Objective To evaluate the performance of the artificial intelligence (AI)-enabled snail identification system for recognition of Oncomelania hupensis robertsoni and Tricula in schistosomiasis-endemic areas of Yunnan Province. Methods Fifty O. hupensis robertsoni and 50 Tricula samples were collected from Yongbei Township, Yongsheng County, Lijiang City, a schistosomiasis-endemic area in Yunnan Province in May 2024. A total of 100 snail sample images were captured with smartphones, including front-view images of 25 O. hupensis robertsoni and 25 Tricula samples (upward shell opening) and back-view images of 25 O. hupensis robertsoni and 25 Tricula samples (downward shell opening). Snail samples were identified as O. hupensis robertsoni or Tricula by schistosomiasis control experts with a deputy senior professional title and above according to image quality and morphological characteristics. A standard dataset for snail image classification was created, and served as a gold standard for recognition of snail samples. A total of 100 snail sample images were recognized with the AI-enabled intelligent snail identification system based on a WeChat mini program in smartphones. Schistosomiasis control professionals were randomly sampled from stations of schistosomisis prevention and control and centers for disease control and prevention in 18 schistosomiasis-endemic counties (districts, cities) of Yunnan Province, for artificial identification of 100 snail sample images. All professionals are assigned to two groups according the median years of snail survey experiences, and the effect of years of snail survey experiences on O. hupensis robertsoni sample image recognition was evaluated. A receiver operating characteristic (ROC) curve was plotted, and the sensitivity, specificity, accuracy, Youden’s index and the area under the curve (AUC) of the AI-enabled intelligent snail identification system and artificial identification were calculated for recognition of snail sample images. The snail sample image recognition results of AI-enabled intelligent snail identification system and artificial identification were compared with the gold standard, and the internal consistency of artificial identification results was evaluated with the Cronbach’s coefficient alpha. Results A total of 54 schistosomiasis control professionals were sampled for artificial identification of snail sample image recognition, with a response rate of 100% (54/54), and the accuracy, sensitivity, specificity, Youden’s index, and AUC of artificial identification were 90%, 86%, 94%, 0.80 and 0.90 for recognition of snail sample images, respectively. The overall Cronbach’s coefficient alpha of artificial identification was 0.768 for recognition of snail sample images, and the Cronbach’s coefficient alpha was 0.916 for recognition of O. hupensis robertsoni snail sample images and 0.925 for recognition of Tricula snail sample images. The overall accuracy of artificial identification was 90% for recognition of snail sample images, and there was no significant difference in the accuracy of artificial identification for recognition of O. hupensis robertsoni (86%) and Tricula snail sample images (94%) (χ² = 1.778, P > 0.05). There was no significant difference in the accuracy of artificial identification for recognition of snail sample images with upward (88%) and downward shell openings (92%) (χ² = 0.444, P > 0.05), and there was a significant difference in the accuracy of artificial identification for recognition of snail sample images between schistosomiasis control professionals with snail survey experiences of 6 years and less (75%) and more than 6 years (90%) (χ² = 7.792, P < 0.05). The accuracy, sensitivity, specificity and AUC of the AI-enabled intelligent snail identification system were 88%, 100%, 76% and 0.88 for recognition of O. hupensis robertsoni snail sample images, and there was no significant difference in the accuracy of recognition of O. hupensis robertsoni snail sample images between the AI-enabled intelligent snail identification system and artificial identification (χ² = 0.204, P > 0.05). In addition, there was no significant difference in the accuracy of artificial identification for recognition of snail sample images with upward (90%) and downward shell openings (86%) (χ² = 0.379, P > 0.05), and there was a significant difference in the accuracy of artificial identification for recognition of snail sample images between schistosomiasis control professionals with snail survey experiences of 6 years and less and more than 6 years (χ² = 5.604, P_adjusted < 0.025). Conclusions The accuracy of recognition of snail sample images is comparable between the AI-enabled intelligent snail identification system and artificial identification by schistosomiasis control professionals, and the AI-enabled intelligent snail identification system is feasible for recognition of O. hupensis robertsoni and Tricula in Yunnan Province.

Objective: To evaluate the effect of remote health interventions on self-management of hypertension. Methods: We systematically searched the literature for studies published in English in PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Cochrane Central Register of Controlled Trials. The database was used to search for relevant studies with full text and evaluate the remote health interventions for hypertension self-management versus usual care for hypertension. RevMan 5.4 was used for data analysis. Results: A total of 19 studies eventually met our inclusion criteria. The results showed that the remote health interventions group could significantly reduce the levels of SBP (MD=5.67, 95% CI=4.12-7.22, p<.001) and DBP (MD=1.88, 95% CI=1.16- 2.60, p<.001), compared with usual care group, it also significantly improving the patient's quality of life (SMD=0.84, 95% CI=0.32- 1.37, p=.002), reduce waist circumference (MD=2.39, 95% CI=0.35-4.44, p=.020) and BMI (MD=0.49, 95% CI=0.06-0.91, p=.020), and significantly increasing the physical activity of patients (SMD=0.19, 95% CI=0.06- 0.31, p=.004). No obvious publication bias was found in this meta-analysis. Conclusion This study showed that remote health interventions for self-management can significantly improve patients’ quality of life with hypertension and better BP control than usual care. Further studies could be assess the long-term clinical effectiveness and economic evaluation of remote health interventions for self-management.

Objective: To evaluate the effect of remote health interventions on self-management of hypertension. Methods: We systematically searched the literature for studies published in English in PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Cochrane Central Register of Controlled Trials. The database was used to search for relevant studies with full text and evaluate the remote health interventions for hypertension self-management versus usual care for hypertension. RevMan 5.4 was used for data analysis. Results: A total of 19 studies eventually met our inclusion criteria. The results showed that the remote health interventions group could significantly reduce the levels of SBP (MD=5.67, 95% CI=4.12-7.22, p<.001) and DBP (MD=1.88, 95% CI=1.16- 2.60, p<.001), compared with usual care group, it also significantly improving the patient's quality of life (SMD=0.84, 95% CI=0.32- 1.37, p=.002), reduce waist circumference (MD=2.39, 95% CI=0.35-4.44, p=.020) and BMI (MD=0.49, 95% CI=0.06-0.91, p=.020), and significantly increasing the physical activity of patients (SMD=0.19, 95% CI=0.06- 0.31, p=.004). No obvious publication bias was found in this meta-analysis. Conclusion This study showed that remote health interventions for self-management can significantly improve patients’ quality of life with hypertension and better BP control than usual care. Further studies could be assess the long-term clinical effectiveness and economic evaluation of remote health interventions for self-management.

Objective: To evaluate the effect of remote health interventions on self-management of hypertension. Methods: We systematically searched the literature for studies published in English in PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Cochrane Central Register of Controlled Trials. The database was used to search for relevant studies with full text and evaluate the remote health interventions for hypertension self-management versus usual care for hypertension. RevMan 5.4 was used for data analysis. Results: A total of 19 studies eventually met our inclusion criteria. The results showed that the remote health interventions group could significantly reduce the levels of SBP (MD=5.67, 95% CI=4.12-7.22, p<.001) and DBP (MD=1.88, 95% CI=1.16- 2.60, p<.001), compared with usual care group, it also significantly improving the patient's quality of life (SMD=0.84, 95% CI=0.32- 1.37, p=.002), reduce waist circumference (MD=2.39, 95% CI=0.35-4.44, p=.020) and BMI (MD=0.49, 95% CI=0.06-0.91, p=.020), and significantly increasing the physical activity of patients (SMD=0.19, 95% CI=0.06- 0.31, p=.004). No obvious publication bias was found in this meta-analysis. Conclusion This study showed that remote health interventions for self-management can significantly improve patients’ quality of life with hypertension and better BP control than usual care. Further studies could be assess the long-term clinical effectiveness and economic evaluation of remote health interventions for self-management.

Objective: To evaluate the effect of remote health interventions on self-management of hypertension. Methods: We systematically searched the literature for studies published in English in PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Cochrane Central Register of Controlled Trials. The database was used to search for relevant studies with full text and evaluate the remote health interventions for hypertension self-management versus usual care for hypertension. RevMan 5.4 was used for data analysis. Results: A total of 19 studies eventually met our inclusion criteria. The results showed that the remote health interventions group could significantly reduce the levels of SBP (MD=5.67, 95% CI=4.12-7.22, p<.001) and DBP (MD=1.88, 95% CI=1.16- 2.60, p<.001), compared with usual care group, it also significantly improving the patient's quality of life (SMD=0.84, 95% CI=0.32- 1.37, p=.002), reduce waist circumference (MD=2.39, 95% CI=0.35-4.44, p=.020) and BMI (MD=0.49, 95% CI=0.06-0.91, p=.020), and significantly increasing the physical activity of patients (SMD=0.19, 95% CI=0.06- 0.31, p=.004). No obvious publication bias was found in this meta-analysis. Conclusion This study showed that remote health interventions for self-management can significantly improve patients’ quality of life with hypertension and better BP control than usual care. Further studies could be assess the long-term clinical effectiveness and economic evaluation of remote health interventions for self-management.

Objective: To evaluate the effect of remote health interventions on self-management of hypertension. Methods: We systematically searched the literature for studies published in English in PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Cochrane Central Register of Controlled Trials. The database was used to search for relevant studies with full text and evaluate the remote health interventions for hypertension self-management versus usual care for hypertension. RevMan 5.4 was used for data analysis. Results: A total of 19 studies eventually met our inclusion criteria. The results showed that the remote health interventions group could significantly reduce the levels of SBP (MD=5.67, 95% CI=4.12-7.22, p<.001) and DBP (MD=1.88, 95% CI=1.16- 2.60, p<.001), compared with usual care group, it also significantly improving the patient's quality of life (SMD=0.84, 95% CI=0.32- 1.37, p=.002), reduce waist circumference (MD=2.39, 95% CI=0.35-4.44, p=.020) and BMI (MD=0.49, 95% CI=0.06-0.91, p=.020), and significantly increasing the physical activity of patients (SMD=0.19, 95% CI=0.06- 0.31, p=.004). No obvious publication bias was found in this meta-analysis. Conclusion This study showed that remote health interventions for self-management can significantly improve patients’ quality of life with hypertension and better BP control than usual care. Further studies could be assess the long-term clinical effectiveness and economic evaluation of remote health interventions for self-management.

OBJECTIVE To compare the efficacy and safety of Cefazolin sodium for injection， Cefuroxime sodium for injection， and Ceftazidime for injection from nationally organized centralized drug procurement （hereinafter referred to as “centralized procurement”） and non-centralized procurement in patients with bacterial infection. METHODS The case data of hospitalized patients who had used 3 kinds of Cephalosporins for injection from centralized procurement or non-centralized procurement in the treatment of bacterial infections were retrospectively collected from 19 medical institutions in Kunming from January 2020 to September 2022. After balancing the baseline differences between the groups with the propensity score matching method， the effectiveness and safety differences of 3 kinds of Cephalosporins for injection from centralized procurement or non- centralized procurement were compared respectively. RESULTS After balancing the baseline differences among the groups， 394 cases in each group of Cefazolin sodium for injection from centralized procurement or non-centralized procurement， 472 cases in each group of Cefuroxime sodium for injection from centralized procurement or non-centralized procurement， 504 cases in group of Ceftazidime for injection from centralized procurement and 590 cases in group of non-centralized procurement were included in the analysis. In terms of effectiveness， there were no significant differences in clinical response rate， 72 h response rate， bacterial clearance rate， and the recovery rate of body temperature， white blood cell count， neutrophil count， neutrophil percentage， C-reactive protein， procalcitonin recovery between the centralized procurement group and non-centralized procurement group of Cefazolin sodium for injection and Cefuroxime sodium for injection （P＞0.05）. The proportion of patients in centralized procurement group of Ceftazidime for injection with C-reactive protein restored to normal reference range was significantly higher than that in non-centralized procurement group （46.9% vs. 27.9%， P＜0.05）， but there were no statistically significant differences in other effectiveness indicators among groups （P＞0.05）. In terms of safety， there was no statistical difference in the incidence of adverse drug reactions between centralized procurement group and non-centralized procurement group of 3 kinds of Cephalosporins for injection （P＞0.05）； the incidence of platelet count reduction in centralized procurement group of Cefazolin sodium for injection was significantly higher than non-centralized procurement group （20.7% vs. 7.1%， P＜0.05）， the incidence of eosinophilia elevation in centralized procurement group of Ceftazidime for injection was significantly higher than non-centralized procurement group （5.3% vs. 1.9%， P＜0.05）. In addition， there was no statistically significant difference in the abnormal rates of other laboratory indicators among the three types of injection Cephalosporins （P＞ 0.05）. CONCLUSIONS The efficacy of 3 kinds of Cephalosporin for injection from centralized procurement is not inferior to non- centralized procurement varieties， and the safety is equivalent to that of non-centralized procurement varieties.

Objective To compare the external morphological characteristics and movement patterns between Schistosoma japonicum and S. sinensis cercariae. Methods S. japonicum and S. sinensis cercariae were heat-fixed, and well-extended cercariae, of 50 each species, were randomly selected for measurement of body length, body width, tail stem length, and tail fork length. The external morphological characteristics of S. japonicum and S. sinensis cercariae were compared. In addition, S. japonicum-infected Oncomelania snails and S. sinensis-infected Tricula snails were observed under a microscope and the movement patterns of S. japonicum and S. sinensis cercariae were compared. Results The mean body length, body width, tail stem length, and tail fork length were (0.16 ± 0.01), (0.05 ± 0.01), (0.14 ± 0.01) mm and (0.06 ± 0.01) mm for S. japonicum cercariae, and (0.13 ± 0.01), (0.05 ± 0.01), (0.13 ± 0.01) mm and (0.06 ± 0.01) mm for S. sinensis cercariae, respectively, and there were significant differences in terms of cercaria body length (t = 14.583, P < 0.05) and tail stem length (t = 3.861, P < 0.05), while no significant differences were seen in terms of body width (t = 0.896, P > 0.05) or tail fork length (t = −0.454, P > 0.05). Microscopy revealed that the tails of both S. japonicum and S. sinensis cercariae swung from side to side and there was no significant difference in their movement pattern. Conclusion S. sinensis and S. japonicum cercariae share highly similar external external morphological characteristics and movement patterns.

Schistosomiasis was once hyper-endemic in Yunnan Province. Following concerted efforts for over 70 years, remarkable achievements have been made for schistosomiasis control in the province. In 2004, the Mid- and Long-term Plan for Schistosomiasis Prevention and Control in Yunnan Province was initiated in Yunnan Province, and the target for transmission control of schistosomiasis was achieved in the province in 2009. Following the subsequent implementation of the Outline for Key Projects in Integrated Schistosomiasis Control Program (2009—2015) and the 13th Five - year Plan for Schistosomiasis Control in Yunnan Province, no acute schistosomiasis had been identified in Yunnan Province for successive 12 years, and no local Schistosoma japonicum infections had been detected in humans, animals or Oncomelania hupensis snails for successive 6 years in the province by the end of 2020. The transmission of schistosomiasis was interrupted in Yunnan Province in 2020. This review summarizes the history of schistosomiasis, changes in schistosomiasis prevalence and progress of schistosomiasis control in Yunnan Province, and proposes the future priorities for schistosomiasis control in the province.

Objective To investigate the capability for distinguishing between the morphology of Oncomelania hupensis and Tricula snails and its influencing factors among schistosomiasis control professionals in Yunnan Province, so as to evaluate the interference of Tricula snails with O. hupensis surveys. Methods O. hupensis and Tricula snails were sampled from 9 schistosomiasis-endemic counties (districts) in Yunnan Province. The capability for distinguishing between O. hupensis and Tricula snails was evaluated using online questionnaire surveys and field blind tests among schistosomiasis control professionals, and the proportions of correct judgment, misjudgment and missed judgment were calculated. Univariate and multivariate logistic regression models were created using the software SPSS 25.0, and factors affecting the proportion of correct judgments of O. hupensis snails were identified among schistosomiasis control professionals. Results Questionnaire surveys and field blind tests showed that the overall proportions of correct judgments of O. hupensis snails were 56.77% (2 305/4 060) and 68.28% (1 556/2 279) among schistosomiasis control professionals in Yunnan Province, respectively. Univariate logistic regression analysis of online questionnaire surveys identified gender [odds ratio (OR) = 1.244, 95% confidential interval (CI): (1.073, 1.441), P < 0.05], professional title [OR = 0.628, 1.741, 95% CI: (0.453, 0.871), (1.109, 2.734), both P < 0.05], working duration [OR = 0.979, 95% CI: (0.971, 0.987), P < 0.05] and classification of schistosomiasis epidemics in endemic foci [OR = 1.410, 0.293, 0.523, 95% CI: (1.103, 1.804), (0.237, 0.361), (0.416, 0.657), all P < 0.05] as factors affecting the proportion of correct judgments of O. hupensis snails among schistosomiasis control professionals in Yunnan Province, and multivariate logistic regression analysis after adjustments showed that the proportion of O. hupensis snail misjudgments was 1.179 times higher among male schistosomiasis control professionals than among females [OR = 1.179, 95% CI: (1.006, 1.382), P < 0.05], and 1.474 times higher among schistosomiasis control professionals in schistosomiasis-elimination areas with snails than in areas without snails [OR = 1.474, 95% CI: (1.145, 1.898), P < 0.05], and the proportions of missed judgments of O. hupensis snails were 0.284 [OR = 0.284, 95% CI: (0.225, 0.359), P < 0.05] and 0.523 times [OR = 0.523, 95% CI: (0.412, 0.664), P < 0.05] higher among schistosomiasis control professionals in transmission-interruption areas with snails and schistosomiasis-elimination areas with snails than in schistosomiasis-elimination areas without snails. Univariate logistic regression analysis of field blind tests showed age [OR = 2.381, 95% CI: (1.677, 3.381), P < 0.05], professional title [OR = 1.688, 95% CI: (1.103, 2.582), P < 0.05］, working duration [OR = 0.970, 95% CI: (0.956, 0.984), P < 0.05] and classification of schistosomiasis epidemics in endemic foci [OR = 0.262, 0.593, 95% CI: (0.188, 0.364), (0.420, 0.837), both P < 0.05] as factors affecting the proportion of correct judgments of O. hupensis snails among schistosomiasis control professionals in Yunnan Province, and multivariate logistic regression analysis after adjustments showed the proportions of missed judgments of O. hupensis snails were 0.263 [OR = 0.263, 95% CI: (0.176, 0.394), P < 0.05] and 0.604 times [OR = 0.604, 95% CI: (0.416, 0.875), P < 0.05] higher among schistosomiasis control professionals in transmission-interruption areas with snails and schistosomiasis-elimination areas with snails than in schistosomiasis-elimination areas without snails. Conclusions Schistosomiasis control professionals in Yunnan Province have a low accuracy rate for distinguishing between the morphology of O. hupensis and Tricula snails, and gender and classification of schistosomiasis epidemics in endemic foci are factors that affect their ability to distinguish. The presence of Tricula snails causes a high degree of interference with O. hupensis surveys in O. hupensis snail-infested areas of Yunnan Province. Reinforced training for distinguishing between O. hupensis and Tricula snails is required among schistosomiasis control professionals in Yunnan Province.