Objective To analyze the schistosomiasis endemic situation and understand its transmission trend in Jiangling County from 2004 to 2013 so as to improving the schistosomiasis control. Methods The relevant data of schistosomiasis were collected and analyzed statistically in Jiangling county from 2004-2013. Results The human prevalence of schistosomiasis was decreased from 10.22%in 2004 to 0.63%in 2013 with the descend rate of 93.84% and the notable descend rate was 76.92%from 2009-2013. The cattle infection rate was decreased yearly from 7.59%in 2004 to 0 in 2013. The appearance rate of frames with living Oncomelaniahupensissnails and the infection rate of snails reduce by 17.53%and 100%respectively. Conclusions Af?ter 10?year control the endemic situation of schistosomiasis in Jiangling County decreases and is at a low level. However the risk factors of transmission still exist. Therefore the comprehensive control measures still should be enhanced continuously.

Objective To investigate the tempo?spatial patterns of schistosomiasis in Jiangling County,Hubei Province,so as to identify the risk areas and provide the scientific evidence in following intervention plans for marshland epidemic areas in the stage of transmission control. Methods The schistosomiasis epidemiological data in Jiangling County from 2009 to 2013 to?gether with the related geographical information were collected and analyzed. The tempo?spatial distribution patterns were ana?lyzed by the spatial autocorrelation analysis and spatial clustering analysis. Results The human infection rate was decreased from 2.15%in 2009 to 0.63%in 2013,which was the historically low level. The results of tempo?spatial analysis showed that there were spatial clustering effects in human schistosomiasis infection for each of the years. The values of spatial autocorrelation index Moran’s I were statistically significant. Eighteen and thirty?five clusters were detected by using SatScan and FlexScan soft?ware,respectively. Conclusions From 2009 to 2013,the schistosomiasis endemic situation in Jiangling County presented a decline trend and reached the historical low level. The identified spatial clustering areas should be targeted as the prioritized ar?eas for schistosomiasis control.

Objective To build a high quality diagnosis system for schistosomiasis surveillance in the situation of low infec-tion in Jianglin County. Methods The network laboratory for schistosomiasis diagnosis was built according to the national crite-ria in Jianglin County in 2012. Results The network laboratory for schistosomiasis diagnosis was established successfully and the operation was quiet well. Conclusion The establishment and operation of the laboratory play an important role in the real-ization of schistosomiasis elimination.

Objective To evaluate the efficacy of routinely used pattern for schistosomiasis diagnosis in lake and marshland regions. Methods A historically heavy endemic village of schistosomiasis named Jinggan Village from Jiangling County was se?lected for field survey. The residents aged 6?65 years were screened by indirect hemagglutination assay(IHA)and dipstick dye immunoassay(DDIA)in parallel. The serological positives were examined by Kato?Katz technique and miracidium hatching technique to determine the infection of schistosome. The consistency of the two serological methods was evaluated. In addition , the schistosome infection rates were estimated according to the 3 detection patterns namely IHA,DDIA,IHA+DDIA combined with the etiologic examination. Results A total of 530 individuals were examined by the serological tests. The positive rate of DDIA was 46.98%(249/530),significantly higher than that of IHA(28.49%,151/530)(χ2=59.55,P<0.01). Totally 279 in?dividuals were serological positives determined by IHA or DDIA,while 252 of them were detected by stool examination,and 22 cases were determined as parasitological positives,while 7 and 3 cases were diagnosed as antibody negatives by IHA and DDIA,respectively. The estimated infection rates determined by IHA,DDIA,IHA plus DDIA combined with stool examination were 3.14%,3.97%、4.60%,respectively. Conclusions Under the condition of endemic situation becoming more and more waning,the current routinely used pattern for schistosomiasis detection may lead to missed diagnosis. So,more sensitive and ef?fective diagnostic tools or appropriate detection patterns need to be explored.

Objective To understand the spatial distribution characteristics of wild feces in schistosomiasis endemic areas of Jiangling County,Hubei Province and further explore the source of infection efficiently,so as to provide the evidence for the development of corresponding monitoring and response technology. Methods In 2011,the fresh wild feces were investigated every two months in the selected 15 villages by the severity of historical endemic in Jiangling County. The schistosome miracidi-um hatching method was used to test the schistosome infection of the wild feces. The descriptive analysis and spatial analysis were used for the description of the spatial distribution of the wild feces. Results Totally 701 wild feces samples were collected with the average density of 0.0556/100 m2,and the positive rate of the wild feces was 11.70%(82/701). The results of the re-gression analysis showed a positive spatial correlation between the positive rate of wild feces and the rate of human infection,the area with infected Oncomelania hupensis and the number of fenced cattle,and the corrected R2 of the model was 0.58. Conclu-sion The infection rate of wild feces is positively correlated with the rate of human infection,area with infected O. hupensis and number of fenced cattle in space in Jiangling County,so the prevention and control measures could be conducted according to the spatial distribution of the positive wild feces.

Objective To observe the Oncomelania hupensis snail control effects of molluscicides with different formula?tions in the ditch with unstable water level in field of marshland and lake areas,so as to provide the evidence for formulating the prevention strategies. Methods A drainage channel with O. hupensis snails in Jiangling County,Jingzhou City were selected as the study field,then it was divided into 6 segments,except 1 segment was treated as the blank control group for observing the natural mortality rate of the snails,the other 5 segments were treated as observation groups,where 4% niclosamide ethanol?amine salt powder,5%niclosamide ethanolamine salt granule,25%suspension concentrate of niclosamide ethanolamine salt, 26% suspension concentrate of metaldehyde and niclosamide ethanolamine salt,50% niclosamide ethanolamine salt wettable powder were applied respectively. Before and after the mollusciciding,the snail surveys were carried out through the systematic sampling method,and the short?and long?term effects of snail control were observed,and the mortality rates of the snails on the slope above the water level and those below the water level were compared. Results When 7 d and 15 d after mullusciciding, the mortality rates of snails on the slope above the water level in each observation group were 79.52%-97.87% and 90.43%-96.30%,respectively,when compared with those before mollusciciding,all the differences were statistically significant(all P<0.01). When 7 d after mullusciciding,the mortality rates of snails below the water level in each observation group were 17.11%-50.00%,which were all lower than those of the snails on the slope above the water level in the corresponding groups(all P<0.05);when 15 d after mullusciciding,the rates were 9.43%-95.24%,and those in 25%suspension concentrate of niclosamide ethanolamine salt,26%suspension concentrate of metaldehyde and niclosamide ethanolamine salt,50%niclosamide ethanol?amine salt wettable powder groups were all lower than those of the snails on the slope above the water level in the corresponding groups(all P<0.01). Compared with the densities of living snails before mollusciciding,those 6 months after mollusciciding in each observation group decreased by 70.21%-78.98%. Conclusions The molluscicides in the formulation of powders and granule are suitable for both the snail environment with or without water,while those in the formulation of suspension agents and wettable powders are suitable only for environments with water.

Objective To implement a two?level community?based health education pattern of schistosomiasis in residents of endemic areas in marshland and lake regions,so as to explore the suitable pattern of health education under hypo?endemic situa?tion. Methods Two schistosomiasis endemic villages in Jiangling County,Hubei Province were collected as study areas,and among which,one village was treated as an intervention group,where the two?level community?based health education pattern as well as regular control measures was implemented;the other village was a control group,where only regular control measures were implemented. The awareness rates on schistosomiasis control,the rates of correct behavior and the compliance rates of ex?amination,treatment and chemotherapy of the two groups before and after the intervention were compared. Results According to the results of the baseline survey in 2014,the awareness rates of schistosomiasis control of the intervention and control groups were 84.00%and 77.45%,respectively,the correct rates of behavior of the two groups were 72.00%and 63.73%,respectively, and the compliance rates of the treatment were 80.36%and 82.28%,respectively,there were no statistically significant differ? ences between all the above rates of the two groups(all P>0.05). After the intervention of the two?level community?based health education,the correct rates of behavior,and the compliance rates of examination and chemotherapy of the two groups were 92.31%and 80.37%,95.11%and 82.55%,84.13%and 63.64%,respectively,and the differences between all the rates above of the two groups were statistically significant(all P<0.05). When compared to those before intervention,the growing rates of the compliance rates of examination,treatment and chemotherapy of the intervention group were 20.97%,15.33%and 23.29%, respectively,while those of control group were 14.27%,4.17%,-3.77%,respectively,the growing rates of the intervention groups were higher than those of the control groups. Conclusions Through the two?level community?based pattern of health edu?cation,the compliance rates of examination and treatment of the residents have improved,and therefore,the pattern is suitable for popularization and application in marshland and lake regions.

Objective:To explore the changes of serum levels of copeptin and α-amylase and their correlations with sleep and cognition in patients with chronic insomnia (CI).Methods:From September 1, 2018 to May 31, 2019, fifty CI outpatients or inpatients from the Department of Sleep Disorder, Affiliated Chaohu Hospital of Anhui Medical University, were enrolled continuously, and thirty good sleepers from the Physical Examination Center of the hospital, were also enrolled to serve as controls. Pittsburgh Sleep Quality Index (PSQI), polysomnography (PSG) and Pre-Sleep Arousal Scale (PSAS) were used to assess the insomnia severity and sleep disorder susceptibility. Montreal Cognitive Assessment scale (MoCA) and Nine-Box Maze were used to respectively assess general cognition and memories. The serum levels of copeptin and α-amylase were detected using enzyme linked immunosorbent assay.Results:Compared to the controls, the CI patients had increased PSQI score (16.0 (15.0, 17.0) vs 4.0 (2.8, 6.0); Z=-7.678, P<0.001) and PSAS score (33.0 (30.0, 37.5) vs 17.0 (16.0, 18.5); Z=-7.350, P<0.001), decreased MoCA score (24.1±2.5 vs 26.7±1.9, t=-4.625, P<0.001), increased numbers of errors in the object working (1.0 (0, 1.0) vs 0 (0, 1.0), Z=-2.099, P=0.036), spatial working (2.0 (1.0, 4.0) vs 1.0 (0, 2.0), Z=-3.935, P<0.001) and object recognition (1.0 (0, 2.0) vs 0 (0, 0), Z=-2.266, P=0.023) memories, and elevated serum levels of copeptin ((35.1±19.9) pg/ml vs (14.8±6.9) pg/ml, t=5.414, P<0.001) and α-amylase ((990.1±193.7) U/L vs (728.9±230.5) U/L, t=5.597, P<0.001). In the CI patients, the level of copeptin was positively correlated with PSQI score ( r=0.338, P=0.013), PSAS score ( r=0.316, P=0.021), sleep latency ( r=0.324, P=0.018), number of awake ( r=0.325, P=0.017) and stage 1 percent of non-rapid eye movement sleep ( r=0.278, P=0.044), and negatively correlated with stage 2 percent of non-rapid eye movement sleep ( r=-0.279, P=0.043); α-amylase was positively correlated with numbers of awake in PSG ( r=0.293, P=0.033). Multiple linear regression analysis showed that copeptin level affected PSQI score (β=0.255, P=0.043) and sleep latency (β=0.254, P=0.043). Conclusion:The levels of copeptin and α-amylase in CI patients elevate, and copeptin may be associated with initial sleep difficulties, but not with cognitive ability, in patients with CI.