Recently, malaria incidence has sharply resurgence in the border area of northern Myanmar, with the parasite incidence rate in 2023 being 21.47 times (95% CI: 18.84-24.48) that of 2019 in Kachin State's Razan and nearby areas. This resurgence caused the number of imported malaria cases to increase from 188 in 2019 to 398 in 2023 in Yunnan Province. In addition to the impact of military conflict, the border malaria joint prevention and control cooperation mechanism and malaria control measures established between China and Myanmar have failed to be implemented effectively due to the impact of the international COVID-19 epidemic. Hence, it is recommended that relevant departments evaluate the quality and effectiveness of the current cross-border transmission measures for malaria in the China-Myanmar border area from a technical perspective, and provide a large demand for primaquine, which can block the spread of malaria and cure vivax malaria, in response to the current prevalent characteristics of vivax malaria predominating in northern Myanmar. Moreover, to effectively reduce the mortality of imported malaria patients and prevent re-importation and transmission, it is necessary to enhance clinical physicians' knowledge, awareness, and vigilance regarding malaria diagnosis and treatment in the Yunnan border region, as well as China's ability and quality of appropriate response to imported malaria.

Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association update the guidelines for the prevention and treatment of chronic hepatitis B (version 2022) in 2022. The latest guidelines recommend more extensive screening and more active antiviral treating for hepatitis B virus infection. This article interprets the essential updates in the guidelines to help deepen understanding and better guide the clinical practice.
Humans ; Hepatitis B, Chronic/drug therapy* ; Hepatitis B/drug therapy* ; Hepatitis B virus ; Antiviral Agents/therapeutic use* ; Gastroenterology

Sarcopenia, a common complication of cirrhosis, has an incidence rate as high as 40% ~ 70%. Furthermore, adverse events such as shortened survival, lower quality of life, prolonged hospital stay, increased complications, a higher mortality rate, and sometimes altering the liver transplantation prognostic outcome in patients with liver cirrhosis are closely related. In recent years, some progress has been made in the research on the treatment of sarcopenia, but there is no clear treatment plan at present; thus, research and development by researchers and clinicians still need to be strengthened. This article briefly describes the relevant treatment methods for sarcopenia in patients with cirrhosis.

Objective:To investigate the effects of a Baqia Huaihua Liangxue decoction on peripheral blood T helper 17 cells/Tregulatory cells(Th17/Treg)balance and the expression of related cytokines in elderly patients with psoriasis.Methods:A total of 124 elderly patients diagnosed with psoriasis and receiving treatment at our hospital from September 2018 to December 2019 were divided into the observation group and the control group according to the parity number table, with 62 cases in each group.All patients underwent conventional treatment and physical therapy, and, in addition, the observation group was treated with a Baqia Huaihua Liangxue decoction for 2 months.The blood indexes including levels of Th17, Treg, Th17/Treg, and Th17/Treg-related cytokines such as interleukin-17(IL-17), IL-22 and IL-23 in the two groups were measured before treatment and 2 months after treatment.The psoriasis area and severity index(PASI)was used to evaluate the severity of skin damage in the two groups.The traditional Chinese medicine(TCM)syndrome scores were evaluated and compared between the two groups.Adverse reactions during treatment were monitored and recorded.Results:After 2 months of treatment, the Th17 and Th17/Treg levels were lower[(1.0±0.1)% vs.(2.4±0.9)%, 0.2±0.1 vs.0.6±0.2, all P<0.05]and Treg levels were higher in the observation group than in the control group[(5.3±1.1)% vs.(4.3±1.0)%, P<0.05]. Levels of IL-17, IL-22 and IL-23 were lower in the observation group than in the control group after 2 months of treatment[(22.1±3.5)ng/L vs.(35.6±4.0)ng/L, (44.8±4.4)ng/L vs.(49.9±5.1)ng/L, (43.7±5.2)ng/L vs.(52.5±5.4)ng/L, all P<0.05]. The PASI score and TCM syndrome score were lower in the observation group than in the control group after 2 months of treatment[(2.9±1.0) vs.(6.1±2.3), (3.2±1.9) vs.(7.6±2.1), all P<0.05]. No adverse reaction occurred in the two groups during treatment. Conclusions:The Baqia Huaihua Liangxue decoction has a clear therapeutic effect in elderly patients with psoriasis.It can stabilize peripheral blood Th17/Treg balance, inhibit the expression of related cytokines, reduce the degree of skin damage and has no adverse reaction during treatment.

Objective:To explore the clinical characteristics and establish a corresponding prognostic scoring model in patients with early-stage clinical features of hepatitis B-induced acute-on-chronic liver failure (HBV-ACLF).Methods:Clinical characteristics of 725 cases with hepatitis B-related acute-on-chronic hepatic dysfunction (HBV-ACHD) were retrospectively analyzed using Chinese group on the study of severe hepatitis B (COSSH). The independent risk factors associated with 90-day prognosis to establish a prognostic scoring model was analyzed by multivariate Cox regression, and was validated by 500 internal and 390 external HBV-ACHD patients.Results:Among 725 cases with HBV-ACHD, 76.8% were male, 96.8% had cirrhosis base,66.5% had complications of ascites, 4.1% had coagulation failure in respect to organ failure, and 9.2% had 90-day mortality rate. Multivariate Cox regression analysis showed that TBil, WBC and ALP were the best predictors of 90-day mortality rate in HBV-ACHD patients. The established scoring model was COSS-HACHADs = 0.75 × ln(WBC) + 0.57 × ln(TBil)-0.94 × ln(ALP) +10. The area under the receiver operating characteristic curve (AUROC) of subjects was significantly higher than MELD, MELD-Na, CTP and CLIF-C ADs( P < 0.05). An analysis of 500 and 390 cases of internal random selection group and external group had similar verified results. Conclusion:HBV-ACHD patients are a group of people with decompensated cirrhosis combined with small number of organ failure, and the 90-day mortality rate is 9.2%. COSSH-ACHDs have a higher predictive effect on HBV-ACHD patients' 90-day prognosis, and thus provide evidence-based medicine for early clinical diagnosis and treatment.

Objective: To evaluate the efficacy and safety of ombitasvir/paritaprevir/ritonavir (OBV/PTV/r) 25/150/100 mg once daily and dasabuvir (DSV) 250 mg twice daily combined with ribavirin in adult patients of Mainland China with chronic HCV genotype 1b infection and compensated cirrhosis. Methods: An open-label, multicenter, phase 3 clinical trial study was conducted in mainland China, Taiwan, and South Korea. Adult patients with compensated cirrhosis (Metavir score =F4) who were newly diagnosed and treated for hepatitis C virus genotype 1b infection with ombitasvir/paritaprevir/ritonavir and dasabuvir combined with ribavirin for 12 weeks were included. Assessed SVR rate of patients obtained at 12 and 24 weeks after drug withdrawal. Efficacy and safety were evaluated in patients who received at least one time study drugs. Results: A total of 63 patients from mainland China were enrolled, 62 of whom (98.4%) had a baseline Child-Pugh score of 5 points. The overall rate of SVR12 and SVR24 in patients was 100% (95% CI: 94.3% to 100.0%). Most of the adverse events that occurred were mild. The incidence of common (≥10%) adverse events and laboratory abnormalities included elevated total bilirubin (36.5%), weakness (19.0%), elevated unconjugated bilirubin (19.0%) and conjugated bilirubin (17.5%), and anemia (14.3%). Three cases (4.8%) of patients experienced Grade ≥ 3 adverse events that were considered by the investigators to be unrelated to the study drug. None patients had adverse events leading to premature drug withdrawal. Conclusion Mainland Chinese patients with chronic HCV genotype 1b infection and compensated cirrhosis who were treated with OBV/PTV/r plus DSV combined with RBV for 12 weeks achieved 100 % SVR at 12 and 24 weeks after drug withdrawal. Tolerability and safety were good, and majority of adverse events were mild.

Objective: To evaluate the safety and efficacy of ombitasvir/paritaprevir/ritonavir (OBV/PTV/r) 25/150/100 mg once daily combined with dasabuvir 250mg, twice daily in non-cirrhotic Chinese adult patients with newly diagnosed and treated chronic HCV genotype 1b infection. Methods: A randomized, double-blind, placebo-controlled, multicenter phase 3 clinical trial was conducted in mainland China, Korea, and Taiwan.Safety and efficacy of OBV/PTV/r plus DSV administered for 12 weeks were evaluated in a newly diagnosed and treated (interferon alpha /pegylated interferon alpha) and ribavirin non-cirrhotic adults with chronic HCVgenotype 1b infection. Patients randomly received OBV/PTV/r plus DSV for 12 weeks (Group A), or placebo for 12 weeks (Group B) followed by an open-label phase of OBV/PTV/r plus DSV for 12 weeks. Sustained response (SVR12) rate obtained at 12 weeks and (SVR24) 24 weeks after discontinuation of treatment, and the incidence of adverse events and laboratory abnormalities after double-blind and open-label phase treatment were assessed. Results: A total of 410 cases of Chinese patients were included and randomly assigned to group A and B (with 205 cases in each group) in a 1:1 ratio. The rates of SVR12 and SVR24 were 99% (95% CI: 94.8% - 99.8%) in the newly diagnosed patients in group A (205 patients) and the rates of SVR12 and SVR24 were 100% in treated patients (95% CI: 96.3% - 100%). Different baseline characteristics had no effect on SVR12 and SVR24 rates. Most of the adverse events occurred were mild, asymptomatic, and≥ 3 laboratory abnormalities during treatment were rare, including elevation of alanine aminotransferase (2 cases in double-blind stage A group), aspartate aminotransferase (Double-blind stage A (3 cases) and total bilirubin (1 case in open-label phase B group); however, those mild adverse events could be recovered after drug withdrawal or discontinuation. only1 person discontinued drugs due to adverse events (Group B, open-label phase). Conclusion The 12 weeks treatment course of OBV/PTV/r combined with DSV produced 99% ~ 100% rates of SVR12 and SVR24 in non-cirrhotic Asian adult patients with newly diagnosed and treated chronic HCV genotype 1b infection, and the tolerance and safety were good.

OBJECTIVE:To establish the method for the content determination of rapamycin (RAPA) in human monocyte THP-1 derived foam cells,and to study the effects of RAPA targeting preparation(RAPA-NP-Apt)targeting at foam cells. METH-ODS:Foam cells model were established through THP-1 cells were induced by oxidized low density lipoprotein. Foam cells were incubated with 200 ng/mL RAPA or 200,400,800 ng/mL RAPA-NP-Apt for 60 min. The content of RAPA was determined by HPLC. The determination was performed on Diamonsil C18 column with mobile phase consisted of acetonitrile-water(90:10,V/V) at flow rate of 1.0 mL/min. The column temperature was set at 40 ℃,and the detection wavelength was 278 nm. The sample size was 20 μL. RESULTS:The concentration of RAPA ranged 50-6400 ng/mL (r=0.99996) with average recovery of 98.72%(RSD=0.62%,n=3). RSDs of inter-day and intra-day were not more than 6.15%(n=6),RSD of stability was lower than 2%(n=6),and RSD of repeatability was 1.64%(n=6). After foam cells were incubated with RAPA or low-concentration,medi-um-concentration and high-concentration of RAPA-NP-Apt,the contents of RAPA were 12,43,98,140 ng/106 cells. CONCLU-SIONS:The method is simple,stable and reproducible. It can be used for content determination of RAPA in foam cells. RA-PA-NP-Apt can improve the effects of RAPA targeting at foam cells.

Objective To understand the impact of Qionghai Lake wetland ecological protection construction on the preva?lence of schistosomiasis,so as to provide the evidence for formulating the strategies for schistosomiasis control and prevention. Methods A retrospective survey of the construction of Qionghai Lake wetland was performed,and eleven villages around the wetland were surveyed for schistosomiasis endemic situation. The influence of the wetland project on the schistosomiasis preva?lence and Oncomelania hupensis snail status were investigated. Results Before the construction of Qionghai Lake wetland,the snail elimination and extended chemotherapy for residents was performed. After the project was finished,the roads and ditches were hardened. From 2009 to 2014,the schistosome infection rate of residents declined from 0.37% to 0. No schistosome infect?ed snails were found and in recent 2 years,no snails were found. No mice were infected in the sentinel tests. Conclusions The construction of Qionghai Lake wetland effectively eliminates snails,and interrupts the transmission of schistosomiasis. Howev?er,the environment of the wetland is more suitable for snail breeding,and therefore,the surveillance still should be strength?ened.

Objective To observe the clinical efficacy of atorvastatin combined with neuroendocrine antagonist in the treatment of chronic heart failure.Methods 70 patients of Wenzhou Medical College Theorem Clinical College of Cardiology Department from March 2014 to March 2015 were randomly divided into observation group and control group of 35 cases in each group.The control group were given the neuroendocrine antagonist, observation group were given atorvastatin combined with neuroendocrine antagonist treatment. The changes of related indicators were recorded. Results The aminoterminal pro-brain natriuretic peptide (NT-ProBNP) and ejection fraction in observation group were [(1264.7 ±174.6)pg/mL, (0.58 ±0.07)], which were higher than those in control group [(2106.5 ±164.8)pg/mL,(0.49 ±0.08)](P<0.05).The total effective rate in observation group was 91.43%, which was higher than 71.43%in control group(P<0.05).Conclusion Atorvastatin joint neuroendocrine antagonist in treatment of chronic heart failure has clinical exact effect with no significant side effects.