Schistosomiasis is closely related to natural environmental factors. The changes of environmental factors such as temperature hydrology vegetation soil etc. all impact the scope and extent of schistosomiasis transmission. Poyang Lake is the largest freshwater lake and one of the major endemic areas with schistosomiasis in China. With global warming the imple-mentation of the Three Gorges Dam operation and the Poyang Lake Ecological Economic Planning the natural environment in Poyang Lake area has been and will continue to change especially the water environment and climate environment which are more closely related to the schistosomiasis transmission. These changes to some extent have affected and will continue to affect the prevalence and transmission of schistosomiasis. This article reviews the relationship between the natural environment and its changes and schistosomiasis transmission in the Poyang Lake region.

This report analyzes the status of schistosomiasis epidemic,surveillance and challenges in transmission?interrupt?ed areas of Jiangxi Province. There are 24 schistosomiasis transmission interrupted counties(cities,districts)among 39 endem?ic counties(cities,districts). Among the 24 counties,there are 6 counties with Oncomelania hupensis snails and 461 villages endemic,with 1.29 million residents. Since 2009,there have not been acute and chronic cases of schistosomiasis and all the pa?tients are historical advanced schistosomiasis cases. The area with snail habitats is 37.02 hm2. Since 2015,the schistosomiasis surveillance has covered the entire transmission interrupted areas. However,there are still many challenges,such as endemic in?stability,weak surveillance capacity,lack of surveillance awareness and other issues. Towards the schistosomiasis elimination, the surveillance should be based on the snail monitoring mainly,supplemented by the mobile population monitoring,and in ad?dition,the capacity building,standardized report of endemic,and snail habitat reform should also be further strengthened.

Objective: Through comparing the hospitalization costs of total knee replacement (TKR) in People’s Hospital of Peking University in 2005 and 2010, to investigate the changing status of hospitalization costs on this operation and the impact of clinical pathway ( CP ) on controlling the hospitalization costs during 5 years , and provide references for controlling medical treatment cost reasonably. Methods: The patients are grouped into undergoing unilateral and bilateral TKR. The total hospitalization cost and cost of each category during 5 years are compared, and SAS 9.2 statistic software is applied to deal the data. Results: Compared with 2005, the total cost for TKR in 2010 decreased. All the charging items decreased, except implant material increased, especially the cost of surgery, hospital room, nursing and pharmacy. Specific to one knee replacement group and both knees replacement, the changing trend of cost is coincident with the total cost. Conclusion: The total cost for TKR in 2010 was lower than that of 2005, which might be the result of adopting CP since 2010. Nevertheless, the implant material cost accounted large proportion of hospitalization cost in 2010, and it has obvious increasing trend compared to 2005. This result is related the increasing application of the new edition of Artificial knee joint prosthesis. Controlling implant material cost is the effective method of decreasing medical costs for TKR.

Objective On the basis of the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ), to establish and appraise a new prognostic evaluation system for elder patients with respiratory failure undergoing mechanical ventilation in order to predict hospital mortality in the respiratory intensive care unit. Methods Two hundred and thirty-eight senile patients with respiratory failure having had mechanical ventilation during their hospitalization were retrospectively analyzed. Patients were randomly divided into 2 groups: model group (n=138) and validation group (n=100). Data of model group were analyzed by monofactorial and multifactorial regression analysis to screen the risk factors. Risk factors were given numerical values according to different grades, and complementary scoring system was then established. APACHE Ⅱ system was combined with complementary scoring system with Logistic multiple regression to form SRFMV system, a special evaluation system for the senile patients with respiratory failure undergoing mechanical ventilation. One hundred patients from validation group were evaluated by both SRFMV system and APACHE Ⅱ system, and the results were then compared to assess the validity and reliability of SRFMV system. Oxygenation index, positive end expiratory pressure (PEEP), tidal volume, phlegm quantity and character, and pulmonary auscultation were selected to serve as standard for complementary scoring system. Mortality equation was set up with logistic multiple regression analysis. Results The predication sensitivity and specificity evaluated by SRFMV system in validation group (0.878 and 0.821, respectively) outstripped that evaluated by APACHE Ⅱsystem (0.818 and 0.771, respectively); the area under ROC curve in SRFMV system and the X2 value in Lemesshow-Hosmer statistic (0.911 and 13.77, respectively) also outstripped that in APACHE Ⅱsystem (0.860 and 11.808, respectively). Conclusions SRFMV system is of better sensitivity and specificity, in which the prediction of mortality is closely consistent with the reality. SRFMV system can be applied to obtain valid predictions of relevant outcomes in senile patients with respiratory failure underwent mechanical ventilation.

OBJECTIVEThis study aimed to investigate the effects of different tooth preparations on the fracture strength and pattern of failure of teeth with severe wedge-shaped defect restored with post and core crowns.

METHODSAccording to whether the teeth above the wedge-shaped defect was removed (represented by B) or not (represented by A), the ferrule next to the wedge-shaped defect was prepared (represented by D) or not (represented by C), the cast post-and-core was chosen (represented by E) or glass-fiber post and resin core was chosen (represented by F). A total of 64 human mandibular premolar teeth were randomly divided into 8 groups: A1-1 (A + C + E), A1-2 (A + C + F), A2-1 (A + D + E), A2-2 (A + D + F), B1-1 (B + C + E), B1-2 (B + C + F), B2-1 (B + D + E), B2-2 (B + D + F), each group 8 teeth. All the teeth were prepared and restored accordingly and then mounted on an electronic pressure universal testing machine. The maximum fracture strength and the patterns of failure were recorded.

RESULTS1) The fracture strength of Group A1-1 > that of Group B1-1, Group A1-2 > Group B1-2, Group B2-1 > Group B1-1, and Group B2-1 > Group B2-2 with significant differences (P < 0.05). 2) The patterns of repairable fracture in Group A1-2 and B1-2 were both 37.5%, and that of the other groups were 0. Furthermore, the difference was significant, and Group A1-2 and B1-2 were higher than other groups.

CONCLUSIONThe maintenance of the overhang above the severe wedge-shaped defect aid in the improvement of the fracture strength of the tooth restored with post and core crown. The ferrule of the wedge-shaped defect is not recommended to be prepared. Furthermore, the glass-fiber post and resin core is favorable for the re-repair of the teeth than the cast post and core.

Objective To investigate the mechanism of different HLA-G isoform mRNA patterns in different cells alters its cell membrane expression.Methods RT-PCR was used to analyze HLA-G isoform mRNA(HLA-Gl-6)of ovarian cancer cell lines HO-8910,HO-8910PM and OVCAR-3,leukemia cell lines Jurkat,K562,HIJ60,MUTIZ-1,and the chorioeareinoma cell lines JEG-3,JAR.HLA-G between cellular membrane and intracellular expression were analyzed by flow cytometry.Results All HLA-G mRNA isoforms were observed in the positive control cell line JEG-3,but none in the negative control cell line JAR.HLA-G1 isoform mRNA was expressed in HO-8910,HO-8910PM,OVCAR-3,MUTZ-1 and Jurkat cells.HLA-G2 mRNA was not detected in any cell line but JEG-3.HLA-G3 mRNA was found in HO-8910,HO-8910PM,K562,HIJ60,MUTZ-1,OVCAR-3 and Jurkat cells.HO-8910,HO-8910PM,HIJ60,Jurkat cells expre8sed HLA-G4 mRNA.Only the Jurkat cells expressed HLA-G5 mRNA.FACS results showed that JEG3 and HO-8910PM cells membrane expressed HLA-G,however,the intraeellular HLA-G expression was detected in all tested cells except the negative control cell JAR.Conclusion Only the HLA-G1 isoform could be exDressed on cell membrane in particular cell lines. Other isoforms including HLA-C2,-G3,-G4,-G5 and HLA-G6 could not reach cell snrface.

Objective To investigate the testing capabilities of clinical transfusion laboratories in medical institutions in Beijing for the regulatory authorities to formulate administrative policies in this regard.Methods Experts assigned by Beijing Clinical Transfusion Quality Control Center made on-site inspections at the transfusion laboratories in medical institutions using quality control products.They recorded the complete testing process of the operators as well as the instruments,detection reagents in use and the testing results,with statistics and analysis made to the data so collected.Results The pass rate of these on-site inspections was lower than that of the external quality assessment.Some laboratories failed to complete the testing of the quality control products in time and the actual operations in some laboratories were inconsistent to the guidelines.55.9％ of level Ⅰ hospitals and 25.6％ of level Ⅱ hospitals were found with insufficient and inadequate instruments and process layout to meet the needs of clinical blood transfusion.Some of the technicians were found without sufficient trainings in their professional knowledge and basic skills,resulting in their poor competence against emergency cases and weakness in independent problem solving.In addition,the records of detection process and results were found to be substandard.Conclusions Transfusion laboratories in Beijing need to improve their testing capabilities in general.

The article clarified, according to the recent research results which have been done in Poyang Lake region of Jiangxi province, bovines are the most important animal hosts of Schistosoma japonicum and infected bovines are main infectious sources of Schistosomiasis in Poyang Lake region. Spring (March to June) is the " cross transmission stage" between definitive host and intermediate host, that is, spring is not only the susceptible season of infection for livestock and human, but also is the susceptible season of infection for snails. In flood season (July to August), the transmission of Schistosomiasis between livestock and snails belong to " low level phase" . Autumn (September to Octber) is the second seasonal peak of cercariae and is the susceptible season of infection for livestock and human. Winter(November to Feburary in next year) is the non- susceptible season of infection. Most of the susceptible zones of infection for livestock, human and snails are the marshlands near the endemic villages.

Objective To investigate the status of self-care ability and cognition among disabled elderly,and to analyze the relationship between self-care ability and cognition,then analyze their influencing factors.Methods A total of 813 disabled elderly accepted long-term care at community or facility were recruited by stratified sampling method and investigated by socio-demographic questionnaire,activities of daily living and short portable mental status questionnaire.Results The total scores of self-care ability of the long-term care disabled was 32.01±11.59,and the total points of cognition was 3.77±3.24.Disabled elderly with severe disorders of self-care ability had a higher obstacle rate in every cognition ability than those with mild disabilities (P＜0.001).There were differences in orientation and memory function with different persistent disabled time (x2 =11.875,14.758,P＜0.01).Disabled elderly with cognition obstacles have a higher obstacle rate in every self-care aspect than those with normal cognition (P＜0.01).The multiple regression analysis showed that the educational level (β=-0.067),arital status (β=-0.071),disabled persistence time (β=0.121),orientation ability (β=0.403),the amount of cognition obstacles (β=0.443) were the influence factors of Basic Activities of Daily Living(BADL) among disabled elderly ; and disabled persistence time (β=0.116),orientation ability (β=0.417),recalled ability (β=0.275),memorial ability (β=0.189),calculative ability (β=0.257),the amount of cognition obstacles (β=0.358) were the important factors influence Instrumental Activities of Daily Living(IADL).Conclusion The self-care ability and cognition of the long-term care elderly were declining sharply,and influencing each other.It is advisable to offer them direct long-term care service combined with the laws and characteristics of cognition and self-care ability.

[ ABSTRACT] AIM: To explore the role of chemokine receptor CXCR 4 in the pathogenesis of protein C system (PCS) in ulcerative colitis (UC).METHODS:In vivo, the mice were divided into control group and UC group .The mac-roscopic score, microscopic score and ulcer index were assessed .The mRNA levels and activity of myeloperoxidase ( MPO) , cyclooxygenase-2 ( COX-2 ) , stromal cell-derived factor-1α( SDF-1α) and monocyte chemotactic protein 1 (MCP-1) both in colonic tissue and plasma were determined .The expression and location of CXCR4,β-arrestin, p-JNK, endothelial cell protein C receptor (EPCR) and thrombomodulin (TM) were detected.The activity of protein C (PC) and protein S ( PS) was measured in each group .In vitro, mouse colonic microvascular endothelial cells were isolated , cultured and identified.Both CXCR4-overexpressing and CXCR4-silencing colonic mucosa microvascular endothelial cells were con-structed.The effects of SDF-1αon the protein levels of EPCR , TM,β-arrestin and p-JNK, and on the activity of PC , PS and activated protein C ( APC) were observed .RESULTS:Compared with control group , UC mice showed increased gross score, histopathological score and ulcer index (P<0.05).The mRNA levels and activity of MPO, COX-2, SDF-1αand MCP-1 in colon and plasma were increased (P<0.01).The protein levels of CXCR4,β-arrestin and p-JNK were up-regu-lated, EPCR expression was down-regulated in colon, and the activity of PC and PS in plasma was decreased (P<0.05 or P<0.01).CXCR4 overexpression further aggravated SDF-1α-induced PCS inhibition in colonic mucosa microvascular en-dothelial cells, and further up-regulated the protein levels of β-arrestin and p-JNK (P<0.05).CONCLUSION:PCS is inhibited in UC.CXCR4 is involved in the regulation of PCS inhibition by mediating chemokines and acting on colonic mu -cosa microvascular endothelial cells through β-arrestin-JNK pathway .