Prevalence of human soil-borne nematode infections in Yunnan Province: a cross-sectional study in 2015 / 中国血吸虫病防治杂志

Objective To investigate the current prevalence of human soil-borne nematode infections in Yunnan province, so as to provide the scientific evidence for formulating the soil-borne nematodiasis control strategy in the province. Methods In 2015, a total of 20 survey sites were sampled in 10 counties (cities) of Yunnan Province using the stratified cluster random sampling method. Stool samples were collected from all local permanent residents at ages of one year and older in each survey site, and the soil-borne nematode eggs were identified using the modified Kato-Katz technique and the egg number was counted. In addition, the hookworm species was identified using the filter-paperculture method, and Enterobius vermicularis eggs were detected using the cellophane tape method in children at ages of 3 to 6 years. Results A total of 5 067 residents received stool examinations, and 950 residents were detected with soil-borne nematode infections, with an overall prevalence rate of 18.75%. The prevalence of Ascaris lumbricoides, Trichuris trichura and hookworm was 7.52%, 8.47% and 9.02%, respectively. Among 446 children detected using the cellophane tape method, 5 children were detected with E. vermicularis infections. Among the 160 residents with hookworm infections, there were 139 residents with Necator americanus infections (86.88%), 16 with A. duodenale infections (10.00%) and 5 with mixed infections (3.12%). Mild A. lumbricoides (67.98%, 259/381), T. trichura (88.58%, 380/429) and hookworm infections (94.53%, 432/457) were predominant. Among the four ecological zones, the highest prevalence of human soilborne nematode infections was found in the East Tibet-South Sichuan Ecological Zone (31.79%), and among the 10 survey counties (cities), the greatest prevalence was seen in Gongshan Derung and Nu Autonomous County (50.13%), while the lowest prevalence was found in Ninglang Yi Autonomous County (0.40%). The prevalence of human soil-borne nematode infections was 5.67% (43/759), 26.67% (610/2 287) and 14.70% (297/2 021) in high-, moderate- and low-economic-level regions, respectively. There were no significant differences in the prevalence of human soil-borne nematode infections in terms of ecological regions, survey counties (cities) or economic development levels (χ2 = 342.20, 814.60 and 201.34, all P < 0.05). There was no significantdifference in the prevalence of human soil-borne nematode infections between male (18.21%, 441/2 422) and female residents (19.24%, 509/2 645) (χ2 = 0.89, P > 0.05), and soil-borne nematode infections were detected in residents at all age groups, with the greatest prevalence found in residents at ages of 1 to 9 years (25.88%). In addition, the highest prevalence of soil-borne nematode infections was seen in residents with the Dulong Ethnic Minority (82.09%), in preschool children (25.06%) and in illiterate residents (24.80%), and there was no age-, ethnicity-, occupation- or education level-specific prevalence of soil-borne nematode infections detected (χ2 = 46.50, 1 016.96, 36.33 and 52.43, all P < 0.05). Conclusions The prevalence of human soil-borne nematode infections remains high in Yunnan Province. The management of soil-borne nematodiasis requires to be reinforced among low-age children, farmers, old people and residents with low educations levels or ethnic groups.

[Investigation of soil - transmitted nematode infections in Xiding Township, Menghai County, Yunnan Province].

OBJECTIVE: To understand the status of soil-transmitted nematode infections in Xiding Township, Menghai County, Yunnan Province, so as to provide the reference for formulating the strategy of soil-transmitted nematodosis control. METHODS: Soil-transmitted nematode eggs in feces were detected by the Kato-Katz method, and the eggs of Enterobius vermicularis were detected by the cellophane tape method in children. The soil samples were collected from vegetable, fruit and other crop fields of 15 residents randomly to detect hookworm. RESULTS: The stool samples from 1 002 residents were examined and the soil -transmitted nematode infection rate was 20.06% (201/1 002). The infection rates of hookworm, Ascaris lumbricoides and Trichuris trichura were 18.96% (190 cases), 1.70% (17 cases) and 0.90% (9 cases) respectively. The percentages of people with light infection of hookworm, A. lumbricoides and T. trichura were 97.37% (185/190), 88.24% (15/17) and 100% (9/9) respectively. No infection of E. vermicularis was found. Fifteen soil samples were tested, and no hookworm was found in the soil. CONCLUSIONS: The infection rate of soil-transmitted nematode in Xiding Township, Menghai County is high, but the infectiosity is light. The control and monitoring of soil-transmitted nematodosis should be strengthened in this area.

Midazolam ameliorates the behavior deficits of a rat posttraumatic stress disorder model through dual 18 kDa translocator protein and central benzodiazepine receptor and neurosteroidogenesis.

Post-traumatic stress disorder (PTSD) is a debilitating anxiety disorder that may develop after an individual has experienced or witnessed a severe traumatic event. It has been shown that the 18 kDa translocator protein (TSPO) may be correlated with PTSD and that the TSPO ligand improved the behavioral deficits in a mouse model of PTSD. Midazolam, a ligand for TSPO and central benzodiazepine receptor (CBR), induces anxiolytic- and anti-depressant-like effects in animal models. The present study aimed to determine whether midazolam ameliorates PTSD behavior in rats as assessed by the single prolonged stress (SPS) model. The SPS rats received daily Sertraline (Ser) (15 mg/kg, i.p.) [corrected] and midazolam (0.125, 0.25, 0.5, and 1 mg/kg, i.p.) [corrected] during the exposure to SPS and behavioral assessments, which included the open field (OF) test, the contextual fear paradigm (CFP), and the elevated plus-maze (EPM). The results showed that, like Ser (15 mg/kg, i.p.) [corrected], midazolam (0.25 and 0.5 mg/kg, i.p.) [corrected] significantly reversed the behavioral deficiencies of the SPS rats, including PTSD-associated freezing and anxiety-like behavior but not the effects on spontaneous locomotor activity. In addition, the anti-PTSD effects of midazolam (0.5 mg/kg, i.p.) [corrected] were antagonized by the TSPO antagonist PK11195 (3 mg/kg, i.p.), the CBR antagonist flumazenil (15 mg/kg, i.p.) [corrected] and the inhibitor of steroidogenic enzymes finasteride (30 mg/kg, i.p.) [corrected], which by themselves had no effect on PTSD-associated freezing and anxiety-like behavior. In summary, this study demonstrated that midazolam improves the behavioral deficits in the SPS model through dual TSPO and CBR and neurosteroidogenesis.

Clinical effectiveness of gene therapy on critical limb ischemia: a meta-analysis of 5 randomized controlled clinical trials.

Therapeutic angiogenesis using gene therapy is a novel strategy for the treatment of critical limb ischemia (CLI). We conducted a meta-analysis to evaluate the efficacy and safety of gene therapy for the treatment of CLI with no option of revascularization. Randomized placebo controlled trials of gene therapy on CLI were identified by searching PubMed (from 1990 to October 2013) and EMBASE (from 1990 to October 2013). Five eligible studies were selected for the meta-analysis. Among these studies, a total of 425 patients received gene therapy of either fibroblast growth factor 1 or hepatocyte growth factor, and 365 patients were given placebo. No statistical differences were observed between the 2 groups in major amputation or death at 1 year (risk ratio [RR], 0.83; 95% confidence interval [CI], 0.51-1.39; P = .48) and wound healing at 6 months (RR, 1.55; 95% CI, 0.73-3.28; P = .25). Gene therapy had similar occurrence of serious adverse events as control (RR, 1.05; 95% CI, 0.97-1.14; P = .23).

Leptin reverses corticosterone-induced inhibition of neural stem cell proliferation through activating the NR2B subunits of NMDA receptors.

Corticosterone inhibits the proliferation of hippocampal neural stem cells (NSCs). The removal of corticosterone-induced inhibition of NSCs proliferation has been reported to contribute to neural regeneration. Leptin has been shown to regulate brain development, improve angiogenesis, and promote neural regeneration; however, its effects on corticosterone-induced inhibition of NSCs proliferation remain unclear. Here we reported that leptin significantly promoted the proliferation of hippocampal NSCs in a concentration-dependent pattern. Also, leptin efficiently reversed the inhibition of NSCs proliferation induced by corticosterone. Interestingly, pre-treatment with non-specific NMDA antagonist MK-801, specific NR2B antagonist Ro 25-6981, or small interfering RNA (siRNA) targeting NR2B, significantly blocked the effect of leptin on corticosterone-induced inhibition of NSCs proliferation. Furthermore, corticosterone significantly reduced the protein expression of NR2B, whereas pre-treatment with leptin greatly reversed the attenuation of NR2B expression caused by corticosterone in cultured hippocampal NSCs. Our findings demonstrate that leptin reverses the corticosterone-induced inhibition of NSCs proliferation. This process is, at least partially mediated by increased expression of NR2B subunits of NMDA receptors.

The efficacy and cost-effectiveness of cell saver use in instrumented posterior correction and fusion surgery for scoliosis in school-aged children and adolescents.

Posterior spinal instrumentation and fusion surgery in school-aged children and adolescents is associated with the potential for massive intraoperative blood loss, which requires significant allogeneic blood transfusion. Until now, the intraoperative use of the cell saver has been extensively adopted; however, its efficacy and cost-effectiveness have not been well established. Therefore, the aim of this study is to determine the efficacy and cost-effectiveness of intraoperative cell saver use. This study was a single-center, retrospective study of 247 school-aged and adolescent patients who underwent posterior spinal instrumentation and fusion surgery between August 2007 and June 2013. A cell saver was used intraoperatively in 67 patients and was not used in 180 patients. Matched case-control pairs were selected using a propensity score to balance potential confounders in baseline characteristics. Allogeneic red blood cell (RBC) and plasma transfusions as well as blood transfusion costs were analyzed. The propensity score matching produced 60 matched pairs. Compared to the control group, the cell saver group had significantly fewer intraoperative allogeneic RBC transfusions (P = 0.012). However, when the combined postoperative and total perioperative periods were evaluated for the use of allogeneic RBC transfusion, no significant differences were observed between the two groups (P = 0.813 and P = 0.101, respectively). With regard to the total cost of perioperative transfusion of all blood products (RBC and plasma), costs for the control group were slightly lower than those of the cell saver group, but this variance did not reach statistical significance (P = 0.095). The use of the cell saver in posterior spinal instrumentation and fusion surgery in school-aged children and adolescents was able to decrease the amount of intraoperative allogeneic RBC transfusion but failed to decrease total perioperative allogeneic RBC transfusion. Moreover, the use of the cell saver was not cost-effective.

Amlodipine and angiotensin-converting enzyme inhibitor combination versus amlodipine monotherapy in hypertension: a meta-analysis of randomized controlled trials.

OBJECTIVE: This study aimed to estimate the efficacy and tolerability of the combination of amlodipine and angiotensin-converting enzyme inhibitors as compared with amlodipine monotherapy in the treatment of hypertension. METHODS: The Cochrane Central Register of Controlled Trials, PubMed, and Embase were searched for relevant articles. A random effect model of meta-analysis was used for the selected randomized controlled trials (RCTs). RESULTS: A total of 17 randomized controlled trials involving 3291 patients were identified using predefined criteria. The combination treatment of amlodipine and angiotensin-converting enzyme inhibitors resulted in a greater reduction of both systolic blood pressure (SBP) [weighted mean difference (WMD) 5.72, 95% CI: (confidence interval) 4.10-7.33] and diastolic blood pressure (DBP) (WMD 3.62, 95% CI: 4.85-2.39) than monotherapy. The combination treatment also generated significantly greater reductions for the mean ambulatory SBP and DBP during the full 24 hours (WMD: SBP 4.24, 95% CI: 6.82-1.67; DBP 2.23, 95% CI: 3.73-0.69), but not for the trough (WMD: SBP 4.52, 9.56 to -0.51; DBP 3.7, 7.65 to -0.25). The hypertension therapeutic control (SPB <140, DBP <90 mmHg) rate for the combination treatment is higher than that for monotherapy [relative risk (RR): 1.36, 95% CI: 1.07-1.73]. The combination treatment also resulted in a lower overall rate of adverse events (RR: 0.86, 95% CI: 0.75-0.99) and edema (RR: 0.40, 95% CI: 0.29-0.56), but a higher rate of cough (RR: 3.28, 95% CI: 2.03-5.29) as compared with monotherapy. CONCLUSION: This meta-analysis suggests that the combination treatment provides superior BP control, fewer adverse events, and better tolerability in hypertensive patients than monotherapy. Further research should explore the mechanism of the combination therapy and whether it is associated with the reduction of cardiovascular disease morbidity and mortality.

[Characteristic of medical support and health care for Shenzhou-5 and Shenzhou-6 astronauts at main landing site].

OBJECTIVE: To investigate the characteristics of medical support and health care for the Shenzhou-5 and Shenzhou-6 astronauts at the main landing site, with special emphasis on the technical requirements for two astronauts during flight, in order to provide reference data for medical support in the battle field and disasters. METHODS: The data associated with accidental injuries of astronauts during the space flight collected from foreign nations and domestically were reviewed retrospectively. Based on the experience in medical support for Shenzhou-5 and Shenzhou-6 astronauts and the special environments of field operations, a scheme for first-aid and emergent treatment were drafted for a system of organization, prophylactic measurements, equipment and their effective implementation pending the test in the real situation. RESULTS: Two sets of high-quality intensive care unit (ICU) equipment were set up in helicopters, and an ambulance was equipped with the instruments and facilities that could be used in the first-aid and surgical operation in case accident and injuries should happen. The three sets of highly mobile ICU mentioned above could cover a vast area of both grassland and desert at the landing site to ensure that the astronauts could be rescued should accident occur, reaction to emergency would be most rapid and technique and equipment would be best. This scheme of first-aid for emergency which might occur in astronauts would seem to be a scientific, reasonable and practical system and would also meet the need in battle field. CONCLUSION: The first-aid scheme for astronauts at the main landing site, and its equipment, first aid strategies as well as it execution might provide an advanced system for medical aid and emergency treatment in the battlefield, disasters, and other special occasions.

[Establishment of a mobile intensive care unit].

OBJECTIVE: To discuss the experience of establishment of a mobile intensive care unit (ICU) for emergency treatment following astronaut flight, disaster, and regional war. METHODS: The data from both foreign and our countries as well as our own clinical experience of first-aid were reviewed, and a mobile ICU was established, including the equipment, supply of drugs, training, and organization. RESULTS: The mobile ICU was set up at the site of landing of the first Chinese astronaut, and proved to be efficient. The new model could be expected to be prompt in first-aid for casualties in disasters and warfare. CONCLUSION: The first-aid on spot of casualties might reduce the rates of invalidity and mortality during disasters and regional war.

[Measure on medical care and rescue for the first Chinese astronaut during manned space flight].

OBJECTIVE: To discuss the experience of medical care and rescue for the first Chinese astronaut during manned space flight. METHODS: Review the experiences of foreign nations in respect to accidental injuries of astronaut during manned space flight, the possible reasons were analyzed, and accordingly a reasonable and effective prophylactic measures and health care were formulated. RESULTS: An effective mobile intensive care unit (ICU) was established on desert or prairie where the capsule would land, so as to ensure the safety of the first Chinese astronaut, and to provide intensive care as well as successful emergency treatment in case of accidental injuries. CONCLUSION: Reasonable and effective prophylactic measures and health care appear to be an important aspect of the successful manned space flight.