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.

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.

Objective:To evaluate the efficacy and safety of Xiao′er Huangjin Zhike Granules in the treatment of cough caused by acute bronchitis in children, which is defined in TCM terms as a syndrome of phlegm-heat obstructing the lung.Methods:This was a block-randomized, double-blind, placebo-controlled, multicenter clinical trial.From January 2022 to September 2023, 359 children aged 3 to 7 years old diagnosed as acute bronchitis (lung-obstructing phlegm-heat syndrome) were enrolled from 21 participating hospitals and randomly assigned to the experimental group and placebo group in a 3︰1 ratio, and respectively treated with Xiao′er Huangjin Zhike Granules and its matching placebo.Cough resolution/general resolution rate after 7 days of treatment was used as the primary efficacy outcome for both groups.Results:(1)On the seventh day of treatment, the rate of cough disappearance/basically disappearance in the experimental group and placebo group were 73.95% and 57.61% retrospectively, which had statistically significance ( P=0.001).(2)After 7 days of treatment, the median duration of cough disappearance/basic disappearance were 5 days and 6 days in the two groups , with a statistically significant difference ( P=0.006).The area under the curve of cough symptom severity time was 7.20 ± 3.79 in the experimental group and 8.20±4.42 in the placebo group.The difference between the two groups was statistically significant ( P=0.039).(3) After 7 days of treatment, the difference between TCM syndrome score and baseline was -16.0 (-20.0, -15.0) points in the experimental group and -15.0 (-18.0, -12.0) points in the placebo group, with significant difference between the two groups ( P=0.004).In the experimental group, the clinical control rate, the markedly effective rate, the effective rate and the ineffective rate were 49.04%, 28.35%, 16.48% and 6.13% severally; and in the placebo group, the clinical control rate, the markedly effective rate, the effective rate and the ineffective rate were 38.04%, 26.09%, 29.35%, and 6.52% separately, which had statistically significant ( P=0.014).(4) There was no significant difference in the incidence of adverse events or adverse reactions during the trial between both groups.Moreover, while adverse reactions in the form of vomiting and diarrhea were occasionally reported, no serious drug-related adverse event or adverse reaction was reported.(5)The tested drug provided good treatment compliance, showing no statistically significant difference from the placebo in terms of compliance rate. Conclusions:Based on the above findings, it can be concluded that Xiao′er Huangjin Zhike Granules provides good safety, efficacy, and treatment compliance in the treatment of cough caused by acute bronchitis, and lung-obstructing phlegm-heat syndrome, in children.

Objective To evaluate the effect of manual massage on complications after endoscopic foam sclerotherapy injection for the treatment of internal hemorrhoids.Methods Consecutive 113 patients with grade Ⅰinternal hemorrhoids were prospectively enrolled and completed endoscopic foam sclerotherapy.The patients were randomly divided into a massage group(n=65)and a control group(n=68).Massage group performed manual perianal massage,Visual analogue scale(VAS)was used to evaluate perianal pain.The postoperative bleeding,short-term and long-term efficacy were also compared.Results The median VAS of 24 h postoperation was 1.0(0.0,3.0)in massage group,which was significantly lower than 2.0(1.0,4.0)in control group,the difference was statistically significant(P=0.014).The no bleeding rate of one week postoperation was 84.6％in massage group,which was significantly higher than 64.7％in control group,the difference was statistically significant(P=0.009).After 12 weeks,6 months and 12 months of follow-up,there were no significant differences in cure rate and remission rate between the two groups(P＞0.05).Conclusion Manual massage after endoscopic sclerosing agent injection is beneficial to relieve postoperative pain of grade Ⅰ internal hemorrhoids and reduce bleeding.

Objective:To evaluate the impact of self-crosslinked hyaluronic acid (SCH) gel on endometrium recovery after artificial abortion.Methods:A multicenter, prospective randomized controlled trial was conducted across 18 hospitals from December 2021 to February 2023, involving 382 women who underwent artificial abortion. Participants were randomly allocated to receive either treatment with SCH gel (SCH group) or no treatment (control group) in a 1∶1 ratio. The primary outcome was endometrium thickness in 14 to 18 days after the first postoperative menstruation. Secondary outcomes included changes in menstrual volume during the first postoperative menstruation, menstruation resumption within 6 postoperative weeks, time to menstruation resumption, duration of the first postoperative menstruation, and incidence of dysmenorrhea.Results:Baseline characteristics of participants were comparable between the two groups (all P>0.05), with 95.3% (182/191) in SCH group and 92.7% (177/191) in the control group completed the study. The postoperative endometrial thickness in SCH group was significantly greater than that in the control group [(9.78±3.15) vs (8.95±2.32) mm; P=0.005]. SCH group also had significantly fewer participants with reduced menstrual volume [23 cases (12.6%, 23/182) vs 31 cases (17.5%, 31/177); P=0.038]. Although SCH group experienced less dysmenorrhea during the first postoperative menstrual period, this difference was not statistically significant [28.5% (51/179) vs 37.1% (65/175); P=0.083]. Outcomes were similar between SCH group and the control group regarding the proportion of participants who resumed menstruation within 6 weeks postoperatively, time to menstruation resumption, and duration of the first postoperative menstruation ( P=0.792, 0.485, and 0.254, respectively). No serious adverse events were observed during the study period, and no adverse events were attributed to SCH gel treatment. Conclusion:The application of SCH gel after artificial abortion is safe and might aid in the recovery of the endometrium.

Objective:To evaluate the safety and long-term effectiveness of endoscopic foam sclerotherapy (FS) combined with endoscopic rubber band ligation (ERBL)in the treatment of grade Ⅱ-Ⅲ internal hemorrhoids.Methods:Consecutive patients diagnosed as having grade Ⅱ-Ⅲ internal hemorrhoids in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January to December 2020 were prospectively enrolled in the study, and randomly divided into ERBL group and FS combined with ERBL group. The 24 h visual analogue scale (VAS) for pain and 1-week degree of bleeding were evaluated after the treatment. After follow-up of 6 months, the effectiveness of treatment was evaluated.Results:A total of 84 patients with age of 54.4±7.9 years were enrolled, 57.1% (48/84) males, and 73.8% (62/84)grade Ⅱ internal hemorrhoids. Forty-three patients were assigned to the ERBL group and 41 to the FS combined with ERBL group. There was no significant difference between the two groups in baseline data ( P>0.05). In the FS combined with ERBL group, the mean amount of polidocanol foam was 13.8±2.5 mL, the mean number of injection site was 4.7±1.2, and the median scores of VAS was 0 (0, 3), which was significantly lower than that of ERBL group [2 (0, 4), Z=-2.116, P=0.034]. The bleeding rate 1 week after treatment in the ERBL and FS combined with ERBL group were 20.9% (9/43) and 29.3% (12/41), respectively, and mild bleeding was the main symptom. There was no significant difference between the two groups in the bleeding degree ( U=807.0, P=0.378). After 6 months of follow-up, the total effective rates in the ERBL group and the FS combined with ERBL group were 81.4% (35/43) and 90.2% (37/41), respectively ( U=684.5, P=0.044). Conclusion:FS combined with ERBL can effectively relieve post-treatment perianal pain, and improve the long-term effectiveness.

Objective:To evaluate the diagnostic value of HPV detection in squamous cell carcinoma of the cervical lymph node metastasis from an unknown primary site.Methods:Clinical data of 6 patients who were initially diagnosed with squamous cell carcinoma of the cervical lymph node metastasis from an unknown primary site and eventually diagnosed with HPV-related oropharyngeal squamous cell carcinoma were collected, and the process of diagnosis was analyzed.Results:Upon the initial admission, all patients were diagnosed with squamous cell carcinoma of the cervical lymph node metastasis with positive p16 expression, positive HPV-16 subtype and negative EBER expression. No obvious primary lesion was found after comprehensive examination. Subsequently, four of them underwent ipsilateral tonsollar blind biopsy ( n=2) and ipsilateral tonsillectomy ( n=2). All these four patients were pathologically diagnosed with tonsillar squamous cell carcinoma. For the other two cases, MRI detected the thickening complicated with enhancement of ipsilateral wall of oropharynx and tongue root after follow-up for D149 and D545 , respectively. Biopsy confirmed the diagnosis of squamous cell carcinoma of the tonsil and tongue root, respectively. Conclusion:For patients with HPV-positive squamous cell carcinoma of the cervical lymph node metastasis from an unknown primary site, the possibility that the primary lesion originates from the oropharyngeal site, especially the tonsil and tongue root, should be highly suspected.

Objective: To evaluate the safety and efficacy of foam sclerotherapy for bleeding internal hemorrhoids. Methods: Consecutive adult patients (aged 18-60 years) with bleeding hemorrhoids were prospectively enrolled between March 2017 and March 2018. All patients were randomly assigned to the foam sclerotherapy (FS) group and the liquid sclerotherapy (LS) group. The foam and liquid sclerotherapy of hemorrhoids nucleus was performed by cap-assisted colonic endoscopy. Results: A total of 108 patients were enrolled, including 62 males (57.4%) with mean age of 44.0±7.6 years. There was no significant difference in gender, age, or body mass index between the FS (n = 55) group and the LS (n =53) group. The total amount of lauromacrogol injection in the FS group was 3.7±0.9 mL, which was significantly lower than that in the LS group (8.0±2.2 mL, P<0.001). In the LS group, 8 patients (15.1%) developed bleeding after needle removal, which was significantly higher than that in the FS group [5.5%(3/53), P=0.022]. Significant pain was found in 2 patients (3.8%) in the LS group and 0 in the FS group (P= 0.025). The short-term cure rate and effective rate of the FS group were 87.3% (48/55) and 9.1% (5/55), while those were 69.8% (37/53) and 22.6% (12/53) in the LS group, respectively (P=0.046). Conclusion Foam sclerotherapy is safe and effective in the treatment of bleeding internal hemorrhoids.

Objective To explore the influence of family-integrated transition care on the daily living ability of discharged patients with stroke.Methods Seventy-eight patients with stroke who were admitted to Renmin Hospital of Wuhan University from May 2016 to October 2017 were selected by convenience sampling and were divided into a control group and a family-integrated transition care group (hereinafter referred to as transition care group).The patients in the control group received routine neurological health education,while those in the transition care group received a family-integrated transition care intervention in addition to routine neurological health education.The family-integrated transition care included team building,skills training for family members,family-integrated guidance for discharged patients,and regular visits.The scores of the modified Barthel index were compared between the two groups of patients at discharge,three months after intervention,and six months after intervention.Results Among the 71 patients that were finally included,35 cases were included in the control group,of which 17 cases were men (49％),18 cases were women (51％),and their mean age was (70.1±3.7) years;the transition care group comprised 36 cases,of which 18 cases were men (50％),18 cases were women (50％),and their mean age was (69.8±4.5) years.The baseline scores of the control group and transition care group on the day of discharge were (49.1 ± 7.5) and (49.7 ± 7.9),respectively,with no significant difference (P＞0.05).In terms of time effects,the scores of the patients in the two groups had statistically significantly improved at six months after discharge (P＜0.05).In the group comparison,the scores of the patients in the transition care group after the intervention were significantly higher compared to the scores of those in the control group (P＜0.05).In terms of time and inter-group effects,there was an interaction (P＜0.05),and therefore,the influence of time effects was excluded and the same timepoint was compared between the two groups.The scores at three months (63.9±8.8) and six months (76.9± 10.1) in the transition care group were higher than those in the control group (58.1 ±8.1 and 66.0 ±9.3,respectively).The difference was statistically significant (P ＜ 0.05).Conclusion Family-integrated transition care can effectively improve daily living ability and isworthy of promoting.

[Abstra ct] Objective To investigate the long-term efficacy and adverse effects of intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC).Methods A total of 869 patients with biopsy-proven NPC without distant metastasis who underwent the whole course of IMRT from 2009 to 2010 were enrolled.Of all the patients, 84.8%received cisplatin-based chemotherapy.The prescribed dose to the primary lesion in the nasopharynx was 66-70Gy in 30-32 fractions, and the dose to the positive lymph nodes in the neck was 66 Gy in 30-32 fractions.The Kaplan-Meier method was used to calculate survival rates, the log-rank test was used for difference analysis and univariate prognostic analysis , and the Cox proportional hazards model was used for multivariate prognostic analysis .Rseu lts The 5-year overall survival( OS ) , local recurrence-free survival, regional recurrence-free survival, distant metastasis-free survival, and disease-free survival ( DFS ) were 84.0%, 89.7%, 94.5%, 85.6%, and 76.3%, respectively.In the patients with locally advanced NPC,concurrent chemotherapy tended to reduce distant metastasis (83.6%vs.75.7%, P=0.050) and improve OS (82.6%vs.77.0 %, P=0.082).Induction chemotherapy tended to improve OS ( 80.7% vs.71.4%, P=0.057 ) , and the induction chemotherapy containing docetaxel or gemcitabine tended to improve OS (83.3%vs.72.2%, P=0.058).The patients who received a boost after the initial radiotherapy had a significantly lower DFS rate than those who did not (52.2%vs.71.1%, P=0.004).The concurrent chemotherapy increased the incidence rates of long-term xerostomia and trismus, while a high dose of cisplatin increased the incidence rates of xerostomia and hearing impairment.Conclusions IMRT for NPC provides satisfactory long-term efficacy.Concurrent chemotherapy combined with IMRT tends to reduce the incidence of distant metastasis, and other values need further investigation.The boost therapy after radiotherapy may be associated with poor prognosis.Chemotherapy increases the incidence of long-term toxicities.