Objective To analyze the molecular karyotypes of ANKA strain of Plasmodium berghei and demonstrate the size and number of chromosomes. Methods To isolate the genome DNA of P.berghei ANKA strain and analyze molecular karyotypes through CHEF-Ⅲ pulsed field gel electrophoresis (PFGE). Results The number of chromosomes was found to be 14, and their size ranged from 0\^6 Mb to 3 Mb. Chromosomes number 5 to 7 and 9 to 12 appeared co-migrated in the gel. Conclusion PFGE technique is useful for analyzing the molecular karyotypes and may be also useful for further study to locate the special gene on chromosomes and carry out the genetic characters and mechanism of drug resistance.

Objective To induce a line of Plasmodium berghei with resistance to artemisinin. Methods The major methods included blood transmission from passage to passage and progressive increase of drug pressure. Results The resistant lines were developed by different protocols: (A) The initial dosage of artemisinin was 126\^2 mg/kg which was increased by 60 mg/kg for the next passage and boosted by 126\^2 mg/kg for every other passage. As developed to passage 60 and 76, the resistant index was 18\^39∶1 and 14\^89∶1 respectively, then decreased gradually. For passage 108, the dosage was 8 862\^5 mg/kg, but the resistant index was only 10\^49∶1. (B) Using passage 66 from (A) as the source, a dosage of 4 000 mg/kg was given each week, the resistance of the passage 40 increased significantly with an index of 27\^5∶1. (C) Using passage 19 of (B) as the source, drug was administered at the dose of 2 000 mg/kg each week. The resistant index of passage 15 was 17\^41∶1. \{ Conclusion \} Line of P.berghei with medium level resistance to artemisinin was established.

Objective To understand the status of Ascaris eggs pollution in soil at national monitoring spots of soil-transmit-ted nematodiasis,so as to provide the evidence for making countermeasures and evaluating the control effect. Methods Ten households were selected from each of the 22 national monitoring spots annually according to the National Surveillance Program of Soil-Transmitted Nematodiasis(Trial),and the soil samples from vegetable gardens,toilet periphery,courtyards and kitchens were collected and examined by using the modified floatation test with saturated sodium nitrate. Fertilized or unfertilized eggs as well as live or dead fertilized eggs were discriminated and identified. In addition,a SWOT analysis of monitoring of Ascaris eggs pollution in the soil of rural China was carried out. Results A total of 1 090 households were monitored in 22 monitoring spots from 2006 to 2010. The total detection rate of Ascaris eggs in the soil was 30.73%,and the detection rates of fertilized,unfertilized and live fertilized eggs were 13.21%,26.42%and 20.28%,respectively. The total detection rates of Ascaris eggs in the vegetable garden,toilet periphery,courtyard and kitchen were 16.51%,13.49%,14.22% and 10.73% respectively. The SWOT analysis demonstrated that the monitoring work had both advantages and disadvantages,and was faced with opportunities as well as threats. Conclusion The pollution status of Ascaris eggs in the soil is still quite severe at some national monitoring spots,and the counter-measures such as implementing hazard-free treatment of stool,improving water supply and sanitation and reforming environment should be taken to protect people from being infected.

Objective To understand the infection status and variation tendercy of Enterobius vermicularis infection among children at national monitoring spots of soil-transmitted nematodosis from 2006 to 2010,and master the epidemic regularity,so as to provide the evidence for making control strategy and evaluating the control effect. Methods A total of 22 national monitor-ing spots of soil-transmitted nematodosis were established according to the National Surveillance Program of Soil-Transmitted Ne-matodiasis(Trial),and the children aged 3-12 years were examined through adhesive cellophane anal swabs,then the infec-tion rates of children with different ages,genders,nationalities and education levels were analyzed. In addition,the advantage, disadvantage,opportunity and threat of the monitoring work were analyzed by SWOT analysis. Results A total of 17 068 chil-dren were examined in 22 monitoring spots from 2006 to 2010,and 1 363 of them were found being infected with E. vermicu-laris,the average infection rate was 7.99%,and the infection rates of male and female children were 7.39%and 8.70%,respec-tivel;the average infection rates in each year were 10.01%,9.68%,7.41%,6.96%and 6.57%,respectively. From 2006 to 2009,the infection rates of E. vermicularis in children in Fujian Province was the highest,which were 56.15%,53.42%, 37.82%and 49.53%,respectively,but in 2010,the infection rate in Guangdong Province(46.06%)was the highest. The fur-ther analysis demonstrated that the female children,3-6 age group,Li nationality and children at kindergarten stage had relative-ly high infection rates. The SWOT analysis showed that the advantage of E. vermicularis monitoring in China was its wide cover-age and continuity,and the disadvantage was the relatively small investment from the government,the opportunity was that the national monitoring spot could drive the monitoring work at the provincial,county and other levels,and the threat was that the work was paid less and less attention to in recent years. Conclusion Though the infection rate of E. vermicularis in children at national monitoring spots of soil-transmitted nematodosis has been decreased year by year,high-endemic areas still exist,and thus the work on enterobiasis control and prevention still needs to be strengthened.

Objective To explore the illness experience and perspectives of youth patients with systemic lupus erythematosus (SLE) in China. Methods The research was conducted following phenomenological approach of qualitative research. Twelve patients with SLE were selected through purposive sampling method.The interviewer conducted hour-long semi-structured interviews according to the proposed interview outline.Data were analyzed based on Colaizzi phenomenological research method. Results Three themes were identified, including emotional experience since illness, SLE related limitations, and perceived stigma. Conclusions There exists a dynamic variation in disease related experience of young SLE patients.Understanding the feelings of those patients can help eliminate the negative factors so as to provide effective nursing intervention for patients and improve the quality of young patients′life with long-term living.

A 24-year-old female patient presented with recurrent itchy annular erythema and scales on the trunk and extremities for 9 years. Histopathological study revealed hyperkeratosis with focal parakeratosis, neutrophil aggregation in the stratum corneum, blisters below the stratum corneum, and perivascular infiltration with lymphocytes, a small number of eosinophils and neutrophils in the superficial and middle dermis. Direct immunofluorescence assay showed negative staining for IgG, IgM, IgA and C3. Whole-exome sequencing of the SPINK5 gene showed a missense mutation c.2423C>T (p.T808I) in exon 25, and a splicing site mutation c.2965-1G>A in exon 31. The compound heterozygosity for the two mutations may be the cause of Netherton syndrome in the patient. Based on the clinical manifestations and genetic testing results, the patient was diagnosed with Netherton syndrome.

The transcription factor Ascl1 can reprogram fibroblasts,astrocytes,Muller glial cells and other somatic cells in-to multiple subtypes of induced neurons,including dopaminergic neurons,amino acid neurons,etc.The complex mechanism in-volved in this process includes hierarchical mechanism and changes in transcription level.This article reviews the research on re-programming of somatic cell into neurons induced by Ascl1.

OBJECTIVE To ev aluate the economical efficiency of nivolumab versus everolimus in the second-line treatment of metastatic clear cell renal cell carcinoma. METHODS From the perspective of China ’s health system ，cost-effectiveness analysis of the two therapies was carried out by developing a three-state partitioned survival model. The clinical parameters were from the updated CheckMate 025 study，and the cost and health utility were from relevant websites and published literatures. The model adopted a 2-week cycle and a lifetime research time. The robustness of the results was verified by sensitivity analysis. The economical efficiency of two therapy schemes were evaluated in the scenario of model simulation time of 80 months and charitable drug donation scheme. RESULTS The results of basic analysis showed that compared with everolimus ，the incremental cost-effectiveness ratio （ICER）of nivolumab was 586 982.60 yuan/quality-adjusted life year （QALY），which was far higher than 3 times of China ’s per capita gross domestic product （GDP）in 2020. The results of single-factor sensitivity analysis showed that the 3 parameters that had the greatest impact on the economic evaluation results were the cost of nivolumab ，the utility value of nivolumab group and everolimus group in progressive disease state. The results of probability sensitivity analysis verified the robustness of the basic analysis results. Results of scenario analysis showed that in the first scenario analysis ，in which model simulation time lasted for 80 months，ICER of nivolumab was 417 204.52 yuan/QALY；in the second scenario analysis ，in which nivolumab charitable drug donation program for low-income people was considered ，ICER of nivolumab was 124 988.58 yuan/QALY. CONCLUSIONS Under the threshold of 1-3 times of China ’s per capita GDP in 2020，compared with everolimus ，it is not economical to use nivolumab as the second-line treatment for metastatic clear cell renal cell carcinoma ； nivolumab is economical when considering its charitable drug donation program for low-income people.

Objective: To understand the characteristics and changes of the incidence of amoebic dysentery in China during 2015-2018, explore the causes of high incidence in some areas and provide a data base for the development of national prevention and control strategies and measures. Methods: Data were collected from the infectious disease reporting management information system from Chinese Disease Control and Prevention. To understand the seasonal, population and area distributions of amoebic dysentery, descriptive epidemiological method and software SPSS 16.0 were used to analyze the amoebic dysentery data. Results: A total of 4 366 amoebic dysentery cases were reported without death in China during 2015-2018. The reported average annual incidence was 0.08/100 000, and the overall proportion of laboratory confirmed cases was 68.23%(2 979/4 366). Amoeba dysentery mainly occurred during May to October. One seasonal peak was observed in 2015 and 2017 (July and June, respectively), and two seasonal peaks were observed in 2016 and 2018 (June and October). The patients were mainly children aged under 5 years (42.28%, 1 846/4 366), and the incidence rate decreased with age in children aged under 10 years. Of these, children under 1 years of age had the highest incidence rate (1.28/100 000). The number of cumulative reported cases in Guangxi, Henan, Guangdong, Heilongjiang and Jiangxi provinces ranked top five from 2015-2018, accounting for 64.50% (2 816/4 366) of the total. The cumulative cases in Dongxing county, Guangxi, in Suixian county, Henan and in Ranghulu district, Heilongjiang, respectively accounted for more than 50.00% of the total number of cases in their provinces. Conclusions The incidence rate of amoebic dysentery reported in China during 2015-2018 showed a decreasing trend, with a higher incidence in children under 5 years old and a higher number of cases in some areas. It is suggested to further investigate and analyze the diagnosis and reporting of amoeba dysentery in key areas and promote the update of the diagnostic standards for amoeba dysentery.