The global malaria epidemic is still severe. Because of simple procedures, rapid detection and accuracy results, rapid diagnostic test (RDT) has become the most important and the most widely used diagnostic tool for malaria prevention and control. However, deletions in the RDT target Plasmodium falciparum histidine-rich protein 2/3 (Pfhrp2/3) genes may cause false-negative results of RDT, which has been included as one of the four biological threats to global malaria elimination. This article reviews the applications of RDT in the global malaria diagnosis, analyzes the threats and challenges caused by Pfhrp2/3 gene deletion, proposes methods for monitoring Pfhrp2/3 gene deletion, and summarizes the causes and countermeasures of negative RDT detections, so as to provide insights into consolidation of malaria elimination achievements in China and contributions to global malaria elimination.

Objective To investigate the seasonal Aedes population fluctuation and the resistance of Aedes populations to common insecticides in Jiangsu Province in 2020, so as to provide insights into vector-borne infectious diseases control.. Methods One village was randomly sampled from each of Xinbei District of Changzhou City and Zhangjiagang County of Suzhou City in southern Jiangsu Province, Hai’an County of Nantong City and Yandu District of Yancheng City in Central Jiangsu Province, and Suining County of Xuzhou City and Sihong County of Suqian City in northern Jiangsu Province during the period between May and October, 2020. A small ponding container was sampled, and larval Aedes mosquitoes were collected using straws once each in early and late stages of each month. All larvae were bred in laboratory to adults for population identification. In addition, larval breeding were observed in all small ponding containers in and out of 30 households that were randomly sampled from six surveillance sites, and the larval mosquito density was estimated using Breteau index. Larval A. albopictus mosquitoes were sampled around Cuiyuan New Village in Jintan District of Changzhou City, and bred in laboratory to the first offspring generation, and the susceptibility of adult female mosquitoes to deltamethrin, lambda-cyhalothrin, malathion, and propoxur was tested using the filter-paper bioassay recommended by WHO. Results A total of 1 165 larval Aedes mosquitoes were captured from small ponding containers in six surveillance sites of Jiangsu Province in 2020, and all were identified as A. albopictus following eclosion. The largest number of Aedes larvae captured was found in July. A total of 1 152 households were investigated in six surveillance sites, and the mean Breteau indexes were 9.58, 13.20, 13.71, 13.20, 12.18 and 5.58 from May to October, respectively, while a high Aedes transmission risk was seen in Xinbei District of Changzhou City, with a higher Breteau index than in Suining (H = 23.667, P_adjusted = 0.001) and Sihong (H = 22.500, P_adjusted = 0.003) counties. The field-captured A. albopictus from Cuiyuan New Village in Jintan District of Changzhou City remained sensitive to malathion, but was resistant to propoxur, and developed high-level resistance to deltamethrin and lambda-cyhalothrin. Conclusions A. albopictus was present in southern, central and northern Jiangsu Province in 2020, and the larval density peaked in July. A. albopictus captured from Cuiyuan New Village in Jintan District of Changzhou City has developed high-level resistance to pyrethroid pesticides.

Objective To investigate the serum 25-hydroxy vitamin D concentrations and related factors in early pregnancy. Methods Plasma was collected in the first trimester from 23 396 pregnant women to inves-tigate the vitamin D level, and its distribution and differences in different age, body maxx index ( BMI) and seasons between primipara and multipara. Preterm birth was used as an indicator of clinical outcomes. Vitamin D concentrations were measured using chemiluminescence microparticle immunoassay. Results 25-hydroxy vi-tamin D level was 42. 0 (17. 6-76. 6) nmol/L in totally 23 396 pregnant women with early pregnancy, and 5% and 95% percentile sites of vitamin D level were 20. 2 nmol/L and 70. 7 nmol/L respectively. There were 18 170 (77. 7%) primiparas and 5 226 (22. 3%) multiparas, with the mean age of 30. 0 (24. 0-38. 0) years and BMI of 20. 7 (16. 5-27. 6) kg/m2. The number of cases detected in spring (March, April and May), summer (June, July and August), autumn (September, October and November months) and winter (Decem-ber, January and February) were 5 878, 5 554, 5 974, and 5 990, respectively, and the vitamin D levels were 40. 0 (29. 3, 52. 7) nmol/L, 46. 2 (35. 6, 57. 2) nmol/L, 43. 8 (33. 1, 54. 8) nmol/L and 37. 2 (26. 9, 49. 9) nmol/L respectively, with the difference in vitamin D levels statistically significant among the four seasons (P<0. 001). According to BMI, all pregnant women were divided into four groups as BMI<18. 5 kg/m2, 18. 5 kg/m2≤BMI≤23. 9 kg/m2, 24 kg/m2≤BMI≤27. 9 kg/m2, BMI≥28 kg/m2, and the levels of 25-hydroxy vitamin D were 43. 5 (30. 9, 56. 9) nmol/L, 42. 1 (30. 8, 53. 8) nmol/L, 39. 9 (30. 7, 50. 4) nmol/L and 39. 7 (30. 7, 49. 4) nmol/L respectively with the difference statistically significant among the four groups. The levels of vitamin D detected in pregnant women with age<25 years, 25~29 years, 30~34 years,≥35 years were 39. 1 ( 28. 4, 52. 3) nmol/L, 41. 3 ( 30. 1, 52. 9) nmol/L, 42. 4 ( 31. 2, 54. 1) nmol/L and 43. 8 (31. 9, 55. 7) nmol/L respectively and the difference was statistically significant (P<0. 001). The levels of 25-hydroxy vitamin D in primary and multiparas were 41. 6 (30. 2, 52. 9) nmol/L and 43. 5 (32. 5, 56. 8) nmol/L with the difference statistically significant (P<0. 001). Among women of different gestational age during childbirth, the differences in serum 25-hydroxy vitamin D in early pregnancy were not statistically significant (P=0. 121). The severe deficiency of vitamin D in early pregnancy was defined as serum level of 25-hydroxy vita-min D less than 5th level. There were statistical differences in the probability of severe vitamin D deficiency of dif-ferent ages, seasons and BMI between primiparas and multiparas. Conclusions Pregnant women of lower weight, lower age and primiparity have higher incidence of the severe vitamin D deficiency in early trimester of pregnancy. There is significant difference in 25-hydroxy vitamin D level among the different seasons (winter

Objective To evaluate the clinical efficacy and safety of endoscopic submucosal dissection (ESD) guided with endoscopic ultrasonography (EUS) for rectal neuroendocrine neoplasms(NENs).Methods A retrospective analysis was performed on 58 patients with rectal ENEs who underwent ESD from January 2011 to December 2015 in JiangSu Province Hospital.Manifestations of EUS, clinicopathological characteristics, proliferation activity grade, complete resection rate, complications and follow-up results of lesion were studied.Results Those treated by ESD included 58 patients with 64 lesions of rectal NENs.EUS results showed that 3 lesions originated from mucosa, 3 from muscularis mucosa and 58 from submucosa.A total of 34 lesions located within 5 cm from anus, 26 in 6-10 cm from anus and 4 more than 10 cm from anus.All 64 lesions were successfully treated by ESD.The mean maximum diameter of the lesions was 0.8 cm(0.2-3.5 cm), and the mean procedure time was 31 min(10-60 min).The complete resection rate was 93.8% (60/64).There were 4 patients with positive basal surgical margin, and two of them underwent additional surgery and two others were treated with argon plasma coagulation after rejecting surgery and ESD.Histological examination determined that 59 lesions were pathologic grade 1(G1) and 5 were pathologic grade 2(G2).Delayed bleeding occurred in 4 cases after ESD,which was managed by medicine in 1 case and endoscopic treatment in 3 cases.No perforation occurred after ESD.During a mean follow-up period of 22.9 months(3-48 months), no lymph node metastasis or distant metastasis was observed.Conclusion EUS is able to distinguish the origin of rectal NENs and aid determining the range and depth of ESD.ESD appears to be a safe, feasible and effective procedure for providing accurate histopathologica1 evaluations as well as curative treatments for rectal NENs limited to submucosa.

Objective To understand the population,density,seasonal fluctuation and nocturnal pattern of malaria vectors in Jiangsu Province,thus to provide evidences for malaria elimination in this province. Methods Seven counties(cities,dis?tricts)were selected as the monitoring sites for malaria vectors in Jiangsu Province from 2013 to 2015. The mosquitoes were cap?tured by human bait trapping in bed nets and mosquito?lured lamp overnight,and the seasonal fluctuation and nocturnal pattern of malaria vectors were observed. Results A total of 11 041 Anopheles sinensis mosquitoes were captured by the mosquito?lured lamps in 7 counties of Jiangsu Province from 2013 to 2015,and no An. anthropophagous was found. Among all the 7 monitoring sites,the number of An. sinensis captured in Sihong County was the most(6 742 mosquitoes),while that in Xuyu County was the least(34 mosquitoes). During this period,the density peaks of An. sinensis were the first half of July,the first half of August and the second half of July. A total of 2 421 An. sinensis were collected in 7 monitoring sites from 2013 to 2015 by human bait trapping in bed nets overnight. Among all the 7 monitoring sites,the captured number of An. sinensis in Sihong County was the most(1 085 mosquitoes),while that in Ganyu County was the least(13 mosquitoes). The nocturnal peak of An. sinensis was from 19:00 to 20:00 and 525 An. sinensis mosquitoes were captured during this period of time,which accounted for 21.68%of the total. Hereafter,the captured number of An. sinensis reduced over time. Conclusion The density of An. sinensis mosquitoes is still high in individual areas in Jiangsu Province,so the epidemic and vector monitoring still should be strengthened to prevent the local transmission of imported malaria.

Objective with the advantages of rapidity in detection protein, We selected the gender-specific amino acid sequence based on human SMCY and SMCX, cloned and expressed SMCY gender-specific fusion antigens. The rabbits were immunized with purified antigens to obtain the polyclonal antibodies. A new method was established for rapidly sex identification of forensic evidence samples by detecting SMCY antigens with the corresponding polyclonal antibodies. Methods We found three differential fragments by analyzing the sequence of human SMCY and SMCX. Then we cloned this three fragments and ligated as a new recombinant.This SMCY gender-specific fusion antigen gene was sub-cloned into pET-28a and expressed in Escherichia coli. The fusion antigen was purified by Ni-NTA column. The rabbits were immunized with purified antigen to produce the specific polyclonal antibodies.The reactivity of the polyclonal antibody was evaluated by ELISA and Western blotting. We developed a colloidal gold test strip for detecting the gender of human samples. Results We successfully selected gender-specific amino acid sequence, the SMCY gender-specific fusion antigen was expressed by prokaryotic expression and the polyclonal antibody was prepared by immunizing rabbit. The results of colloidal gold strip tests showed that there is a significant difference between male and female serums. Conclusion The results showed that the SMCY gender-specific fusion antigen could be recognized by the polyclonal antibody.The colloidal gold strip tests made by SMCY gender-specific fusion antigens and the corresponding polyclonal antibodies could be used for rapidly determining the gender of forensic evidence samples.

Up to 80% of type 1 diabetes melitus children present with diabetic ketoacidosis (DKA). Stroke in children with DKA children is uncommon but life-threatening. Various types of stroke, such as ischemic, cerebral venous thrombosis, and hemorrhagic stroke were observed in children with DKA. In this article, we review the literatures regarding stroke in children with DKA.

Objective To explore the effect of different temperatures on the different development stages of Aedes albopic?tus. Methods The changes at different development stages of mosquitoes(egg,larva,pupae)and gonotrophic cycle were ob?served at different temperature conditions of 10,15,20,25,30,35℃and 40℃. The full developmental cycles were com?pared during different temperatures. Results All the stages of the mosquitoes could not develop at 10℃. Under the different temperatures of 15,20,25,30,35℃and 40℃,the hatchabilities of the mosquitoes were 0,32%,82%,83%,82%and 59%respectively;the pupation rates of the mosquitoes were 38%,53%,84%,88%,72%and 42%respectively;and the emer?gence rates of the mosquitoes were 92% 95% 97% 97% 83%and 17%respectively. The mosquitoes could well develop at 20 25 30℃and 35℃ the development time was 37.73 18.50 16.92 and 13.66 days respectively. Conclusion The devel?opment time of Aedes albopictus is shorter at the higher temperature. The optimum temperature for the mosquitoes to develop is between 25-30℃ and higher or lower the temperatures will suppress the development of the mosquitoes.

Objective To understand the malaria epidemic situation and characteristics in Jiangsu Province in 2012,so as to provide the evidence for formulating and adjusting effective malaria elimination strategies and measures. Methods The reported malaria cases from the Internet Reporting System and the epidemiological data of malaria in Jiangsu Province were collected and analyzed. Results A total of 198 malaria cases were reported in Jiangsu Province in 2012 with the incidence of 0.026/10 000, which decreased by 47.06%compared with that in 2011(374 cases). A total of 198 malaria cases were reported from 13 prefec-tures of Jiangsu and the cases were mainly distributed in Yangzhou(34 cases),Nantong(31 cases),Nanjing(22 cases),Tai-zhou(21 cases),Xuzhou(17 cases)and Huaian(17 cases),which accounted for 71.72%(142/198)among the total cases of the province. There were no local malaria cases reported from Jiangsu in 2012,and the imported malaria cases from other countries de-creased by 45.15%compared with that in 2011. Conclusions For the first time,there are no local malaria cases reported from Ji-angsu in 2012. However,the imported case distribution is further expanded and the infected plasmodium parasites are more di-verse. Imported malaria from other countries remains the key for malaria control in Jiangsu Province.

Objective To evaluate the toxic effect of Bacillus thuringiensis var. israelensis(Bti)wettable powder against Ae-des,Culex and Anopheles larvae. Methods The biological assay was applied to test the lethal concentration of 50%(LC50)of Bti wettable powder against Aedes,Culex and Anopheles larvae. Results The LC50(s) of Bti wettable powder against Aedes albopictus, Culex pipiens pallens and Anopheles sinensis larvae were 0.104,0.160μg/ml and 0.324μg/ml,respectively;its biological poten-cies against them were 0.125,0.192 IU/ml and 0.389 IU/ml,respectively. The LC50(s) of continuous contact of Bti wettable powder with An. sinensis stageⅢlarvae for 1,2 d and 3 d were 0.324,0.092μg/ml and 0.032μg/ml,respectively,and its biological po-tencies were 0.389,0.110 IU/ml and 0.038 IU/ml,respectively. The LC50(s) of the bacteria against An. sinensis stageⅠ,Ⅱ,Ⅲ,Ⅳwere 0.024,0.137,0.324 μg/ml and 0.450 μg/ml,respectively,and the biological potencies were 0.029,0.164,0.389 IU/ml and 0.540 IU/ml,respectively. Conclusion Bti wettable powder has a good toxicity to Aedes,Culex and Anopheles larvae,espe-cially for the latter two. It is better to apply the bacteria at the early stage of mosquito larvae.