Objective To analyze the current endemic situation of schistosomiasis and evaluate the control effects of the implementation of comprehensive management measures for 4 years,so as to provide references for making control strategy in the next stage. Methods The endemic villages were grouped into categories based on egg positive rates of fecal examinations among villagers. Praziquantel chemotherapy regimens were provided for villagers and domestic animals,respectively. Snail control on the basis of niclosamide was conducted in snail habitat areas in the hilly area and inside embankment in Dongting Lake,and in infected snail distributed areas outside the embankment in the lake. A slow releasing formation of niclosamide were applied for cercariae killing in transmission areas outside the embankment in the lake in the flood season. The modification of snail habitat areas was integrated into the water conservancy and agricultural development projects. The varied health education,safe water supply and disinfestation toilet facilities were provided for residents in the community. Results The infection rate of schistosomiasis in residents dropped by 49.88%,and the estimated patients reduced by 39.62%. Acute schistosomiasis cases significantly decreased. The total number of advanced schistosomiasis cases slightly increased. The infection rate of schistosomiasis in livestock dropped by 66.36% and snail areas reduced by 33.31% as well as no infected snails were found inside the embankment. Yet,the total areas of snail habitats and distributed areas of infected snails slightly increased,with a high density. The first scale of villages and the second scale of villages were lowered into the third or fourth scale of villages. Out of 31 endemic counties (districts,farms),7 reached the criteria of transmission control,24 reached the criteria of infection control. Conclusions The implementation of the comprehensive management measure has achieved the anticipated results of reducing the infection rate of schistosomiasis among villagers and dropping the incidence of acute schistosomiasis. Yet the snail area on beaches outside the embankment slightly increases,with a high density of infected snails and so there is an infection danger there.

Advanced schistosomiasis,encompassing a wide range of pathologic entities and multi-complications,poses a se-rious threat on the patients'health. Through comprehensive analysis and evaluation on related aspects regarding clinical classifi-cation,main methods of auxiliary examination and treatment(including types of surgical procedure)of advanced schistosomia-sis,we think that the individual based multidisciplinary comprehensive treatment according to varying conditions of patients is the most optimal treatment mode of advanced schistosomiasis. It is further proposed that multidisciplinary collaborative diagnosis and treatment system should be undoubtedly established,multidisciplinary case discussions be regularly organized,and treat-ment expert teams be stably formed,in order to significantly improve the level of diagnosis and treatment of advanced schistoso-miasis,so as to reduce the misdiagnosis and improve the therapeutic effect in advanced schistosomiasis control.

Objective To explore the clinical effects and safety of treatment for colorectal cancer to pulmonary metastases with percutaneous multiple electrodes radiofrequency-2000 (RF-2000) under CT-guided.Methods 26 pulmonary metastatic tumors in 11 cases were treated with RF-2000. The following extents were observed: (1) blood pressure,pulse rate and oxygen saturation during the treatment;(2)the variety of the liver function,the lung function and renal function after treatment;(3) the variety of the volume and low dense shadow of tumors after treatment;(4)the survival rate for 5 years. Results (1) The blood pressure,pulse rate and oxygen saturation were not changed during the treatment;(2) the liver function,the lung function and renal function after treatment were also not changed;(3) the volume of tumors were increased one month after treatment,three months later,23 lesions of 26 tumors were disappeared,2 decreased to more than 80% and 1 to 50%~80% in volume,and the low dense shadow within the tumors appeared as Ⅰtype (less than 50%) in one,Ⅱtype (50%~80%) in 3 and Ⅲ type (more than 80%) in 22;(4)The survival rate for 5 years was 81.82%(9/11). Conclusion The clinical effects and safety of treatment of colorectal cancer to lung metastases with percutaneous radiofrequency-2000 (RF-2000) under CT-guided is excellent.

Objective To explore the risk factors of newly emerging advanced schistosomiasis patients in endemic areas.Methods The study areas were selected in two counties of Dongting Lake regions and a 1 :2 match case-control study was designed.Sixty schistosomiasis patients,who newly evolved into advanced schistosomiasis from 2006 to 2007,were selected into the case group,and 120 cases with chronic schistosomiasis into the control group.Questionnaires including potential risk factors of advanced schistosomiasis were designed and the information was collected based on face to face interviews.SPSS 12.0 was used to analyze the simple factors and multi ones (logistic regression) attributable to the development of advanced schistosomiasis.Results The history of hepatitis B (OR = 10.729),models of water contact (OR = 3.919) ,yearly exposure days to the infested water (OR = 5.457) and times of chemotherapy in the nearly 10 years(OR = 1.578) were the risk factors of development of advanced schistosomiasis.The times of examinations with positive schistosome eggs were protective factors.No association was found between yearly income,education degree,times of checking for schistosomiasis,times of examination with sera positive results and the emergence of advanced schistosomiasis.Conclusion The high frequency of exposure to the infested water,repeated infections,incomplete diagnosis and treatment are the risk factors of advanced schistosomiasis.The concurrent infection with hepatitis B is associated with the acceleration of development of advanced schistosomiasis.

Objective To study the impact of precipitation and water level on acute schistosomiasis for providing reference to control acute schistosomiasis in advance. Methods The historical data on precipitation and water level as well as acute schistosomiasis from 2003 to 2007 in Eastern, Southern and Western Dongting Lake regions were collected and analysed for the correlation between acute schistosomiasis and precipitation and water level in local areas. Results Acute schistosomiasis gradually decreased year by year from 2003 to 2007. Compared with 2003, the number of acute schistosomiasis in 2007 reduced by 95.37%. There was no outbreak of acute schistosomiasis from 2005 to 2007.In the period of peak acute schistosomiasis, the average monthly rainfall reduced from year to year for the successive 5 years. There was a significantly correlation between acute schistosomiasis and monthly average water level. Conclusions The acute schistosomiasis is directly affected by nature factors and has a close correlation with the rainfall and water level in Dongting Lake regions.

Objective To analyze the schistosomiasis epidemic of 4 national pilots in Dongting Lake regions during 5 years period, and provide references for control strategy and policy making. Methods Four longitudinal monitoring pilots were set up in Dongting Lake regions from 2000 to 2004, and the field work in pilots was carried out based on “National Scheme on Schistosomiasis Epidemic Monitoring”. Results During the monitoring period, the infection rate of Schistosoma japonicum kept at 4% in Dongjia, 5% in Xinshang and over 12% in Quanxing, but in Changjiang, the rate was 8.92% in the first year of monitoring period, and stayed at 4% in the next 4 years. For all pilots, 20-49 age group had the highest infection rate, with the rate in male being higher than that in female and centering on the fishermen, farmers and students in occupation. There was the occurrence of acute and new advanced cases. The infection rate in domestic animals was fluctuated at 20%. There was extensive distribution of infected snails on marshlands outside embankments. Conclusion Schistosomiasis is seriously endemic in Dongting Lake regions, and intensive control measures are necessary.

Objective To evaluate the effect of elimination of schistosomiasis infectivity in water body by applying molluscicide on transmission marshland outside an embankment in Dongting Lake.Methods Two patches of transmission marshland with similar Oncomelania snails and infectious snails density in the northern part of eastern Dongting Lake regions were selected as molluscicide trail and control groups,respectively,and the snails and water body infectious indicators were investigated and compared between them.Results Adjusted death rate of snails in the trail group 15 days after applying molluscicide was 94.13%,without infected snails.The infection rate of sentinel mice in the trial group 50 days after applying molluscicide was 100.00%,with average 56.6 worms per mice.The infection rate of sentinel mice in the control group without molluscicide was also 100.00%,with average 147.8 worms per mice.Conclusions In transmission marshland areas outside the embankment of rivers or lakes,it is impossible for focus mollusciciding to eliminate the infectivity of schistosomiasis in water body,yet possible to reduce the degree of infectivity to a certain extent.

Objective To comprehensively evaluate the effect of the program of treatment and assistance to advanced schis-tosomiasis patients in Hunan Province from 2004 to 2013. Methods The fund investment of the program,the profits of hospi-tals and the improvement of the patients’health were investigated by data collection and questionnaire survey. The evaluation index system of treatment and assistance to advanced schistosomiasis in Hunan Province was constructed by the Delphi method and analytic hierarchy process,and the program was assessed comprehensively. Results The evaluation index system includ-ing 6 primary indices and 33 secondary indices was established. Among all the primary indices,the score of the treatment and assistance(22.25)was the highest,and that of the satisfaction assessment(8.15)was the lowest,and the score of the compre-hensive assessment was 87.06. The average cure rate of the patients was 13.08%from 2004 to 2013. More than 60%of the pa-tients’disease condition got better,and nearly 70%of the patients’psychological condition improved,and more than 70%of patients’self-help ability and social contact improved,as well as family happiness increased. In addition,the annual average cost for caretakers decreased by 2000 Yuan,and the profits of all the fixed-point hospitals for treatment and assistance in-creased. Conclusion The effectiveness and efficiency of the treatment and assistance to advanced schistosomiasis patients in Hunan Province is obvious,and the government should continuously invest in the program.

Objective To understand the Oncomelania hupensis snail distribution in the working areas of Yangtze River hy?drologic agencies located in the middle and lower reaches of the Yangtze River in 2016,so as to provide the evidence for assess?ing the risk of schistosome infection of hydrological workers and establishing the control strategies. Methods The suspicious en?vironments with O. hupensis snails in the above working areas were selected as study areas,and the snail situation was surveyed by the system sampling method combined with the environmental sampling method. The survey data were collected and analyzed statistically. Results Totally 19 working areas from 17 hydrological agencies were selected as the investigation sites,among which,10 working areas from 9 agencies were found with O. hupensis snail distribution. The constituent ratio of the areas with snails reached to 38.81%of the investigation areas,the occurrence rate of frames with snails was 3.08%,and the average densi?ty of living snails was 0.07/0.1 m2. By comparison,the average density of living snails and occurrence rate of frames with snails in hydrological agencies under the jurisdiction of the Middle Reaches Administrative Bureau were the most serious among three administrative bureaus of the Yangtze River Water Resources Commission. Conclusions There are various degrees of O. hupen?sis breeding in the working areas of hydrological agencies located in the middle and lower reaches of the Yangtze River ,and the hydrological workers are facing with the risk of schistosome infection.

Objective To explore the spatial-temporal characteristics and changing regularities of Schistosoma japonicum in-fections among human from 2004 to 2011. Methods The township level spatial databases of schistosomiasis in Hunan Province from 2004 to 2011 were established,and the related spatial analysis was performed by SPSS 17.0,ArcGIS 10.1 and SaTScan 7.03. Results The schistosome infection rate among human in Hunan Province sharply decreased from 3.0％in 2004 to 0.8％in 2011. However,the rate among residents in parts of some townships in 2011 was still hovering at a higher level (P90=2.12％),and the higher rate was distributed along the Oncomelania hupensis snail ridden areas outside embankment. The auto-correlation analysis showed that the global Moran's I for schistosome infection rate among human was 0.34 to 0.53 from 2004 to 2011,and was higher than the expected value(Z>8.71,P<0.05). The local G statistics indicated that the positive hotspot high-high clustering areas were mainly near the coast of Dongting Lake from 2004 to 2011,and the number of townships with schistosomiasis endemic in the clustering areas reached 30 to 70. The spatial scan analysis showed that the number of townships in the clustering areas ran up to 145 to 183 from 2004 to 2011. Conclusions The schistosome infection rate among human de-creased significantly in Hunan Province from 2004 to 2011. However,the rate in parts of some townships still remains at a com-paratively high level,and there are positive spatial correlation and spatial agglomerations in the schistosome infection rate among human,suggesting that the prevention and control work on schistosomiasis in these areas should be strengthened in the fu-ture.