Objective: To present a modified method for harvesting and shaping fibular flap in reconstruction of mandibular defect. Methods: Fibula flap harvesting was performed under non-blood-evacuation of the donor limb and two gaps were made at the upper and lower ends of the fibular flap during the flap harvesting. Step-like osteotomy was performed to obtain 3 segments(each segment was 3~5 cm in length) of fibular bone. The shaping was achieved by fitting the bone segments together based on the natural contour of the mandible. The modified operation was conducted in 7 patients for mandibular reconstruction. Results:The method was successfully used in all patients with less bleeding during the flap harvesting and after reconstruction.The bone segments were rigidly fixed with good bony consolidation and contour. No complications occurred.Conclusion: The modified fibular flap harvesting method is feasible in mandible reconstruction.

Objective To evaluate the effects of the schistosomiasis control mode(“Hubei mode”)that includes“compre-hensive measures in a whole endemic county”,“co-action of Health Ministry and Province”and“replacing cattle with machine”in Hubei Province. Methods The data of schistosomiasis control in Hubei Province from 2008 to 2012 were collected and a data-base including the annual schistosome infections of human and cattle,acute schistosome infection,outbreak of schistosomiasis en-demic,schistosome infected Oncomelania hupensis snails,and other prevention indicators was established and analyzed by using SPSS. Results Compared with 2008,in 2012,the infection rates declined by 64.91%and 88.63%in human and cattle respec-tively. The area with snails decreased from 5 423.85 hm2 in 2008 to zero. There were no acute schistosomiasis patients and out-break of schistosomiasis endemic. Conclusion The schistosomiasis control mode(“Hubei mode”)is effective significantly.

Objective To evaluate the effect of wild feces detection in Oncomelania hupensis environments on the surveil?lance of infection source of schistosomiasis,and find the weakness in schistosomiasis control in Hubei Province,so as to put for?ward the targeted strategies and measures. Methods Four environments with O. hupensis snails in endemic areas of Hubei Provinces,where human and livestock often haunted,were selected according to the river systems,namely the Juzhanghe River beach in Jingzhou City,Changjiang River beach in Jiayu County,Hanbei River beach in Tianmen City,and Changshou River beach in Zhongxiang City,then the snail survey and wild feces detection were implemented in the selected environments. Re?sults There were O. hupensis snails,livestock,wild feces of cattle or sheep as well as positive cattle feces found in all the 4 environments,and the positive rate of schistosome miracidium incubation was 47.62%. Conclusion The schistosome miracidi?um positive rate of wild feces of cattle is high in the environments with snails in endemic areas of Hubei Province ,which has high risk for schistosomiasis transmission.

Objective To analyze the construction and operation status of management system of laboratories of schistosomi?asis control institutions in Hubei Province,so as to provide the reference for the standardized detection and management of schis?tosomiasis laboratories. Methods According to the laboratory standard of schistosomiasis at provincial,municipal and county levels,the management system construction and operation status of 60 schistosomiasis control institutions was assessed by the acceptance examination method from 2013 to 2015. Results The management system was already occupied over all the labora?tories of schistosomiasis control institutions and was officially running. There were 588 non?conformities and the inconsistency rate was 19.60%. The non?conformity rate of the management system of laboratory quality control was 38.10%(224 cases)and the non?conformity rate of requirements of instrument and equipment was 23.81%(140 cases). Conclusion The management system has played an important role in the standardized management of schistosomiasis laboratories.

Objective To investigate the effect and current situation of the standardized construction of laboratories of schis?tosomiasis control institutions in Hubei Province,so as to provide the evidence for establishing and improving the quality control system of diagnosis of schistosomiasis after the transmission of schistosomiasis was under control. Methods According to the procedures of self?examination,field operation,and laboratory on?site,five laboratories were assessed,and all the results were analyzed comparatively. Results The average number of staffs were(7.00 ± 1.58)persons,and the staffs of the laboratories of the schistosomiasis control institutions with senior professional titles in the city level were more than that in the county level(t=5.563,P<0.05). The average space was(3.20±1.64)rooms,and the average area was(117.00±88.29)m2. The average score of field operation was(96.40 ± 4.49)points. The average score of laboratory on?site assessment was(106.6 ± 6.15)points. The highest and lowest of the laboratory on?site assessment scores were environment and facilities(19.60 ± 0.55)points and manage?ment system of laboratory quality control(15.70 ± 2.39)points(F=2.869,P<0.05),respectively. Conclusion The cultiva?tion of laboratory staff should be strengthened,and the diagnostic capacity should be maintained and improved. The laboratory quality control system should be paid more attention to,and the construction and management of schistosomiasis laboratories should be standardized.

Objective To analyze the spatial clustering of human schistosomiasis at the village level in key counties in Hubei Province, to provide scientific evidence for formulating strategies for human schistosomiasis prevention and control in the next stage. Methods Gong^'an County and Jiangling County in Hubei Province were selected as representative counties for this study. A town or village was set up as a research unit. Schistosomiasis cases of a positive fecal examination in 2015 and cases with positive detection for schistosomiasis serological antibody titer equal or above 80 in 2016-2018 were selected as research subjects in these two counties. The Kulldorff circular scan statistic was used for the spatial clustering analysis of human schistosomiasis infection status in the population. Results There was spatial clustering of positive schistosomiasis cases of fecal examination, at the level of a town or village in both counties in 2015. There was spatial clustering of positive human serological antibody detection at the level of town or village from 2016-2018. Eighty-six endemic villages in five towns in the northeast of Gong^'an County, along the Yangtze river,including Mahaokou Town, Zhakou Town, Yangjiachang Town, Jiazhuyuan Town and Douhuti Town, were the most prominent. There was no spatial clustering of positive results of human serological antibody detection at the town and village level in Jiangling County, in2017, while there was spatial clustering of human serological antibody detection in 2016 and 2018,respectively. Fifty-seven endemic villages in two towns (Puji Town and Xionghe Town) in the southwest of Jiangling County, along the Yangtze river,were the most prominent. Conclusion There were spatial clustering of human schistosomiasis epidemic at village level both in Gong^'an County and Jiangling County, Hubei Province. Compared with the previous studies, there was a trend of shrink and decline of clustering areas. Therefore, the current situation of the epidemic has put forward higher requirements for the implementation of precise prevention and control in the progress of schistosomiasis elimination work in various epidemic areas.