Comparison of the effectiveness before and after the adjustment of schistosomiasis control strategies in Nanjing City / 预防医学

Objective@#To compare the effectiveness before and after the adjustment of schistosomiasis control strategies in Nanjing City, so as to provide the evidence for improving schistosomiasis control interventions.@*Methods@#The prevalence of Schistosomasis japonicum infections in humans, livestock, Oncomelania hupensis and sentinel mice was collected in Nanjing City from 1993 to 2018, and the prevalence of S. japonicum infections in humans, livestock, sentinel mice and O. hupensis, and the areas of snail habitats, areas of infected snail habitats and snail control areas were compared before (1993-2004) and after (2005-2018) the adjustment of schistosomiasis control strategies to evaluate the effectiveness.@*Results@#The prevalence of S. japonicum infections in humans, livestock, O. hupensis and sentinel mice was 0.77% and 0.02% (χ2=6 430.634, P<0.001), 0.46% and 0.01% (χ2=344.401, P<0.001), 0.19% and 0.11% (χ2=239.685, P<0.001), and 34.35% and 1.56% (χ2=1 856.286, P<0.001) in Nanjing City before and after the adjustment of schistosomiasis control strategies, respectively. The median areas (interquartile range) of snail habitats, infected snail habitats and snail control were 4 175.37 (1 301.65) and 2 366.44 (885.27) hm2 (Z=-3.755, P<0.001), 870.49 (1 001.75) and 0 (158.89) hm2 (Z=-3.654, P<0.001) and 1 383.23 (793.57) and 5 031.94 (629.11) hm2 (Z=-4.320, P<0.001) in Nanjing City before and after the adjustment of schistosomiasis control strategies, respectively.@*Conclusions@#After the adjustment of schistosomiasis control strategies, remarkable effects on schistosomiasis control has achieved in Nanjing City, where the transmission of schistosomiasis was interrupted. Nevertheless, the strategy requires to be continued and improved to move towards elimination of schistosomiasis in Nanjing City.

Endemic situation of schistosomiasis at national surveillance sites in Nanjing City,2015 / 中国血吸虫病防治杂志

Objective To understand the dynamic endemic situation of schistosomiasis in Nanjing City,2015,so as to pro-vide evidences for policy-making of schistosomiasis control. Methods According to The National Scheme of Schistosomiasis Surveillance(2014),the endemic situation of schistosomiasis was monitored in 11 national surveillance sites in Nanjing. Re-sults The positive rates of serological(IHA)and stool examinations were 2.97%(97/3269)and 0 for local residents,and 0.52%(12/2298)and 0 for migrant people,respectively. No schistosome-infected livestock was found. Totally 147.2953 hm2 area with Oncomelania hupensis snails were found,but no schistosome-infected snails were discovered. Conclusions The en-demic situation of schistosomiasis declines greatly in Nanjing City in 2015. However,the control work still should be strength-ened to consolidate the achievements of schistosomiasis control.

The surveillance of iodine deficiency disorders in Nanjing after the adjustment of iodized salt standard / 中华地方病学杂志

Objective To master the current status of iodine nutrition of people in Nanjing after the adjustment of iodized salt standard,and to provide scientific basis for reasonable iodine supplementation and strategies for iodine nutrition control.Methods The probability proportional to size (PPS) sampling method was employed in the investigation.We firstly selected 30 streets in the whole city,and then chosen 50 children aged 8-10 years from each of 30 primary schools respectively,which was selected from 30 different streets to examine the size of thyroid gland by palpation and B-type ultrasound.We also collected urine and edible salt samples from 12 children aged 8-10 years from each primary school,to detect their urinary and salt iodine content.Moreover,20 pregnant women and 10 lactating women were picked out from each of 30 schools nearby to detect their urinary and salt iodine content.We also conducted a unique questionnaire survey in 30 fifth-grade students selected from each of 30 schools,and 5 housewives selected from these schools nearby to understand their knowledge of iodine deficiency disorders.Results The thyroid palpate swelling rate was 0.33％(5/1 500) in 1 500 children aged 8-10.The medians of urinary iodine level were 220.5 μg/L in 362 school-age children,196.7 μg/L in 600 pregnant women and 152.0 μg/L in 300 lactating women.A total of 1 260 samples of edible salt were tested.The coverage rate of iodized salt and the consumption rate of eligible iodized salt were 99.7％ (1 256/1 260) and 96.9％ (1 221/1 260),respectively.The mean iodine content of edible salt was (24.5 ± 4.5) mg/kg.A total of 900 fifth-grade students and 150 housewives were surveyed for health knowledge of iodine,and the eligible rate was 83.2％ (2 246/2 700) and 91.6％ (412/450),respectively.Conclusions After the adjustment of iodized salt content,iodine nutrition level of people in Nanjing has maintained appropriately.However,health education should be further strengthened.Improving the awareness rate of iodine deficiency knowledge,and guiding scientific iodine consciousness are our serious task in the future.

Comparison of Schistosoma japonicum development between single sexual infection and double sexual infection in mice and rabbits / 中国血吸虫病防治杂志

Objective To observe the development of Schistosoma japonicum after single sexual infection and double sexual infection respectively. Methods A single Oncomelania hupensis snail was infected by a single schistosome miracidium. The lar?va were induced and released from the snail after 60?day incubation at 26℃. The mice were infected by the larva(single sexual infection)and dissected 40 days after the infection. All the worms were collected and the sex of the larvae was determined by the sex of the adult worms. Then,the mice and rabbits were infected by single sex of larvae(single sexual infection)and double sex of larvae(double sexual infection)respectively. The mice and the rabbits were dissected 40 days after the infection. All the worms were collected and measured under a microscope. Results All the male or female worms were collected from the mice and rabbits after single sexual infection. There were three main forms of worms after dissection of double sexual infection of mice and rabbits:folded mature male and female,male or female. Few folded male and immature female were found. Only the double sexual larva infected mice or rabbits had schistosome eggs in the liver and the liver had typical schistosome egg nodules. The sin?gle sexual larva infected mice or rabbits had no schistosome eggs or schistosome egg nodules in the liver tissues. The single male larva could develop to worms with the testis,and with a little smaller size compared to the mature folded male,while the single sexual infection female worm could not develop to the mature stage with much thinner and smaller compared to the mature folded female. Conclusions The male or female worms from single sexual infection are smaller than those from double sexual infection (mature worms?folded male and female). So it is necessary to check single sex worms in vessels of intestinal mucosa thoroughly in the sentinel mice when no schistosome eggs were found in the liver.

Clinical Observation of Recombinant Human Brain Natriuretic Peptide Combined with Levosimendan in the Treatment of Acute Decompensated Heart Failure / 中国药房

OBJECTIVE:To observe the clinical efficacy of recombinant human brain natriuretic peptide (rhBNP) combined with levosimendan in acute decompensated heart failure(ADHF). METHODS:In retrospective study,120 cases diagnosed as AD-HF were divided into observation group and control group according to treatment plan,with 60 cases in each group. The patients of control group received rhBNP on the basis of conventional treatment,intravenously pulsed with dose of 0.15 μg/kg firstly,then maintained dose of 0.007 5 μg/kg viacontinuous intravenous pumping for 24-72 h;On the basis of control group,treatment group received levosimendan with loading-dose of 12 μg/(kg·min)for 10 min,maintenance dose of 0.1 μg/(kg·min)via intravenous pump,for 24 h,adjusted according to clinical manifestations of patients. The vital signs,hemodynamic and UCG indexes,the rate of dyspnea recovery,plasma level of BNP,urine and the occurrence of ADR were recorded in 2 groups. RESULTS:The vital sign and hemodynamic indexes of control group had no significant change 1 h after treatment;the levels of HR,RR,SBP,MPAP and MPCWP in 2 groups after treatment were significantly lower than before,while the levels of SaO2 and CO were significantly higher than before,with statistical significance (P0.05). 48 h after treatment,LVEF of 2 groups were increased while plasma levels of BNP were decreased,compared to before treatment;the improvement of observation group was more significant than control group,with statistical significance(P0.05). CONCLU-SIONS:rhBNP combined with levosimendan could effectively improve vital sign,hemodynamic indexes,UCG indexes and dys-pnea,and decrease the plasma level of BNP with good safety.

Epidemiological analysis of malaria prevalence in Nanjing City from 2010 to 2015 / 中国血吸虫病防治杂志

Objective To analyze the epidemiological characteristics of malaria in Nanjing City,so as to provide the evi?dence for further formulating and adjusting the malaria prevention and control strategy. Methods The data of malaria situation, malaria cases and epidemiological investigations were collected from the Internet Reporting System in Nanjing City from 2010 to 2015 and analyzed statistically. Results A total of 137 confirmed malaria cases were reported in Nanjing City from 2010 to 2015,including 102 falciparum malaria cases(74.45%),33 vivax malaria cases(24.09%),one ovale malaria case(0.73%) and one quartan malaria case(0.73%). Among the 137 malaria cases,126 cases(91.97%)were imported from foreign coun?tries,2 cases(1.46%)were infected locally,and nine cases(6.57%)were imported from other provinces in China. Among the 126 overseas imported cases,117 cases were imported from African countries and 9 from Asian countries. These malaria cases were majorly young men working as migrant workers,laborers and technical persons. About 19.30%of the cases went to hospital on onset day,and 55.65%were confirmed by medical institutions as malaria in the same day. The majority of diagnosis institu?tions were municipal hospitals(74.45%). Conclusions The number of malaria cases in Nanjing City is declining year by year. The local infections are eliminating gradually. However,the situation of imported malaria from overseas is still serious. There?fore,the surveillance work and health education still should be strengthened,so as to reduce the risk of imported malaria.

Integration and demonstration of key techniques in surveillance and fore-cast of schistosomiasis in Jiangsu Province I Layout and effect of the demonstra-tion sites for schistosomiasis surveillance and forecast / 中国血吸虫病防治杂志

Objective To explore and integrate the key techniques used in the surveillance and forecast of schistosomiasis in the water regions along the Yangtze River,so as to provide technical support for identifying rapidly the risk of schistosomiasis transmission and implementing control measures targeting the risk. Methods According to the distribution of water systems and water regions along the Yangtze River in Jiangsu Province,the demonstration sites for surveillance and forecast of schistoso? miasis were set across the province,where the integration and demonstration of the techniques regarding monitoring of Schistoso?ma japonicum infection in sentinel mice,human and animal activities,release of forecast information,and emergency treat?ment of water regions at risk of infection were performed. The pattern of human and animal activities was compared with the S. ja?ponicum infection in sentinel mice in the demonstration sites,and the operability of the release of information and emergency treatment of the risk of S. japonicum infection was evaluated. Results A total of 50 demonstration sites for surveillance and forecast of schistosomiasis were set in fixed anchor points,opening of the navigation lock to the Yangtze River,freight terminal, agritainment places,ferry,large construction places,and places for guaranteeing the Youth Olympic Games in 23 counties(dis?tricts)of 5 cities,Jiangsu Province. During the period between May and September,2014,the infectivity of water body was monitored by using 5 batches of sentinel mice,with a 99.06%(4 954/5 001)gross recovery rate of mice. S. japonicum infection was detected in a demonstration site,and an infected mouse was found,with a 0.02%(1/4 933)gross positive rate of sentinel mice. The field survey showed 2 088 person?times contacting water,including 91.95%(1 920/2 088)contacting water due to the production such as capturing fish,harvesting and cultivating crops,and repairing and building boats,and 8.05%(168/2 088)contacting water due to the life activity,such as fishing,washing vegetables and playing with water. The people contacted water predominantly in August and September(49.57%). A total of 859 boats containing 1 877 boatmen were observed,68.22%(586/859)of which were fishing boats containing 1 306 fishermen(69.58%). There were 32 sheep found in 4 demonstration sites,and 3 sheep were seen in the demonstration site with infected sentinel mouse. Four blue forecasts(emergence of water con?tact)and one orange forecast(S. japonicum?infected sentinel mouse detected)were released across the province,with one fore?cast map released which showed 5 sites with fishing and one site with sheep grazing,one emergency response system initiated, mollusciciding implemented in 10 hm2 high?risk regions,120 sheep grazed in fence,and 35 fishermen given health?education materials,schistosomiasis examination and preventive therapy. In addition,no acute schistosomiasis occurred in the demonstra?tion site with S. japonicum?infected sentinel mice. Conclusions The integration and demonstration of the techniques regarding monitoring of S. japonicum infection in sentinel mice,human and animal activities,release of forecast information,and emer?gency treatment of water regions at risk of infection provides an effective approach for the large?scale surveillance and forecast of schistosomiasis.

Surveillance and risk assessment system of schistosomiasis in Jiangsu Prov-ince I Distribution of surveillance site and effectiveness of the system / 中国血吸虫病防治杂志

Objective To establish the surveillance and risk assessment system of schistosomiasis in Jiangsu Province,so as to provide technical support for timely understanding of the risk of schistosomiasis transmission and implementation of target-ed control measures. Methods The surveillance sites of schistosomiasis were assigned according to the epidemic status and en-demic type of schistosomiasis as well as the characteristics of the water system,and the prevalence of Schistosoma japonicum in humans and domestic animals,and snail status were investigated. In addition,the quality control of serum detection of S. japon-icum infections was performed. The prevalence of human and animal S. japonicum infections,snail status and missing diagnosis of serum detection were analyzed and compared among regions. Results A total of 27 surveillance sites of schistosomiasis were set up in 26 counties of 10 cities,Jiangsu Province,including 14 sites in transmission-interrupted villages and 13 sites in trans-mission-controlled villages,and 15 sites in marshland and lake regions,9 sites in plain regions with water network and 3 sites in mountainous region. In the 27 surveillance sites,a total of 16 617 residents were screened for S. japonicum infection by using dipstick dye immunoassay(DDIA),and 326 were sero-positive,with a sero-prevalence of 1.96%(2.17%for men and 1.8%for women). Of the 326 individuals undergoing parasitological examination,2 positive cases were detected in the marshland and lake region,with a S. japonicum human prevalence of 0.01%. Of the 762 floating population detected,10 were positive for blood test,with a sero-prevalence of 1.31%,and no egg-positive individuals were detected. No infection was found in the 476 do-mestic animals. Of the 746 settings surveyed,a total of 240.7 hm2 snail area was detected,with a mean snail density of 0.06 snails/0.1 m2,and no infected snails were found. There were 780 quality-control sera detected in 26 surveillance sites of schisto-somiasis,and the gross coincidence rate was 95.13%,with misdiagnosis rate of 1.28%and missing diagnosis rate of 19.23%. Conclusion The surveillance sites of schistosomiasis show reasonable distribution in Jiangsu Province,and the endemic situa-tion of schistosomiasis appears a low level in the whole province.

Effect of schistosomiasis control in Bianmin River of Nanjing City / 中国血吸虫病防治杂志

Objective To evaluate the effect of comprehensive control for schistosomiasis with emphasis on environmental modification in the Bianmin River water system of Nanjing City.so as to provide scientific evidence for making up further control measures in this water system.Methods Schistosome infections of Oncomelania snails in the waterway.sentinel mice in water and neighbouring human were investigated longitudinally from 1998 to 2007,and the changes of huaman infection rates in differentyears,the infection rates of sentinel mice and snails in different settings were analyzed and compared.Results A total of 77 395 snails collected from the Bianmin River water system were dissected from 1998 to 2007,and among them,27 snails were infected with Schistosoma japonicum,with a total snail infection rate of 0.03%.A total of 61 039 snails collected from the neighbouring marshland which connected to the Yangtze River wore dissected,and among them,257 were infected with S.japonicum,with a total snail infection rate of 0.42%,and there was a significant difference compared with that in the water system(χ~2=248.55,P<0.01).After the protection works in the waterway,the infection rates of sentinel mice in the water system decreased from 69.68% in 1998 to 17.50% in 2001.with a reduction rate of 74.89%.Two years afterthe clearance ofmarshlandinthewaterway,no infected sentinel mouse was found.The infection rates of residents from 1998 to 2007 were 1.96%,1.37%,1.34%,1.60%,0.30%, 0.26%,0.16%,0.10%,0.04% and 0,respectively,andthe rates declined year by year afterthecomprehensive control.Conclusions The control measures based on the elimination of snail habitats in the waterway that is connected to the Yangtze River have achieved obvious effect.However,the clearance of the re-emerging snail habitats should be carried out termly to consolidate the control effect.

The evaluation of the quality of jaws after dental implants and its significance / 医学研究生学报

Implant performance is closely related to the load transmission at the bone-to-implant interface where bone quality will be highly variable.It has been demonstrated that poor quality bone is associated with high failure rates.To date,Digital Radiography,Dual energy X-ray absorptiometry and Computed tomography scan technique have gained increasing popularity for precise evaluation of the dental implant field in clinic,which would enable the surgeons to predict implant properties and immediate loading capacity before surgery.Individual preoperative measurements of local bone mineral density could be used to determine the best suited implant sites and types and optimize the prosthetic plan accordingly,which has important significance in the prognosis of the dental implants.

Endemic Situation of Schistosomiasis at the National Surveillance Sites of Nanjing, 2006 / 中国寄生虫学与寄生虫病杂志

Three endemic villages were selected as the national surveillance sites and Schistosoma japonicum infec-tion in residents and livestock was investigated in 2006. The positive rate of serological (IHA) and stool examinations was 10.06%(307/3 053) and 0.13%(4/3 053) for local residents, 10.8%(7/65) and 0(0/7) for moving people respectively. No infected livestock was found.