Objective To investigate the epidemiological characteristics and spatial distribution characteristics of Clonorchis sinensis human infections in Guangdong Province from 2016 to 2022, so as to provide insights into formulation of the clonorchiasis control measures in the province. Methods Xinhui District of Jiangmen City, Longmen County of Huizhou City and Wengyuan County of Shaoguan City in Guangdong Province were selected as fixed surveillance sites for human clonorchiasis from 2016 to 2022, and additional 10% to 15% counties (districts) endemic for clonorchiasis were sampled from Guangdong Province as mobile surveillance sites each year from 2016 to 2022. A village (community) was randomly selected from each surveillance site according to the geographical orientations of east, west, south, north and middle, and subjects were randomly sampled from each village (community). C. sinensis eggs were detected in subjects’ stool samples using the Kato-Katz technique, and the prevalence and intensity of C. sinensis infections were calculated. In addition, subjects’ gender, age, ethnicity, educational level and occupation were collected. The Guangdong Provincial 1:1 million electronic map in vector format was downloaded from the National Geomatics Center of China, and kernel density analysis and spatial autocorrelation analysis of C. sinensis human infections in Guangdong Province from 2016 to 2022 were performed using the software ArcGIS 10.7. Results A total of 153 188 residents were tested for C. sinensis infections in Guangdong Province from 2016 to 2022, including 75 596 men (49.35%) and 77 592 women (50.65%), and there were 5 369 residents infected with C. sinensis, with 3.50% overall prevalence of infections. The prevalence rates of severe, moderate and mild C. sinensis infections were 0.76%, 7.26% and 91.97% among C. sinensis-infected residents in Guangdong Province from 2016 to 2022, and there were age-, gender-, ethnicity-, occupation- and educational level-specific prevalence of C. sinensis human infections (χ² = 2 578.31, 637.33, 52.22, 2 893.28 and 1 139.33, all P values < 0.05). Global spatial autocorrelation analysis showed a cluster in the prevalence of C. sinensis human infections in Guangdong Province (Moran’s I = 0.63, Z = 27.31, P < 0.05). Kernel density analysis showed that the prevalence of C. sinensis human infections with a high kernel density in Guangdong Province was mainly distributed along the Zhujiang River basin in Pearl River Delta areas, followed by in eastern and northern Guangdong Province. In addition, local spatial autocorrelation analysis identified 73 high-high clusters of the prevalence of C. sinensis human infections in Guangdong Province. Conclusions The prevalence of C. sinensis human infections was high in Guangdong Province from 2016 to 2022, and mild infection was predominant among all clonorchiasis cases, with spatial clusters identified in the prevalence of C. sinensis human infections. Targeted clonorchiasis control measures are required among high-risk populations and areas.

Objective To investigate the expression of pepsin in vocal cord polyps and vocal cord cancer,and to compare the difference of pepsin expression.Methods From May 2020 to December 2021,27 patients with vocal cord polyp,27 patients with vocal cord cancer and 23 healthy volunteers were selected.RSI and RFS scoring scales were used for scoring,pepsin detection kit was used for saliva pepsin detection,and immunohistochemical methods were used to detect the expression of pepsin in vocal cord tissues of patients with vocal cord polyps and vocal cord cancer.Results The RSI score,RFS score and pepsin test kit results of vocal cord polyp group and vocal cord canc-er group were higher than those of non-vocal cord disease group,and the differences of the three indexes were statis-tically significant(P＜0.05).RSI score,pepsin detection kit results and pepsin immunohistochemistry results of vocal cord polyp group showed no significant difference compared with vocal cord cancer group(P＞0.05).The RFS score of vocal cord polyp group was significantly different from that of vocal cord cancer group(P＜0.05).Conclusion Pepsin may be an important pathogenic factor of vocal cord polyp and vocal cord cancer,and play an im-portant role in the occurrence of these two diseases.The difference of pepsin expression in vocal cord polyp and vo-cal cord cancer suggests that pepsin may have different pathogenesis.

ObjectiveTo investigate the possible mechanism of Buzhong Yulin Decoction （补中愈淋汤） in the prevention and treatment of recurrent urinary tract infection. MethodsThe mouse models of recurrent urinary tract infection were established by uropathogenic Escherichia coli （UPEC） strain UTI89 by bladder perfusion， and the successful mouse models were randomly divided into a model group， an antibiotic group， and a low- and high-dose Buzhong Yulin Decoction group， with six mice in each group. In addition， 5 C57BL/6 mice without modelling were taken as blank group. The low- and high-dose Buzhong Yulin Decoction groups received 0.1 ml/10 g of decoction by gavage， with concentrations of 1.3 g/ml and 5.2 g/ml， respectively； the antibiotic group received 0.1 ml/10 g of levofloxacin hydrochloride solution with 5 mg/ml by gavage； the blank and model groups received 0.1 ml/10 g of distilled water by gavage. Each group was gavaged once a day for 7 consecutive days. The total number of urine marks， the number of central urine marks， and the total urine volume of the urine marks were observed by the urine marking test； HE staining was used to observe the histopathological changes in the bladder of mice； serum levels of the inflammatory factors interleukin 1β （IL-1β）， interleukin 6 （IL-6） and tumour necrosis factor α （TNF-α） were detected by ELISA； the morphology of the epithelial cells of bladder was observed by scanning electron microscopy； immunofluorescence assay to detect bladder tissue anti-UroPlakin 3A protein level and UPEC bacterial load； the spread plate method to detect urinary bacterial load and bacterial load of bladder epithelial cells； RT-PCR method to detect Ras-related protein Rab-11A （RAB11A） and Ras-related protein Rab-27B （RAB27B） mRNA level in bladder tissue； immunoblotting to detect microtubule-associated protein 1 light chain3 （LC3） and P62 protein levels in bladder tissue. ResultsCompared with the blank group， the bladder epithelial cell layers were lost and showed abnormal morphology in mice of the model group； bladder tissue UroPlakin 3A protein and RAB11A and RAB27B mRNA levels reduced， the total number of urine marks， the number of central urine marks， bladder tissue UPEC bacterial load， urinary bacterial load， bacterial load in bladder epithelial cells， serum IL-1β， IL-6， and TNF-α levels， and LC3 and P62 protein levels in bladder tissue all elevated （P＜0.05 or P＜0.01）. Compared with the model group， the bladder epithelial cell layers were intact and the morphology of epithelial cells were regular in the low- and high-dose Buzhong Yulin Decoction groups； the average surface area of bladder epithelial cells reduced， the levels of UroPlakin 3A protein and RAB11A and RAB27B mRNA in bladder tissues elevated， and total number of urine marks， the number of central urine marks， bladder tissue UPEC bacterial load， urinary bacterial load， bacterial load in bladder epithelial cells， serum IL-1β， IL-6， and TNF-α levels， and P62 protein levels in bladder tissue all reduced （P＜0.05 or P＜0.01）， but LC3 protein levels showed no statistically significant （P＞0.05）. In the antibiotic group， the bladder epithelial cells were partially missing and the morphology of epithelial cells was abnormal. Compared with the antibiotic group， the average surface area of the bladder epithelial cells in the mice increased in the low- and high-dose Buzhong Yulin Decoction groups， the bacterial load of the bladder epithelial cells decreased， and the P62 protein level of the bladder tissue decreased （P＜0.05）. When comparing between the low- and high-dose Buzhong Yulin Decoction groups， the differences in each index were not statistically significant （P＞0.05）. ConclusionBuzhong Yulin Decoction may prevent and treat recurrent urinary tract infection by repairing the bladder mucosal barrier， increasing RAB11A and RAB27B level and enhancing autophagy in bladder tissues， thereby facilitating bacterial clearance from bladder epithelial cells and reducing the bacterial load of bladder epithelial cells.

Objective:To explore the barriers and facilitators for family members to inform elderly cancer patients of their condition.Methods:From August 2020 to September 2021, a total of family members of 16 elderly cancer patients admitted to the Renmin Hospital of Wuhan University were selected by convenient sampling. Semi-structured qualitative interview was conducted with the patients' family members. Colaizzi 7-step analysis method was used to analyze, sort out and refine the data.Results:A total of 8 themes were extracted. Barriers included integrating the patient's personality and experience to speculate the patient's acceptance, it was predicted that the sadness would be aggravated after being informed according to the current condition, lack of support and communication barriers. Facilitators included conjecture based on the patient's personality and willingness, there was a need to know the condition, maintaining family atmosphere and family culture and reference to relevant external information.Conclusions:There are many barriers and facilitators in the condition notification of elderly cancer patients. Medical and nursing staff and family members should not blindly conceal patients' condition. We should pay attention to patients' expression and respect their wishes, and provide personalized information and care strategies based on their past experience and current situation.

Objective To analyze the epidemic status of principal human parasites, so as to provide scientific evidence for making prevention countermeasures for Guangdong Province in the future. Methods In 2015, a survey was performed according to the scheme of "The 3rd National Survey of Principal Human Parasites"as well as the incidence of parasites disease in Guangdong Province,the residents at 48 investiation sites in counties were surveyed. The survey of the soil-transmitted nematodes (Ascariasis, Ancylostoma, Trichuris trichiura and Enterobius vermicularis) and intestinal protozoa were performed based on the ecological regions and stratified by economic and geographic situation.The survey of food borne Clonorchis sinensis was performed along with the soil-transmitted nematodes in rural areas, and it was performed by the sample method of random cluster in cities and towns.The residents in each investigation site as the object, the ovum of the soil-transmitted nematodes, Clonorchis sinensis and other helminths were examed by the modified Kato-Katz method, test tube filter paper was used to identify Hookwormspecies, and the intestinal protozoa was checked by direct smear method. The transparent tape anal swabs method for children aged 3 - 6 years to check Enterobius vermicularis. Results Totally 12 401 residents of 48 survey sites from 22 counties were surveyed, and the total infection rate of intestinal parasites was 8.29%(1 028/12 401). The infection rate of soil-transmitted nematodes was 3.39% (420/12 401),in which the infection rate of Ascariasis, Ancylostoma, Trichuris trichiura and Enterobius vermicularis were 0.52% (64/12 401), 1.89%(234/12 401),0.46%(57/12 401),and 0.52%(65/12 401),respectively.The infection rate of Clonorchis sinensis was 4.90%(608/12 401). Nine hundred and sixty-seven children were tested for eggs of Enterobius vermicularis with the infection rate of 12.41% (120/967). The number of hook larva culture was 153, among them, 140 were hookworm larvae of America and no duodenal hookworm larvae and other nematode species were found.Totally 9 309 residents were tested for intestinal protozoa infection,and the infection rate was 0.31%(29/9 309). Conclusion In Guangdong Province, the infection rate of soil-transmitted nematodes is decreasing while the infection rate of Clonorchis sinensis is still high, and the control work of parasites still should be strengthened especially for food borne parasitic diseases.

Objective To observe the effects of recombinant protein ferritin heavy chain of Clonorchis sinensis (CsFHC) on human hepatic stellate cell line LX-2. Methods LX-2 cells were cultured in vitro by the cell culture method . Cell proliferation/toxicity detection kit (CCK-8) was used to detect the cell proliferation activity of LX-2 cells stimulated with CsFHC recombinant protein [0 (control), 1, 2, 5, 10, 20 nmol/L] at 48 h and 72 h, respectively, and the effect of CsFHC recombinant protein on cell cycle was analyzed by flow cytometry; a semi quantitative RT-PCR was used to detect the mRNA expression of type I collagen (Collagen Ⅰ), type Ⅲ collagen (Collagen Ⅲ) and α smooth muscle actin (Αsma). Results The effects of CsFHC on proliferation of LX-2 cells (48 h: 0.987 ± 0.042, 1.315 ± 0.105, 1.298 ± 0.078, 1.432 ± 0.089, 1.781 ± 0.040, 1.581 ± 0.056; 72 h:1.050 ± 0.030, 1.503 ± 0.111, 1.671 ± 0.102, 1.769 ± 0.123, 1.927 ± 0.067, 1.492 ± 0.081) between groups were significantly different statistically (F = 1892.133, 534.136, P<0.05). The quiescent stage/DNA synthesis (G0/G1 ) cells in 1, 2, 5, 10, and 20 nmol/L CsFHC recombinant protein groups (74.93 ± 4.05, 75.87 ± 4.16, 76.73 ± 5.03, 78.57 ± 5.51, 74.90 ± 3.61) were significantly higher than that of control group (54.90 ± 3.61, P<0.05);the synthesis phase (S) + DNA synthesis late/mitotic (G2/M) cells (22.24 ± 3.06, 24.13 ± 2.00, 18.54 ± 1.53, 18.71 ± 1.53 and 21.17 ± 3.06) were lower than that of control group (33.26 ± 2.65,P < 0.05). In control and 1, 2, 5, 10, 20 nmol/L CsFHC recombinant protein groups, the differences of Mrna expression levels of Collagen Ⅰ, Collagen Ⅲ and α SMA were statistically significant (48 h:F=81.419, 14.417, 70.456;72 h:F=79.224, 50.461, 41.872, P<0.05). Conclusion The CsFHC recombinant protein can stimulate the proliferation and activation of LX-2 cells in vitro, the CsFHC involved in the process of hepatic fibrosis induced by Clonorchis sinensis.

In the past decades, people's work and life styles have dramatically changed during the rapid economic development and urbanization in China. A national survey reported that Chinese adults spend an average of 81% of daily time in indoor environment. Exposure to indoor air pollution plays key roles for human health but is likely to be neglected due on the relatively lower concentration levels and lower awareness among common people. Till now, published studies focus more on the pollution levels or the toxicological effects of indoor air pollutants but there is a lack of disease burden assessment attributable to indoor air pollution. In this review, several international studies were introduced on the disease burden estimation attributable to indoor air pollution, as well as the estimation methods. The current situation of national study was also reviewed. The strengths and limitations of the representative international studies were discussed. This review is helpful in providing data to guide the research on disease burden assessment attributable to indoor air pollution in China, and further helps to prioritize the indoor air pollution control based on disease burden ranking among pollutants and motivate public policies to protect the public health.

Objective To investigate the long-term clinical efficacy of simplified multivisceral transplantation in patients with end-stage liver disease and type 2 diabetes.Methods The clinical data of 31 cases of simplified multivisceral transplantations between 2009 to 2017 were retrospectively analyzed.Results Median post-transplant follow-up was currently 13 ± 26 (0-86) months.Two recipients died of multiple organ dysfunction system (MODS) followed by severe sepsis on postoperative day (POD) 15 and 18,respectively.One recipient died from severe pneumonia with pyemia on POD 37.One recipient died of graft versus host disease (GVHD) on POD 40.One recipient died from acute myelogenous leukemia.Two recipients died of tumor recurrence at postoperative month (POM) 9 and 26,respectively.No biliary complication or diabetes recurrence was observed during follow-up.Condusion Donation after citizen's death is becoming the only organic source in China.Our results indicate that combined en-bloc liver-pancreas transplantation is technically feasible and leads to excellent long-term control of glucose metabolism and satisfactory quality of life in recipients with end—stage liver disease and diabetes mellitus.

ObjectiveTo evaluate temporary balloon occlusion of the abdominal aorta in high-order position sacral tumor surgical operation as a useful adjuvant technique.MethodsReviewed 79 cases of patients from 2005 to 2015 treated in our department and the diagnosis of high-order position sacral tumor. Temporary balloon occlusion of abdominal aorta was used in 50 patients(male 29,female 21)during the sacral tumors surgical operations. The other 29 patients(male 18,female 11)with sacral tumors who received the non-temporary balloon occlusion therapy were used as control group. The statistical differences of the whole surgery time,the blood loss during the surgery,the happening of the postoperative deep vein thrombosis,the time of the postoperative extubation were analyzed. ResultsThe differences were statistically significant(P<0.001)in the whole surgery time of balloon occlusion group(146.36±29.38)min vs non-balloon occlusion group(206.03±125.93)min,the blood loss of balloon occlusion group(1610.70±491.14)ml vs non-balloon occlusion group(2658.62±562.213)mL, and the time of the postoperative extubation of balloon occlusion group(6.60±2.76)d vs non-balloon occlusion group(12.52±2.86)d. However,there was not significant difference of the happening of the postoperative deep vein thrombosis between balloon occlusion group and non- balloon occlusion group. ConclusionTemporary balloon occlusion of abdominal aorta is effective and reliable. It significantly reduced the time of operations,the loss of blood,mean days in hospital,effusion of post-operation and recurrence rate. It makes the operation of sacral tumors much more safer than before and is a technique worthy of popularizing.

Objective To investigate the features of peripheral nerve injuries in workers exposed to vibration.Methods A total of 197 male workers [median age:34 years (21-50 years);median working years of vibration exposure:7.3 years (1-20 years)] engaged in grinding in an enterprise were enrolled.Their clinical data and electromyography results were analyzed to investigate the features of peripheral nerve impairment.Results Of all workers,96 (48.73％) had abnormal electromyography results.Of all workers,88 (44.7％) had simple mild median nerve injury in the wrist,who accounted for 91.7％(88/96) of all workers with abnormal electromyography results.Six workers had ulnar nerve injury,superficial radial nerve injury,or/and superficial peroneal nerve injury and accounted for 6.3％ of all workers with abnormal electromyography results.Of all workers,88 had a reduced amplitude of median nerve sensory transduction,and 28 had slowed median nerve sensory transduction.A total of 46 workers were diagnosed with occupational hand-arm vibration disease and hospitalized for treatment.They were followed up for more than 4 months after leaving their jobs,and most of them showed improvements in neural electromyography results and returned to a normal state.Conclusion Workers exposed to vibration have a high incidence rate of nerve injury in the hand,mainly sensory function impairment at the distal end of the median nerve,and all injuries are mild peripheral nerve injuries.After leaving the vibration job and being treated,most workers can achieve improvements and return to a normal state.