Objective Objective To analyze the potential spatial factors affecting the genetic differentiation of Oncomelania hupensis robertsoni in Yunnan Province. Methods A total of 13 administrative villages were selected from schistosomiasis-endemic areas of Yunnan Province as O. hupensis snail sampling sites. At least 200 snails were collected in each site, and the spatial variable data of each site were recorded, including longitude, latitude and altitude. Thirty active and Schistosoma japonicum uninfected O. hupensis snails were selected from each sampling site by means of the crawling method and the cercarial shedding method. Genomic DNA was extracted from O. hupensis snails. Following PCR amplification, purification of PCR amplification products and sequencing, the gene sequences of O. hupensis snail samples were spliced and edited using the DNAstar software and the NCBI database to yield the complete mitochondrial sequences of O. hupensis snails at each sampling site, and the mitochondrial genetic distance matrix of O. hupensis robertsoni was calculated at each sampling site. The geographical coordinates of each sampling site were marked using the software ArcGIS 10.2, and the straight-line geographical distance between each sampling site was calculated. The altitude difference, longitude difference and latitude difference between each sampling site were calculated using the Excel software, and the correlation between the mitochondrial genetic distance matrix of O. hupensis robertsoni and each spatial variable matrix was examined by using the Mantel test at 13 sampling sites in Yunnan Province. Results Among the 13 O. hupensis snail sampling sites in Yunnan Province, the largest mitochondrial genetic distance of O. hupensis robertsoni snail populations was seen between Anding Village, Nanjian Yi Autonomous County and Caizhuang Village, Midu County (26.244 2), and the largest geographical distance was seen between Dongyuan Village, Gucheng District and Cangling Village, Chuxiong County (272.64 km). The highest altitude difference was seen between Anding Village, Nanjian Yi Autonomous County and Dongyuan Village, Gucheng District (1 086.10 m), and the largest longitude difference was found between Qiandian Village, Eryuan County and Cangling Village, Chuxiong County (1.86°), while the largest latitude difference was measured between Leqiu Village, Nanjian Yi Autonomous County and Dongyuan Village, Gucheng District (1.81°). In addition, the mitochondrial genetic distance of O. hupensis robertsoni snail populations was positively correlated with altitude at 13 snail sampling sites in Yunnan Province (r = 0.542 8, P < 0.001), and showed no significant correlations with geographical distance (r = 0.093 4, P > 0.05), longitude (r = −0.199 5, P > 0.05) or latitude (r = 0.205 7, P > 0.05). Conclusion Altitude may be a potential spatial factor affecting the genetic differentiation of O. hupensis robertsoni in Yunnan Province.

Oral squamous cell carcinoma(OSCC)is a malignant lesion originating from the oral mucosal squamous epithelium,account-ing for over 80％of oral and maxillofacial malignancies.Key etiological factors include tobacco,alcohol abuse,and betel quid chewing.In China,its incidence has shown an overall upward trend,posing a significant threat to public health.OSCC exhibits high local invasive-ness,making early diagnosis critical for improving prognosis.Its clinical management requires close multidisciplinary collaboration among oral and maxillofacial surgery,head and neck surgery,radiation oncology,medical oncology,reconstructive surgery,radiology,patholo-gy,and nutritional support teams.Given the increasing disease burden of OSCC and rapid development of multidisciplinary collaborative models,an expert panel has formulated this integrated management consensus based on evidence-based medicine and extensive deliber-ation.Centered on the'Prevention-Screening-Diagnosis-Treatment-Rehabilitation'framework,the consensus provides comprehensive guidance for the entire disease course of OSCC patients,aiming to standardize clinical practice.

Oral squamous cell carcinoma(OSCC)is a malignant lesion originating from the oral mucosal squamous epithelium,account-ing for over 80％of oral and maxillofacial malignancies.Key etiological factors include tobacco,alcohol abuse,and betel quid chewing.In China,its incidence has shown an overall upward trend,posing a significant threat to public health.OSCC exhibits high local invasive-ness,making early diagnosis critical for improving prognosis.Its clinical management requires close multidisciplinary collaboration among oral and maxillofacial surgery,head and neck surgery,radiation oncology,medical oncology,reconstructive surgery,radiology,patholo-gy,and nutritional support teams.Given the increasing disease burden of OSCC and rapid development of multidisciplinary collaborative models,an expert panel has formulated this integrated management consensus based on evidence-based medicine and extensive deliber-ation.Centered on the'Prevention-Screening-Diagnosis-Treatment-Rehabilitation'framework,the consensus provides comprehensive guidance for the entire disease course of OSCC patients,aiming to standardize clinical practice.

Objective: To discuss the role of enhanced recovery after surgery (ERAS) in patients with colorectal carcinoma after natural orifce specimen extraction surgery (NOSES). Methods: From March 2017 to May 2018, 86 patients diagnosed with colorectal carcinoma and received NOSES at Tangshan Gongren Hospital were randomized to the control group and the observation group. Doctors utilized traditional interventions in the control group. In the observation group were orally administered with electrolyte solution for 12 hours before surgery, without gastrointestinal decompression tube routinely. Patients were fasting for 6 hours before surgery, 2 hours of water inhalation, and oral administration of 10% glucose 3 hours before surgery. During surgery, patients received intraoperative warming and controlled infusion volume. After operation, no drainage tube was placed, and multi-mode analgesia was used. The patient was given a fluid diet on the first day after surgery, and gradually transitioned to a normal diet. The intraoperative blood loss, number of lymph node dissection, operation time, hospitalization time, hospitalization expenses, first drinking time after surgery, diet time, exhaust time, time to get out of bed, pre-and post-operative self-rating anxiety scale (SAS) and self-rating depression scale (SDS) score, postoperative Barthel index and complication were compared between the two groups. Results: The intraoperative blood loss, number of lymph node dissection, and operation time were almost the same between the two groups (all P>0.05). The hospitalization time (6.8±1.2 d versus 8.5±1.5 d) and expenses (58±10 thousand Yuan versus 69±12 thousand Yuan) were significantly reduced in The first drinking time after surgery(1.31±0.35 d versus 2.28±0.24 d), diet time(1.8±0.4 d versus 3.0±0.4 d), exhaust time(2.4±0.5 d versus 2.9±0.6 d), and time to get out of bed (12.0±2.4 d versus 16.8±2.5 d) were all earlier in the observation group (all P<0.05). The SAS and SDS score before the operation were similar between the two groups (all P>0.05), while post-operative SAS (57±7 versus 69±8) and SDS (57±4 versus 62±9) score were significantly decreased in the observation group (all P<0.05). The incidence rates of complication after surgery was 7.0%(3/43) in the observation group, which was significantly lower than the control group (27.9%, 12/43, P=0.011). Conclusion The combination of NOSES and EARS could reduce stress response, complications, recovery time and expense after surgery, while improving the quality of life in these patients.

Objective To discuss the role of enhanced recovery after surgery ( ERAS) in patients with colorectal carcinoma after natural orifce specimen extraction surgery (NOSES). Methods From March 2017 to May 2018, 86 patients diagnosed with colorectal carcinoma and received NOSES at Tangshan Gongren Hospital were randomized to the control group and the observation group. Doctors utilized traditional interventions in the control group. In the observation group were orally administered with electrolyte solution for 12 hours before surgery, without gastrointestinal decompression tube routinely. Patients were fasting for 6 hours before surgery, 2 hours of water inhalation, and oral administration of 10% glucose 3 hours before surgery. During surgery, patients received intraoperative warming and controlled infusion volume. After operation, no drainage tube was placed, and multi?mode analgesia was used. The patient was given a fluid diet on the first day after surgery, and gradually transitioned to a normal diet. The intraoperative blood loss, number of lymph node dissection, operation time, hospitalization time, hospitalization expenses, first drinking time after surgery, diet time, exhaust time, time to get out of bed, pre?and post?operative self?rating anxiety scale (SAS) and self?rating depression scale (SDS) score, postoperative Barthel index and complication were compared between the two groups. Results The intraoperative blood loss, number of lymph node dissection, and operation time were almost the same between the two groups (all P＞0.05). The hospitalization time (6.8±1.2 d versus 8.5 ± 1.5 d) and expenses (58± 10 thousand Yuan versus 69± 12 thousand Yuan) were significantly reduced in The first drinking time after surgery(1.31±0.35 d versus 2.28± 0.24 d), diet time(1.8±0.4 d versus 3.0±0.4 d), exhaust time(2.4±0.5 d versus 2.9±0.6 d), and time to get out of bed (12.0±2.4 d versus 16.8±2.5 d) were all earlier in the observation group (all P＜0.05). The SAS and SDS score before the operation were similar between the two groups ( all P＞0.05), while post?operative SAS (57±7 versus 69±8) and SDS (57±4 versus 62±9) score were significantly decreased in the observation group (all P＜0.05).The incidence rates of complication after surgery was 7.0%(3／43) in the observation group, which was significantly lower than the control group ( 27.9%, 12／43, P＝0.011). Conclusion The combination of NOSES and EARS could reduce stress response, complications, recovery time and expense after surgery, while improving the quality of life in these patients.

Objective To discuss the role of enhanced recovery after surgery ( ERAS) in patients with colorectal carcinoma after natural orifce specimen extraction surgery (NOSES). Methods From March 2017 to May 2018, 86 patients diagnosed with colorectal carcinoma and received NOSES at Tangshan Gongren Hospital were randomized to the control group and the observation group. Doctors utilized traditional interventions in the control group. In the observation group were orally administered with electrolyte solution for 12 hours before surgery, without gastrointestinal decompression tube routinely. Patients were fasting for 6 hours before surgery, 2 hours of water inhalation, and oral administration of 10% glucose 3 hours before surgery. During surgery, patients received intraoperative warming and controlled infusion volume. After operation, no drainage tube was placed, and multi?mode analgesia was used. The patient was given a fluid diet on the first day after surgery, and gradually transitioned to a normal diet. The intraoperative blood loss, number of lymph node dissection, operation time, hospitalization time, hospitalization expenses, first drinking time after surgery, diet time, exhaust time, time to get out of bed, pre?and post?operative self?rating anxiety scale (SAS) and self?rating depression scale (SDS) score, postoperative Barthel index and complication were compared between the two groups. Results The intraoperative blood loss, number of lymph node dissection, and operation time were almost the same between the two groups (all P＞0.05). The hospitalization time (6.8±1.2 d versus 8.5 ± 1.5 d) and expenses (58± 10 thousand Yuan versus 69± 12 thousand Yuan) were significantly reduced in The first drinking time after surgery(1.31±0.35 d versus 2.28± 0.24 d), diet time(1.8±0.4 d versus 3.0±0.4 d), exhaust time(2.4±0.5 d versus 2.9±0.6 d), and time to get out of bed (12.0±2.4 d versus 16.8±2.5 d) were all earlier in the observation group (all P＜0.05). The SAS and SDS score before the operation were similar between the two groups ( all P＞0.05), while post?operative SAS (57±7 versus 69±8) and SDS (57±4 versus 62±9) score were significantly decreased in the observation group (all P＜0.05).The incidence rates of complication after surgery was 7.0%(3／43) in the observation group, which was significantly lower than the control group ( 27.9%, 12／43, P＝0.011). Conclusion The combination of NOSES and EARS could reduce stress response, complications, recovery time and expense after surgery, while improving the quality of life in these patients.

Objective To assess the theoretical knowledge and practical skills of parasitic diseases among technicians from disease control and prevention institutions. Methods The Assessment on National Parasitic Disease Control and Prevention Techniques was organized in September,2015. Together,124 subjects from disease control and prevention institutions at prov-ince,prefecture or county levels in 31 provinces joined the assessment. A database was built consisting of subjects'basic infor-mation and assessment scores. Statistical analysis was used to analyze the scores by gender,age,professional title,institutions and places of participants. Results The average total score of all the subjects was 123.3,with a passing rate of 57.3%. The av-erage scores of male subjects(48 subjects)and female subjects(76 subjects)were 125.9 and 121.7 respectively;the average scores of the subjects aged under 30 years(57 subjects),between 30 and 40 years(61 subjects)and above 40 years(6 sub-jects)were 119.6,128.1 and 111.2 respectively;the average scores of persons with junior(94 subjects),intermediate(28 sub-jects)and senior(2 subjects)professional titles were 119.2,135.9 and 140.5 respectively. The average theoretical assessment score of all the subjects was 61.9,with a passing rate of 62.9%. The average practical skill assessment score of all the subjects was 61.4,with a passing rate of 58.1%. Conclusions The theoretical assessment results range widely. The theoretical knowl-edge results of technicians from disease control and prevention institutions are low in general. Therefore ,the specific training based on daily work needs to be enhanced.

Objective To provide the reference for schistosomiasis control through analyzing the changes of endemic status of schistosomiasis in China in recent years. Methods The annual data of schistosomiasis prevention and control from 2002 to 2012 were collected, and the descriptive analysis was conducted to describe the changes of schistosomiasis endemic status. Re?sults Sichuan, Yunan and Jiangxi provinces reached the criteria of transmission controlled from 2002 to 2010 while Hubei, Hu?nan, Jiangxi and Anhui provinces reached the criteria of infection controlled in 2008. The number of counties where the trans?mission of schistosomiasis was controlled decreased from 110 in 2002 to 80 in 2010. The numbers of estimated schistosomiasis cases and reported acute cases fell from 810.4 thousands and 913 in 2002 to 325.8 thousands and 43 in 2010, respectively, and they were reduced by 59.79%and 95.40%respectively. The number of infected bovine went down from 23 199 in 2002 to 7 173 in 2010, with a fall of 69.03%. However, the Oncomelania hupensis snails breeding areas kept in 3.7 to 3.8 billion m2 and among which, 125 million m2 areas were newly discovered in non?endemic areas during the nine years. In 2010, 90%of schistosomiasis cases, acute cases, infected bovine, and snail breeding areas were concentrated in 5 provinces, especially in the Dongting Lake and Poyang Lake areas and the regions along the Yangtze River. Conclusions The epidemic of schistosomiasis decreased sig?nificantly from 2002 to 2010. The lake regions are the key and tough areas for schistosomiasis prevention and control. To consoli?date the achievements, the surveillance and case management need to be strengthened as the extension of snail breeding areas and acute cases reported from other places becomes common.

Objective To analyze the time and space aggregation of acute schistosome infections in marshland and lake areas in five provinces(Jiangsu,Anhui,Jiangxi,Hubei and Hunan province)from 2005 to 2012,so as to provide the evidence for es-tablishing control strategies and taking effective control measures. Methods The data of patients with acute schistosome infection in marshland and lake areas in five provinces from 2005 to 2012 were collected and analyzed with the concentration ratio and circu-lar distribution methods for the epidemic season features and time aggregation of the infection,and with the spatial autocorrelation analysis for the space aggregation of the infected cases. Results According to the concentration ratio,the occurrence of acute schistosome infection had strong seasonality,and the concentration ratio was 0.758;according to the circular distribution method, the peak day of acute schistosome infections was 10th,August. The spatial analysis suggested that the infected cases highly gath-ered around Poyang Lake,Dongting Lake and Yangtze River Basin in 23 counties of the five provinces,and the result of spatial au-tocorrelation analysis showed that the spatial autocorrelation index I was 0.16(P=0.01). Conclusion The occurrence of acute schistosome infections in lake regions of the 5 provinces shows strong seasonality and space aggregation,therefore we can bring the control mark forward,and take targeted prevention and control measures in high aggregation areas of acute schistosomiasis.

This report presented the endemic status of schistosomiasis in the People's Republic of China at national level in 2013. By the end of 2013,there are 184 943 schistosomiasis japonica cases. Meanwhile,nine acute cases were reported,and 4 cases reduced compared with that of 2012. A total of 29 796 advanced cases were reported;while 911 cases were determined as advanced cases and 1 700 cases were dead in 2013. Nationally,there were around 365 467.99 hm2 Oncomelania snail infested areas in total and 9.25 hm2 of them habituated infected snails in 2013. There were 287.28 hm2 of snail infested areas found in non?endemic areas historically. Moreover,962 065 cattle were estimated to be raised in endemic regions and 633 cattle were deter?mined as positive by stool examinations. The data showed that the endemicity of schistosomiasis in China decreased further. How?ever,challenges exist to reach the aims of the medium and long term national program. Further control and effective surveillance need to be strengthened as the endemicity of schistosomiasis is unstable in the areas after schistosomiasis transmission under con?trol or interruption.