[Diagnostic knowledge and skills of parasitic diseases based on competition of professional personnel in Jiangsu Province, China].

Objective To understand the integrated ability of parasitic disease prevention and control of professional personnel of Jiangsu Province through the contest. Methods Totally 56 players from the whole province were selected, and all the players participated in the contest. The theory knowledge and skill scores were collected and the statistical analyses were conducted. Results The average theoretical score of the participants was 88.86±15.56 and the passing rate was 91.1%. The average skill operating score was 69.16±16.01 and the passing rate was 67.9%. The average Plasmodium microscopy score was 16.54±8.09 and the passing rate was 50%. The average helminth egg microscopy score was 34.27±10.66 and the passing rate was 67.9%. There were statistical differences among the age groups and different levels of schistosomiasis endemic situation (F = 5.10, 6.39, both P < 0.01). The theoretical knowledge including schistosomiasis, malaria, hydatid disease and others and the score rates were 91.07%, 90.94%, 85.83% and 90.93%, respectively. The hydatid disease score rate was lower (χ2 = 19.17, P < 0.01). The radar chart displayed that the score rates of tabletting and microscopy test in Kato-Katz film production, malaria blood film production and microscopy test were all low. Conclusion In Jiangsu Province, the participants have higher score in the theory test. However, they have lower skill test score, especially in the parasite species identification. The operational skills still need to be strengthened for center for disease control (CDC) participants.

Preliminary experience with alemtuzumab induction therapy combined with maintenance low-dose tacrolimus monotherapy in small-bowel transplantation in China.

INTRODUCTION: The goal of combining alemtuzumab induction therapy with low-dose tacrolimus monotherapy in small-bowel transplantation (SBTx) is to enable improved graft acceptance without immunologic unresponsiveness caused by stronger immunosuppression regimens. Herein, we report preliminary experience using this protocol in 5 patients who underwent SBTx in China. METHODS: Patients received methylprednisolone sodium succinate (Solu-Medrol), 1 g, followed by alemtuzumab infusion, 30 mg, during SBTx and another gram of prednisolone before reperfusion. Tacrolimus monotherapy without steroid was used for maintenance immunosuppression. Tacrolimus trough levels were 10 to 15 ng/dL during the first 3 months, and weaned to 5 to 10 ng/mL after 3 months. RESULTS: Three recipients have survived for longer than 1 year; 1 patient is currently alive at 9 months, and another at 5 months post-SBTx. Grafts in these 5 recipients achieved excellent function, and in all patients, total parenteral nutrition was discontinued at 2 to 3 weeks postoperatively and normal oral intake was resumed. One recipient died at 13 months post-SBTx of severe rejection; the condition of the other 4 recipients who were still alive was good. Pathologic analysis of ileoscopic biopsy specimens revealed 4 episodes of indeterminate to mild acute cellular rejection (ACR) at 1 to 3 months, 3 episodes of indeterminate to mild ACR at 4 to 6 months, 3 episodes of moderate ACR at 7 to 12 months, and 1 episode of severe ACR at 13 months. All episodes of indeterminate to moderate ACR were totally resolved; only treatment of severe ACR failed. One patient experienced an episode of invasive fungal infection and another episode of cytomegaloviral infection, with total recovery after treatment. CONCLUSIONS: Our preliminary experience in these 5 cases showed that the protocol combining alemtuzumab induction therapy with low-dose tacrolimus monotherapy without maintenance steroid therapy past-SBTx can effectively control rejection with excellent graft function. Nevertheless, close surveillance of ACR should be still performed after 6 months.