Objective　To timely understand the current status and distribution of nail snails (Oncomelania hupensis) in Tongjiang River channels in Zhenjiang City, providing a scientific basis for achieving the goal of eliminating schistosomiasis. Methods　From 2019 to 2023, nine Tongjiang River channels on the south bank of the Yangtze River under the jurisdiction of Zhenjiang City were selected as the monitoring area. Snail monitoring was carried out onshore and beach nail snails floats in the Tongjiang River channels, nail snails on attachments in hardened areas, snails induced by straw curtains, and snails carried by boats and domestic animals. Results　The monitoring results of shoreline snail from 2019 to 2023 showed that the snail situation in the Tongjiang River channel and its outer river bank remained relatively stable from 2019 to 2020; however, in 2021, under the influence of the Yangtze River flooding disaster in 2020, the area of snails increased significantly. In 2021, the area with snails in the Tongjiang River channel and the outer river bank increased by 45.70% (11.95/26.15) and 100.00% (20.00/20.00) compared to 2020; the average density of nails snails in the Tongjiang River channel and the outer river bank and the emergence rate of snail frames both showed a significant increase, rising by 94.73% (0.18/0.19) and 68.08% (8.68/12.75) compared to 2020, and by 122.73% (0.81/0.66) and 102.78% (43.26/42.09), respectively. The differences in the increase in the occurrence rate of spiked frames in the Tongjiang River channel Chili River and Renmin River were not statistically significant (χ2=0.329, P>0.05; χ2=0.646, P>0.05). From 2022 to 2023, the density of nail snails and the occurrence rate of framed snails in the Tongjiang River channel showed a decreasing trend (F=4.72, P=0.04 and χ2=372.58, P<0.01). The area of nail snails, density of live snails, and occurrence rate of framed snails in the outer river bank showed a decreasing trend (F=13.96, P=0.02; F=23.43, P<0.01; χ2=1 029.69, P<0.01). During the five years, no nail snails were detected in the ancient canal and 11 tributaries. From 2019 to 2023, 180 times of 3 003 kg of floating objects were salvaged, with a total of 148 live snails detected. A total of 17 live snails were captured on attachments in the hardened berm area; a total of 11 live snails were captured by straw curtain snail baiting;112 boats were inspected, and no snails were found; there were 112 boats surveyed, and no snails were found; 97 cattle were observed, and 2 cattle were found to carry 1 live snail on their hooves; 321 sheep were observed, and no snails were found on their hooves; and no infectious snails were found in the monitoring area in 5 years. Conclusions　Nail snails continue to exist in the Tongjiang River channel, and the risk factors for schistosomiasis transmission have not been completely eliminated. It is still necessary to carry out accurate monitoring of the snail situation in the Tongjiang River and the river bank, so as to grasp the risk of transmission in time and take emergency measures.

Objective To analyze the effect on clinical outcome of sepsis patients treated by early positive and standardized treatment in primary hospitals. Methods The clinical data of sepsis patients admitted to intensive care unit (ICU) of Dushanzi People's Hospital from January 1, 2015 to December 31, 2018 were retrospectively analyzed. The sepsis patients were further divided into a control group (from January to December, 2015) who received non-standardized treatment of sepsis, only according to doctors' experience, using routine antibiotics, fluid resuscitation, detection of lactic acid, etc. and a study group; from 2016, the patients with sepsis (the study group) received standardized diagnosis and treatment according to the Guidelines of Sepsis 3.0 and the actual conditions of our hospitals, and they were further subdivided into three periods: 2016 (from January to December, 2016), 2017 (from January to December, 2017), and 2018 (from January to December, 2018) periods. The main clinical outcome indicator of these patients in 4 time periods, 28-day mortality, the secondary clinical outcome indicators such as the length of stay in ICU and medical expenses in ICU were observed. Results Sixty-six patients with sepsis were finally enrolled, including 17 cases in 2015, 18 cases in 2016, 17 cases in 2017 and 14 cases in 2018. Compared with 2015, the length of ICU stay in 2016, 2017 and 2018 were significantly shorter (days: 17.45±9.09, 12.95±5.93, 12.14±4.92 vs. 20.85±13.45, all P <0.05), and the medical cost of ICU stay were significantly lower (ten thousand yuan: 9.93±5.35, 7.22±3.86, 5.15±2.88 vs. 13.37±14.14, all P < 0.05); the 28-day mortality was significantly decreased [16.67% (3/18), 11.76% (2/17), and 14.29% (2/14) vs. 35.3% (6/17), all P < 0.05]. Conclusion Early standardized treatment for patients with sepsis can significantly reduce the length of stay in ICU and medical expenses in ICU.

Objective To quantitatively estimate the range and area of environmental contamination by the feces of Schistoso?ma japonicum?infected that were freely grazed,so as to provide the theoretical evidence for the scientific assessment of the role of the freely grazed goat in the transmission of schistosomiasis japonica and development of control strategy. Methods All the fecal samples excreted by the infected goat at daytime(12 h)were collected by using a self?made goat fecal collector,weighed and counted. The quantity and dispersal of the feces excreted by the freely grazed goat at daytime under a natural condition were investigated,and the walking route and speed of the freely grazed goat at daytime were recorded with a multifunction GPS data logger. The maximum range and area of the environment contaminated by the feces of the freely grazed goat at daytime were esti?mated,and the maximum range and area of the Oncomelania hupensis snails that may be infected by the schistosome miracidium released from the eggs in the fecal samples of the freely graze goat at daytime were calculated. Results During the walking along the marshland at daytime(12 h),the quantity of the feces execrated by the freely grazed infected goat was(232.8 ± 39.8) g per goat,and the fecal samples were composed of(819.2 ± 152.1)pellets. The goat had a mean walking speed of(0.522 7 ± 0.099 7)km/h,and the longest distance,largest radius and largest range of walking activity were(6.272 4 ± 1.195 8)km, 3.136 2 km and(3 191.113 0 ± 1 189.709 4)hm2at daytime,respectively. The area of the snails that may be infected by the mi?racidium released from the eggs in the fecal samples of the freely graze goat(range of key regions for infected snails detection and control)at daytime was estimated to be(3 210.717 5 ± 1 190.907 3)hm2. Conclusions The intensity of environmental contamination by the eggs in the fecal samples of the freely grazed goat is linked to the number of infected goat. The contamina?tion range caused by the feces of the freely grazed goat with fixed fences is relatively stably kept within the walking range at day?time,and the range and area of goat fecal contamination is associated with the number of households that breed goat and the dis?tribution of goat fence. The area of the snails that may be infected by the miracidium released from the eggs in the fecal samples of the freely graze goat is larger than the area of setting contaminated by the eggs in the goat feces ,indicating that the range of in?fected snail examination and control is larger than the range of goat feces detected.

Objective To investigate the survival of Schistosoma japonicum eggs in goat feces in natural marshlands and the factors affecting its survival,so as to provide evidences for understanding of the role of eggs in goat feces in the transmission of schistosomiasis and the development of the interventions pertaining to disease control and elimination. Methods The goat ani?mals of schistosomiasis japonica were modeled in laboratory,and the feces of infected goat were collected. In laboratory,the ef?fects of environmental temperature and water content in goat feces on egg hatching were evaluated,and in the field,the effect of duration of goat feces on marshland on egg hatching and the effect of direct sunshine on egg survival were evaluated. Results At 25℃in laboratory,the hatching rate of eggs in goat feces was high?positively correlated with the water content in goat feces (r=0.87). If the water content reduced to 7.6%in goat feces,the eggs in goat feces lost the ability to hatch. Under the same wa?ter content in goat feces,the hatching rate of eggs gradually decreased with the extension of the duration of exposure of goat feces to-5℃,which reduced to 0 following 5 h exposure. At 5,15 and 25℃,the hatching rates of eggs gradually decreased with the extension of the duration of exposure of goat feces,and the miracidium hatching rates of eggs were 2.3%,5%and 0.9%respec?tively following the exposure for 52 d. At 35℃,the hatching rate of eggs gradually decreased with the extension of the duration of exposure,which reduced to 0 following 13 d exposure. In winter(-2?10℃),the hatching rate of eggs gradually decreased with the extension of the duration of exposure of goat feces on marshlands,which reduced to 0 after 21 d of exposure,and in spring(16?19℃),the hatching rate of eggs gradually decreased with the extension of the duration of exposure of goat feces on marshlands,which reduced to 0.9%after 5 d of exposure. At the same time point on the same marshland,the hatching rate of eggs in goat feces exposed to marshlands with direct sunshine was lower than that without direct sunshine. Conclusion The sur?vival of S. japonicum eggs in goat feces is associated with environmental temperature and water content(humidity)in goat feces, and the temperature and humidity are major natural factors affecting egg hatching.

Objective To develop a simple,feasible goat feces collector to improve the collection accuracy and integrity of goat fecal samples without pollution,and to modify the miracidium hatching test with a plastic tube to achieve simple,standard and comparative procedures,so as to provide technical support for pathogenic diagnosis and scientific research of goat schistoso?miasis japonica. Methods According to the body features of goat in marshland regions,a goat fecal collector,which was made of coarse fabric cottons,was devised,which was able to be fixed onto the goat buttocks and avoid urine pollution. Prior to mira?cidium hatching test,the goat fecal samples were pieced by using a mechanical method instead of the conventional artificial piec? ing method,and the effect of mechanical piecing treatment on miracidium hatching was evaluated. A filter membrane was added between the tube and rubbery ring to block the floater in fecal residues into the tube. The effects on miracidium hatching by us?ing thin fat?free cotton,thick fat?free cotton,nylon gauze at 100 pores/25.4 mm2 and 150 pores/25.4 mm2 were compared. Re?sults The goat feces collector was composed of foreleg fixing garment,hindleg fixing garment and stool bag. The functions of the fixing garment were as a fixed collector to allow non?shift and tolerance of weight during goat activity ,while the major func?tion of stool bag was in storage of stool. The goat activity was not influenced by the use of collector ,and all fecal samples were ex?creted to the bag. This collector was easy to perform and could avoid urine pollution,which was reusable after cleaning. Prior to miracidium hatching,the goat fecal samples,together with water,were pieced at 18 000 to 23 000 r/min for successive three times in a cooking machine,of 10 s each time at an interval of 5 s. Mechanical piecing had no clear?cut effect on miracidium hatching of eggs in fecal samples. A total of 541,620,344 and 211 miracidia were detected by using the miracidium hatching test with nylon gauze at 100 pores/25.4 mm2 and 150 pores/25.4 mm2,thin fat?free cotton and thick fat?free cotton respectively, indicating a better detection efficacy by using nylon gauze at 100 pores/25.4 mm2 and 150 pores/25.4 mm2. Conclusions The goat fecal collector is an easy?to?perform,accurate,unpolluted and reusable device to collect goat feces,which is suitable for pathogenic diagnosis of goat schistosomiasis. Mechanical piecing and use of nylon gauze at 150 pores/25.4 mm2 allow a simple, accurate and stable technique for parasitological diagnosis of schistosomiasis japonica,which provides a reliable tool for schisto?somiasis control and research.

Objective To describe the growth and development of Schistosoma japonicum in goat and the intensity and tem?poral distribution of eggs excreted by goat feces,so as to provide baseline data for the control and elimination of the role of goat in the transmission of schistosomiasis. Methods The goat animal models of schistosomiasis were established,and stool sam?ples were collected for parasitological examinations. The number of adult worms recovered,variation of schistosomes in goat at different time points post?infection,number of eggs in schistosomes,variation in number and temporal profiles of eggs excreted from goat feces were observed. Results Of the 6 schistosome?infected goat,415 adult worms were recovered,with a mean adult worm recovery of 34.58%(range,23.00%to 45.50%). Among the 5 goat infected with 200 cercariae each,47,93,77, 74 and 73 adult worms were recovered 2,5,8,11 and 14 months post?infection,respectively. There were(200.00 ± 42.33), (226.20±45.88),(168.20±25.85),(183.80±55.13)and(190.80±53.53)eggs detected in female schistosomes. The mean pre?patent period of eggs excreted by 10 infected goat was(37.7±3.02)d. From 2 to 14 months post?infection,7 batches of goat fe?ces were hatched,and there were 30,23,14,1 and 2 times for miracidium intensity of“++++”,“+++”,“++”,“+”and“-”, respectively,with 42.86%,32.86%,20.00%,1.43%and 2.86%constituent ratios of miracidium intensity. Conclusions Ap?proximately 1/3 S. japonicum cercariae may develop to adults in goats post?infection,and the prepatent period of eggs is(37.7± 3.02)d. There is no remarkable decrease seen in the number of adult worms,eggs in female schistosomes and eggs in goat feces within 14 months post?infection. Our findings suggest a long duration for infected goat in the transmission of schistosomiasis ,and there is no evidence to prove the“self?cure”phenomenon in goat,indicating that goat is an important source of infection for schistosomiasis japonica.

Objective:To investigate whether the nutrition support team (NST) benefits esophageal carcinoma (EC) patients who are concurrently undergoing chemoradiotherapy. Methods: Between June 2012 and December 2013, 40 EC patients undergoing chemoradiotherapy were divided into the NST group and routine treatment (RT) group, with 20 patients in each group. At the end of chemoradiotherapy, the nutritional status, incidence of complications, and completion rates of radiotherapy were evaluated. The length of hospital stay (LOS) and cost were also compared between the two groups. Results:The nutrition and blood parameter values of the NST group were better (P<0.05) than those of the RT group. The incidence of complications was lower in the NST group (P<0.05) than that in the RT group. In addition, all patients in the NST group achieved the treatment plan, whereas five of the patients in the RT group interrupted or delayed the plan (P<0.05). The average LOS decreased by 3.8 d (P<0.05), and the hospitalization costs were reduced to 6300 RMB person-times (P>0.05) for the patients of the NST group. Conclusion: NST could maintain the nutritional status and improve the treatment compliance and tolerance of EC patients undergoing chemoradiotherapy, thereby shortening the LOS time and reducing the costs.

Objective To study the effects of He-Ne laser irradiation on histological changes and the expression of proliferating cell nuclear antigen ( PCNA ) and B-cell lymphoma/leukemia-2 ( Bcl-2 ) in the gastric mucosa of rats with chronic atrophic gastritis (CAG) so as to elucidate the relationship of He-Ne laser irradiation with precancerous lesions and apoptosis in the gastric mucosa. Methods The rats were divided into a normal group,a model group and a laser group.A model of CAG was established by gastric perfusion with a mixture of sodium salicylate and alcohol combined with irregular fasting and forced exercise.A He-Ne laser was used to irradiate the rats at 3.36 J/cm2 for 7 min daily for 20 d.Histopathological changes including the severity of inflammation in the gastric mucosa and the morphology and structure of the parietal cells were observed with a light microscope,and the expression of PCNA and Bcl-2 was detected with immunohistochemical methods. Results The pathologic morphological changes in the gastric mucosa of the model group were atrophy of the glands of the gastric mucosa and notable inflammatory infiltration.But in the laser group inflamed cells decreased,and the morphology,structure and volume of the cells all recovered close to normal.The immunohistochemistry results showed that during the atrophy of the gastric mucosa the expression of PCNA and Bcl-2 was elevated,and it was significantly higher in the model group than in the normal group.After irradiation the expression of PCNA and Bcl-2 was significantly lower. Conclusions There was hyper-proliferation in the gastric mucosa of the CAG model rats,with high expression of apoptosis suppressor PCNA and Bcl-2 proteins.Laser irradiation can reduce the expression of PCNA and Bcl-2,enhance cell proliferation and induce apoptosis,preventing the development of cancer.Laser irradiation has a good adjuvant therapeutic effect for all the pathological changes observed.

Objective To study the effects of He-Ne laser irradiation dosage on the expression of heat shock protein ( HSP70) and CyclinD_1 in rats with chronic atrophic gastritis ( CAG). Method Fifty-two adult male Wistar rats were randomly divided into five groups: a normal control group, model group and three groups receiving different doses of He-Ne laser irradiation. CAC was induced using an enema of 2% sodium salicylate and 30% alcohol combined with irregular fasting and forced exercise as pathogenic factors. Laser irradiation was applied for 20 days (large dose 6.24 J/cm~2 , medium dose 4. 80 J/cm~2, small dose 3. 36 J/cm~2). The changes in HSP70 and CyclinD_1 expression were observed. Results The expression of HSP70 and CylinD_1 were highest in the normal control group and the small dose laser group. Compared with the model group, the average expression of HSP70 and CyclinD_1 increased significantly in the small dose group. Conclusions Irradiation with a He-Ne laser at 3. 36 J/cm~2 provides good adjuvant therapeutic effect for CAG in rats. After irradiation, the expression of HSP 70 and CyclinD_1 increased. HSP is important in improving mucosal defenses and promoting cell proliferation in CAG, and it can be promoted through small doses of He-Ne laser irradiation.

BACKGROUND: Recently, Chinese herb and comprehensive therapy are widely adopted for the treatment of chronic atrophic gastritis (CAG), while infrared ray is widely used in the fields of physical therapy and scientific research. Therefore, some scholars suggest whether the physical characteristics of infrared ray have effects on the treatment of chronic atrophic gastritis.OBJECTIVE: To observe the effect of infrared ray on the changes of gastric mucosa tissue in rat models with chronic atrophic gastritis.DESIGN: Randomized controlled observation.SETTING: Hebei North University.MATERIALS: Thirty-five adult Wistar male rats weighing from 180 to 230 g were purchased from Hebei Experimental Animal Center [SCXK (ji) 2003-1-003]. The experiment was disposed with the ethical standard. Sodium salicylate powder produced by Beijing Fangcao Chemical Company (batch number: 890720). The drug was prepared with distilled water. Infrared lamp (220 V, 200 W) was bought by Equipment Division of our college.METHODS: The experiment was carried out in the Experimental Center of Hebei Beifang College from June 2005 to January 2006. ① Experimental intervention: Rats were fed with conventional standard granules for one week. Among them, 8 rats were selected as the normal control group, and other rats underwent model establishment. Rats were perfused with sodium salicylate and alcohol to stimulate gastric mucosa, and then chronic CAG models were established for 8 weeks based on exertion, irregular diet and other factors. Five rats were randomly selected for the check of histopathology before the end of model confirmedly making, and then the model rats were randomly divided into model group and infrared group with 11 in each group. Infrared lamp (220 V, 200 W, 0.76–1.5 μm in wavelength) was used to vertically radiate at the gastric projective area of rats in the infrared group, once a day, ten minutes once for twenty days. The rats in normal group and model group were regularly breed. ② Experimental evaluation: The body mass was weighed every week in 1, 4, 9 and 12 weeks after modeling. The infiltration of inflammatory cells and thickness of gastric mucosa were observed under optic microscope.MAIN OUTCOME MEASURES: ① Changes of body mass; ② pathohistological changes of gastric mucosa.RESULTS: All 30 rats were involved in the final analysis. ① Changes of body mass: From the end of the 4th week, increasing percentage of body mass in the model group and infrared group was decreased gradually as compared with that in the normal group, and there was significant difference (P < 0.05). ② Pathohistological changes of gastric mucosa: Gastric mucosa of rats in the model group was thinner, and atrophic glands, notable inflammatory infiltration and partial intestinal metaplasia were observed under optic microscope. The thickness of gastric mucosa in the infrared group was significantly thicker than that in model control group, and there was significant difference (P < 0.01); the inflammatory cells in the infrared group were less than those in the model group, and there was significant difference (P < 0.05). Morphologic structure and volume of the parietal cells were all recuperated or closed to normal.CONCLUSION: Infrared ray can decrease thickness of gastric mucosa and reduce inflammatory cells of rats with chronic atrophic gastritis, and it has greatly therapeutic achievements.