Seven decades towards malaria elimination in Yunnan, China.

BACKGROUND: Yunnan Province was considered the most difficult place in China for malaria elimination because of its complex malaria epidemiology, heterogeneous ecological features, relatively modest economic development, and long, porous border with three malaria endemic countries: Lao People's Democratic Republic, Myanmar, and Viet Nam. METHODS: Academic publications and grey literature relevant to malaria elimination in Yunnan covering the period from 1950 until 2020 inclusive were considered. The following academic indexes were searched: China Science Periodical Database, China National Knowledge Infrastructure Database, and MEDLINE. Grey literature sources were mainly available from the National Institute of Parasitic Diseases (NIPD), the Chinese Center for Diseases Control and Prevention, and the Yunnan Institute of Parasitic Diseases (YIPD). RESULTS: A malaria elimination campaign in the 1950-1960s, based mainly on mass administration of antimalarial drugs and large-scale vector control, reduced morbidity and mortality from malaria and interrupted transmission in some areas, although elimination was not achieved. Similar strategies were used to contain outbreaks and a resurgence of disease during the 1970s, when malaria services were discontinued. From the 1980s, malaria incidence declined, despite the challenges of large numbers of mobile and migrant populations and an unstable primary health care system in rural areas following economic transformation. Launch of the national malaria elimination programme in 2010 led to adoption of the '1-3-7' surveillance and response strategy specifying timely detection of and response for every case, supported by the establishment of a real-time web-based disease surveillance system and a new primary health care system in rural areas. Border malaria was addressed in Yunnan by strengthening the surveillance system down to the lowest level, cross-border collaboration with neighbouring countries and non-governmental organizations, and the involvement of other sectors. CONCLUSIONS: Seven decades of work to eliminate malaria in Yunnan have shown the importance of political commitment, technically sound strategies with high quality implementation, a robust surveillance and response system at all levels, community participation and effective management of border malaria. The experiences and lessons learned from elimination remain important for prevention re-establishment of malaria transmission in the Province.

The clinical efficacy and safety of atropine combined with omeprazole in the treatment of patients with acute gastritis: a systematic review and meta-analysis.

BACKGROUND: To date, guidelines on the impact and value of atropine combined with omeprazole in the treatment of acute gastritis have not been well established or well defined. This study aimed to clarify the efficacy and safety of combined atropine and omeprazole therapy for the management of patients with acute gastritis. METHODS: Through searching the electronic database, the related literature of the combination of atropine with omeprazole in the treatment of acute gastritis were reviewed. A meta-analysis was performed after literature selection according to inclusion criteria. The treatment efficiency and the incidence of adverse reactions were used as the main outcome indicators. The odds ratios (ORs), standardized mean differences (SMDs), and 95% confidence intervals (CIs) of the two treatment regimens were analyzed. RESULTS: This study analyzed 11 articles from the literature with a total of 1,053 subjects. The combination of atropine and omeprazole significantly improved the clinical outcomes of patients with acute gastritis compared to patients treated with combined anisodamine and omeprazole (control group). The effective rate of combined atropine and omeprazole treatment was 1.21 times higher than that observed with the control group, and the incidence of adverse reactions was 0.41 times that of the control group. Atropine combined with omeprazole significantly alleviated the clinical symptoms of the patients. The total treatment time was shortened by 0.57 days, duration of abdominal pain was shortened by 2.82 days, duration of diarrhea was reduced by 1.99 days, and the duration of nausea and vomiting was shortened by 2.68 days compared to the control group. DISCUSSION: The combination of atropine with omeprazole in the treatment of acute gastritis demonstrated a high effective rate with few adverse reactions than. It was effective at alleviating the clinical symptoms associated with acute gastritis. The results of this study provide support for the clinical implementation of combined atropine and omeprazole in the treatment of patients with acute gastritis.

Successful treatment of ileal ulcers caused by immunosuppressants in two organ transplant recipients.

Although gastroduodenal ulcers are common in solid organ transplant patients, there are few reports on multiple giant ulcers in the distal ileum and ileocecal valve caused by immunosuppressants Herein, we report on a liver transplant recipient and a renal transplant recipient with multiple large ulcers in the distal ileum and ileocecal valve who rapidly achieved ulcer healing upon withdrawal of sirolimus or tacrolimus and administration of thalidomide. In case 1, a 56-year-old man with primary hepatocellular carcinoma had received a liver transplantation. Tacrolimus combined with sirolimus and prednisolone was used as the anti-rejection regimen. Colonoscopy was performed because of severe abdominal pain and diarrhea at post-operative month 10. Multiple giant ulcers were found at the ileocecal valve and distal ileum. The ulcers healed rapidly with withdrawal of sirolimus and treatment with thalidomide. There was no recurrence during 2 years of follow-up. In case 2, a 34-year-old man with end-stage kidney disease received kidney transplantation and was put on tacrolimus combined with mycophenolate mofetil and prednisolone as the anti-rejection regimen. Twelve weeks after the operation, the patient presented with hematochezia and severe anemia. Colonoscopy revealed multiple large ulcers in the ileocecal valve and distal ileum, with massive accumulation of fresh blood. The bleeding ceased after treatment with intravenous somatostatin and oral thalidomide. Tacrolimus was withdrawn at the same time. Colonoscopy at week 4 of follow-up revealed remarkable healing of the ulcers, and there was no recurrence of bleeding during 1 year of follow-up. No lymphoma, tuberculosis, or infection of cytomegalovirus, Epstein-Barr virus, or fungus was found in either patient. In post-transplantation cases with ulcers in the distal ileum and ileocecal valve, sirolimus or tacrolimus should be considered a possible risk factor, and withdrawing them or switching to another immunosuppressant might be effective to treat these ulcers.

[The short-term and long-term effects on neck pain caused by cervical spondylosis treated with combination of acupuncture and moxibustion with seed-sized moxa cone].

OBJECTIVE: To evaluate the short-term and long-term effects on treatment of neck pain caused by cervical spondylosis with the combination of acupuncture and moxibustion with seed-size moxa cone. METHODS: One hundred and forty-five patients of neck pain were randomly divided into an acupuncture-moxibustion group (49 cases), an acupuncture group (48 cases) and a moxibustion group (48 cases). Acupoints of Bailao (Extra), Dazhui (GV 14), Jianzhongshu (SI15) and Zhongzhu (TE 3) were adopted for all the 3 groups. Acupuncture was applied at all the acupoints with 20 min needling retention for the acupuncture group. Moxibustion with seed-size moxa cone was used with 5 cones on each point for the moxibustion group. And both acupuncture and moxibustion with seed-size moxa cone were adopted for the acupuncture-moxibustion group. The treatment was applied once every 3 days, and 10 treatments should be finished within 4 weeks. Follow-up should be carried out for 3 months. The short-term and long-term effects were evaluated with the scores of Northwick Park Pain Questionnaire (NPQ) and McGill Pain Questionnaire (MPQ) as the indices of therapeutic effect. RESULTS: The NPQ score and MPQ score of all the 3 groups after the treating course and the 3-month follow-up were both decreased when compared with those before the treatment (all P<0. 05). The scores of NPQ and MPQ the acupuncture-moxibustion group were lower than that of the other two groups. And the difference had obvious significance (P<0. 05). High efficiency of pain relieving for cervical spondylosis could be found in all the 3 groups, which showed that short-term and long-term effects were good for all the 3 groups. And the highest curative effect could be found in acupuncture-moxibustion group. CONCLUSION: Combination of acupuncture and moxibustion with seed-size moxa cone has reached a superior effect in short-term and long-term for neck pain caused by cervical spondylosis.

[Response of soil microbial community to the bioremediation of soil contaminated with PAHs].

The diversity of bacterial community in soil contaminated with polycyclic aromatic hydrocarbons (PAHs) was investigated during the plant-microbe remediation enhanced by biosurfactant rhamnolips (RH), using the polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) method. The results showed that Shannon-Weaver diversity index was only 3.17 before bioremediation, and increased to 3.24-3.45 after bioremediation, in particular, highest value was found in the treatment of alfalfa (AL) inoculated with arbuscular mycorrhizal fungi (AM) and PAHs-degrading bacteria (DB) among all the treatments. The clustering analysis showed that the similarities of soil bacterial community of AL, AL + RH, AL + AM and AL + AM + RH were above 90%. At the same time, the similarity of AL + DB was much closer to those of the four treatments mentioned above. Additionally, when the bacterial communities of AL + DB + RH, AL + DB + AM and AL + DB + AM + RH were grouped together, the similarities of these three treatments were also higher than 80%. By sequence alignment, it was found that the predominant and characteristic bands in DGGE patterns were closely related with PAHs-degrading bacteria, such as Bacillus, Pseudomonas, Acidobacteria, Sphingmonas, Rhodopseudomonas, Firmicutes, and Methylocytaceae. Application of rhamnolipids in plant-microbe bioremediation not only improved the bioavailability of PAHs, but also had a simultaneous influence on the diversity of soil bacterial community, resulting in the efficient promotion of PAHs removal from soils.

[Postoperative abdominal endogenic field hyperthermia combined with FOLFOX regimen in the treatment of 68 cases of advanced gastric cancer].

OBJECTIVE: To assess the therapeutic efficacy and adverse effects of endogenetic field hyperthermia (EFH) in combination with L-OHP /LV / 5-FU in the treatment of advanced gastric cancer. METHODS: This study included 147 surgical patients with stage II-IV gastric cancer, who received postoperative chemotherapy with FOLFOX (L-OHP 85 mg /m square, 3 h intravenous infusion, followed by infusion of LV at 200 mg /m square in 2 h, intravenous injection of 5-Fu at 400 mg /m square, and intravenous infusion of 5-FU at 3000 mg /m square in 48 h). Eight treatment cycles (each lasting for 14 days) were administered. In 68 cases randomly selected from the cohort, EFH was performed on the first and third days (treatment group), but not in the other 79 cases (control group). RESULTS: The response rate was 68.4% in the treatment group and 36.4% in the control group, showing significant difference between them (P<0.05). The 1-year survival rate was 88.2% in the treatment group, similar to the rate of 81.0% in the control group (P< 0.05), but the 3, 5-year survival rates in treatment group (67.6% and 30.9%) was significantly higher than those in the control group (47.6% and 15.4%, P<0.05). The adverse effects were similar between the two groups. CONCLUSION: EFH combined with the chemotherapeutic regimen FOLFOX might improve the therapeutic effect of stage II-IV gastric cancer without obviously increasing the adverse effects.