BACKGROUND: Neglected tropical diseases (NTDs) and malaria pose a major health challenge, especially in low- and middle-income countries. METHODS: Initially, we performed a descriptive analysis of the Global Burden of Disease (GBD) 2021 database, categorizing data by subtypes. Next, linear regression models were employed to analyze temporal trends. We then utilized four predictive models to forecast the future burden. Additionally, we explored the relationship between estimated annual percentage change (EAPCs) and age-standardized rates (ASRs), as well as Human Development Index (HDI) scores for 2021. Furthermore, decomposition analysis was applied to assess the influence of aging, population dynamics, and epidemiological changes. Lastly, frontier analysis was conducted to examine the connection between disease burden and sociodemographic development. RESULTS: In 2021, NTDs and malaria contributed significantly to the global disease burden, with considerable disparities across genders, age groups, Socio-demographic Index (SDI) regions, GBD regions, and individual countries. From 1990 to 2021, both the number of cases and the associated ASRs have shown a recent downward trend. The EAPCs are positively correlated with ASRs and HDI scores. Projections indicate a continued decline in disease burden through 2046. Additionally, our decomposition analysis highlighted the positive impact of aging and epidemiological shifts on the reduction of the disease burden. Finally, frontier analysis revealed that countries and regions with higher SDI scores have greater potential for further reducing their health burden. CONCLUSION While the global burden of NTDs and malaria has improved overall, significant disparities remain across regions and countries. Our findings highlight the importance of implementing targeted intervention strategies and maintaining sustained investments to tackle the ongoing challenges.
Malaria/epidemiology* ; Humans ; Neglected Diseases/epidemiology* ; Global Burden of Disease/trends* ; Global Health/statistics & numerical data* ; Male ; Female ; Tropical Medicine ; Adult ; Cost of Illness ; Child, Preschool ; Middle Aged ; Adolescent ; Young Adult ; Infant

Objective:To investigate the relationship between microRNA (miR)-1, miR-133b and hepatic fibrosis in patients with hepatic alveolar echinococcosis.Methods:From October 2020 to April 2021, patients who were definitely diagnosed as hepatic alveolar echinococcosis (9 cases), cirrhosis (9 cases) and hepatocellular carcinoma (5 cases) in the First Affiliated Hospital of Xinjiang Medical University were selected as the research subjects, and healthy volunteers in the same period were taken as the control (10 cases). Peripheral blood samples of all subjects were collected to prepare plasma, and the expression levels of miR-1 and miR-133b in peripheral blood were detected by quantitative real-time PCR. At the same time, tissue samples around the liver lesion (proximal), and the corresponding tissues about 5 cm from the lesion (distal) were collected from 5 patients with hepatic alveolar echinococcosis, and immunohistochemical staining was used to detect the cell activation related indicators [cyclinD1, cyclin dependent kinase 1 (CDK1), α-smooth muscle actin (α-SMA)], fibrosis indicators (Collagen Ⅰ, Collagen Ⅲ), transforming growth factor-β1 (TGF-β1) signal pathway related genes [TGF-β1, TGF-β1 receptor type Ⅰ/Ⅱ (TGF-β1RⅠ, TGF-β1RⅡ)] and its downstream related proteins (SMAD2, SMAD3).Results:The quantitative real-time PCR results showed that there were significant differences in the expression levels of miR-1 and miR-133b in the peripheral blood of patients with hepatic alveolar echinococcosis, cirrhosis, hepatocellular carcinoma and the control group ( H = 16.54, 28.40, P < 0.001); the expression levels of miR-1 and miR-133b in hepatic alveolar echinococcosis group were higher than those in control group, cirrhosis group ( P < 0.05). The expression levels of CDK1 (0.46 ± 0.02, 0.42 ± 0.01), α-SMA (0.54 ± 0.09, 0.51 ± 0.07), TGF-β1 (0.55 ± 0.15, 0.51 ± 0.13), TGF-β1RⅠ (0.58 ± 0.09, 0.57 ± 0.08), and TGF-β1RⅡ(0.40 ± 0.05, 0.39 ± 0.05) between the proximal and distal tissue of liver lesion in hepatic alveolar echinococcosis patients were statistically significantly different ( t = 5.56, 3.17, 3.18, 4.27, 5.65, P = 0.005, 0.034, 0.034, 0.024, 0.011). There was no statistically significant difference in the expression levels of CyclinD1, Collagen Ⅰ, Collagen Ⅲ, SMAD2 and SMAD3 between the proximal and distal tissue of liver lesion in hepatic alveolar echinococcosis patients ( t = 3.06, 3.06, 2.86, 1.43, 1.50, P = 0.055, 0.055, 0.064, 0.247, 0.230). Pearson correlation analysis showed that miR-1 in the patients' peripheral blood was positively correlated with TGF-β1RⅠ in the proximal tissue of the liver lesion ( P = 0.001); there was no correlation between miR-1, miR-133b and CDK1, α-SMA, TGF-β1, TGF-β1RⅡ( P > 0.05). Conclusions:The expression of TGF-β1 signaling pathway related factors in the proximal tissue of liver lesion in patients with hepatic alveolar echinococcosis is up-regulated. The expression of miR-1 and miR-133b in peripheral blood is upregulated, and miR-1 is positively correlated with TGF-β1RⅠ level in proximal tissue of liver lesion, suggesting that miR-1 may promote the occurrence of liver fibrosis in hepatic alveolar echinococcosis.

Objective:To investigate the changes of natural killer (NK) cells, natural killer T (NKT) cells and T lymphocytes in the peripheral blood after nanosecond pulse ablation of hepatic vesicular hydatid in rats with different energy levels.Methods:A total of 32 SD rats were randomly divided into hepatic vesicular hydatid model group, low voltage group (1 000 V), medium voltage group (1 500 V) and high voltage group (2 000 V). The hydatid model of rats was established by selective injection of 100 μl of echinococcosis head suspension with concentration of 500/100 μl into the left hepatic portal vein in all the 4 groups. After 3 months, nanosecond pulse therapy was applied to the left lobe vesicular hydatid lesions in the low voltage group, medium voltage group and high voltage group. On the third day after treatment, flow detector was used to calculate the ratio of CD 4+ T to CD 8+ T in peripheral blood of four groups by CD 3+ T, CD 4+ T, CD 8+ T, NK cells and NKT cells. Results:CD 3+ T was expressed in the high voltage group with (62.08±2.75)%, the medium voltage group with (63.84±7.73)%, the low voltage group with (55.19±8.55)% and the control group with (54.76±8.28)% ( P<0.05). CD 4+ T number was larger in high voltage group (43.7±6.51)% than medium voltage group (38.82±5.47)%, low voltage group (37.31±6.96)% and model group (38.12±3.04)% ( P<0.05). CD 8+ T ratio in the high voltage group was (20.03±2.40)%, the medium voltage group was (21.22±1.74)%, the low voltage group was (19.00±3.06)%, and the model group (20.56±3.98)%, with no statistically significant difference ( P>0.05). NK cells ratio in high voltage group was (6.49±1.60)%, medium voltage group was (3.02±0.32)%, low voltage group was (3.42±0.91)% and model group was (3.44±0.55)% ( P<0.05). NKT cells ratio in high voltage group was (1.53±0.16)%, medium voltage group was (0.82±0.09)%, in low voltage group was (0.70±0.17)% and model group (0.78±0.10)% ( P<0.05). CD 4+ T/CD 8+ T high voltage group was (2.26±0.65), medium voltage group was (1.90±0.40), low voltage group was (1.98±0.37) and model group was (2.06±0.35) ( P<0.05). Conclusion:High voltage (2 000 V) increased number of T, NK and NKT cells in peripheral blood compared with medium voltage (1 500 V) and low voltage (1 000 V), which may be the immune response of the body caused by nanosecond pulse ablation of hepatic vesicular hydatid in rats.

Objective: To study the clinical outcomes using laparoscopic complete dissection of cysts, subtotal cystectomy and partial hepatectomy in the treatment of hepatic cystic echinococcosis. Methods: A retrospective study was conducted on 40 patients with hepatic cystic echinococcosis treated by laparoscopic surgery from January 2014 to June 2018 at the First Affiliated Hospital of Xinjiang Medical University. According to the different surgical methods, these patients were divided into three groups: group A (n=14): the laparoscopic complete capsulectomy group, group B (n=14): the laparoscopic subtotal capsulectomy group, group C (n=12): the laparoscopic partial hepatectomy group. The operation time, intraoperative blood loss, time to pass first flatus, duration of drainage tube placement, days of hospitalization after operation, hospitalization expenses, complications of the residual cavity and local recurrence were compared among the 3 groups. Results: In this study, all the 40 patients with hepatic cystic hydatidosis were cured, and no death occurred during the perioperative period. The intraoperative blood loss, postoperative duration of drainage tube placement, and hospitalization cost of the three groups were significantly the highest in group C (all P<0.05). The operative time and the time to pass first flatus in group C were both significantly greater than group B (P<0.05). The length of postoperative hospitalization in group A was significantly less than in group C (P<0.05). Postoperative recurrence and complications in group B were significantly worse than those in group A and group C (all P<0.05). Conclusion Laparoscopic complete dissection of the external capsule turned out to be the best laparoscopic treatment of hepatic cystic echinococcosis, followed by laparoscopic partial hepatectomy. Open surgery should be considered in patients with lesions which are evaluated preoperatively to have difficulty in carrying out laparoscopic complete dissection of capsule or partial hepatectomy.

Objective: To analyze the changes of local immune cells in liver of mice caused by nanosecond pulse therapy for hepatocellular carcinoma. Methods: Forty C57BL-6J of mice were randomly divided into four groups: negative control group (n=10), tumor group (n=10), surgical resection group (n=10) and nanosecond pulse group (n=10). Hepa 1-6 cells were injected into the left hepatic lobe of mice in tumor group, resection group and nanosecond pulse group to construct the orthotopic xenograft tumor model. Left hepatic lobectomy was performed in the surgical excision group and nanosecond pulse was performed in the nanosecond pulse group 7 days after the construction. All mice were sacrificed 7 days after the treatment. CD₃^＋ was detected by flow cytometry in the left hepatic lobe lesion, the nanosecond pulse group and the normal liver tissue of the right hepatic lobe in the liver and tumor groups of the blank control group. T, CD₄^＋T, CD₈^＋T, regulatory T cells (Treg), myeloid-derived suppressor cells (MDSC), natural killer cells (NK), B cells, and the ratio of CD₄^＋T to CD₈^＋T. Results: In the blank control group, the tumor group the number of lesion in the mice and the pulse area of the nanosecond pulse group CD₄^＋T cells in blank control group (normal liver)>nanosecond pulse group>tumor group [(25.77±3.76)% vs. (15.72±2.70)% vs. (12.68±3.13)%, P<0.05]; CD₈^＋T cell tumor group>blank control group>nanosecond pulse group [(14.01±2.75)% vs. (13.99±1.41)% vs. (8.42±2.21)%, P<0.05]. The ratio of CD₄^＋T to CD₈^＋T in nanosecond pulse group > blank control group > tumor group [(1.90±0.17) vs. (1.86±0.32) vs. (0.93±0.21), P<0.05]; B cell nanosecond pulse group> blank control group > tumor group [(47.65±3.77)% vs. (33.74±3.91)% vs. (15.94±6.10)%, P<0.05]; MDSC cell tumor group > nanosecond pulse group > blank control group [(18.49±2.74)% vs. (8.41±3.05)% vs. (2.15±0.69)%, P<0.05]. However, CD₃^＋T cells, NK cells and Treg cells showed no statistical significance among the three groups (all P>0.05). Normal liver tissue in right lobe of liver in 4 groups the ratio of CD₄^＋T to CD₈^＋T in blank control group >nanosecond pulse group >surgical resection group >tumor group [(1.86±0.32) vs. (1.85±0.43) vs. (1.52±0.16) vs. (1.36±0.29), P<0.05]; B cell nanosecond pulse group >surgical resection group >blank control group> Tumor group [(46.85±8.30)% vs. (34.23±6.17)% vs. (33.74±3.91)% vs. (27.64±2.20)%, P<0.05]; Treg cell tumor group >resection group>nanosecond pulse group>blank control group [(26.34±6.23)% vs. (7.01±2.04)% vs. (3.63±1.59)% vs. (3.19±1.50)% , P<0.05]; MDSC in tumor group >resection group>nanosecond pulse group>blank control group [(12.22±2.02)% vs. (5.00±0.73)% vs. (2.87±0.96)% vs. (2.15±0.69)%, P<0.05]. However, there were no statistically significant differences in CD₃^＋T, CD₄^＋T, CD₈^＋T and NK cells among the four groups (all P>0.05). Conclusion Nanosecond pulse ablation of primary hepatocellular carcinoma of mice can induce immune response in ablation area and other hepatic lobes, which may be due to the anti-tumor immunity induced by nanosecond pulse.

Liver cancer still threatens human health nowadays, so it is urgent to explore new minimally invasive methods for the treatment of liver cancer. This article reviews the general status of liver cancer in China and describes local ablation and immunotherapy for liver cancer. This article also introduces the basic principle of nanosecond pulse in the treatment of liver cancer and the mechanism of action of heat shock protein 70 (HSP70) in antitumor immunity and points out that as an exogenous electrical stimulation, nanosecond pulse can increase the expression of HSP70 in the body to strengthen the body′s anti-tumor immunity. This article perfects the immunological mechanism of nanosecond pulse in the treatment of liver cancer and provides new thoughts for immunotherapy for liver cancer.