Objective:To construct an integrated medical care service mode in hemodialysis and explore the application effect of the concept of integrated medical service in hemodialysis patients.Methods:In 2016,100 patients who had regular hemodialysis(lasting for more than 3 months) were selected from July to Septembe ras the control group,while another100 patients who had the regular hemo dialysis (lasting for more than 3 months) and received the concept of integrated medical care service were selected from October to December as the observation group.The treatment compliance,the incidence of hemodialysis complications,and patient satisfaction of twogroups were compared.Results:Both the treatment compliance and patient satisfaction of the participants in the observation group were significantly higher than those in the control group (P ＜ 0.05),while the incidence of hemodialysis complications in the observation group was significantly lower than that in the control group (P ＜ 0.05).Conclusion:The implementation of integrated medical careservice concept can fully deepen the service concept of people-oriented and patient-centered,carry out humanized services,improve the treatment compliance of hemodialysis patients,reduce the complications,promote the cooperation of doctors and nurses,enhance the effect of health education,and improve the patient satisfaction.

Objective To obtain cDNA fragment of CYP6 gene from Anopheles anthropophagus. Methods The degenerate RT-PCR technique was used to amplify the CYP6 mRNA from susceptible and deltamethrin-resistant strains of An.anthropophagus. The specific cDNA fragments were sequenced and analyzed. Results The 250 bp specific cDNA fragments of CYP6 gene from both susceptible and resistant strains were cloned and sequenced by the Direct Cloning Method. Total of 10 sequences, including 2 from susceptible strain and 8 from resistant strain, were obtained. Compared with P450 sequence databases from GenBank, all of the 10 sequences obtained were new P450 sequence and were lodged in GenBank (Accession numbers: AY273927-AY273936). According to being checked up by Nomenclature Committee of Cytochrome P450, 7 of them were confirmed as the new CYP6 genes and the others were alleles and all of them belonged to the subfamilies CYP6Z, CYP6P, CYP6N and CYP6M in CYP6 family, respectively. Conclusion The cloned 10 sequences are gene fragments from members of CYP6 family.[

Objective To study the relationship between P450 (CYP6 and CYP4) genes and deltamethrin resistance in Anopheles anthropophagus. Methods The real-time RT-PCR technique was used for semi-quantitative analysis of mRNA copy numbers of CYP6 and CYP4 gene from susceptible and deltamethrin-resistant strains. Results It is found that the mRNA copy numbers of CYP6 gene in deltamethrin-resistant strain were about 1. 39 times higher than those in susceptible strain, and the mRNA copy numbers of CYP4 gene in deltamethrin-resistant strain were about 3. 63 times higher than those in susceptible strain of Anopheles anthropophagus. Conclusion The higher expressions of CYP6 and CYP4 mRNA are observed in deltamethrin resistance strain and indicate that both CYP6 and CYP4 genes may be involved in the deltamethrin resistance in Anopheles anthropophagus.

ObjectiveTo observe the effectiveness of Responsar against Anopheles sinensis and Anopheles anthropophagus. MethodsThe cotton and nylon gauze absorbing Responsar solutions of 10,15 and 20 mg/m~2 (effective dosage) were used in the test. An. sinensis and An. anthropophagus raised in the lab were used as probational worms, having the knockdown power, lethiferous power and effective keeping observation. ResultsWith Responsar of 10,15 and 20 (mg/m~2) impregnating two different kinds of bednets, the KT_(50(s)) of An. sinensis and An. anthropophagus were between 3.98 and 7.30 min after touching the bednets. The knocked down mosquitoes were resumed breeding for 24 h, and the mortality was 100%. Touching nets 3 min, resuming breeding for 24 h, the mortality of mosquitoes was more than 90%. The nets hung for 180 d after impregnated with the insecticide and the knockdown power was still between 8.57 and 16.31 min for Anopheles vector, and resuming breeding for 24 h, the mortality was still 100%. ConclusionThere is strong deadly effect of Responsar to Anopheles sinensis and Anopheles anthropophagus, and the effect can keep more than 180 d.

Objective To analyse the epidemic characteristics and control measures of malaria in Jiangsu Province during the past fifty years, evaluate the control effect and explore the current appropriate control strategy and measures. Methods The historical data about malaria cases and control measures from 1951 to 2008 in Jiangsu Province were collected, and the effects of malaria control in different stages were assessed. Results The integrated control measures with emphasis on the control of infectious source were adopted during the stage of two outbreaks of malaria. In the stage of basical elimination of malaria, the comprehensive measures with emphasis on the vector control in the areas of Anopheles anthropophagus were adopted, and the measures with emphasis on the surveillance of infectious source surveillance and early treatment of malaria in other areas were adopted. In the stage of consolidation, the measures including the surveillance of infectious source and management, surveillance of vector and epidemic situation, management of floating population, etc, were adopted. The malaria incidence dropped from 2 495/10 000 in 1960 to 0.09/10 000 in 2008, and was under 1/10 000 in all the counties of Jiangsu Province during the past 2 years, which demonstrated the various measures were feasible and effective in different stages of malaria. Conclusions Malaria has been controlled effectively in Jiangsu Province, however, the improvement of early diagnosis and norm treatment of malaria cases, the enhancement of health education and promotion, as well as the malaria surveillance and management among floating population, are still necessary for achieving the goal of malaria elimination.

Objective To observe the residual effect of Demand CS - impregnated bednets to Anopheles sinensis.Methods The numbers of adult mosquitoes which were knocked down at every minute after treatment were observed by using the enforced contact method recommended by WHO,and the mortality of mosquitoes tested after 24 h was calculated.Results The Kt_(50) of Demand CS - impregnated bednets with impregnations concentrations of 10,15,20 mg/m~2 to Anopheles sineasis were 21.40,16.20,15.70 min,respectively,and the 24 h mortality was 100%.The Kt_(50) of Responsar SC (12.5 % Beta - cyfluthrin) impregnated bednets with a impregnation concentration of 15 mg/m~2 to Anopheles sinensis was 16.06 min,and the 24 h mortality was 100%,too.Conclusions Both the Demand CS - impregnated bednets and the Responsar SC impregnated bednets can kill Anopheles sinensis.

Objective To establish a fast and sensitive method to detect Plasmodium sporozoites in mosquitoes. Methods Anopheles anthropophagus (An.a) artificially infected with Plasmodium vivax (P.v), Anopheles dirus (An.d) infected with Plasmodium falciparum (P.f) and both of P.v and P.f, field mosquitoes of Anopheles sinensis (An.s) captured in epidemic seasons were detected by nested-PCR. Results The results of 28 batches of An.a infected with P.v, 2 batches of An.d with P.f and 1 batch of An.d mixed with P.v and P.f by nested-PCR were accorded with the microscopical examination absolutely. Two positives of 589 An.s field mosquitoes were discovered with a positive rate of 0.34%. Conclusion The nested-PCR is fast and sensitive for detecting different species of Plasmodium in mosquitoes.

Objective To compare the growth of Plasmodium vivax in Anopheles sinensis(An.s) and Anopheles anthropophagus(An.a) during the periods of malaria clinic attack and diapause. Methods The blood samples of patients during the clinic attack and diapause of vivax malaria patients in the vivax epidemic area in China were collected, feeding the mosquitoes of An.s and An.a by using the artificial membrane feeding system in vivo in the lab, and the mosquitoes were dissected during the day 7-9th and 14th after the infection and the oocysts and sporozoites in the stomach and gland of the mosquitoes were counted, respectively. Results The oocyst positive rate in An.s fed by Plasmodium vivax during the fever stage was lower than that in non-fever stage, the sporozoite positive rate in An.a fed by Plasmodium vivax during the fever stage was lower than that in non-fever stage. The positive mosquito rate with oocyst and sporozoite infected by Plasmodium vivax in the fever stage to An.s and An.a were lower than those in non-fever stage. The infective sporozoite intensity of An.s fed by Plasmodium vivax in the fever stage was lower than that in non-fever stage, but the reverse result was found to An.a. Conclusion There is a significant difference between the periods of malaria clinic attack and diapause of the oocyst and sporozoite infection to An.s and An.a.

Objective To compare the susceptibility of Anopheles anthropophagus from Jiangsu, Guangdong and Liaoning provinces in China to Plasmodium vivax.Methods The blood samples of patients with P. vivax in endemic areas of China were collected to feed the mosquitoes of An. anthropophagus from different areas by using the artificial in vitro membrane feeding system in the lab, and then the mosquitoes were dissected during the 7-9th day and on the 14th day after the feeding and the oocysts and sporozoites in the stomach and salivy gland of mosquitoes were counted. Results The mosquitoes from Jiangsu, Guangdong and Liaoning were simultaneously fed with the blood of 35 cases of P. vivax. The oocyst positive rates of An. anthropophagus from Jiangsu, Guangdong and Liaoning during the 7-9th day after the feeding were 68.57%, 60.00% and 68.57%, as well as the sporozoite positive rates of them on the 14th day after the feeding were 22.86%, 14.29% and 22.86%, respectively. On the 7th day after the feeding, 228, 235, 228 mosquitoes of An. anthropophagus from Jiangsu, Guangdong and Liaoning were dissected, and the positive mosquito rates with oocyst infection were 28.07%, 25.11% and 26.75%, respectively. On the 14th day after the feeding, 150, 142, 135 mosquitoes of An. anthropophagus from the three areas were dissected, the positive rates with sporozoite infection were 10.67%, 8.45% and 11.85%, respectively. The num-bers of mosquitoes dissected with infective grade("+","++","+++","++++") of sporozoites of An. anthropophagus from Jiangsu, Guangdong and Liaoning were 4, 3, 2, 7; 2, 2, 3, 7 and 1, 6, 3, 8, respectively. Conclusions An. anthropophagus from Jiangsu, Guangdong and Liaoning is susceptible to the parasites of Plasmodium vivax and there is no significant difference among the susceptibilities of An. anthropophagus from the three areas to Plasmodium vivax.

Objective To analyze the genetic characteristics of deltamethrin resistant strain of Anopheles anthropophagus. Methods The study was performed with LC-P curve method for the genetic mode of deltamethrin resistant of An. anthropophagus. Results The resistant coefficient of F_1 generation from cross and reciprocal cross were 15.19 and 16. 66 respectively. The LC-P curve of F_1 generation got near to that of resistant parents (D=0.651). There were no obvious platforms in 50% mortality of BC generation and 25% - 75% mortality of F_2 generation.There were significant differences between the determining curve and theoretical cure in both BC and F_2 generations, P