1.Spatiotemporal distribution characteristics analysis of schistosomiasis in Wuhan City, 2013-2022
LI Yang ; WANG Hao ; LIU Cong ; ZHANG Jiajing ; WANG Shuai ; XIONG Yuelin ; LUO Huatang
China Tropical Medicine 2024;24(2):200-
Objective To analyze and visualize the epidemic changes of schistosomiasis in Wuhan from 2013 to 2022 based on a geographical information system (GIS), providing references for further schistosomiasis control activities. Methods According to the historical data of the annual reports of schistosomiasis screening and street-level vector map of Wuhan City from 2013 to 2022, a spatial database of epidemic information at the street level was established. The Joinpoint regression model was utilized to analyze the trend of phased changes in blood positivity rate for schistosomiasis. ArcMap 10.8 was employed for the spatial visualization of the positive rate of serological tests for schistosomiasis among the screened population in the endemic areas of Wuhan over the past decade, as well as conducting hot spot analysis (Getis-Ord Gi*) to explore the spatial clustering relationship and spatiotemporal trends. Heatmaps were generated to reflect the changes in the positive rate of blood tests for schistosomiasis over a decade in various streets, and the areas were classified by the ward’s method of hierarchical clustering using the sum of squared deviations. Results Over the past decade, the overall annual positive rate of schistosomiasis screening in Wuhan declined from 2.23% in 2013 to 0.47% in 2022, showing a general downward trend. The Joinpoint regression model analysis of the blood positive rate indicated the presence of one connection point in 2015; from 2013 to 2015, the annual percent change (APC) of the positive rate was 2.17%, showing an upward trend (P>0.05); from 2015 to 2022, the APC was -23.34%, indicating a downward trend (P<0.05). The map of positive street-level schistosomiasis screening rates for 2013-2022 shows that the positive rate count on the streets of Caidian District and Hannan District in southwestern Wuhan and Huashan Street on the east side, had a significant decrease over the ten years, while the rate in the streets under the jurisdiction of Dongxihu District in the west showed an increase. The hot spot analysis graph revealed that hot spots of the positive rate in Wuhan shifted from the southwest to the west beginning in 2018. The heatmap indicated the largest disparity in trend changes, with the most noteworthy decline in streets under Caidian District and an increasing trend in the streets under Dongxihu District. Conclusions The overall epidemic situation of schistosomiasis in Wuhan is on a downtrend, although the positive rate of blood tests has increased in some areas. This has been attributed to a reduction in the total number of people participating in the blood tests and the slow decrease of antibodies in certain patients who were repeatedly sampled for testing. It is important to further strengthen the construction of monitoring capabilities, improve the sensitivity of monitoring systems, identify potential risks promptly, and handle them properly.
2.Cognitive map study of type 2 diabetic nephropathy based on BP neural network model
Shixin HUANG ; Jiajing LUO ; Yaling LUO ; Xueqing ZHOU ; Tianyao CHEN
Chinese Journal of Endocrinology and Metabolism 2017;33(11):943-949
Objective A BP neural network model for diagnosing type 2 diabetic nephropathy based on laboratory tests was developed and evaluated. Methods Patients with type 2 diabetic nephropathy from 5 hospitals of Chongqing,Guizhou and Sichuan Provinces from January 2016 to December 2016 were collected in the study. Totally 89 parameters were analyzed by univariate analysis to identify significant variables by SPSS 19. 0 and MATLAB 2014a. The diagnostic performance of the two methods were compared. Results A total of 477 patients with type 2 diabetic nephropathy and 449 patients of control group were included. Univariate analysis showed that 42 variables had significant difference. Logistic regression analysis showed that 12 variables were included in the optimal regression equation. This BP neural network had 42 input layer nodes,15 hidden layer nodes and 1 output layer nodes. The Youden index of logistic regression analysis and BP neural network(training set and test set) were 0.76,0.89 and 0.83. The accurately diagnosed were 88.12%,94.24%,and 91.34%,the AUC were 0.95,0.98,and 0.96. Conclusion A BP neural network model was developed,which has important accessory diagnostic value for diagnosis of type 2 diabetic nephropathy. But all these conclusions need further validation in clinic.
3.Clinical study on the treatment of kidney deficiency and blood stasis syndrome of lumbar intervertebral disc herniation with Bushen Huoxue Shujin Decoction and thunder fire moxibustion
Jiajing LUO ; Ming LI ; Qi LI ; Jianuo ZHANG ; Shengxian WU ; Xiangchun LIU
International Journal of Traditional Chinese Medicine 2023;45(12):1502-1507
Objective:To evaluate the clinical efficacy of Bushen Huoxue Shujin Decoction combined with thunder fire moxibustion in the treatment of lumbar intervertebral disc herniation with kidney deficiency and blood stasis syndrome.Methods:Randomized controlled trial. A total of 200 lumbar intervertebral disc herniation patients from Dongzhimen Hospital of Beijing University of Chinese Medicine from January to December 2021 were selected as observation objects and the computer random method was used to divide 66 patients into combination group, 67 in the control group 1, and 67 in the control group 2. The Control group 1 was given conventional western medicine and thunder fire moxibustion, the control group 2 was given conventional western medicine and Bushen Huoxue Shujin Decoction, and the combined group was given conventional western medicine and Bushen Huoxue Shujin Decoction and thunder fire moxibustion. All the groups were treated with 14 days as a course of treatment, a total of 3 courses. TCM syndrome scores were performed before and after treatment, and lumbar joint activity was measured by using a muscle state testing analyzer; the levels of NF-κB, prostaglandin E2 (PGE2) and hypoxia-inducible factor-2α (HIF-2α) were determined by ELISA; adverse reactions during treatment were recorded and clinical efficacy was evaluated.Results:The total effective rate of the combination group was 92.42%(61/66), the control group 1 was 71.64% (48/67), and the control group 2 was 74.63% (50/67), with a statistically significant difference among the three groups ( χ2=10.28, P=0.006). After treatment, the scores of waist and leg pain, lumbar stiffness, lower limb numbness, and tongue dullness in the combination group were significantly lower than those in the control group 1 and control group 2 ( F values were 15.25, 12.21, 11.77, 14.49, respectively, P<0.01); the range of motion of lumbar joint forward flexion, backward extension, lateral flexion, and lateral rotation in the combination group were significantly greater than those in the control group 1 and control group 2 ( F values were 19.66, 29.50, 33.33, and 24.54, respectively, P<0.01); the levels of serum NF-κB [(41.29±5.91)ng/L vs. (49.97±5.98)ng/L, (50.92±6.02)ng/L, F=47.00], PGE2 [(67.09±8.08)ng/L vs. (80.22±9.92)ng/L, (78.17±9.09)ng/L, F=40.27], HIF-2α[(16.95±3.46) ng/L vs. (20.83±3.98)ng/L, (19.67±3.89)ng/L, F=18.38] in combination group were significantly lower than those in the control group 1 and control group 2 ( P<0.01). During the treatment period, the incidence of adverse reactions in the combination group was 15.15% (10/66), control group 1 was 8.96% (6/67), and control group 2 was 10.45% (7/67), there was no statistically significant difference between the three groups ( χ2=1.36, P=0.506). Conclusion:The combination of Bushen Huoxue Shujin Decoction and thunder fire moxibustion can improve the TCM syndrome and range of motion of patients with kidney deficiency and blood stasis syndrome of lumbar intervertebral disc herniation, inhibit the expression of inflammatory factors, improve clinical efficacy, and have good safety.
4.Analysis of anxiety and depressive status and influencing factors in patients with colorectal polyps in part of Xinjiang area
Xuejiao TAN ; Yaqiong PENG ; Xin PENG ; Miaomiao LUO ; Jian QIN ; Jiaxue LI ; Lina YE ; Ronghui PU ; Li LAI ; Jiajing MA ; Qinglin ZHANG ; Fang LIU ; Weigang CHEN
Chinese Journal of Digestion 2023;43(7):472-480
Objective:To investigated the prevalence of anxiety and depression symptoms in patients with colorectal polyps in part of Xinjiang area and to explore the associated influencing factors related to psychological status, and to provide evidence and clues to promote the diagnosis and treatment of psychosomatic diseases in digestive system.Methods:From December 2021 to June 2022, at the First Affiliated Hospital of Shihezi University, the Fourth Division Hospital of Xinjiang Production and Construction Corps, the Third Division Hospital of Xinjiang Production and Construction Corps (Kashgar Hospital), the Thirteenth Division Red Star Hospital of Xinjiang Production and Construction Corps, the Tenth Division Beitun Hospital of Xinjiang Production and Construction Corps, the Seventh Division Hospital of Xinjiang Production and Construction Corps, the Fifth Division Hospital of Xinjiang Production and Construction Corps, patients who underwent colonoscopy and colorectal polyps detected were enrolled. The generalized anxiety disorder scale-7 (GAD-7) was used to screen anxiety symptoms, and the patient health questionaire-8 (PHQ-8) was performed to screen depression symptoms, and the general situation questionnaire was used to collect clinical information of patients. The questionnairs were completed via the Questionnaire Star platform or paper questionnaire, and a database was established. The patients were divided into groups according to whether with anxiety and depression symptoms. Multivariable logistic regression models was performed to analyze the factors related to anxiety and depression.Results:A total of 516 questionnaires were distributed and collected, among which 9 questionnaires were incomplete and 507 questionnaires were valid, the effective rate of questionnaires was 98.26%. The detection rates of anxiety and depression symptoms in 507 patients with colorectal polyps were 21.50%(109/507) and 19.33%(98/507), respectively. The results of multivariable logistic analysis revealed that female ( OR=3.87, 95% confidence interval (95% CI) 2.30 to 6.51, P<0.001), maximum diameter of polyp ( OR=1.74, 95% CI 1.14 to 2.67, P=0.011), perception of polyps as cancer ( OR=13.96, 95% CI 1.48 to 132.07, P=0.022), and the occurrence of gastrointestinal symptoms after polyp detection ( OR=5.43, 95% CI 1.74 to 16.92, P=0.004) were independent risk factors of anxiety in patients with colorectal polyps. Female ( OR=2.42, 95% CI 1.47 to 4.00, P=0.001), the number of polyps ( OR=1.07, 95% CI 1.01 to 1.13, P=0.028) and the count of gastrointestinal symptoms ( OR=2.04, 95% CI 1.34 to 3.10, P=0.001) were independent risk factors of depression in patients with colorectal polyps. Conclusion:Gender, polyp size, number of polyps, disease perception, and concomitant gastrointestinal symptoms are associated with anxiety and depression in patients with colorectal polyps.
5.Trends in Oncomelania hupensis distribution in Wuhan City from 2003 to 2022 based on the Joinpoint regression model
Yuelin XIONG ; Hao WANG ; Yang LI ; Jiajing ZHANG ; Shuai WANG ; Cong LIU ; Huatang LUO
Chinese Journal of Schistosomiasis Control 2024;36(2):159-164
Objective To analyze the trends in Oncomelania hupensis distribution in Wuhan City, Hubei Province from 2003 to 2022, so as to provide insights into precision schistosomiasis control. Methods Data pertaining to O. hupensis snail survey in Wuhan City from 2003 to 2022 were collected. The trends in the proportion of areas with snail habitats, actual area with snail habitats, mean density of living snails and prevalence of Schistosoma japonicum infection in snails were evaluated in schistosomiasis-endemic areas of Wuhan City from 2003 to 2022 with the slope of trend curve (β), annual percent change (APC) and average annual percent change (AAPC) using a Joinpoint regression model. Results During the period from 2003 through 2022, there were two turning points for the proportion of areas with snail habitats in Wuhan City in 2005 and 2015, with a rise during the period from 2003 to 2005 (β1 = 5.93, t = 1.280, P > 0.05), a decline from 2005 to 2015 (β2 = −0.88, t = −2.074, P > 0.05) and a rise from 2015 to 2022 (β3 = 1.46, t = −2.356, P < 0.05). During the period from 2003 through 2022, there were two turning points for the proportion of areas with snail habitats in islet endemic areas of Wuhan City in 2006 and 2015, with no significant differences in the trends from 2003 to 2006 (β1 = 4.64, t = 1.888, P > 0.05) or from 2006 to 2015 (β2 = −1.45, t = −2.143, P > 0.05), and with a tendency towards a rise from 2015 to 2022 (β3 = 2.04, t = −3.100, P < 0.05). During the period from 2003 through 2022, there were two turning points for the proportion of areas with snail habitats in inner embankment endemic areas of Wuhan City in 2012 and 2020, with a tendency towards a decline from 2003 to 2012 (β1 = −0.39, t = −4.608, P < 0.05) and with no significant differences in the trends from 2012 to 2020 (β2 = 0.03, t = 0.245, P > 0.05) and from 2020 to 2022 (β3 = 1.38, t = 1.479, P > 0.05). During the period from 2003 to 2022, the actual area with snail habitats all appeared a tendency towards a decline in Wuhan City, and in islet and inner embankment endemic areas of Wuhan City from 2003 to 2022 (AAPC = −2.39%, −5.75% and −2.35%, all P values < 0.05). The mean density of living snails reduced from 0.087 snails/0.1 m2 in 2003 to 0.027 snails/0.1 m2 in 2022 in Wuhan City, with a significant difference in the tendency towards the decline (APC = AAPC = −11.47%, P < 0.05). The annual mean decline rate of the mean density of living snails was 17.36% in outside embankment endemic areas of Wuhan City from 2003 to 2022 (APC = AAPC = −17.36%, P < 0.05), and there was no significant difference in the trends in the mean density of living snails in islet endemic areas of Wuhan City from 2003 to 2022 (APC = AAPC = −0.97%, P > 0.05). In addition, the prevalence of S. japonicum infection in snails appeared a tendency towards a decline in Wuhan City from 2003 to 2022 (APC = AAPC = −12.45%, P < 0.05). Conclusions The proportion of areas with snail habitats, actual area with snail habitats, mean density of living snails and prevalence of S. japonicum infection in snails all appeared a tendency towards a decline in Wuhan City from 2003 to 2022. Intensified snail control, modification of snail habitats, shrinking of areas with snails and implementation of grazing prohibition in snail-infested settings are required, in order to facilitate the progress towards schistosomiasis elimination in Wuhan City.