[Effect of strategy of control and prevention of intestinal nematodiasis in Dongtai City, Jiangsu Province].

OBJECTIVE: To explore the strategy of intestinal nematodiasis control in Dongtai City, Jiangsu Province. METHODS: The strategy of mass drug administration assisted with health education was applied in Dongtai City, which was a high endemic area of intestinal nematodiasis, and then the health education and promotion assisted with drug administration of focus population and other integrated control measures, such as the improvement of drinking water, lavatories, and environment, was applied to consolidate the achievement. RESULTS: The infection rate of intestinal nematodes reduced from 79.97% in 1989 to 6.30% in 1999, and the infection rates of hookworm, Ascaris lumgricoides and Trichuris trichura reduced to 3.31%, 0.60% and 2.57%, respectively, achieving the standard of intestinal nematodiasis control. In 2002, the infection rate of intestinal nematodes reduced to 3.73%, and the infection rates of hookworm, Ascaris lumgricoides and Trichuris trichura reduced to 2.46%, 0.20% and 1.08%, respectively, achieving the standard of effective intestinal nematodiasis control. The infection rate of intestinal nematodes was kept less than 1% after 2004. CONCLUSION: The integrated strategy of intestinal nematodiasis control in Dongtai City is effective and valuable for promotion in high endemic areas of intestinal nematodiasis.

[Surveillance and risk assessment system of schistosomiasis in Jiangsu Province. II. Surveillance pattern and effect of Oncomelania hupensis snail status in Dongtai City, Jiangsu Province].

OBJECTIVE: To explore the method of Oncomelania hupensis snail surveillance in transmission-interrupted regions of schistosomiasis, so as to provide a new pattern for the surveillance of snail status in the transmission-interrupted areas. METHODS: In Dongtai County, north of Jiangsu Province where the transmission of schistosomiasis was interrupted, the surveillance of snail status was performed by means of the village-level general survey, village-level sampling survey, snail survey in key settings of township and county, and snail reporting by residents. In addition, quality-control snail sites were set up for quality control. The effectiveness and cost of the four methods of snail surveillance was compared. RESULTS: A total of 163 079 settings and 22 785.62 hm2 were surveyed in Dongtai County from 2008 to 2013, and 89 residual snail breeding sites were found, with a snail area of 1.48 hm2. The patterns of village-level general survey, village-level sampling survey, and snail survey in key settings of township and county were employed for investigation of 94 550, 45 033 and 23 496 settings, consisting of 57.98%, 27.61% and 14.41% of total settings, and 2, 0 and 6 settings were found with snails, with 0.021/thousand, 0, and 0.255/thousand detection rates of settings with snail breading sites, respectively. The pattern of snail survey in key settings of township and county was more effective than that of village-level survey to detect-snail breeding sites (χ2 = 19.158, P = 0). The recovery rate of quality-control snail breeding sites was 52.56%, 38.27% and 73.62% for the three patterns of snail survey, respectively, and the pattern of snail survey in key settings of township and county showed a higher quality for snail survey than that of village-level survey (χ2 = 111.597 and 85.991, both P = 0). During the period from 2008 to 2013, 289 person-times reported 279 suspected snail habitats and 1 501 living snails, and no Oncomelania snails were found. During the 6-year period, there were 1617.5, 964.7 and 527.7 thousand RMB invested for village-level general survey, village-level sampling survey, and snail survey in key settings of township and county, and the cost of snail survey per hm2 was 129.88, 133.6 and 162.57 RMB/hm2, respectively. The cost of village-level general survey and snail survey in key settings of township and county to detect a snail-breeding site was 808 800 and 88 000 RMB, respectively (t = 12.850, P = 0.000), and the cost of snail survey in key settings of township and county was 10.88% of that of village-level general survey. CONCLUSION: The snail survey in key settings of township and county is a highly effective and high-quality method for snail surveillance, which miay serve as a prior way for the surveillance of snail status in the transmission-interrupted areas of schistosomiasis.

[Immunogenicity of single-dose HBsAg-PLGA controlled release microspheres in mice].

AIM: To investigate the level of immune response and the immune mechanism of the single-dose hepatitis B surface antigen (HBsAg)-poly (d, l)-lactide-co-glicolide acid (PLGA) microspheres in BALB/c mice. METHODS: Three kind of HBsAg-PLGA microspheres, HBsAg-PLGA50/50-COOH microspheres, HBsAg-PLGA75/25 microspheres and HBsAg-PLGA50/50 microspheres, were prepared by double emulsion microencapsulation technique used three kinds of PLGA with different L/G ratio. The single-dose of HBsAg-PLGA microspheres was subcutaneously injected into BALB/c mice at the dose of 7.5 microg HBsAg per mouse. The conventional aluminum-adjuvant vaccine was subcutaneously injected at 0, 1 and 2 month as positive control. In certain time interval, the induced immune level of total antibody was detected by enzyme linked immunosorbent assay (ELISA). For subclass of IgG antibody and cytokines studies, the dose of HBsAg was 2.5 microg per mouse. RESULTS: The HBsAg-PLGA microspheres could successfully induce a humoral immune response in BALB/c mice. Compared with the conventional aluminum-adjuvant vaccine, the antibody response of the HBsAg-PLGA50/50-COOH microspheres was significantly lower than the group received three injections of aluminum-adjuvant vaccine (P < 0.01) except for a higher priming response during the early 6 weeks. The results were ascribed to the relatively rapid degradation charactics of PLGA50/50-COOH polymer. The immune response for the HBsAg-PLGA50/50 microspheres and HBsAg-PLGA75/25 microspheres were comparable to the group administered with aluminum-adjuvant vaccine (P > 0.05) which was due to the sustained degradation of PLGA50/50 and PLGA75/25 polymer. CONCLUSION: The HBsAg-PLGA microsphere is a promising candidate for the controlled delivery of a vaccine which does not require multiple injections.

Pharmaceutical and immunological evaluation of a single-dose hepatitis B vaccine using PLGA microspheres.

The objective of the study was to investigate the feasibility of a single-dose hepatitis B vaccine based on three kinds of poly (D, L)-lactide-co-glicolide acid (PLGA) microspheres. PLGA microspheres loaded with recombinant hepatitis B surface antigen (HBsAg) were formulated using a double emulsion microencapsulation technique. The pharmaceutical characteristics of size, surface morphology, protein loading efficiency, antigen integrity, release of HBsAg-loaded PLGA microspheres and degradation of the polymer in vitro were evaluated. The degradation of the polymer corresponded with the composition of the polymer (lactide/glycolide ratio), molecular weight of the polymer (viscosity) and morphology of the microspheres. These PLGA microspheres were able to continuously release antigen under conditions that mimic the environment in vivo. The single subcutaneous injection of HBsAg-loaded PLGA50/50 microspheres, PLGA75/25 microspheres and a mixture of PLGA50/50, PLGA75/25, and PLGA50/50-COOH microspheres in mice resulted in comparable serum antibody titers to those of three injections of the conventional aluminum adjuvant formulated HBsAg vaccine. Based on these findings in vitro and in vivo, it was concluded that HBsAg was successfully loaded into the PLGA microspheres, which can auto-boost an immune response, and the HBsAg-loaded PLGA microsphere is a promising candidate for the controlled delivery of a vaccine.

[Preparation, release and immunogenicity evaluation of HBsAg-PLGA microspheres].

OBJECTIVE: To investigate microencapsulation technique, release of HBsAg-PLGA microspheres and degradation of the polymer in vitro, and the level of immune response after the single-dose HBsAg-PLGA microspheres subcutaneously injected (sc) to BALB/c mice. METHODS: HBsAg-PLGA microspheres were prepared by double emulsion microencapsulation technique with orthogonal experiments. The pharmaceutical characteristics of size and surface morphology, antigen loading efficiency, release of HBsAg-PLGA microspheres and degradation of the polymer in vitro, and the level of immune response after single sc of PLGA microspheres in BALB/c mice were investigated. RESULTS: The concentration of PVA was the significant factor affecting the particle size (P<0.05). The release of protein from the microspheres was controlled mainly by the bulk erosion of polymer matrix. When single sc of HBsAg-PLGA microspheres mixed with different formulations, the immunogenicity effect was comparable to that of the aluminium adjuvant vaccine. CONCLUSION: The single-dose HBsAg-PLGA microspheres mixture with different release behavior is a promising candidate for controlled delivery vaccine.

[Transplantation of free latissimus dorsi myocutaneous flaps for craniomaxillofacial reconstruction].

OBJECTIVE: This clinical study was to improve the surgical treatment to craniomaxillofacial tissue defects. METHODS: Since 1997, eight cases with severe craniomaxillofacial defects were treated using free latissimus dorsi myocutaneous flaps. In the operation, nerve anastomosis was performed. Of the 8 cases, 7 were treated in one stage, 1 was treated in 3 steps. The craniomaxillofacial defects ranged from 10 cm x 8 cm to 30 cm x 12 cm. The flaps was 12 cm x 10 cm to 32 cm x 16 cm in size. RESULTS: Postoperative follow-up for 6 months to 4 years demonstrated satisfactory results in all the cases. There was neither necrosis nor ulcer after the operation. The sensation recovery of the flap was also satisfactory. CONCLUSION: Free transfer of the latissimus dorsi myocutaneous flap is an ideal treatment to severe craniomaxillofacial defects as it possesses the advantages of reliable blood supply, ability against infections, large size, concealed donor site, and functional restoration of sensation and movement.