Objective To investigate the current situation of management of institutions of schistosomiasis prevention and control in Hubei Province so as to explore the probable competency building standards for these institutions at the county and township levels. Methods By using a combination of quantitative and qualitative methods the institutions of schistosomiasis prevention and control at county and township levels were investigated for the institutional setup staffing and fulfillment func-tions since the reform of 2004. Results Among 63 schistosomiasis endemic counties cities districts of Hubei Province there were 26 independent schistosomiasis control institutions 41.27% there were 24 institutions which were incorporated in-to CDC 38.10% and there were no institutions in 13 counties 20.63% . Among 518 endemic towns there were 299 institu-tions 57.72% . The total staffing size were 1 932 but there were 1 586 82.09% people actually working in the post and therefore there were 346 17.91% empty positions. The average rates of carrying out the six functions were 91.48%-71.19%but only 19.23%of the institutions participated in the comprehensive schistosomiasis control management project and its effect assessment. Conclusion According to the management model for schistosomiasis control institutions under the current institu-tional mechanisms we need a rigorous industry standard to constrain guide and standardize the management and capacity-building of the institutions in different historical periods.

Objective To understand the human resources of the grassroots institutions of schistosomiasis control and pre?vention so as to provide the evidence for formulating the standards of institutional capacity?building. Methods By using the combination of quantitative and qualitative methods the hierarchy of schistosomiasis control institution workers structural fea?tures of workers and benefits of workers were investigated and the results were analyzed statistically after the 2004 reform. Re?sults The constituent ratios of personnel≤30 years old 30 to 45 years old and≥45 years old were 6.8% 64.0%and 29.2%respectively with an average age of 43.1 years. For education levels 61.35%of the personnel had secondary or high school lev?els. At the city level the structural proportion of the senior professional medium professional and primary professional titles was 1.4∶5.6∶3.0 and at the county level the proportion was 0.5∶6.1∶3.4. There was 14 200 yuan per capita at the township schistosomiasis control institutions. Conclusion The technology of the personnel in schistosomiasis institutions of Hubei Prov?ince is weak the average age of personnel is old and the salary is low.

Objective To explore the significance of MYCN gene amplification in children with neuroblastic tumors(NT).Methods The clinicopathological data of 154 cases with NT were reviewed,including general data, classification of pathology,clinical stage and prognosis.MYCN gene amplification was detected by fluorescence in situ hybridization(FISH) and its relationship between pathological characteristics and prognostic significance was analyzed.Results There was 154 cases of NT aged 1 day to 11 years,with a mean age of 26.1 months,and the median age of 20.5 months.Male and female ratio was 1.48 : 1.00.According to International Neuroblastoma Staging System (INSS) ,20 cases were of stage Ⅰ (13.0％) ,23 cases of stage Ⅱ (14.9％) ,43 cases of stage Ⅲ (27.9％) ,64 cases of stage Ⅳ(41.6％) and 4 cases of Ⅳs (2.6％).There were 72 cases(46.8％) with favorable histology,and 82 cases(53.2％) with unfavorable histology.MYCN amplification was found in 20 cases (13.0％) and the signal ratio of MYCN and chromosome 2 (CEP2) was 4.08-43.29.One hundred and thirty-four cases of MYCN non-amplification included MYCN gain in 91 cases(68.0％) ,MYCN negative in 43 cases(32.0％).MYCN expression showed the significant differences in ages, neuroblastoma type, international neuroblastoma pathology classification (INPC), mitosis karyorrhexis index (MKI), and clinical stages (all P ＜ 0.05).No significant difference was found in gender(P ＞ 0.05).Of 20 MYCN amplification cases,4 cases (20.0％) survived and 16 cases (80.0％) died,and the overall survival rate was 20.0％ (4/20 cases) ,with survival time was (17.10 ± 2.24) months;of 134 MYCN non-amplification cases,96 cases (71.6％) survived and 38 cases (28.4％) died, with survival time of (28.71 ± 1.28)months.Survival analysis showed the cases with MYCN amplification had worse prognosis (x2 =19.596, P ＜ 0.05).Conclusions Patients with MYCN amplification had poorer prognosis and lower incidence of MYCN amplification of pediatric NT was found in China.

Objective To evaluate the effect of schistosomiasis control in“Oriental Star shipwreck event”in Jianli County, Hubei Province,so as to provide experiences for schistosomiasis prevention and control in rescue of emergency in the future. Methods According to the data of historical schistosomiasis prevalence and the results of the field survey in the townships in the upstream and downstream of the rescue spots,the emergency handling measures of schistosomiasis control were evaluated. Meanwhile,the Oncomelania hupensis snail situation,priority crowd chemotherapy,key aquatic monitoring,and illness moni?toring of people and livestock were investigated to evaluate the schistosomiasis control effect after the events comprehensively. Results There were no schistosome?infected snails found in the place of shipwreck and the rescue spots. The average density of O. hupensis snails in 5 townships of Jianli County was 0.064 snails/0.1 m2 ,and there were no infected snails found. The positive rate of 2 090 migrants in the schistosomiasis serologic tests was 0.29%and there were no positive ones found in the fecal exami?nation. There were no acute schistosomiasis cases found by the sentinel surveillance fever clinics,and also no positive cattle were found. The results of sentinel mice monitoring in the place of shipwreck and 4 villages in the upstream and downstream showed no infected mice were found. Conclusion The schistosomiasis control measures taken after the shipwreck is effective, which achieves the goal of no schistosomiasis transmission after emergency.

Objective To compare the molluscicidal effects between“Luo-wei”(TDS),a plant molluscicide in 4 percent, and metaldehyde and niclosamide(MNSC)in the field. Methods A natural ecological environment with Oncomelania hupensis was selected as the test area,the test concentrations of TDS and MNSC were 2.5 g/m3 and 2 ml/m3 respectively by the immersion method;the test doses of TDS and MNSC were 3 g/m2 and 2 ml/m2 respectively by the spray method;the doses of WPN in a control group were 2 g/m3 and 2 g/m2 respectively by the two methods above-mentioned. The molluscicidal effects between TDS and MNSC were compared by using the synchronous design method and parallel comparative method. Results In the TDS group,the death rate of snails was 90.70%by immersion for 24 hours,reached to 81.40%after spraying for 7 days,and there were no significant differences among the observation time points in molluscicidal effects(P>0.05). One day after the spraying,the death rate of snails was less in the TDS group compared with that in the MSCN group(P<0.01),but the death rates of snails were similar in both groups 3 days after the spraying(P>0.05). In the MSCN group,the death rate of snails was 99.17%by immersion for 24 hours,reached to 66.07% by spraying for 1 day. In the WPS group,the death rate of snails was 97.15% by immersion for 24 hours,reached to 71.43%after spraying for 1 day,and there were no significant differences(both P>0.05). Conclusion TDS has a good molluscicidal activity and stable efficacy,and the molluscicidal effect of TDS is similar to that of MSCN in the filed, but the molluscicidal sensitivity of TDS is lower than that of MSCN.

In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available concerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based recommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P<0.05); but no significant differences were found in the percentages of basic medical services providing between PCHSs and GCHSs (P>0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P<0.05), except for resident health records establishment and health education materials distribution (P>0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.

Objective To investigate the effect of the angle correction factors of ionization chamber array Matrixx on the dosimetric verification of volumetric modulated arc therapy plan.Methods The Matrixx (IBA)was put in the middle of the MultiCube Phantom. Computed tomography scan was performed and the results were sent to the Raystation treatment planning system(TPS). All data calculated from TPS and actually measured using MatriXX were gained under the following conditions:6 MV,100 MU,28 cm×28 cm radiation field. And the directions of beam were from 0°to 180°with an interval of 5°(except an interval of 1° from 85° to 95°). The angle correction factors(CF)(θ)cor of MatriXX were calculated by the calculated dose values from TPS and the measured values using MatriXX and then mirrored to the opposite side. CF (θ)cor values were compared with CF(θ)def values that were given by manufacturer. The comparison was made by paired t-test. Results CF(θ)cor and CF(θ)def were different, and the difference was significant between 85° and 95°,with a maximum of 7.5%(P<0.05). The CF(θ)cor correction method had a higher gamma pass rate than the CF(θ)def correction method,with a maximum of 17%(P<0.05). Conclusions The ionization chamber array MatriXX has an angular dependence and the angle correction should be performed.The angle correction factors have the individual characteristics and are different in every unit ionization chamber of the MatriXX. Therefore, it is necessary to do angle correction for every unit ionization chamber of the MatriXX and the possible errors caused by various factors should be considered in order to improve the accuracy rate and gamma pass rate of the plan verification.

Objective To investigate the value of multi?arterial phase differential sub?sampling with cartesian ordering (DISCO) technique in the evaluation of hepatic vascular anatomy with gadolinium?ethoxybenzyl?diethylenetriamine pentaacetic acid (Gd?EOB?DTPA). Methods Forty?eight patients with suspected hepatic malignancy were prospectively enrolled and underwent both of Gd?EOB?DTPA enhanced DISCO MRI and CTA within two weeks. The hepatic arterial anatomy of two examination methods were evaluated by four?point scoring method. The arterial scores between DISCO and CTA images were compared by Wilcoxon test. The difference among multiple arterial scores of DISCO and CTA were compared by Kruskal?Wallis H test respectively. Results There was no difference of arterial scores in celiac artery, common hepatic artery, proper hepatic artery, left hepatic artery, right hepatic artery, first branch of right hepatic artery, splenic artery, left gastric artery and gastroduodenal artery between DISCO and CTA (P>0.05), but the arterial score of first branch of left hepatic artery [2 (2,2)] was lower than that of CTA [2 (2,3)] (Z=-3.138,P=0.002). In the multiple comparison among different arteries, there were differences between PHA and LAH (P<0.05), B?LHA and B?RHA (P<0.05) in DISCO, but no difference was found in CTA (P>0.05). Conclusion The DISCO sequence with Gd?EOB?DTPA enhancement MRI can supply comparable image quality to CTA in hepatic artery and its main branches display, which has no ionizing radiation and can also provide more diagnostic information for clinic.

In China,with the restructuring of health care system moving forward,private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas.However,only limited evidence is available concerning the service functions of private community health facilities in China.The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based recommendations for policy-making and practice in the development of urban community health services systems.A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs)located in 28 cities of China were investigated in 2008.The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions.The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P＜0.05); but no significant differences were found in the percentages of basic medical services providing between PCHSs and GCHSs (P＞0.05).The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P＜0.05),except for resident health records establishment and health education materials distribution (P＞0.05).At present,the GCHSs are still the mainstream in urban China,which will last for a long period in future.However,our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs,and the PCHSs were willing to provide public health services.In view of current inadequacy of health resources in China,it is feasible to further develop PCHSs under the guidance of the government,given that PCHSs can perform the basic functions of community health services,which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.

Objective:To evaluate the safety and efficacy of endovascular interventional treatment of the intracranial vertebrobasilar trunk large aneurysms (VBTLAs) compared with conservative treatment.Methods:This is a prospective multi-center cohort study. From October 2012 to October 2018, a total of 69 patients with intracranial vertebrobasilar trunk large aneurysm (diameter>10 mm) from Henan Province People's Hospital and People's Liberation Army Rocket Medical Center were included in this study. Patients themselves chose either endovascular interventional therapy (interventional group) or conservative treatment (conservative group) after discussion with their doctors. The χ 2 test was used to compare the incidence of deaths, stroke, and all other serious adverse events including other site bleeding, myocardial infarction and others between the two groups. Results:A total of 69 patients were enrolled, of whom 51 patients were enrolled in interventional group, 18 patients underwent endovascular reconstructive therapy, 11 patients underwent deconstructive therapy, and 4 patients underwent conjunction interventional treatments. Eighteen patients were enrolled in conservative group, of whom 11 cases received simple risk factor control, 7 cases received antiplatelet and risk factors control. The proportions of hypertensive patients 94.4% (17/18) and giant aneurysms 50.0% (9/18) in the conservative group were higher than those in the surgery group 64.7% (33/51, χ 2=4.500, P=0.034), 19.6% (10/51, χ 2=4.730, P= 0.030).The incidence of all serious adverse events associated with protocol was 15.7% (8/51) in the interventional group and 44.4% (8/18) in the conservative group [risk ratio (RR) =0.353, 95% confidence intervals (CI): 0.156-0.801], and the difference was significant (χ 2=4.668, P=0.031). The incidence of fatal events associated with protocol was 2.0% (1/51) in the interventional group and 38.9% (7/18) in the conservative group (RR=0.050, 95%CI: 0.007-0.382), and the difference was significant (χ 2=14.281, P<0.001). The incidence of hemorrhage events associated with protocol was 2.0% (1/51) in the interventional group and 22.2% (4/18) in the conservative group (RR=0.088, 95%CI: 0.011-0.738), and the difference was significant (χ 2 =5.391, P=0.020). Follow-up imaging showed that the occlusion rate of aneurysms in 44 patients in the interventional group was 56.8% (25/44) after a median follow-up of 6 months. Imaging follow-up was obtained in 9 patients, whose occlusion rate of aneurysms was 0 and the median follow-up time was 12 months, in the conservative group. The difference was significant(χ 2 =7.534, P=0.006). Conclusion:Compared with conservative treatment, endovascular intervention of the intracranial VBTLAs has lower incidences of serious adverse events and death events.