1.Textual research on Fuxiong.
Fang-Yuan MU ; Jia-Xin TIAN ; Kun-Yu LI ; Hai-Guang MA ; Feng GAO
China Journal of Chinese Materia Medica 2025;50(6):1715-1720
Fuxiong has a long history of cultivation. Since its first record in the Beneficial Formulas from the Taiping Imperial Pharmacy of the Song Dynasty, Fuxiong had always been used by ancient physicians and became a preponderant variety for some reasons during the periods of the Ming Dynasty, Qing Dynasty, and Republic of China. However, as for modern use, only Chuanxiong Rhizoma is valued, and the medicinal value of Fuxiong is gradually being overlooked. This article systematically researches the nomenclature, producing area, origin, and efficacy of Fuxiong, proving that the planting technology of Fuxiong matured in the Song Dynasty at the latest, slightly later than the emergence of Chuanxiong Rhizoma in the Sui and Tang Dynasties. Over the years, the producing area of Fuxiong has not undergone significant changes, and it is mainly cultivated within Jiangxi province. According to the analysis of the origin of Xiongqiong, combined with modern genetic research, it can be basically clarified that the early source of Xiongqiong may not be single. With the popularization of cultivation, Chuanxiong Rhizoma became a Dao-di herb earliest, gradually replacing Xiongqiong and being recognized clinically. After cultivation, the polyploidy of Chuanxiong Rhizoma varieties formed stable inheritance, forming the later Fuxiong. Medical experts have gradually deepened their understanding of the efficacy of Fuxiong. Initially, they believed that it was a substitute for Chuanxiong Rhizoma and had weaker efficacy than Chuanxiong Rhizoma. Medical experts in Jin and Yuan Dynasties such as Zhu Danxi and Dai Sigong believed that Fuxiong was good at relieving stagnation. Books and records of materia medica in the Ming and Qing Dynasties explicitly proposed the great ability of Fuxiong to relieve stagnation. Fuxiong should be distinguished from Chuanxiong Rhizoma when applied, and the application differences should be clearly reflected in medical records. Based on the comprehensive research in this article, it can be concluded that although most of ancient physicians have attached great importance to genuineness of Chuanxiong Rhizoma, Fuxiong, as a dominant variety of traditional application, has a clear historical context and significant efficacy characteristics, worthy of further in-depth study.
Drugs, Chinese Herbal/history*
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China
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Medicine, Chinese Traditional/history*
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History, Ancient
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Humans
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History, Medieval
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Plants, Medicinal/chemistry*
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Rhizome/growth & development*
2.Exploration of Decision-Making Methods Based on Syndrome Differentiation by “Data-Knowledge” Dual-Driven Models: A Case Study of Gastric Precancerous State
Weichao XU ; Yanru DU ; Xiaomeng LANG ; Yingying LOU ; Wenwen JIA ; Xin KANG ; Shuo GUO ; Kun ZHANG ; Chunzhi SU ; Junbiao TIAN ; Xiaona WEI ; Qian YANG
Journal of Traditional Chinese Medicine 2024;65(2):154-158
Data analysis models may assist the transmission of traditional Chinese medicine (TCM) experience and clinical diagnosis and treatment, and the possibility of constructing a “data-knowledge” dual-drive model was explored by taking gastric precancerous state as an example. Data-driven is to make clinical decisions around data analysis, and its syndrome-differentiation decision-making research relies on hidden structural models and partially observable Markov decision-making processes to identify the etiology of diseases, syndrome elements, evolution of pathogenesis, and syndrome differentiation protocols; knowledge-driven is to make use of data and information to promote decision-making and action processes, and its syndrome-differentiation decision-making research relies on convolutional neural networks to improve the accuracy of local disease identification and syndrome differentiation. The “data-knowledge” dual-driven model can make up for the shortcomings of single-drive numerical simulation accuracy, and achieve a balance between local disease identification and macroscopic syndrome differentiation. On the basis of previous research, we explored the construction method of diagnostic assisted decision-making platform for gastric precancerous state, and believed that the diagnostic and decision-making ability of doctors can be extended through the assistance of machines and algorithms. Meanwhile, the related research methods were integrated and the core features of gastric precancerous state based on TCM syndrome differentiation and endoscopic pathology diagnosis and prediction were obtained, and the elements of endoscopic pathology recognition based on TCM syndrome differentiation were explored, so as to provide ideas for the in-depth research and innovative application of cutting-edge data analysis technology in the field of intelligent TCM syndrome differentiation.
3.Detection of five tick-borne pathogens in Maanshan City,Anhui Province,China
Guo-Dong YANG ; Kun YANG ; Liang-Liang JIANG ; Ming WU ; Ying HONG ; Ke-Xia XIANG ; Jia HE ; Lei GONG ; Dan-Dan SONG ; Ming-Jia BAO ; Xing-Zhou LI ; Tian QIN ; Yan-Hua WANG
Chinese Journal of Zoonoses 2024;40(4):308-314
Here,5 important pathogens carried by ticks in Maanshan City,Anhui Province,China were identified.In to-tal,642 ticks were collected from 13 villages around Maanshan City and identified by morphological and mitochondrial COI genes.The 16S rRNA gene of Francisella tularensis,ssrA gene of Bartonella,16S rRNA,ompA and ompB genes of Rickett-sia,16S rRNA and gltA genes of Anaplasma,and groEL and rpoB genes of Coxiella were sequenced.Reference sequences were retrieved from a public database.Phylogenetic trees were constructed with MEG A1 1.0 software.In total,36 Rickettsiae isolates were detected in 640 Haemaphysalis longicornis ticks,which included 20 isolates of Rickettsia heilongjian-gensis,16 of Candidatus Rickettsia jingxinensis,2 of Ana-plasma bovis,and 186 of Coxiella-like endosymbiont.R.hei-longjiangensis HY2 detected in this study and Anhui B8 strain,Ca.R.jingxinensis QL3 and those from Shanxi Prov-ince and Jiangsu Province,A.bovis JX4 and those from Shanxi Province were clustered on the same branch.Overall,17 ticks had combined infections and none of the 5 bacteria were detected in two Amblyomma testudinarium ticks.This is the first report of Ca.R.jingxinensis detected in H.longicornis ticks from Anhui Province.It is recommended that the two types of Rickettsia that cause spotted fever and A.bovis should be reported to local health authorities to initiate appropriate prevention and control measures.
4.Effect of different suspension moxibustion methods on syndrome characteristics of rats with rheumatoid arthritis of heat bi syndrome based on "moxibustion can be used for heat syndrome".
Zhong-Ting ZHAO ; Yi-Kun ZHAO ; Jia-Lian CHEN ; Tian-Tian ZHU ; Xing-Ke YAN ; Yan-Feng ZHANG
Chinese Acupuncture & Moxibustion 2023;43(9):1062-1069
OBJECTIVE:
To observe the effects of different suspension moxibustion methods on the syndrome characteristics and inflammatory factors of rats with rheumatoid arthritis (RA) of heat bi syndrome and to prove the concept of "moxibustion can be used for heat syndrome".
METHODS:
Among seventy Wistar rats, 12 rats were randomly selected as a normal group, and the remaining rats were induced by collagen combined with wind, dampness, and heat environmental stimulation to establish the RA model of heat bi syndrome. Forty-eight rats with successful model establishment were further randomly divided into a model group and three moxibustion groups (mild moxibustion group, rotating moxibustion group and sparrow-pecking moxibustion group), with 12 rats in each group. The acupoints "Quchi" (LI 11), "Dazhui" (GV 14) and ashi point were used in all moxibustion groups, with mild moxibustion, rotating moxibustion, and sparrow-pecking moxibustion intervention given respectively, each acupoint was treated with moxibustion for 10 min a day, and 6 days were considered one course of treatment, with a total of three courses. After the intervention, the arthritis index (AI), the Evans blue (EB) extravasated volume in the soft tissue of the right hind paw, and the levels of tumor necrosis factor (TNF)-α and interleukin (IL)-10 in the serum were measured by ELISA in each group. The volume of the bilateral hind paw was measured; the infrared thermal imaging was collected to analyze the temperature of the plantar area of the bilateral foot pads, and the reaction time of plantar heat pain was calculated before and after modeling, as well as after the 1st, 2nd and 3rd courses of interrention. The ankle dorsiflexion angle of the right hind foot was also measured before and after modeling, as well as after the intervention.
RESULTS:
After modeling, compared with the normal group, the rats in the model group had more high-temperature areas in the bilateral hind limbs, abnormal AI score, abnormal bilateral hind paw volume, abnormal temperature of the plantar area of the bilateral foot pads, abnormal foot pain response time, abnormal right hind ankle dorsiflexion angle, abnormal right hind paw soft tissue EB extravasation, and abnormal serum TNF-α and IL-10 levels (P<0.01, P<0.05). After the intervention, compared with the model group, the rats in each moxibustion group had decreased or disappeared high-temperature areas in the bilateral hind limbs, EB extravasated volume in the soft tissue of the right hind paw was reduced (P<0.05), and the right ankle dorsiflexion angle was increased (P<0.05), serum level of TNF-α was reduced, and level of IL-10 increased (P<0.05); the AI scores in the mild moxibustion group and the sparrow-pecking moxibustion group was decreased (P<0.01, P<0.05). After the 1st, 2nd and 3rd courses of intervention, compared with the model group, the bilateral hind paw volume of rats in each moxibustion group was decreased (P<0.05, P<0.01), and plantar heat pain reaction time was increased (P<0.05). After the 2nd course and the 3rd course of intervention, the temperature of the right hind paw pad area was decreased in each moribustion group (P<0.05); after the 3rd courses of intervention, the temperature of the left hind paw pad area was decreased in the mild moxibustion group (P<0.05).
CONCLUSION
Suspension moxibustion could adjust the serum levels of TNF-α and IL-10 to improve the syndrome characteristics of RA rats of heat bi syndrome, such as joint redness, swelling, heat, pain and activity restriction. The effect of mild moxibustion is the most prominent. The findings could provide scientific basis for "moxibustion can be used for heat syndrome".
Animals
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Rats
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Arthritis, Rheumatoid/therapy*
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Evans Blue
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Hot Temperature
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Interleukin-10/genetics*
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Moxibustion
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Rats, Wistar
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Tumor Necrosis Factor-alpha/genetics*
5. Resveratrol promotes autophagy through zinc ion and induces cardiomyocyte protection
Pei WANG ; Jin-Kun XI ; Hu MA ; Ying YANG ; You-Cheng HU ; Tian-Yu LIU ; Jia-Bao GUO ; Yong-Gui HE
Chinese Pharmacological Bulletin 2023;39(6):1048-1054
Aim To investigate whether resveratrol (Resveratrol, Res) induces cardiomyocyte protection by increasing intracellular zinc ion and its possible signal mechanism. Methods H9c2 cells were routinely cultured and 2-deoxyglucose (2-DG) was used to establish an endoplasmic reticulum stress (ERS) model. The experiment was randomly divided into control group, 2-DG group, Res +2-DG group, TPEN + Res + 2-DG group and 3-MA + Res +2-DG group. Cell viability was detected by MTT and CCK-8; the expression levels of ERS molecular chaperone proteins glucose-regulated protein 78 (GRP78), glucose-regulated protein 94 (GRP94) and autophagy proteins LC3 II / I, p62 and p-AMPK were detected by Western blot; the expression of LC3 protein was measured by cellular immunofluorescence; the mitochondrial membrane potential (Aijjm) and the intracellular zinc ion level were measured by laser scanning confocal microscope. Results Compared with the control group, 2-DG reduced cell activity and resveratrol inhibited the changes caused by 2-DG, which was reversed by zinc chelator TPEN. 2-DG increased GRP78 and GRP94 expression and resveratrol inhibited the protein changes caused by 2-DG, which was reversed by TPEN. 2-DG increased the expression of LC3 II / I, p-AMPK and decreased the expression of p62, and resveratrol promoted the effect of 2-DG. 2-DG increased the fluorescence intensity of LC3, and resveratrol enhanced the effect of 2-DG, which was reversed by TPEN and 3-MA. 2-DG reduced the red fluorescence intensity of mitochondrial TMRE and green fluorescence intensity of intracellular zinc ions, and resveratrol inhibited these changes caused by 2-DG, which was also reversed by TPEN and 3-MA. The above differences were all statistically significant (P < 0. 05). Conclusion Resveratrol increases intracellular zinc to promote ERS-induced autophagy and prevent the mPTP opening in H9c2 cardiac cells.
6. Effects of berberine on colon dermal cell apoptosis in mice with ulcerative colitis based on JAK/STAT signaling pathway
Chun-Lin LI ; Pi-Xian SHUI ; Shi-Chao LI ; Ying-Tian JIA ; Jian LI ; Kun-Peng ZHAO
Chinese Pharmacological Bulletin 2023;39(5):938-945
Aim To analyze the effects of berberine on the apoptosis of colon epithelial cells and polymorpho-nuclear neutrophils ( PMNs) in mice with ulcerative colitis ( UC ) by regulating JAK/STAT signaling pathway. Methods The UC mouse models were established by dextran sulfate sodium ( DSS) method and were randomly divided into control group, UC group, low-dose, middle-dose and high-dose berberine groups and positive drug group ( mesalazine enteric-coated tablet group) . In addition, the mice were randomly di¬vided into UC group, high-dose berberine group, AG490 group, and high-dose berberine + AG490 group. Levels of serum tumor necrosis factor a (TNF-α) and interleukin 6 (IL-6) and colon epithelial cell apoptosis and PMN apoptosis were compared among the groups. Western blot was used to detect the expres¬sions of colon tissue apoptosis-related and JAK/STAT signaling pathway-related proteins. Results The lev¬els of serum TNF-α and IL-6, apoptosis rate of colon epithelial cell and protein expressions of Fas, FasL, Bax, caspase-3, p-JAK2/JAK2 and p-STAT3/STAT3 in each dose berberine group and positive drug group were significantly lower than those in UC group (P < 0.05), and the above indicators in berberine groups were reduced gradually (P <0.05) . The PMN apoptosis rate and Bcl-2 protein expression were significantly higher in each dose berberine group and positive drug group than those in UC group (P <0. 05) , and the two indicators increased gradually in berberine groups ( P < 0.05). AG490 could reverse the above effects of berberine ( P < 0. 05 ). Conclusions Berberine can inhibit the apoptosis of colon epithelial cell and promote the apoptosis of PMN in UC mice by regulating the JAK/STAT signaling pathway, and then play a role in the treatment of UC.
7.Clinical observation on filiform-fire needling of "Biaoben acupoint combination" for 33 cases of sequelae of coronavirus disease 2019 during recovery period.
Zhi-Hui LUO ; Kun-Xiu WANG ; Yan-Lin ZHANG ; Zi-Qin CHEN ; Bei CHEN ; Jia CHEN ; Ting ZHOU ; Xiao-Lei GU ; Chong-Li LI ; Peng YAN ; Ling-Ling TIAN ; Chi-Cheng XU ; Bo-Lin CHEN ; Song CHEN ; Feng-Xia LIANG ; Song WU
Chinese Acupuncture & Moxibustion 2022;42(7):760-764
OBJECTIVE:
To observe the clinical therapeutic effect of filiform-fire needling of "Biaoben acupoint combination" on the sequelae of patients with coronavirus disease 2019 (COVID-19) during the recovery period.
METHODS:
A total of 33 patients with COVID-19 during the recovery period were treated with filiform-fire needling at the acupoints of Mingmen (GV 4), Shenzhu (GV 12), Gaohuang (BL 43), Zusanli (ST 36) and Shangjuxu (ST 37), etc., once every other day, 3 times a week, and 3 times was one course of treatment and totally 2 courses of treatment were required. The TCM symptom, Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) scores, pulmonary function indexes (forced vital capacity [FVC], forced expiratory volume in one second [FEV1], peak expiratory flow [PEF]) and chest CT imaging change were observed before and after treatment, and the therapeutic effect was evaluated.
RESULTS:
After treatment, the scores of TCM symptom, HAMA and HAMD were decreased compared with those before treatment (P<0.05), and the levels of FVC, FEV1 and PEF were increased compared with those before treatment (P<0.05), and the recovery rate of 22 patients with pulmonary ventilation dysfunction was 86.4% (19/22). After treatment, the lung shadow area was smaller than that before treatment (P<0.05). The effective rate of 25 patients with lung CT abnormalities was 84.0% (21/25). After treatment, 23 cases were cured, 5 cases were markedly effective, 4 cases were effective, 1 case was ineffective, the cured and markedly effective rate was 84.8%.
CONCLUSION
The filiform-fire needling of "Biaoben acupoint combination" could significantly reduce the sequelae of cough, fatigue, chest tightness, etc. and mental symptoms such as anxiety and depression in patients with COVID-19 during the recovery period, and promote inflammatory exudation absorption of pulmonary lesion and improve lung ventilation function.
Acupuncture Points
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Acupuncture Therapy
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COVID-19/therapy*
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Humans
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Lung
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Vascular Surgical Procedures
8.Clinical Efficacy of Modified Sanxiaoyin in Treatment of Mild or Moderate COVID-19 Patients: Based on Retrospective Analysis
Zhi-hui LUO ; Kun-xiu WANG ; Yan-lin ZHANG ; Zi-qin CHEN ; Bei CHEN ; Jia CHEN ; Ting ZHOU ; Xiao-lei GU ; Chong-li LI ; Peng YAN ; Ling-ling TIAN ; Chi-cheng XU ; Bo-lin CHEN ; Song CHEN ; Qing QI
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(1):150-156
ObjectiveTo retrospectively analyze the clinical data of 52 patients with coronavirus disease-2019 (COVID-19) and explore the clinical efficacy of modified Sanxiaoyin on mild/moderate COVID-19 patients. MethodThe propensity score matching method was used to collect the clinical data of mild or moderate COVID-19 patients enrolled in the designated hospital of the Second Hospital of Jingzhou from December 2019 to May 2020. A total of 26 eligible patients who were treated with modified Sanxiaoyin were included in the observation group, and the 26 patients treated with conventional method were the regarded as the control. The disappearance of clinical symptoms, disappearance time of main symptoms, efficacy on traditional Chinese medicine (TCM) symptoms, hospitalization duration, laboratory test indicators, and CT imaging changes in the two groups were compared. ResultThe general data in the two groups were insignificantly different and thus they were comparable. After 7 days of treatment, the disappearance rate of fever, cough, fatigue, dry throat, anorexia, poor mental state, and poor sleep quality in the observation group was higher than that in the control group (P<0.05), and the difference in the disappearance rate of expectoration and chest distress was insignificant. For the cases with the disappearance of symptoms, the main symptoms (fever, cough, fatigue, dry throat, anorexia, chest distress) disappeared earlier in the observation group than in the control group (P<0.01). After 7 days of treatment, the scores of the TCM symptom scale of both groups decreased (P<0.01), and the decrease of the observation group was larger that of the control group (P<0.01). All patients in the two groups were cured and discharged. The average hospitalization duration in the observation group [(12.79±2.68) d] was shorter than that in the control group [(15.27±3.11) d] (P<0.01). The effective rate in the observation group (92.31%, 24/26) was higher than that in the control group (76.92%, 20/26) . After 7 days of treatment, the lymphocyte (LYM) count increased (P<0.05), and white blood cell (WBC) count and neutrophil (NEUT) count decreased insignificantly in the two groups. Moreover, levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and procalcitonin (PCT) reduced in the two groups after treatment (P<0.01) and the reduction in the observation group was larger than that in the control group (P<0.01). Through 7 days of treatment, the total effective rate on pulmonary shadow in the observation group (90.00%, 18/20) was higher than that in the control group (77.27%, 17/22) (P>0.05) and the improvement of lung shadow in the observation group was better than that in the control group (P<0.01). ConclusionModified Sanxiaoyin can significantly alleviate fever, cough, fatigue, anorexia, chest distress, poor sleep quality, and other symptoms of patients with mild or moderate COVID-19, improve biochemical indicators, and promote the recovery of lung function. This paper provides clinical evidence for the application of modified Sanxiaoyin in the treatment of mild or moderate COVID-19.
9.Mechanisms of Ersi Decoction on Rheumatoid Arthritis Rats Induced by Bovine Type Ⅱ Collagen-solution
Tian-yue MA ; Yi-mei FANG ; Gan-lin GUO ; Jia-xi YANG ; Bin YANG ; Yi-kun YANG ; Qiu-ai KOU
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(5):38-45
ObjectiveTo observe that effect of Ersi decoction on rats with rheumatoid arthritis (RA) induced by using the complete Freund's adjuvant emulsion containing bovine type Ⅱ collagenand and elucidate underlying menchanisms involving to inhibit inflammation and joint synovial angiogenesis. MethodThe rat model of RA was established by immune induction with complete Freund's adjuvant emulsion containing bovine type Ⅱ collagen. All male SD rats were randomly divided into blank group, RA model group, methotrexate group(1.0 mg·kg-1), and low-, medium- and high-dose group(30,15,7.0 g·kg-1·d-1)of Ersi decoction, with 8 rats in each group. Except the blank group, rats in the methotrexate group and Ersi decoction groups were given corresponding doses of methotrexate and Ersi decoction after establishment of RA induced by strengthen immunity,respectively,and those in the model group and blank group received normal saline of equivalent volume,once a day for 28 days. After the administration, the degree of joint swelling of rats in each group was analyzed by joint swelling volume and index. The small animal ultrasound imaging system was used to detect the score and area of synovial hyperplasia of knee joint in right lower limb of rats and hematoxylin-eosin(HE)staining to observe the histomorphological changes in joint synovium of rats. The levels of tumor necrosis factor-α(TNF-α) and interleukin-1β(IL-1β) were measured by enzyme-linked immunosorbent assay(ELISA). Immunohistochemistry was employed to analyze the expression of CD31 and vascular endothelial growth factor receptor 2(VEGFR2) in in joint synovium. ResultCompared with the blank group, the model group demonstrated significant increase in joint swelling volume and index, inflammatory cytokines including TNF-α and IL-1β in serum, the score and area of synovial hyperplasia of knee joint in right lower limb, obvious pathological changes in the synovium and the expression of CD31 and VEGFR2 in joint synovium. Medium and high-dose Ersi decoction significantly alleviated the pathological changes of synovium tissue, attenuated joint swelling volume and index and decreased the expression of CD31 and VEGFR2 in joint synovium as compared with the model group. Moreover, high-dose Ersi decoction showed significantly lower levels of TNF-α and IL-1β in serum, and the score and area of synovial hyperplasia of knee joint in right lower limb. But medium-dose Ersi decoction only showed lower levels of TNF-α and area of synovial hyperplasia of knee joint. ConclusionErsi decoction could reduce synovial inflammation and hyperplasia through inhibiting synovial angiogenesis in rats with RA induced by bovine type Ⅱ collagen for achieving the effect of reducing RA joint damage, which provides an important reference for anti-RA of Ersi decoction in clinical application.
10.Analysis of the new WHO guideline to accelerate the progress towards elimination of schistosomiasis in China.
Zhao Yu GUO ; Jia Xin FENG ; Li Juan ZHANG ; Yi Biao ZHOU ; Jie ZHOU ; Kun YANG ; Yang LIU ; Dan Dan LIN ; Jian Bing LIU ; Yi DONG ; Tian Ping WANG ; Li Yong WEN ; Min Jun JI ; Zhong Dao WU ; Qing Wu JIANG ; Song LIANG ; Jia Gang GUO ; Chun Li CAO ; Jing XU ; Shan LÜ ; Shi Zhu LI ; Xiao Nong ZHOU
Chinese Journal of Schistosomiasis Control 2022;34(3):217-222
On February 2022, WHO released the evidence-based guideline on control and elimination of human schistosomiasis, with aims to guide the elimination of schistosomiasis as a public health problem in disease-endemic countries by 2030 and promote the interruption of schistosomiasis transmission across the world. Based on the One Health concept, six evidence-based recommendations were proposed in this guideline. This article aims to analyze the feasibility of key aspects of this guideline in Chinese national schistosomiasis control program and illustrate the significance to guide the future actions for Chinese national schistosomiasis control program. Currently, the One Health concept has been embodied in the Chinese national schistosomiasis control program. Based on this new WHO guideline, the following recommendations are proposed for the national schistosomiasis control program of China: (1) improving the systematic framework building, facilitating the agreement of the cross-sectoral consensus, and building a high-level leadership group; (2) optimizing the current human and livestock treatments in the national schistosomiasis control program of China; (3) developing highly sensitive and specific diagnostics and the framework for verifying elimination of schistosomiasis; (4) accelerating the progress towards elimination of schistosomiasis and other parasitic diseases through integrating the national control programs for other parasitic diseases.
China/epidemiology*
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Disease Eradication
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Humans
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Public Health
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Schistosomiasis/prevention & control*
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World Health Organization

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