Screening analysis of flat foot disease among school age children in Kunming City / 中国学校卫生

Objective@#To investigate the prevalence of flat feet and associated factors in school aged children in Kunming City, to provide evidence supporting the prevention of flat feet.@*Methods@#From December 2021 to February 2022, 4 444 children aged 7-13 in five primary schools in Kunming were screened for flat feet with the optical foot assessment and recording device. The incidence of flatfoot was counted, and Logistic regression was used to analyze the influencing factors of flatoccurrence.@*Results@#The overall prevalence rate was 29.10%, of which 21.79% were mild, 52.43% were moderate, 25.78% were severe, 89.10 % were bipedal, and 10.90% were monopedal. The prevalence rates in the 7-year old and 13-year old groups were 36.91% and 10.43%, respectively, and the risk in the former was 5.00 times that in the latter( OR=5.00, 95%CI =3.22-7.52). The prevalence rates in rural and urban students were 38.53%, 22.46%, respectively, and the risk in the former was 2.17 times that in the latter( OR=2.17, 95%CI =1.90-2.47). The prevalence of flat feet in male and female students were 34.21%, 23.29%, respectively, and the risk in male students was 1.71 times higher than that in female students( OR=1.71, 95%CI =1.50-1.95). The incidence of flat feet correlated with BMI, and the risk of flat feet was higher in the group with overweight and obese groups than normal( OR=1.31, 1.10, P < 0.01). @*Conclusion@#The prevalence of flat feet in school age children aged 7-13 years decreased with age. The prevalence and risk of flat feet is lower in girls than boys, and the incidence and risk of flat feet are lower in urban than rural children. The incidence of flat feet in most children is moderate, and the risk increased with increasing BMI. For school aged children with flat feet, early prevention, detection and treatment are needed.

Spatial distribution of Oncomelania hupensis spread in Hubei Province from 2020 to 2022 / 中国血吸虫病防治杂志

Objective To identify the spatial distribution pattern of Oncomelania hupensis spread in Hubei Province, so as to provide insights into precision O. hupensis snail control in the province. Methods Data pertaining to emerging and reemerging snails were collected from Hubei Province from 2020 to 2022 to build a spatial database of O. hupensis snail spread. The spatial clustering of O. hupensis snail spread was identified using global and local spatial autocorrelation analyses, and the hot spots of snail spread were identified using kernel density estimation. In addition, the correlation between environments with snail spread and the distance from the Yangtze River was evaluated using nearest-neighbor analysis and Spearman correlation analysis. Results O. hupensis snail spread mainly occurred along the Yangtze River and Jianghan Plain in Hubei Province from 2020 to 2022, with a total spread area of 4 320.63 hm2, including 1 230.77 hm2 emerging snail habitats and 3 089.87 hm2 reemerging snail habitats. Global spatial autocorrelation analysis showed spatial autocorrelation in the O. hupensis snail spread in Hubei Province in 2020 and 2021, appearing a spatial clustering pattern (Moran’s I = 0.003 593 and 0.060 973, both P values < 0.05), and the mean density of spread snails showed spatial aggregation in Hubei Province in 2020 (Moran’s I = 0.512 856, P < 0.05). Local spatial autocorrelation analysis showed that the high-high clustering areas of spread snails were mainly distributed in 50 settings of 10 counties (districts) in Hubei Province from 2020 to 2022, and the high-high clustering areas of the mean density of spread snails were predominantly found in 219 snail habitats in four counties of Jiangling, Honghu, Yangxin and Gong’an. Kernel density estimation showed that there were high-, secondary high- and medium-density hot spots in snail spread areas in Hubei Province from 2020 to 2022, which were distributed in Jingzhou District, Wuxue District, Honghu County and Huangzhou District, respectively. There were high- and medium-density hot spots in the mean density of spread snails, which were located in Jiangling County, Honghu County and Yangxin County, respectively. In addition, the snail spread areas negatively correlated with the distance from the Yangtze River (r = −0.108 9, P < 0.05). Conclusions There was spatial clustering of O. hupensis snail spread in Hubei Province from 2020 to 2022. The monitoring and control of O. hupensis snails require to be reinforced in the clustering areas, notably in inner embankments to prevent reemerging schistosomiasis.

Objective evaluation of the effect of posterior scleral reinforcement surgery on the prevention and control of high myopia / 中华眼底病杂志

Due to the high incidence and the earlier onset age, high myopia has become an important public health problem in China. Posterior scleral reinforcement surgery has been developed for over 60 years in order to control the rapid progression and complications of high myopia. By suturing a certain size of material on the surface of the posterior eyeball, thickness and elasticity modulus of the local sclera significantly increase. As the result, the rapid growth of the axial length and the chorioretinopathy could be alleviated. At present, controversies about its clinical efficacy and safety still exist, so posterior scleral reinforcement surgery has not been widely carried out all over the world. An in-depth analysis of the mechanism, surgical manipulations and materials, the clinical application status of posterior scleral reinforcement surgery on control of high myopia can provide a basis for further standardized application of this surgery

Famine exposure during early life and risk of metabolic syndrome in adulthood in China: a meta-analysis / 中华内分泌代谢杂志

Objective:To analyze the relationship between early-life famine exposure and the risk of metabolic syndrome in Chinese population.Methods:Relevant literature on the relationship between early-life famine exposure and the risk of metabolic syndrome in the Chinese population was retrieved from databases such as CNKI, Wanfang, VIP, CBM, Web of Science, and PubMed. The search was conducted from the inception of the databases up to October 2022. Two researchers independently extracted and systematically evaluated the data from the literature, and meta-analysis was performed using Stata 16.0 software. Results:A total of 12 publications met the inclusion criteria, including 71 470 study subjects. Meta-analysis results showed that early-life famine exposure increased the risk of metabolic syndrome in the Chinese population( OR=1.28, 95% CI 1.16-1.40). Subgroup analysis showed that both fetal famine exposure( OR=1.25, 95% CI 1.03-1.52) and childhood famine exposure( OR=1.29, 95% CI 1.15-1.45) increased the risk of developing metabolic syndrome compared to the non-exposed group, and this significant association was only found in the female population. Conclusion:Early-life exposure to famine may increase the risk of developing metabolic syndrome in adulthood in the Chinese population, particularly among females.

Epidemiological trends for human schistosomiasis prevalence in Hubei Province from 2004 to 2018 based on Joinpoint regression analysis / 中国血吸虫病防治杂志

Objective To analyze the trends of human schistosomiasis prevalence in Hubei Province from 2004 to 2018, so as to provide the evidence for formulating the schistosomiasis elimination strategy in the province. Methods All data pertaining to human schistosomiasis prevalence in Hubei Province were collected from 2004 to 2018, and the trends for changes in seroprevalence, egg-positive rate and prevalence of human Schistosoma japonicum infection were analyzed using a Joinpoint regression model. Results Both of the numbers of residents seropositive and egg-positive for S. japonicum infections appeared a tendency towards a decline in Hubei Province from 2004 to 2018, and the prevalence of human S. japonicum infections reduced from 6.85% in 2004 to 0 in 2018. Joinpoint regression analysis showed that the prevalence of human S. japonicum infections appeared an overall tendency towards a reduction in Hubei Province from 2004 to 2018 [average annual percent change (AAPC) = −24.1%, P < 0.01], and the trends for the reduction were both significant during the period from 2004 to 2006 [annual percent change (APC) = −35.1%, P < 0.01] and from 2006 to 2018 (APC = −22.1%, P < 0.01). The prevalence of human S. japonicum infections appeared a tendency towards a decline in islet (AAPC = −25.1%, P < 0.01), inner embankment (AAPC = −26.4%, P < 0.01) and hilly subtypes of schistosomiasis-endemic areas (AAPC = −32.5%, P < 0.01) of Hubei Province from 2004 to 2018, and the prevalence all appeared a tendency towards a decline during the infection control stage (from 2004 to 2008), the transmission control stage (from 2009 to 2013) and the transmission interruption stage (from 2014 to 2018) (AAPC = −28.0%, −24.4% and −63.8%, all P values < 0.01). The seroprevalence of human S. japonicum infections appeared an overall tendency towards a decline in Hubei Province from 2004 to 2018 (AAPC = −14.5%, P < 0.01), and the trends for the reduction were both significant during the period from 2004 to 2012 (APC = −8.4%, P < 0.01) and from 2012 to 2018 (APC = −22.1%, P < 0.01). In addition, the egg-positive rate of human S. japonicum infections appeared an overall tendency towards a decline in Hubei Province from 2004 to 2018 (AAPC = −30.6%, P < 0.05), and the trend for the reduction was significant during the period from 2007 to 2014 (APC = −15.5%, P < 0.01). Conclusions The prevalence of human schistosomiasis appeared a tendency towards a decline in Hubei Province from 2004 to 2018, and the islet and inner embankment subtypes of endemic areas are a high priority for schistosomiasis control during the stage moving towards elimination in Hubei Province.

Risk factors for necrotizing enterocolitis and establishment of prediction model of necrotizing enterocolitis in preterm infants / 中国当代儿科杂志

OBJECTIVES@#To investigate the risk factors for necrotizing enterocolitis (NEC) in preterm infants, and to establish a scoring model that can predict the development and guide the prevention of NEC.@*METHODS@#A retrospective analysis was performed on the medical data of preterm infants who were admitted to the Department of Neonatology,Bethune First Hospital of Jilin University, from January 2011 to December 2020. These infants were divided into two groups: NEC (298 infants with Bell II stage or above) and non-NEC (300 infants). Univariate and multivariate analyses were performed to identify the factors influencing the development of NEC. A nomogram for predicting the risk of NEC was established based on the factors. The receiver operator characteristic (ROC) curve and the index of concordance (C-index) were used to evaluate the predictive performance of the nomogram.@*RESULTS@#The multivariate logistic regression analysis showed that grade ≥2 intracranial hemorrhage, peripherally inserted central catheterization, breast milk fortifier, transfusion of red cell suspension, hematocrit >49.65%, mean corpuscular volume >114.35 fL, and mean platelet volume >10.95 fL were independent risk factors for NEC (P<0.05), while the use of pulmonary surfactant, the use of probiotics, and the platelet distribution width >11.8 fL were protective factors against NEC (P<0.05). The nomogram showed good accuracy in predicting the risk of NEC, with a bootstrap-corrected C-index of 0.844. The nomogram had an optimal cutoff value of 171.02 in predicting the presence or absence of NEC, with a sensitivity of 74.7% and a specificity of 80.5%.@*CONCLUSIONS@#The prediction nomogram for the risk of NEC has a certain clinical value in early prediction, targeted prevention, and early intervention of NEC.

Effects of GSK3β/eEF2K signaling pathway on pulmonary fibrosis in mice / 中国应用生理学杂志

Objective: To investigate the effects of glycogen synthase kinase-3β (GSK3β)/eukaryotic extension factor kinase 2 (eEF2K) signaling pathway on the process of pulmonary fibrosis through in vivo experiments, and find new ideas for clinical treatment of pulmonary fibrosis. Methods: The pulmonary fibrosis model of C57BL/6 male mice was induced by bleomycin with intratracheal injection at the dose of 2 mg/kg. After 14 days of modeling, animals were divided into model group, negative inhibition group and inhibition group (n=5 for each group), and control group was not processed. The inhibition group was treated with TDZD-8 (4 mg/kg) after modeling, the negative inhibition group was given DMSO solution after modeling, and the samples were collected after 28 days. Hematoxylin-eosin staining method was used to detect lung fibrosis in mice and scored according to Ashcroft scale. Expression levels of GSK3β, p-GSK3β, eEF2K, p-eEF2K (Ser70, Ser392, Ser470), precursor protein of matrix metalloproteinase-2 (pro-MMP-2), matrix metalloproteinase-2 (MMP-2), collagen I (Col I), collagen Ⅲ (Col Ⅲ) and α-smooth muscle actin (α-SMA) were detected by Western blot. Results: Compared with control group, the fibrosis score was up-regulated, the expression levels of GSK3β, p-GSK3β, p-eEF2K (Ser70, Ser392, Ser470), pro-MMP-2, MMP-2, Col I, Col Ⅲ and α-SMA were increased, while that of eEF2K was decreased in model group (P＜0.05). Compared with model group, the fibrosis score, expression levels of GSK3β, p-GSK3β, p-eEF2K (Ser70, Ser392, Ser470), pro-MMP-2, MMP-2, Col I, Col Ⅲ and α-SMA were decreased, but the expression level of eEF2K was increased in inhibition group (P＜0.05). Conclusion: GSK3β can activate eEF2K by phosphorylation at the sites of Ser70, Ser392 and Ser470, increase the contents of fibrosis indicators, promote the formation of pulmonary fibrosis, and aggravate lung tissue lesions.

Ultrasonographic analysis of cat-scratch disease associated lymphadenitis of the elbow / 中国医师杂志

Objective:To analyze the ultrasonographic features of lymphadenitis caused by cat-scratch disease (CSD) of the elbow, and to improve the diagnosis and differentiation of CSD by sonologist.Methods:According to the inclusion and exclusion criteria, we retrospectively collected the patients who visited Changsha Third Hospital from March 2015 to October 2021 due to elbow mass, and divided them into CSD group and non CSD group according to the pathological source. We compared and analyzed the ultrasonic manifestations inside and around the mass in the two groups, and summarized the ultrasonic image characteristics of CSD.Results:In 90 cases of elbow mass, there were 14 cases in CSD group and 76 cases in non CSD group. There were 8 cases of cat scratch history and 2 cases of bite history in CSD group. The incubation period ranged from 4 days to 3 months. There were 4 cases of denied cat scratch and bite history or close contact history. Eight patients were treated with antibiotics, and 6 patients did not receive any treatment. 14 patients with CSD were followed up after 1-3 months. There was statistically significant difference between CSD group and non CSD group in tumor location (χ 2=14.507, P<0.05), the masses in CSD group were all located in the medial elbow; The specificity of internal ultrasound in CSD lymphadenitis was not high, but the ultrasonic changes outside the mass had certain characteristics, such as lymphadenitis and localized superficial phlebitis. There was also a statistical difference between CSD group and non CSD group in the ultrasonic changes outside the mass (χ 2=34.070, P<0.05). Conclusions:CSD lymphadenitis usually occurs in the medial epitrochlear region of the elbow. Ultrasound can be highly suggestive when there is a relevant epidemiological history and typical intra and extra-nodal sonographic changes, thus reducing the unnecessary invasive manipulation of the elbow mass.

Clinical characteristics of 14 patients with chronic eosinophilic pneumonia / 中国医师杂志

Objective:To summarize the clinical characteristics of patients with chronic eosinophilic pneumonia (CEP), so as to provide reference for clinicians and improve the level of diagnosis and treatment.Methods:14 patients who met the diagnostic criteria of CEP in Xiangya Second Hospital of Central South University from January 2012 to July 2021 were analyzed retrospectively. Their clinical manifestations, laboratory examination, imaging characteristics, diagnosis and treatment were analyzed.Results:The male to female ratio of 14 patients with CEP was 6∶1, with a median age of 51 years. 3 patients had allergic rhinitis, sinusitis, rash and other allergic history. The course of the disease was about 4 months. The common symptoms included cough (14 cases), expectoration (13 cases), shortness of breath (10 cases), and occasional extrathoracic symptoms such as rash and lymphadenopathy (2 cases). Eight patients had abnormal pulmonary auscultation, mainly coarse respiratory sounds of both lungs and scattered dry and wet rales. The eosinophil count (EOS) in peripheral blood was increased in all patients, and the median EOS count was about 1.42×10 9/L. Total serum IgE increased in 11 patients, of which 10 cases were more than 1 000 ng/ml. Pulmonary function tests were performed in 11 patients, including 5 cases of normal pulmonary function, 3 cases of obstructive ventilation dysfunction and 3 cases of restrictive ventilation dysfunction. All 14 patients underwent lung computer tomography (CT) examination. Most of them (13 cases) were double lung infiltration. The pathological signs were mainly patch shadow (6 cases), ground glass shadow (4 cases), grid shadow (3 cases) and consolidation shadow (3 cases), and scattered nodule shadow (3 cases) was seen in some cases; Mediastinal or hilar lymphadenopathy occurred in 6 patients. 9 patients underwent bronchoscopic alveolar lavage (BAL) and cell classification and counting. Only 3 cases had EOS counts higher than the normal value (normal value<3%). 10 patients underwent bronchoscopic lung biopsy, and 6 patients had EOS infiltration in lung tissue. 9 patients were treated with glucocorticoids, 8 patients were treated with oral corticosteroids (OCS) (prednisone or methylprednisolone), and the initial dose was 30-50 mg; One case was treated with budesonide atomization alone; Five patients were not diagnosed with CEP, only used antibiotics or other symptomatic treatment, and did not use hormones. Conclusions:As a rare pulmonary disease, CEP has no specific clinical manifestations. The common symptoms are cough, expectoration, shortness of breath, etc, which is easily misdiagnosed. Laboratory tests often indicate increased peripheral blood EOS count and total IgE, and imaging usually shows diffuse infiltration in both lungs, with lymph node enlargement. OCS therapy is the first-line treatment for CEP. The short-term prognosis after OCS treatment is good, but it is prone to relapse. Some novel monoclonal antibody biologics can be used as alternative therapy.

Historical evolution of Salviae Miltiorrhizae Radix et Rhizoma processing methods / 中国中药杂志

China has a long history of Salviae Miltiorrhizae Radix et Rhizoma processing with multiple methods available. The pre-sent study collated and summarized the Salviae Miltiorrhizae Radix et Rhizoma processing methods recorded in 23 related herbal medicine books, all editions of Chinese Pharmacopoeia, the 1988 edition of National Regulations for Processing of Chinese Medicine, and 20 current local processing specifications and standards. The results demonstrated various processing methods of Salviae Miltiorrhizae Radix et Rhizoma, such as removing residual part of stem, plantlet, or soil, smashing, filing, cutting, decocting, washing with wine, soaking in wine, and stir-frying with wine or blood from pig heart, while raw and wine-processed products are mainly used in modern times. Due to the lack of unified standards, the phenomena of multiple methods adopted in one place and different methods in different places have led to uneven quality of Salviae Miltiorrhizae Radix et Rhizoma pieces, even affecting the safety and effectiveness of its clinical medication. This study is expected to provide a reference for the development of Salviae Miltiorrhizae Radix et Rhizoma processing and its rational medication.

Studying on detecting of spacial clusters of schistosomiasis japonica in mountainous and hilly areas, Hubei Province / 公共卫生与预防医学

Objective To understand the application value of spacial clusters detection of human schistosomiasis epidemic,based on small scale level in heavy mountainous and hilly endemic areas, Songzi County,Hubei Province,China. Methods Positive results of human serological detection antibody titer equal or above 80,and positive schistosomiasis cases of fecal examination from 2016 to 2018 as research object in Songzi County.The flexible irregular space scan statistics was used to analyse the spatial clustering analysis of human schistosomiasis epidemic in the heavy mountainous and hilly endemic areas, setting parameter K=2 ,K=6 or K=10, respectively,based on small scale of village level in Songzi County. Results There was none positive schistosomiasis cases of fecal examination in Songzi County from 2016 to 2018.The number of human serological detection antibody titer equal or above 80 were  74, 206, 83, from 2016 to 2018，respectively.There was spatial clusters of positive of human serological detection antibody titer equal or above 80 for schistosomiasis cases in the county from 2016-2018. Areas of flexible irregular space scan statistic in cluster detection changing with the change of different K values. Under different parameters of flexible irregular space scan statistic results show that the most likely cluster of 40 endemic villages in three towns,inculding Laocheng town,Chendian town and Wangjiaqiao town were the prominent. Conclusion There are spatial clusters of human schistosomiasis based on small scale of village level by flexible irregular space scan statistic in mountainous and hilly endemic areas, Songzi County,Hubei Province.Therefore,the monitoring and control of schistosomiasis should be consolidated in the future,in order to achieve schistosomiasis elimination in Hubei Province at an early date.

Clinical study on intravenous combined with aerosol inhalation of polymyxin B for the treatment of pneumonia caused by multidrug-resistant Gram-negative bacteria / 中华危重病急救医学

Objective:To investigate the efficacy of intravenous combined with aerosol inhalation of polymyxin B for the treatment of pneumonia caused by multidrug-resistant Gram-negative (G -) bacteria. Methods:A observational study was conducted. The clinical data of 45 patients with pneumonia due to multidrug-resistant G - bacteria admitted to intensive care unit of Fujian Medical University Union Hospital from January to October in 2020 were analyzed. According to the different use methods of polymyxin B, 25 patients who received single intravenous drip (the first dose was 2.0 mg/kg, then 1.25 mg/kg, once every 12 hours) from January to April in 2020 were enrolled in the routine group, and 20 patients who received intravenous drip combined with aerosol inhalation (25 mg once every 12 hours, sputum in the airway was sucked and then sprayed aerosol) from May to October in 2020 were enrolled in the combination group. After the treatment course of polymyxin B, the total bacterial clearance rate, total clinical efficiency rate, recovery time of body temperature, time of bacterial clearance and the change of serum procalcitonin (PCT) level before and after treatment were compared between the two groups. Moreover, the incidence of adverse reactions during treatment in the two groups was observed. Results:The results of sputum culture in the routine group were Acinetobacter baumannii in 13 patients, Klebsiella pneumoniae in 5 patients, Pseudomonas aeruginosa in 6 patients, Enterobacter cloacae in 1 patient; the sputum culture results of the combination group showed that there were 5 patients of Acinetobacter baumannii, 9 Klebsiella pneumoniae and 6 Pseudomonas aeruginosa. There was no significant difference in the results of sputum culture between the two groups ( P > 0.05). The total bacterial clearance rate and the total clinical efficiency rate of the combination group were significantly higher than those in the routine group (total bacterial clearance rate: 70.0% vs. 40.0%, total clinical efficiency rate: 75.0% vs. 40.0%, both P < 0.05). The recovery time of body temperature and the time of bacterial clearance of the combination group were significantly shorter than those in the routine group [recovery time of body temperature (days): 6.0±3.9 vs. 10.2±7.3, time of bacterial clearance (days): 6.1±5.2 vs. 11.5±6.8, both P < 0.05]. No significant difference was found in serum PCT level before treatment between the two group. There was no significant difference in serum PCT level before and after treatment in the routine group [μg/L: 0.85 (0.44, 2.87) vs. 1.43 (0.76, 5.30), P > 0.05]. The serum PCT level after treatment in the combination group was significantly lower than that before treatment [μg/L: 0.27 (0.10, 0.70) vs. 0.91 (0.32, 3.53), P < 0.05], and it was significantly lower than that in the routine group [μg/L: 0.27 (0.10, 0.70) vs. 0.85 (0.44, 2.87), P < 0.01]. The incidence of renal toxicity of polymyxin B between the combination group and the routine group was not significantly different (5.0% vs. 4.0%, P > 0.05). Conclusions:The efficacy of intravenous combined with aerosol inhalation of polymyxin B for the treatment of pneumonia due to multidrug-resistant G - bacteria is better than that of intravenous drip of polymyxin B only. The aerosolized polymyxin B will not increase the risk of renal injury.

A study on the current situation and influencing factors of humanistic care needs of inpatients with schizophrenia in convalescence / 中国实用护理杂志

Objective:To understand the current situation of the demand for humanistic care of schizophrenics in convalescence and analyze the influencing factors, so as to provide the basis for clinical nurses to carry out targeted humanistic care for patients.Methods:A self-produced scale with a total score of 49-245 was used to investigate 516 convalescent period schizophrenic patients in 18 tertiary mental health institutions in 13 provinces of China, single factor analysis and multiple regression analysis were performed on their influencing factors.Results:The Likert 5-point scoring method was used. The overall score of the nursing care needs of hospitalized schizophrenic patients was (202.85±35.06) points, and the average score of total items were (4.14±0.16) points. Multiple linear regression results showed female ( B=0.100, P=0.024), stable marriage ( B=-0.098, P=0.026),high school (including secondary school) Education ( B=-0.107, P=0.018), family per capita monthly income of 2 000 yuan or above ( B=0.093, P=0.043),central region ( B=-0.110, P=0.014) were the main factors that affect the demand for humanistic care of inpatients with schizophrenia in convalescence. Conclusion:The hospitalized schizophrenic patients have higher and diversified needs for humanistic care. Patients with different genders, marital status, education level, monthly family income and living area have different needs for humanistic care. Individualized and standardized nursing should be given according to the actual situation of patients' needs to provide a more supportive environment for their rehabilitation.

Good / 中南大学学报(医学版)

A patient with thymoma associated immunodeficiency syndrome (Good's syndrome) and bronchiectasis was retrospectively analyzed. Good's syndrome is a rare condition of immunodeficiency that is characterized by thymoma and hypogammaglobulinemia. It is important to bear in mind that Good's syndrome should be included in the differential diagnosis When patients repeatedly visited for bronchiectasis or infection, we should alert to their immune state and history of thymoma. Early screening of immunological status and aggressive correction of immune deficiency are beneficial to improving the prognosis to patients with Good's syndrome.

Effect of Myofascial Trigger Points Electric Stimulation on Phantom Limb Pain after Lower Limb Amputation / 中国康复理论与实践

Objective:To explore the clinical efficacy of myofascial trigger point electric stimulation based on mirror therapy on phantom limb pain after lower limb amputation. Methods:From May to November, 2020, 50 patients with phantom limb pain after lower limb amputation were randomly divided into control group (n = 25) and experiment group (n = 25). Both groups accepted mirror therapy, while the experiment group received myofascial trigger point electric stimulation before mirror therapy, for four weeks. They were assessed with short-form of McGill Pain Questionnaire (SF-MPQ), Pittsburgh Sleep Quality Index (PSQI), Hamilton Anxiety Scale (HAMA), Timed 'Up & Go' Test (TUGT) and 6-minute walk test (6MWT) before and after treatment. Results:All the indexes improved in both groups after treatment (|t| > 8.210, P < 0.001), and improved more in the experiment group than in the control group (|t| > 5.103, P < 0.001), except the present pain intensity of SF-MPQ. Conclusion:Mirror therapy is effective on phantom limb pain after lower limb amputation in terms of pain, sleep, anxiety and walking, and the effect could be stronger after myofascial trigger point electric stimulation.

Establishment of an indicator system for schistosomiasis transmission risk assessment after transmission interruption in Hubei Province based on the Delphi method / 中国血吸虫病防治杂志

Objective To establish an indicator system for assessment of schistosomiasis transmission risk after transmission interruption in Hubei Province, so as to provide insights into the precise control of schistosomiasis. Methods The indicator system was preliminarily established based on data collection, literature review, expert interviews. Two rounds of expert consultation were performed. The indicator system was screened based on the importance, operability, sensitivity and comprehensive score of the indicators, and the weights of each indicator were calculated. The credibility of the Delphi method was evaluated by calculating the active coefficient of the experts, degree of expert authority and coordination levels of experts’ opinions. Results An indicator system for assessment of schistosomiasis transmission risk was preliminarily established, including 3 primary indicators, 12 secondary indicators and 44 tertiary indicators. A Delphi consultation was performed among 17 experts participating in schistosomiasis control, management and research. Following two rounds of consultation, a risk assessment indicator system was finally constructed, including 3 primary indicators, 10 secondary indicators and 35 tertiary indicators. Among the primary indicators, the variable with the highest normalized weight was the current status of schistosomiasis (0.420 2), followed by social factors (0.397 3) and natural environments (0.182 5). Among the secondary indicators, those with high combined weights included risk monitoring (0.142 3), current snail status (0.140 1), and current prevalence of human and livestock infections (0.137 8). Among the tertiary indicators, those with high combined weights included the positive rate of wild feces (0.049 8), the prevalence of snail infections (0.047 4), and the area of snail habitats submerged by floods (0.046 8). During the two-round consultation, the active coefficients of the experts were 85.00% and 100.00%, the degree of expert authority was both 0.75 and greater, and the coordination levels of experts’ opinions were 0.405 to 0.521 and 0.592 to 0.695 (all P values < 0.05). Conclusion An indicator system for assessment of schistosomiasis transmission risk is successfully established after transmission interruption in Hubei Province based on the Delphi method, which provides insights into the identification of the schistosomiasis transmission risk and the targets for schistosomiasis control in Hubei Province.

Treatment of intrahepatic cholangiocarcinoma / 国际外科学杂志

Intrahepatic cholangiocarcinoma has low resectability rate, high recurrence and short survival. It is very important to formulate and optimize the strategy of surgical treatment. The only potentially effective treatment for intrahepatic cholangiocarcinoma is surgical resection. Liver transplantation also has some application prospects. Intrahepatic cholangiocarcinoma can be divided into four types: mass forming type, intraductal growth type, periductal infiltration type, mass forming + periductal infiltration(mixed)type. Clinically, the treatment strategy is mainly determined according to the general classification. The application of methods such as preoperative portal vein embolism, neoadjuvant therapy and lymph node dissection make it possible for more patients to undergo surgical resection and improve the surgical effect. Adjuvant treatment including chemotherapy and radiotherapy can significantly improve the prognosis of the patients. The rapid development of molecular targeted therapy and immunotherapy is gradually changing the clinical treatment of intrahepatic cholangiocarcinoma.

A first-aid procedure for staff who fainted in coronavirus disease 2019 isolation ward / 第二军医大学学报

Since the outbreak of the coronavirus disease 2019 (COVID-19), tens of thousands of medical staff and paramedical staff have been involved in the treatment of COVID-19 patients. Heavy personal protective equipment and continuous high-intensity work have brought great challenges to the staff. Fainting incidents occur frequently in the isolation ward. The emergency treatment after fainting is directly related to the safety and health of the injured. Based on the latest domestic and international literatures and guidelines, we proposed a first-aid procedure for staff who fainted in the isolation ward, aiming to provide reference for the treatment of staff fainting in the isolation ward.

A frst-aid procedure for staff who fainted in coronavirus disease 2019 isolation ward / 第二军医大学学报

Since the outbreak of the coronavirus disease 2019 (COVID-19), tens of thousands of medical staff and paramedical staff have been involved in the treatment of COVID-19 patients. Heavy personal protective equipment and continuous high-intensity work have brought great challenges to the staff. Fainting incidents occur frequently in the isolation ward. The emergency treatment after fainting is directly related to the safety and health of the injured. Based on the latest domestic and international literatures and guidelines, we proposed a first-aid procedure for staff who fainted in the isolation ward, aiming to provide reference for the treatment of staff fainting in the isolation ward.

Endemic situation of schistosomiasis in national surveillance sites of Hubei Province from 2015 to 2019 / 中国血吸虫病防治杂志

ObjectiveTo analyze the changing tendency in the endemic situation of schistosomiasis in the national surveillance sites of Hubei Province, so as to provide the scientific evidence for facilitating the progress towards the elimination of schistosomiasis in the province. Methods According to the National Schistosomiasis Surveillance Scheme (2014 version), a total of 65 national schistosomiasis surveillance sites were assigned in Hubei Province, and the Schistosoma japonicum infections in humans, domestic animals, snails and wild feces were monitored in these national surveillance sites from 2015 to 2019. All data pertaining to the surveillance results were descriptively analyzed. Results There were 151 159 person-time local residents and 70 928 person-time mobile populations screened for S. japonicum infections in the 65 national surveillance sites of Hubei Province from 2015 to 2019, and the seroprevalance of S. japonicum infections reduced from 3.45% (1 077/31 197) in 2015 to 1.57% (431/27 371) in 2019 among local residents and from 1.06% (98/9 249) in 2015 to 0.81% (116/14 318) in 2019 among mobile populations. During the period from 2015 through 2019, there were 22 egg-positive local residents and 2 egg-positive mobile populations identified in 2015, with 0.07% and 0.02% prevalence rates of S. japonicum infections, respectively. During the 5-year period, a total of 7 025 herd-time domestic animals examined for S. japonicum infections, with no infections detected, and a total of 2 035 wild feces were tested, with no egg-positives identified in the 65 national surveillance sites of Hubei Province. Snail survey was conducted covering 28 767.35 hm2 during the 5-year period, and the area of snail habitats ranged from 1 609.82 to 2 119.81 hm2. The mean density of living snails and occurrence of frames with snails reduced from 0.360 5 snails/0.1 m2 and 11.26% in 2015 to 0.175 9 snails/0.1 m2 and 8.43% in 2019, respectively, and no S. japonicum infection was found in snails during the 5-year period. In addition, no snails were found in the potential schistosomiasis transmission foci in the two national surveillance sites in the Three Gorges Dam. Conclusions The overall endemic situation of schistosomiasis appears a tendency towards a decline in Hubei Province during the period from 2015 through 2019; however, the schistosomiasis transmission risk remains. Improving the surveillance system of schistosomiasis and increasing the sensitivity and performance of the surveillance system are required to provide insights into the implementation of precision control strategy and interventions in Hubei Province.