . 3%, respectively ) . This paper suggests that, with focus on training, health education, health promotion, health management and disease manage-ment as the core mainline, the chronic disease management model has effectively improved the chronic disease service capabilities in rural areas,. The comprehensive and integrated chronic disease interventions implemented by the pro-ject in the rural areas is practical, and it has value of popularization and application.

Objective To explore the consistency among different indices of abdominal ultrasonography for the diagnosis of schistosomiasis japonica-related morbidity and the best combination of the indices. Methods Six indices of abdominal ultrasonography were selected to investigate schistosomiasis-related morbidity in residents in a village of Hunan Province, and the Kappa coefficients of diagnostic consistency among different indices and Cronbach's alpha coefficients of different combinations of indices were computed. Results The Kappa coefficients of 'liver parenchyma≥gradeⅡ' with 'right midclavicular subcostal' and with 'portal vein diameter' were 0^4131 and 0^4655 respectively, higher than normal level. The degree of their consistency was fair, and others showed poor or almost no consistency. Among the combinations made up of different indices, the Cronbach's alpha coefficient of the combination made up of 'liver parenchyma≥gradeⅡ', 'right midclavicular subcostal' and 'portal vein diameter' was 0^6566 which was the highest, showing the strongest internal consistency. Conclusion The six indices can not be replaced with each other in assessing schistosomiasis-related morbidity. Before abdominal ultrasonography is used extensively to assess the morbidity, it is necessary to study the diagnostic consistency of these indices and the best combination of the indices.

Objective To explore the degree of genetic diversity among populations of Oncomelania hupensis. {Methods AFLP method} was used to amplify the genomic DNA of thirteen snail populations from nine provinces (i.e. Yunnan, Sichuan, Guangxi, Fujian, Hunan, Hubei, Jiangxi, Anhui and Jiangsu) and the genetic diversities among snail populations were analyzed. Results The number of AFLP fragments amplified ranged from 403 to 472 for thirteen Oncomelania populations. Among the thirteen snail populations, the genetic diversity within the population from Xingzi County, Jiangxi Province, was most significant, and the percentage of polymorphic loci, Nei’s genetic diversity and Shannon’s information index were 93^22%, 0^345 and 0^510 respectively, while these indices for the snail population from Yizhou City, Guangxi Region, were the lowest, 55^80%, 0^191 and 0^287 respectively. The similarity between the in-group-individuals from Yizhou City, Guangxi Region, was most significant, and the average coefficient of similarity was 0^904, and that from Dantu County, Jiangsu Province, was the lowest (0^748). The genetic diversities among snail populations were significantly different for the thirteen snail populations ( P

Objective To explore morphologic variations and their spatial correlation among Oncomelania hupensis populations from the mainland of China. Methods Twenty-seven snail populations from ten provinces were collected. The morphologic indices of shells and geographic distances between the snail spots were measured respectively, and the morphologic variations among snail populations and the correlations between morphologic variations and geographical distances were analyzed. Results The median of Euclidean distances was 3.24 (95% CI: 2.88-3.81) among 20 snail populations of O.h.hupensis including a snail population from Guangxi Province, and was 3.15 (95% CI: 2.86-3.76) excluding the Guangxi snail population; the median was 1.69 (95% CI: 1.33-2.27) among 6 populations of O.h.robertsoni. Whether including a snail population from Guangxi Province or not, the median among O.h.robertsoni was less than that among O.h.hupensis (P0.05). The correlation coefficient was 0.2655 for O.h.hupensis including a snail population from Guangxi Province, 0.2567 not including it; and was 0.3121 for ribbed-shell population. Conclusions Morphologic variation among O.h.hupensis is bigger than that among O.h.robertsoni, and morphologic variation among ribbed-shell populations is bigger than that among smooth-shell populations. There is significant spatial structure among ribbed-shell snail populations of Oncomelania hupensis distributed in the mainland of China.