Objective To investigate the effectiveness of the integrated schistosomiasis control programme in Sichuan Province during the stage moving from transmission interruption to elimination (2015—2023), so as to provide insights into formulation of the schistosomiasis control measures during the post-elimination stage. Methods Schistosomiasis control data were retrospectively collected from departments of health, agriculture and rural affairs, forestry and grassland, water resources, and natural resources in Sichuan Province from 2015 to 2023, and a database was created to document examinations and treatments of human and livestock schistosomiasis, and snail survey and control, conversion of paddy fields to dry fields, ditch hardening, rivers and lakes management and building of forests for snail control and schistosomiasis prevention. The completion of schistosomiasis control measures was investigated, and the effectiveness was evaluated. Results A total of 20 545 155 person-times received human schistosomiasis examinations in Sichuan Province during the period from 2015 to 2023, and 232 157 person-times were seropositive, with a reduction in the seroprevalence from 2.10% (44 299/2 107 003) in 2015 to 1.12% (9 361/837 896) in 2023 (χ² = 7.68, P < 0.001). The seroprevalence of human schistosomiasis appeared a tendency towards a decline in Sichuan Province over years from 2015 to 2023 (b = −8.375, t = −10.052, P < 0.001); however, no egg positive individuals were identified during the period from 2018 to 2023, with the prevalence of human Schistosoma japonicum infections maintained at 0. Expanded chemotherapy was administered to 2 754 515 person-times, and medical assistance of advanced schistosomiasis was given to 6 436 persontimes, with the treatment coverage increasing from 46.80% (827/1 767) in 2015 to 64.87% (868/1 338) in 2023. Parasitological tests for livestock schistosomiasis were performed in 35 113 herd-times, and expanded chemotherapy was administered to 513 043 herd-times, while the number of fenced livestock decreased from 121 631 in 2015 to 103 489 in 2023, with a reduction of 14.92%. Snail survey covered 433 621.80 hm² in Sichuan Province from 2015 to 2023, with 204 602.81 hm² treated by chemical control and 4 637.74 hm² by environmental modifications. The area of snail habitats decreased from the peak of 5 029.80 hm² in 2016 to 3 709.72 hm² in 2023, and the actual area of snail habitats decreased from the peak of 8 585.48 hm² in 2016 to 473.09 hm² in 2023. The mean density of living snails remained low across the study period except in 2017 (0.62 snails/0.1 m²). Schistosomiasis control efforts by departments of agriculture and rural affairs in Sichuan Province included conversion of paddy fields to dry fields covering 153 346.93 hm², hardening of 6 110.31 km ditches, building of 70 356 biogas digesters, replacement of cattle with 227 161 sets of machines, and captive breeding of 21 161 070 livestock from 2015 to 2023, and the control efforts by departments of water resources included rivers and lakes management measuring 5 676.92 km and renovation of 2 331 irrigation areas, while the control efforts by departments of forestry and grassland included building of forests for snail control and schistosomiasis prevention covering 23 913.33 hm², renovation of snail control forests covering 8 720 hm² and newly building of shelterbelts covering 764 686.67 hm². All 63 endemic counties (cities and districts) had achieved the criterion for schistosomiasis elimination criteria in Sichuan Province by the end of 2023. Conclusion Following the integrated control efforts from 2015 to 2023, remarkable achievements have been obtained in the schistosomiasis control programme in Sichuan Province, with all endemic counties successfully attaining the schistosomiasis elimination target at the county level.

Objective:To explore the expression of family with sequence similarity 83 member A (FAM83A) in colorectal cancer, and the effect of FAM83A knockdown on the proliferation of colorectal cancer cells and the related mechanism.Methods:The expression of FAM83A in the tissues of 102 patients with colorectal cancer and its adjacent tissues was detected by immunohistochemistry. HCT116 cells were divided into experimental group and control group. The experimental group cells were transfected with FAM83A-siRNA plasmid, and the control group cells were transfected with MOCK-siRNA plasmid. The mRNA content of FAM83A in each group was detected by fluorescence quantitative PCR. The expressions of FAM83A, P13K, p-AKT and p-mTOR in each group were detected by Western blot. CCK8 assay and clonogenesis assay were used to detect cell proliferation.Results:The positive rate of FAM83A in colorectal cancer patients was 88.23% (90 cases /102 cases), and the expression rate of FAM83A in paracancer tissues was 10.78% (11 cases /102 cases). The expression rate of Fam83a in colorectal cancer tissues was significantly higher than that in paracancer tissues, with statistical significance ( P<0.001). After siRNA transfection, the mRNA expression levels of FAM83A in HCT116 cells of the experimental group and control group were 1.23±0.20 and 0.43±0.12, respectively, and the protein expression levels of FAM83A were 1.19±0.11 and 0.23±0.08, respectively. The expression levels of P13K were 1.21±0.17 and 0.28±0.09, the expression levels of p-AKT were 1.35±0.23 and 0.57±0.18, and the expression levels of p-mTOR were 1.48±0.20 and 1.05±0.14. The expression of P13K, p-Akt and p-mTOR was down-regulated (all P<0.05). The absorbance of HCT116 cells in the experimental group and the control group was 1.09±0.22 and 2.21±0.27, respectively. The cloning rate of HCT116 cells in the experimental group and the control group was 21.6%±2.4% and 62.7%±4.1%, respectively. The proliferation ability of HCT116 cells in the experimental group decreased significantly ( P<0.05) . Conclusions:The expression of FAM83A is significantly increased in colorectal cancer tissues, which may be related to the malignant degree of colorectal cancer. FAM83A affects the proliferation of colorectal cancer cells through the P13K/AKT/mTOR signaling pathway.

Objective To compare the clinical outcomes between oblique lumbar interbody fusion(OLIF)and transforaminal lumbar interbody fusion(TLIF)for patients with degenerative spondylolisthesis during 2-year follow-ups.Methods Patients with symptomatic degenerative spondylolisthesis who underwent OLIF(46 cases)and TLIF(45 cases)between July 2017 and September 2020 with 2-year follow-ups were retrospectively reviewed.One level or two-level lumbar fusion were included.The primary outcomes were Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI)at 2 years after surgery.The secondary outcomes included radiographic parameters,fusion rate,cage subsidence rate,and permanent nerve injury rate.Results No significantly different changes were noted in VAS-back[2(2,3)vs.2(2,2),P=0.943],VAS-leg[2(2,2)vs.2(2,2),P=0.988],and ODI[17％(10％,22％)vs.14％(10％,22％),P=0.417]between the OLIF group and the TLIF group,respectively.Greater restoration of disc height and segmental lordosis were obtained in the OLIF group[mean,(11.9±1.5)mm and 15.7°±7.2°]than in the TLIF group[mean,(9.2±2.0)mm and 12.5°±5.9°]at postoperative 2-year(P＜0.001 and P=0.029).The subsidence rate was lower in the OLIF group than in the TLIF group[19.6％(9/46)vs.40.0％(16/40),P=0.037].The fusion rates at postoperative 2-year were 93.5％(43/46)in the OLIF group and 87.5％(35/40)in the TLIF group,having no significant difference(P=0.562).The rates of permanent nerve injury were similar between the two groups[4.3％(2/46)vs.6.7％(3/45),P=0.980]at postoperative 2-year.Conclusion Short segment OLIF doesn't show better clinical outcomes and fusion rate than TLIF for degenerative spondylolisthesis,except for greater disc height restoration,greater segmental lordosis,and lower subsidence rate at postoperative 2-year.

Extracorporeal membrane oxygenation is an extracorporeal life support technique used to rescue patients with respiratory and (or) heart failure. Infection is one of the most serious complications of extracorporeal membrane oxygenation, which can affect patients' clinical outcomes. This article reviews the definition, diagnosis, incidence, site of infection, pathogenic bacteria, risk factors, prevention and treatment measures of extracorporeal membrane oxygenation associated nosocomial infection, so as to provide reference for the prevention and treatment of extracorporeal membrane oxygenation associated nosocomial infection.

OBJECTIVE: To explore the molecular pathogenesis for a pedigree affected with hereditary coagulation factor XII (FXII) deficiency. METHODS: Potential variant of the F12 gene was analyzed by PCR and Sanger sequencing. Expression plasmids were constructed by site-directed mutagenesis based on the wild-type and transiently transfected into 293T cells. FXII:C and FXII:Ag of the expression products were determined in the supernatant and cell lysate. Western blotting was used to verify the identify of the protein. RESULTS: Gene sequencing revealed that the proband has carried 46TT genetype and heterozygous p.Glu502Lys variants in exon 13, and a heterozygous p.Gly542Ser variant in exon 14 of the F12 gene. Transfection experiment suggested that the FXII:C and FXII:Ag of p.Glu502Lys variant in the supernatant were 28% and 24%, compared with the wild-type (100%) and FXII:Ag of cell lysates was 39% compared to the wild-type (100%). The FXII:C and FXII:Ag of p. Gly542Ser variant in the supernatant were 32% and 17% and the FXII:Ag of cell lysates was 59%. CONCLUSION The 46TT genetype, p.Glu502Lys and p.Gly542Ser variants of the F12 gene probably underlie the low FXII level in the proband. As shown by in vitro experiment, the p.Glu502Lys and p.Gly542Ser variants can both inhibit the synthesis and secrection of the FXII protein.
Exons ; Factor XII ; genetics ; Factor XII Deficiency ; genetics ; Heterozygote ; Humans ; Pedigree

Objective:To explore the genetic characteristics, clinical features, and prognostic values of RAS mutations in patients with myelofibrosis (MF) .Methods:We analyzed 112-gene targeted sequencing data from 226 patients who had a diagnosis of either primary myelofibrosis (PMF) or post-polycythemia vera/post-essential thrombocythemia (post-PV MF and post-ET MF) from December 2011 to December 2019. A retrospective analysis of the genetic characteristics, clinical features, and prognosis of RAS mutations was performed.Results:Among 266 patients diagnosed PMF or post-PV/ET MF, RAS mutations were found in 14 (6.2%) cases, including 9 (4.0%) cases of NRAS mutations, 8 (3.5%) cases of KRAS mutations, and 3 (1.3%) cases of both NRAS and KRAS mutations. All of the NRAS mutations were located in codons 12 and 13. The median VAFs of RAS mutations were significantly lower than those of the driver mutations, confirming that they represent sub-clonal events that are acquired during the disease course. SETBP1, SRSF2, and MPL tended to be clustered with RAS mutations. Patients with RAS mutations had a higher number of additional oncogenic mutations (median, 3.36 vs 1.17, P<0.001) . RAS mutations had a statistically significant association with elevated monocyte cell counts ( P=0.003) , lower platelet counts ( P=0.026) , higher bone marrow blasts ( P=0.022) , splenomegaly ( P=0.005) , and very high-risk (VHR) karyotype abnormality percentage ( P=0.031) . In univariate analysis, the OS of patients with NRAS mutations were significantly inferior in the entire MF and PMF cohorts ( P=0.001, P=0.008) . In a multivariate model, NRAS retained an independent negative prognostic factor in PMF. Conclusion:RAS gene mutations were constantly related to elevated monocyte cell counts, lower platelet counts, higher bone marrow blasts, and VHR karyotype abnormality percentage that usually defined high-risk disease and often occurred as sub-clonal events. NRAS mutation is an independent poor prognostic factor in PMF.

Objective To observe the effects of insulin caliper for blood glucose control on glycemic central tendency, fluctuation and incidence of hypoglycemia in patients with sepsis, and evaluate its application value. Methods One hundred sepsis patients with significant hyperglycemia from December 2015 to December 2017 were selected. All patients needed continuous intravenous insulin infusion to maintain blood glucose. The patients were divided into caliper group and conventional group by random digits table method with 50 cases each, patients of 2 groups adopted an insulin dose modification scheme based on insulin caliper for blood glucose control and paper-based insulin dose modification scheme respectively to control blood glucose. Finally, 92 cases completed the study, including 47 cases in caliper group and 45 cases in conventional group. Blood glucose was measured every 2 hours 0 to 12 hours after intravenous insulin and every 4 hours 16 to 72 hours after intravenous insulin. The incidence of hypoglycemia, insulin dose, ICU time, total hospital stay and hospitalization cost were observed. The proportion of hypoglycemia to total blood glucose measurement, proportion of achieving the glucose control target at each time point, glycemic coefficient of variance, glycemic lability index (GLI) and mean amplitude of glycemic excursion (MAGE) were calculated. Results A total of 1 379 blood glucose values were obtained in caliper group, and a total of 1 332 blood glucose values were obtained in conventional group. There were no statistical difference in blood glucose values 0 to 12 hours after intravenous insulin between 2 groups (P＞0.05). The blood glucose values 16 to 72 hours after intravenous insulin in caliper group were significantly lower than those in conventional group, and there were statistical differences (P＜0.01 or ＜0.05). There were no statistical differences in glycemic coefficient of variance, insulin dose, incidence of hypoglycemia and proportion of hypoglycemia to total blood glucose measurement between 2 groups (P＞0.05). The GLI and MAGE in caliper group were significantly lower than those in conventional group: 12.96 (8.73, 19.58) vs. 23.27 (13.07, 44.61) and (0.66 ± 0.22) mmol/L vs. (0.87 ± 0.28) mmol/L, the proportion of achieving the glucose control target at each time point was significantly higher than that in conventional group: 41.99% (579/1 379) vs. 27.18% (362/1 332), and there were statistical differences (P＜0.01). There were no statistical differences in ICU time, total hospital stay, hospitalization cost, nosocomial infection rate and prognosis between 2 groups (P＞0.05). Conclusions For emergent and critical patients with sepsis, insulin caliper for blood glucose control presents favorable application value for achieving glucose control target, reducing glycemic fluctuation, lowering the incidence of hypoglycemia, low cost and good operability.

We investigated the third-generation cephalosporins-resistant Shigella and its genotype in Ningbo,China,providing a basis for disease prevention and control.Pathogenic bacteria were analyzed by direct isolation combined with enrichment culture isolation.Antimicrobial susceptibility was determined by K-B disk diffusion method and PCR was used for detecting multidrug resistance genes like CTX-M,OXA,TEM and SHV.BLAST analysis was used to determine the genotype.Results showed that 69 strains of third-generation cephalosporins-resistant Shigella were detected by drug sensitivity screening,accounting for 74.19％ of ESBLs Shigella.Drug resistance gene CTX-M(CTM-M-1 and CTM-M-9),OXA and TEM were detected.The detection rate were 79.71％,79.01％ and 26.09％ respectively.With no CTX-M-2 and SHV,DNA sequence alignment showed CTX-M-1 group were mainly of CTX-M-15 type besides seven other types;CTX-M-9 group were mainly of CTX-M-14 type besides six other types;49 strains of OXA and 18 strains of TEM were sequenced to be type 1 (OXA-1 and TEM-1 type).The 21 Shigella strains carrying more than two drug resistance genes accounts for 30.43 ％.Shigella in Ningbo has high third-generation cephalosporins-resistance rate and many kinds of ESBLs enzymes were detected.The mainstream enzyme type was CTX-M,meanwhile they also carried a variety of drug resistance genes,which could bring difficulties to disease prevention and control.The high carrying rate of OXA-1 type suggests that we should pay more attention.The detection rate of group B was higher than that of group D,including not only the phenotype resistance but also the drug-resistance genes;these findings will be useful in the study of the drug resistance prevalence of Shigella.

Objective To explore the effect of hospital-family continuous nursing on the symptoms and life quality of COPD patients.Methods A total of 80 stable COPD patients in our hospital from July to November 2016 were selected as research objects and were divided into two groups according to the time of admission,patients in odd-numbered admission day was as observation group (hospital-family continuous nursing),and patients in even-numbered day was as control group (routine nursing),self-management,symptom control and life quality after 3 months of discharge in the two groups were compared.Results The total score of self-management after 3 months of discharge in the observation group was higher,but the CAT score was lower,and times of disease onset was less than that in the control group,the differences were statistically significant (P ＜ 0.05).The life quality scores in influence,symptoms,and activities after 3 months of discharge in the observation group was lower than that in the control group,and the difference was statistically significant (P ＜0.05).Conclusion The hospital-family continuous nursing for COPD patients can improve the self-management ability,relieve the symptoms and improve the life quality.

Objective To explore the effect of hospital-family continuous nursing on the symptoms and life quality of COPD patients.Methods A total of 80 stable COPD patients in our hospital from July to November 2016 were selected as research objects and were divided into two groups according to the time of admission,patients in odd-numbered admission day was as observation group (hospital-family continuous nursing),and patients in even-numbered day was as control group (routine nursing),self-management,symptom control and life quality after 3 months of discharge in the two groups were compared.Results The total score of self-management after 3 months of discharge in the observation group was higher,but the CAT score was lower,and times of disease onset was less than that in the control group,the differences were statistically significant (P ＜ 0.05).The life quality scores in influence,symptoms,and activities after 3 months of discharge in the observation group was lower than that in the control group,and the difference was statistically significant (P ＜0.05).Conclusion The hospital-family continuous nursing for COPD patients can improve the self-management ability,relieve the symptoms and improve the life quality.