Objective To master the prevalence status of schistosomiasis in Yunnan Province in 2016,so as to provide the evidence for formulating the control strategy and intervention measures. Methods The schistosomiasis heavy-endemic villages were selected from each of 18 endemic counties as the survey sites. Then,the serological and etiological tests were carried out in the local residents and floating population,and the infection status of the livestock,field feces and Oncomelania hupensis snails were surveyed. Results The serum positive rate of schistosomiasis of local residents was 8.78％and the serum positive rate was 2.26％of floating population. No schistosome eggs were found in the stool examinations in the population. The area with snails was 80.0546 hm2 in 2016 with an increasing rate of 45.47％compared to that in 2015. The average density of living snails was 0.0317/0.1 m2. No schistosome-infected snails were found for the last four years and no new area with snails was found for the last three years. No positive livestock or feces were found. Conclusions The schistosomiasis epidemic situation is stabilized in Yunnan Province in 2016. However,the area with snails and the number of living snails are increasing,and therefore,the schis-tosomiasis epidemic risk still exists. So,the comprehensive control measures should be strengthened continuously.

Central neurocytomas (CNs), initially asymptomatic, sometimes become huge before detection. We described and analyzed the clinical, radiological, operational and outcome data of 13 cases of huge intraventricular CNs, and discussed the treatment strategies in this study. All huge CNs (n=13) in our study were located in bilateral lateral ventricle with diameter ≥5.0 cm and had a broad-based attachment to at least one side of the ventricle wall. All patients received craniotomy to remove the tumor through transcallosal or transcortical approach and CNs were of typical histologic and immunohistochemical features. Adjuvant therapies including conventional radiation therapy (RT) or gamma knife radiosurgery (GKRS) were also performed postoperatively. Transcallosal and transcortical approaches were used in 8 and 5 patients, respectively. Two patients died within one month after operation and 3 patients with gross total resection (GTR) were additionally given a decompressive craniectomy (DC) and/or ventriculoperitoneal shunt (VPS) as the salvage therapy. Six patients received GTR(+RT) and 7 patients received subtotal resection (STR)(+GKRS). Eight patients suffered serious complications such as hydrocephalus, paralysis and seizure after operation, and patients who underwent GTR showed worse functional outcome [less Karnofsky performance scale (KPS) scores] than those having STR(+GKRS) during the follow-up period. The clinical outcome of huge CNs seemed not to be favorable as that described in previous reports. Surgical resection for huge CNs should be meticulously considered to guarantee the maximum safety. Better results were achieved in STR(+GKRS) compared with GTR(+RT) for huge CNs, suggesting that STR(+GKRS) may be a better treatment choice. The recurrent or residual tumor can be treated with GKRS effectively.
Antineoplastic Agents ; therapeutic use ; Combined Modality Therapy ; Humans ; Neurocytoma ; therapy ; Radiotherapy ; Surgical Procedures, Operative

OBJECTIVETo ascertain the causation of a pregnant woman with undefined pneumonia reported from the People's Hospital of Tongling city in Anhui province on November 2005.

METHODSEpidemiological and clinical information of the case was collected from the keypersons close to the case and referring to the medical record. A medical observation was carried out on the close contacts of the case and sick or dead poultry. Tracheal aspirates being collected were tested by both RT-PCR and real-time PCR to detect viral nucleic acids of A/H5N1, and were inoculated into special pathogen free (SPF) embryonated hens' eggs.

RESULTSThe pregnant woman was found to have been contacted with the sick/dead poultry directly on the 4th day before onset of illness. All the 122 close contacts were healthy after a 10-day medical observation. The major clinical features of the case were viral pneumonia with rapidly developed leukopenia and lymphopenia. The progress to acute respiratory distress syndrome and multiple organ dysfunction syndromes was found at clinical presentation. HA and NA gene of A/H5N1 virus were positive. The 8 gene fragments of A/Anhui/1/2005 (H5N1) isolated from the tracheal aspirates had not carried genes from a human virus through reassortment, and the receptor-binding site of the hemagglutinin was polybasic cleavage site.

CONCLUSIONThis was the first documented case of H5N1 infection in pregnant woman. The immunotolerant state of pregnancy might have predisposed to the fatal outcome of the patient.

Adult ; China ; Fatal Outcome ; Female ; Humans ; Influenza A Virus, H5N1 Subtype ; genetics ; isolation & purification ; Influenza, Human ; complications ; pathology ; Multiple Organ Failure ; Pneumonia ; virology ; Polymerase Chain Reaction ; Pregnancy ; Pregnancy Complications, Infectious ; virology ; Respiratory Distress Syndrome, Adult ; Trachea ; virology

Objective To investigate the infection status of intestinal nematodes and their risk factors in rural residents of Jiangxia District, Wuhan City, so as to provide the reference for the establishment of targeted prevention and control measures. Methods According to the requirements of cross-sectional study of the national human key parasitic diseases, the residents in Shanpo Sub-district, Jiangxia District were randomly selected as the objects for the investigation of the infection status of Ascaris lumbricoides, hookworm and Trichuris trichiura. A questionnaire survey was performed simultaneously. Results Totally 236 residents received the stool tests, and only the hookworm eggs were found, with an infection rate of 7.63% (18 cases). The survey of intestinal parasitic infection status and their risk factors in 600 residents found 397 cases of suspected roundworm infection, 355 cases of suspected hookworm larvae dermatitis, 295 cases of suspected hookworm infection, and 145 cases of suspected whipworm infection, respectively. The Logistic regression analysis found that the risk factors of suspected roundworm infection included not always washing hands after toilet, using manure and fertilizer, and not often wearing shoes when doing farm work; the protective factors included knowing how roundworm infection was gained, and not using fresh dung for fertilization. The risk factors of suspected hookworm infection included using well water and pond water as the source of drinking water, eating food off the ground, using manure and fertilizers, and not washing when there was only one cutting board, and its protective factors included using tap water and well water as drinking water source, knowing how the roundworm infection was gained, and sometimes or not suing fresh feces for fertilization. The risk factors for suspected whipworm infection included eating food off the ground. Conclusions The intestinal parasite prevalence in the residents of the Shanpo Sub-district, Jiangxia District in Wuhan City is relatively high, and some risk factors associated with their infection indeed exist. Therefore, the regional government and health department should strengthen the health education to improve the residents’ knowledge about parasitic diseases and selfprotection awareness. At the same time, the residents should take physical examination regularly and take necessary deworming treatment to effectively control the prevalence and spread of intestinal parasitic diseases.

A three-level (provincial, municipal and county levels) schistosomiasis diagnosis network platform had been created in Yunnan Province, and assessment of laboratory quality-control samples and field evaluation of nucleic acid diagnostic techniques and immunodiagnostic reagents had been performed. This paper described the review process of the schistosomiasis diagnosis network laboratory and the operation of schistosomiasis diagnosis network laboratory and analyzed the problems of the schistosomiasis diagnosis network laboratory in Yunnan Province. The establishment of the schistosomiasis diagnosis reference (network) laboratory will provide a strong support for schistosomiasis control in Yunnan Province in the new era.

The histopathological features of the middle cerebral artery (MCA) and superficial temporal artery (STA) from moyamoya disease (MMD) and their relationships with gender, age, angiography stage were explored. The causes and the clinical significance of vasculopathy of STA were also discussed. The clinical data and specimens of MCA and STA from 30 MMD patients were collected. Twelve samples of MCA and STA from non-MMD patients served as control group. Histopathological examination was then performed by measuring the thickness of intima and media, and statistical analysis was conducted. The MCA and STA specimens from MMD group had apparently thicker intima and thinner media than those from the control group. There was no significant pathological difference between the hemorrhage group and non-hemorrhage group, and between the males and females in MMD patients. Neither the age nor the digital subtraction angiography (DSA) stage was correlated with the thickness of intima in MCA and STA. MMD is a systemic vascular disease involving both intracranial and extracranial vessels. Preoperative external carotid arteriography, especially super-selective arteriography of the STA, benefits the selection of donor vessel.
Adult ; Angiography ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Middle Cerebral Artery ; diagnostic imaging ; pathology ; Moyamoya Disease ; diagnostic imaging ; pathology ; surgery ; Temporal Arteries ; diagnostic imaging ; pathology ; Tunica Intima ; diagnostic imaging ; pathology

BackgroundPrevious studies have shown that hypertension is an important factor contributing to the occurrence and progression of diabetic kidney damage. However, the relationship between the patterns of blood pressure (BP) trajectory and kidney damage in the diabetic population remains unclear. This prospective study investigated the effect of long-term systolic BP (SBP) trajectory on kidney damage in the diabetic population based on an 8-year follow-up community-based cohort.

MethodsThis study included 4556 diabetic participants among 101,510 participants. BP, estimated glomerular filtration rate (eGFR), and urinary protein were measured every 2 years from 2006 to 2014. SBP trajectory was identified by the censored normal modeling. Five discrete SBP trajectories were identified according to SBP range and the changing pattern over time. Kidney damage was evaluated through eGFR and urinary protein value. A multivariate logistic regression model was used to analyze the influence of different SBP trajectory groups on kidney damage.

ResultsWe identified five discrete SBP trajectories: low-stable group (n = 864), moderate-stable group (n = 1980), moderate increasing group (n = 609), elevated decreasing group, (n = 679), and elevated stable group (n = 424). The detection rate of kidney damage in the low-stable group (SBP: 118-124 mmHg) was the lowest among the five groups. The detection rate of each kidney damage index was higher in the elevated stable group (SBP: 159-172 mmHg) compared with the low-stable group. For details, the gap was 4.14 (11.6% vs. 2.8%) in eGFR <60 ml·min·1.73 m and 3.66 (17.2% vs. 4.7%), 3.38 (25.0% vs. 7.4%), and 1.8 (10.6% vs. 5.9%) times in positive urinary protein, eGFR <60 ml·min·1.73 m and/or positive urinary protein, and eGFR decline ≥30%, respectively (P < 0.01).

ConclusionAn elevated stable SBP trajectory is an independent risk factor for kidney damage in the diabetic population.

Asian Continental Ancestry Group ; Blood Pressure ; physiology ; Female ; Glomerular Filtration Rate ; physiology ; Humans ; Hypertension ; physiopathology ; Logistic Models ; Male ; Prospective Studies ; Risk Factors

Famous traditional formula Sanpian Decoction(SPD)comes from Dialectical Records of Chen Shiduo of the Qing Dynasty,and ranks among 100 classic prescriptions of Classic Famous Traditional Formula catalogue(the First Batch). SPD was prepared according to Management Standards for Traditional Chinese Medicine Decoction Room in Medical Institutions. According to the polarity of different components in SPD,two HPLC fingerprints were established, in which six herbs, namely Chuanxiong Rhizoma, Paeoniae Randix Alba, Sinapis Semen, Glycyrrhizae Radix et Rhizoma, Pruni Semen, Angelicae Dahuricae Radix,are all reflected in the fingerprints; The dry extract rate, transfer rate and similarities of fingerprints were used as indicators to study the relationship between the quality value transmitting of medicinal herbs-decoction pieces-whole decoction of Chuanxiong Rhizoma. Experiment result shows that,the transfer rate of ferulic acid from medicinal herbs to decoction pieces is between 72.00% and 108.36%; the transfer rate of ferulic acid from decoction pieces to SPD is between 31.76% and 64.09%; the dry extract rate of the whole decoction is between 14.69% and 20.16%;The similarity range of fingerprint 1 of 15 batches of SPD is between 0.971 and 0.998, and the similarity range of fingerprint 2 is between 0.980 and 0.996. The established fingerprint has rich information,and the established quality evaluation method is suitable for the quality control of medicinal herbs-decoction pieces-whole decoction of Chuanxiong Rhizoma, which can provide a certain reference for developing the quality control evaluation method for formulated granules, famous formulae and other terminal products derived from traditional Chinese medicine decoction.
Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal/chemistry* ; Medicine, Chinese Traditional ; Quality Control ; Rhizome

The etiology and pathogenesis of moyamoya disease (MMD) remain elusive. Some inflammatory proteins, such as cyclooxygenase (COX)-2, are believed to be implicated in the development of MMD. So far, the relationship between COX-2 and MMD is poorly understood and reports on the intracranial vessels of MMD patients are scanty. In this study, tiny pieces of middle cerebral artery (MCA) and superficial temporal artery (STA) from 13 MMD patients were surgically harvested. The MCA and STA samples from 5 control patients were also collected by using the same technique. The expression of COX-2 was immunohistochemically detected and the average absorbance (A) of positively-stained areas was measured. High-level COX-2 expression was found in all layers of the MCA samples from all 5 hemorrhagic MMD patients, while positive but weak expression of COX-2 was observed only in the endothelial layer of the MCA samples from most ischemic MMD patients (6/8, 75%). The average A values of COX-2 in the hemorrhagic MMD patients were substantially higher than those in their ischemic counterparts (t=4.632, P=0.001). There was no significant difference in the COX-2 expression among the "gender" groups, or "radiographic grade" groups, or "lesion location" groups (P>0.05 for all). The COX-2 expression was detected neither in the MCA samples from the controls nor in all STA specimens. Our results suggested that COX-2 was up-regulated in the MCA of MMD patients, especially in hemorrhagic MMD patients. We are led to speculate that COX-2 may be involved in the pathogenesis of MMD and even contribute to the hemorrhagic stroke of MMD patients.
Adult ; Case-Control Studies ; Cyclooxygenase 2 ; genetics ; metabolism ; Female ; Humans ; Intracranial Hemorrhages ; enzymology ; etiology ; Male ; Middle Aged ; Middle Cerebral Artery ; metabolism ; Moyamoya Disease ; complications ; enzymology

Objective To characterize a species of the genus Tricula and parasitized trematodes in schistosomiasis-endemic areas of Yunnan Province using a molecular analysis, so as to understand their taxonomic positions. Methods Tricula spp. and Oncomelania snails were collected from Xiangyun County, Yunnan Province, and cercaria parasitizing snails were observed using crushing followed by microscopy. Cercaria parasitizing Tricula snails at various morphologies were sampled using a shedding method. Genomic DNA was extracted from snail soft tissues and cercariae, and the 16S rRNA, COI, 28S rDNA genes in snails and the ND1 and 28S rDNA genes in cercariae were amplified using a PCR assay and sequenced. The species of Tricula snails and their parasitized trematodes was characterized using sequence alignment and phylogenetic analysis. Results Among 382 Tricula snails detected, there were three types of trematode cercariae found, including the non-forked (20.94%, 80/382), double-forked (3.40%, 13/382) and swallow shapes (7.07%, 27/382). Sequence and phylogenetic analyses showed that the 16S rRNA, COI and 28S rDNA gene sequences of this species of Tricula had high homology to those in Delavaya dianchiensis, and were clustered in a branch. Sequencing analysis of the ND1 and 28S rDNA genes revealed that the non-forked cercariae belonged to the family Pleu- rogenidae, the swallow-shaped cercariae belonged to the family Opecoelidae, and the double-forked cercariae belonged to another species of the genus Schistosoma that was different from S. sinensium and S. ovuncatum. Conclusion The species and taxonomy of Triculla spp. and their parasitized trematodes are preliminarily determined in schistosomiasis-endemic areas of Yunnan Province; however, further studies are required to investigate the more definite taxonomy and pathogenicity.