Evaluation of lifestyle behaviors, anxiety and depression in patients with hematologic disorders.

Patients with hematologic disorders may experience anxiety and depression due to their immunocompromised status and potential side effects of therapies. Healthy lifestyle behaviors might enhance the mental health. To evaluate the association of both separate and clustering pattern lifestyle behaviors with anxiety and depression in hematological patients, healthcare providers can develop future initiatives that respond to the specific needs of this population. A total of 185 patients with hematologic disorders were enrolled in this cross-sectional study. Linear regression analysis was performed to measure the association of separate lifestyles with anxiety and depression. Latent class analysis was further conducted to identify homogeneous and mutually exclusive lifestyle classes, and the logistic regression was then used to assess the relationship between class memberships and symptoms of anxiety and depression. The study found sleep quality was correlated with anxiety and depression. Nevertheless, no association of anxious and depressive symptoms with sitting and exercise, dietary habits, toxicant exposure, drinking, and smoking, in either the overall patient population or patients classified by hematologic neoplasms. Two latent classes of lifestyle behaviors were further identified, but the class memberships were independent of anxiety and depression. The study suggested that promoting sleep quality was a viable intervention for patients with hematologic disorders. However, the clustering pattern of lifestyles may not be a reliable indicator of psychological issues.

Effects of Kinesio Taping for Chronic Nonspecific Low Back Pain: A Systematic Review and Meta-analysis.

Context: Chronic nonspecific low back pain (CNLBP) is a common musculoskeletal disorder that seriously affects patients' quality of life (QoL). Clinicians have used Kinesio Taping (KT) in the treatment of CNLBP patients, but evidence is still lacking on the benefits of KT for CNLBP. Objective: The study aimed to perform a systematic review and meta-analysis of the currently published randomized controlled trails (RCTs) to determine KT's efficacy for CNLBP patients. Design: The research team performed a literature search using five major electronic databases-PubMed, Embase, Web of science, Cochrane Library, MEDLINE and OpenGrey-and included studies form inception to January 2018. The search used the keywords "kinesio tap*", "kinesio*", and "chronic low back pain (CLBP)" or "CNLBP". Setting: The study took place in the 942 Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army. Outcome Measures: The research team performed the meta-analysis using RevMan 5.3 software. The team selected studies that used pain intensity and disability as the primary outcome measures, and if the study used other outcomes, they had to be the secondary outcomes. Results: The systematic review included nine RCTs in the meta-analysis. KT can significantly reduce pain intensity between baseline and immediately postintervention (SMD = -0.47, 95% CI -0.93 to -0.02, P = .04) and between baseline and the short-term follow-up period (SMD = -0.67, 95% CI -0.44 to -0.20, P = .03). However, no significant differences existed between KT's ability to relieve other symptoms of CNLBP-disability, trunk flexion range of motion (ROM), change in status, fear of movement, isometric endurance of the trunk muscles, or extension-when compared to either sham taping or KT as an adjunct to physical therapy. Conclusions: KT can have immediate and short-term positive effects on reducing pain intensity, but existing evidence doesn't support KT's superiority to other interventions in improving functions for individuals with CNLBP.

The impact of Teach-back method on preoperative anxiety and surgical cooperation in elderly patients undergoing outpatient ophthalmology surgery: A randomized clinical trial.

BACKGROUND: The literatures have demonstrated that Teach-back method is an effective communication tool to understand health education, especially in the elderly patients. However, there is limited research of Teach-back method in preoperative education for outpatient surgical patients. This study was conducted to investigate the effects of the Teach-back method on preoperative anxiety and surgical cooperation in elderly patients undergoing outpatient ophthalmology surgery. METHODS: One hundred sixteen elderly patients who underwent outpatient ophthalmology surgery were selected as the research objects. They were divided into the observation group (58 cases) and the control group (58 cases). The Teach-back preoperative education was adopted in the observation group and the standard preoperative education method was adopted in the control group. The degree of anxiety, surgical cooperation, and awareness of health knowledge were compared between the 2 groups, and the variations of blood pressure and heart rate, as well as the highest values of intraoperative blood pressure and heart rate before and after method, were recorded and compared. RESULTS: The preoperative systolic blood pressure in the observation group was significantly lower than that in the control group. The intraoperative (the highest value) heart rate, systolic blood pressure, and diastolic blood pressure in the observation group were lower than those in the control group, and the differences were statistically significant (P < .05). After intervention, the anxiety score and information demand score of the observation group were lower than those of the control group, and the differences were statistically significant (P < .05). The degree of surgery cooperation and awareness of perioperative health knowledge in the observation group were all higher than those in the control group; the differences were statistically significant (P < .05). CONCLUSION: The Teach-back method could relieve the preoperative anxiety of the patients, improve the quality of patients surgery cooperation, and facilitate the awareness of health knowledge. Moreover, it could effectively improve the intraoperative stress response of the elderly patients and reduce the large fluctuations of blood pressure and heart rate.

Current status and influencing factors of fatigue in patients with rheumatoid arthritis: A cross-sectional study in China.

AIM: This study aimed to explore the level and influencing factors of fatigue in patients with rheumatoid arthritis. METHODS: This cross-sectional study was conducted in 243 patients with rheumatoid arthritis from April 2016 to March 2017. The Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire, Arthritis Self-Efficacy Scale-8, Visual Analogue Scale for pain, physical function subscale of Short Form 36-Item Health Survey, Hospital Anxiety and Depression Scale, Perceived Social Support Scale, Pittsburgh Sleep Quality Index and a self-designed demographic and disease-related information questionnaire were used to collect the data. Stepwise linear multiple regression was used to clarify the impact of statistically significant variables (P < 0.05) in the independent sample t test, one-way ANOVA and correlation analysis on the level of fatigue. RESULTS: Stepwise linear multiple regression analyses showed that disease activity, self-efficacy, physical function, pain, depression, duration of morning stiffness and anxiety were major factors influencing fatigue in patients with rheumatoid arthritis, which explained 59.5% of the total variance. CONCLUSION: Our study demonstrated a moderate level of fatigue in Chinese patients with rheumatoid arthritis. In clinical practice, nurses should explore individualized intervention programmes based on related predictors of fatigue to help patients relieve fatigue.

Demoralization and depression in Chinese cancer patients.

OBJECTIVE: Demoralization and depression are common in cancer patients and closely related to suicide. But the association and difference between them are not clear. The aim of this study is to investigate demoralization and depression in Chinese cancer patients. METHODS: This study is a cross-sectional study. Two hundred ninety-six cancer patients completed the questionnaire. First is using the DS-II to evaluate demoralization in advanced cancer patients and using the PHQ-9 to evaluate their depression. Then determine the association between demoralization and depression by Pearson rank correlation test. Finally, an ANOVA was conducted using DS-II as the categorical variable and PHQ-9 as the continuous variable and using PHQ-9 as the categorical variable and DS-II as the continuous variable. RESULTS: There is a positive association between demoralization and depression. A special case that patients with high demoralization but low depression was discovered, which accounted for a large proportion. CONCLUSION: Demoralization and depression are two different psychological states, which require medical staff to identify and take corresponding intervention measures in time. Patients with high demoralization but low depression require further attention.

Novel putative bluetongue virus serotype 29 isolated from inapparently infected goat in Xinjiang of China.

Bluetongue virus (BTV) is the 'type' species of the genus Orbivirus causing bluetongue (BT) in sheep, bovine and other ruminants. Twenty-four serotypes and several atypical serotypes of BTV were identified worldwide. In present study, a novel strain of BTV (V196/XJ/2014) was isolated from an asymptomatic sentinel goat in Yuli County, Xinjiang of China. Serotype identification of this isolate exhibited uniform negative results by serotype-specific conventional RT-PCR and real-time RT-PCR for BTV-1 to BTV-27, and virus neutralization tests using reference sera of BTV-1 to BTV-24. Genomic analysis showed V196/XJ/2014 grouped with atypical serotypes of BTV-25 to BTV-28, BTV-X/XJ1407, BTV-X/ITL2015 and BTV-Y/TUN2017, while segment 2 and VP2 protein of V196/XJ/2014 shared <63.4%/61.4% nucleic acids and amino acids sequence identities with other recognized BTV serotypes and its segment 2 formed a separate 'nucleotype' in phylogenetic tree. These results indicated V196/XJ/2014 does not belong to any reported serotypes of BTV. Further studies of infectivity and pathogenicity showed that goats infected with V196/XJ/2014 did not exhibit observed clinical symptoms, but high level of virus amplification and homologous neutralization antibodies were detected post-infection. Our studies suggested a novel putative serotype of BTV-29 was isolated in Xinjiang of China, which expands our knowledge about the diversity of BTV.

Nursing intervention reduces depression for patients with rheumatoid arthritis: A randomized controlled trial protocol.

BACKGROUND: Rheumatoid arthritis (RA) is a kind of chronic disease of inflammatory joint, which can lead to the damage and disability of bone and cartilage. Psychiatric comorbidity is related to the adverse results of RA. Symptoms of depression is associated with the increased disease activity and decreased response to the treatments. Therefore, the depression may be an effective intervention target to improve the life quality and subjective health of the patients with RA. The objective of this experiment is to evaluate the effectiveness of nursing intervention for reducing depression for patients with RA. METHOD: It is a single-center randomized controlled study to be conducted from January 2021 to December 2021. It was admitted via the Ethics Committee of Tianjin Medical University (202018384). One hundred patients are included in the study. The inclusion criteria contains:The exclusion criteria contains:All the patients participating in this study are randomly divided into control group and study group, with 50 patients in each group. The primary result is the severity of depression in the patients with RA, based on the generally utilized questionnaires (Hospital Anxiety and Depression Scale). The secondary outcome is the patients life quality, which is evaluated with the short form 36 questionnaire. The analysis of all the data are conducted with the software of IBM SPSS Statistics for Windows, version 20. RESULTS: Table will show the clinical outcomes after various interventions. CONCLUSION: This paper instructs the nurses to develop protocol based on evidence to improve the clinical efficacy for the RA patients. TRIAL REGISTRATION NUMBER: researchregistry6114.

Care stress in caregivers of disabled stroke patients: a cross-sectional survey.

BACKGROUND: A cross-sectional survey was performed on the family membersof disabled stroke survivors, those who are both the patient's medical authorizer and caregiver,to identify the sources of the caring stress and inform appropriate interventions. METHODS: A total of 242 family members of stroke patients, who were treated in a tertiary geriatric hospital in Haikou, the capital city of Hainan Province, were enrolled in the current study by using convenience sampling. Questionnaire forms were used to investigate care stress caused by family members' current care activitiesand analyze its causes. RESULTS: The care stress of the family members was moderately positively correlated with financial pressure (r=0.476, P<0.01). Family members' educational background, financial pressure, the times of hospitalizations, the dependency of stroke patients, and the degree of family members' participation in treatment decisionmaking during the patient's hospital stay were the primary sources of the caring stress (P<0.05 or P<0.01). CONCLUSIONS: A substantial proportion of family members are under high stress when caring for disabled stroke patients. Strategies including knowledge training, empowerment, home-based rehabilitation, and information and emotional support may effectively relieve the caring stress, to improve the family support of patients, improve the quality of life of both patients and caregivers, and enhance the rehabilitation effectiveness.

Dynamic Changes in the Global Transcriptome and MicroRNAome Reveal Complex miRNA-mRNA Regulation in Early Stages of the Bi-Directional Development of Echinococcus granulosus Protoscoleces.

BACKGROUND: Cystic echinococcosis is a life-threatening disease caused by the larval stages of the dog tapeworm Echinococcus granulosus. Protoscoleces (PSCs) of this worm have the ability of bi-directional development to either larval cysts or strobilar adult worms. However, the molecular mechanisms underlying this development process are unknown. RESULTS: RNA and small RNAs sequencing was employed to characterize the gene and miRNA expression at 0-24 h and 7-14 days in the bi-directional development of PSCs. A total of 963 genes and 31 miRNAs were differentially expressed in the early development of PSCs to adult worms whereas 972 genes and 27 miRNAs were differentially expressed in the early development of PSCs to cysts. Pairwise comparison between the two developmental patterns showed that 172 genes and 15 miRNAs were differentially expressed at three time-points. Most of these genes were temporally changed at 24 h or 7 days. GO enrichment analysis revealed that the differentially expressed genes in early adult worm development are associated with nervous system development and carbohydrate metabolic process; whereas, the differentially expressed genes in early cystic development are associated with transmembrane transporter activity and nucleoside triphosphatase activity. In addition, miR-71 and miR-219 regulated genes are likely involved in oxidation reduction in adult worm development. CONCLUSION: The early stages of bi-directional development in E. granulosus PSCs are controlled by miRNAs and genes likely associated with nervous system development and carbohydrate metabolic process. ATP-dependent transporter genes are associated with cystic development. These results may be important for exploring the mechanisms underlying early development in E. granulosus providing novel information that can be used to discover new therapeutics for controlling cystic echinococcosis.

Comparison of the Post-Total Knee Arthroplasty Analgesic Effect of Intraoperative Periarticular Injection of Different Analgesics.

OBJECTIVE: To compare post-TKA (total knee arthroplasty) analgesic effect of periarticular injection of different analgesics during surgery. STUDY DESIGN: Experimental study. PLACE AND DURATION OF STUDY: Tianjin People's Hospital, from December 2016 to July 2018. METHODOLOGY: Patients undergoing unilateral TKA were randomly divided into Group A and Group B, with 67 patients in each group. In Group A, compound analgesics of ropivacaine, ketorolac, adrenaline, morphine and normal saline were injected periarticularly during surgery. While in Group B, compound analgesics of bupivacaine, methylprednisolone, adrenalin, morphine and normal saline were injected periarticularly during surgery. Visual analogue scale (VAS), range of motion (ROM) of knee joint, and rehabilitation of knee joint of both groups were compared. RESULTS: VAS scores of Group A at 6-hour, 24-hour, 48-hour and 72-hour after surgery was lower than those of Group B (p=0.046, p<0.001, p<0.001 and p<0.001, respectively). ROM of knee joint of Group A on the 3rd, 7th, 10th and 14th day after surgery was superior to that of Group B (all p<0.001). On the 14th day after surgery, excellent and good rate of rehabilitation of knee joint of Group A was higher than that of Group B (p=0.032). CONCLUSION: Compared with periarticular injection of compound analgesics of bupivacaine, methylprednisolone, adrenaline, morphine and normal saline during surgery, periarticular injection of compound analgesics of ropivacaine, ketorolac, adrenaline, morphine and normal saline during surgery can alleviate post-TKA pain more effectively, improve early ROM of joint knee after surgery, increase rehabilitation effect of knee joint.

Dog vaccination with EgM proteins against Echinococcus granulosus.

BACKGROUND: Dogs play a pivotal role in the transmission of cystic echinococcosis (CE), a zoonosis caused by the tapeworm Echinococcus granulosus. We showed previously that dogs vaccinated with two E. granulosus adult-worm specific proteins, EgM9 and EgM123, emulsified with Freund's adjuvants induced significant protective efficacy in terms of reduction in worm burden and egg production after 45 days post-infection. It was not known whether this protection can be sustained using adjuvants suitable for use in dogs. METHODS: Recombinant EgM9 and EgM123 were mixed with Quil A or ISCOMs for vaccinating dogs. After three vaccine injections, all the dogs were orally challenge-infected with 200 000 protoscoleces of E. granulosus. After 45 days of infection, all the dogs were euthanized and necropsied for collecting and counting E. granulosus worms. Immunoglobins, including the IgG subclasses IgG1 and IgG2, were detected in the sera of vaccinated dogs by ELISA. To determine whether the protection efficacy could be maintained after 45 days post-infection, we implemented a longevity trial to count eggs in dog faeces for 170 days after infection. RESULTS: The dogs vaccinated with EgM9 and EgM123 mixed with Quil A and ISCOMs showed similar protective efficacy as the proteins emulsified with Freund's adjuvants in our previous study in terms of reduction of worms and eggs at 45 days post-infection. The longevity trial showed that EgM9 protein-vaccinated group released lower number of eggs per gram compared with the egg counts in the control dogs during the dog trial study. CONCLUSION: EgM9 and EgM123 are thus suitable vaccine candidates against E. granulosus infection in dogs.

Exploring Meaning in the Life of Chinese Breast Cancer Survivors.

BACKGROUND: Breast cancer is the most common cancer among women worldwide, and spiritual fulfillment such as experiencing meaning in life plays an important role in coping with the disease. OBJECTIVE: The objectives of this study were to explore and understand Chinese breast cancer survivors' perspective on meaning in life. METHODS: This study used Grounded Theory; 23 participants were recruited using convenience sampling, purposive sampling, and theoretical sampling. Semistructured interviews were conducted, and the data were analyzed using open coding, axial coding, and selective coding. RESULTS: A core category emerged as "satisfaction with my life" to explain Chinese breast cancer survivors' perspective of meaning in life, and 4 subcategories described the core category including (1) living a healthy and peaceful life, (2) having a good relationship with others, (3) achieving purpose in life, and (4) fulfilling responsibility. CONCLUSION: Chinese breast cancer survivors value physical health as well as spiritual fulfillment. The experience of adapting to life with cancer, having a good relationship with others, pursuing life goals, and fulfilling responsibility consists of a satisfying life, which makes life more meaningful. IMPLICATIONS FOR PRACTICE: Health providers should pay more attention to survivors' experience of meaning in life and help them enhance meaning in life and improve their quality of life through building good relationship with others, achieving purpose in life, and fulfilling responsibility for family and society.

Protective Effect of Luteolin Against Renal Ischemia/Reperfusion Injury via Modulation of Pro-Inflammatory Cytokines, Oxidative Stress and Apoptosis for Possible Benefit in Kidney Transplant.

BACKGROUND The acceptances and long-term outcomes of the renal transplantations are seriously jeopardized by inflammatory responses and damage to tissues. The present study intended to explicate the pharmacological effect of luteolin (LT) in renal ischemia/reperfusion (I/R) injury and the possible mechanism of action of LT. MATERIAL AND METHODS The effect of LT on the level of interleukin (IL)-1ß, IL-6, and tumor necrosis factor (TNF)-α in the homogenates of kidney tissues of male Swiss albino mice was determined after I/R injury. The effect of LT on MDA (malondialdehyde), SOD (superoxide dismutase), CAT (catalase), and glutathione were also identified by enzyme assay. In addition, Western blotting was used to determine the level of Bcl-2, Bax, and caspase-3 in the presence of LT. RESULTS The results showed that LT caused significant reduction in the level of TNF-α, IL-1ß, and IL-6 compared to the I/R group without LT (p>0.05). To further confirm this, the efficacy of LT on the histopathology of I/R injured renal tissues was studied. It was found that LT restored cellular viability of damaged renal tissue. This observation was further confirmed by TUNEL assay, where it was found that LT caused considerable reduction in the population of apoptotic cells. LT pretreatment significantly increased Bcl-2 expression and reduced the level of Bax expression together with a reduction in the level of caspase-3 expression. CONCLUSIONS Luteolin showed its effect by interfering and attenuating a number of pathways, including pathways for inflammation and apoptosis in renal tissues.

Psychometric properties of the Chinese version of Arthritis Self-Efficacy Scale-8 (ASES-8) in a rheumatoid arthritis population.

The Arthritis Self-Efficacy Scale-8 (ASES-8) is a valid tool to measure patients' arthritis-specific self-efficacy. However, evidence about reliability and validity of the ASES-8 in Chinese arthritis patients is lacking. This study aimed to culturally adapt and test the psychometric properties of the Chinese version of the ASES-8. Chinese ASES-8 was translated from original English version using translation and back-translation procedures. Validation survey was then conducted in a university-affiliated hospital by a set of questionnaires comprised Chinese ASES-8, pain-VAS, The Hospital Anxiety and Depression Scale (HADS), Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F), and Short Form 36-Item Health Survey (SF-36) physical functioning subscale. A convenience sample of 134 patients with rheumatoid arthritis was recruited from the department of rheumatology. Validity was assessed by Pearson's correlation analysis and exploratory factor analysis. Reliability was assessed using the intra-class correlation coefficient (ICC) and Cronbach's alpha. Exploratory factor analysis extracted one dimension that explained of the 71.35% variation. Significant negative correlations were found between the ASES-8 and pain-VAS, HADS-D, HADS-A scores (r -0.487 to -0.656, p < 0.01), while positive correlations were found between the ASES-8 and SF-36 PH (r = 0.561, p < 0.01), FACIT-F (r = 0.660, p < 0.01). Excellent test-retest reliability (ICC = 0.98) and internal consistency (Cronbach's alpha = 0.942) were demonstrated. The Chinese version of the ASES-8 had statistically acceptable levels of reliability and validity for assessing self-efficacy in patients with rheumatoid arthritis. This disease-specific scale is particularly valuable for use among patients with rheumatoid arthritis from the Chinese population.

Development of the Chinese version of Meaning in Life Scale for cancer patients and psychometric evaluation.

AIMS AND OBJECTIVES: To develop a Meaning in Life Scale for cancer patients in Chinese version and to test the validity and reliability. BACKGROUND: Meaning in life is a protective factor of psychological well-being and is negatively related to depression and demoralisation among cancer patients. The existing scales measuring meaning in life are mostly designed in English and there is no scale designed for Chinese cancer patients based on Chinese cultural background. DESIGN: Process of instrument development and psychometric evaluation were used. METHODS: Items were generated from literature review and a focus group interview. Delphi technique was used to test the content validity. Item analysis and exploratory factor analysis were performed with data from 251 cancer patients. The internal consistency of the scale was tested by Cronbach's alpha. RESULTS: A 25-item Meaning in Life Scale in Chinese version with five domains was developed. The five factors explained 62·686% of the variance. The Cronbach's alpha for the total scale was 0·897. CONCLUSIONS: The Meaning in Life Scale in Chinese version has acceptable internal consistency reliability and good content validity and acceptable construct validity. The content of the scale reflected the attitudes of cancer patients towards meaning in life based on Chinese cultural background. RELEVANCE TO CLINICAL PRACTICE: The Chinese version of Meaning in Life Scale for Cancer Patients appears to be a new scale to assess meaning in life among Chinese cancer patients exactly and the concept of meaning in life presented in this scale provides new ideas of meaning intervention in routine clinical practice.

Epidemiology and control of echinococcosis in central Asia, with particular reference to the People's Republic of China.

At least 270 million people (58% of the total population) are at risk of cystic echinococcosis (CE) in Central Asia including areas of Mongolia, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan, Afghanistan, Iran, Pakistan and western China. The annual surgical incidence rate in Uzbekistan and Tadjikistan has been estimated to be as high as 25-27 cases/100,000 with the highest prevalence reaching 10% (range from 0.8 to 11.9%) in some Tibetan communities in western China. Echinococcus transmission in the region is largely associated with social factors including limited community knowledge of echinococcosis, small-scale household animal production, home killing of livestock, and the feeding of dogs with uncooked offal. Alveolar echinococcosis (AE) is also endemic in Central Asia and is recognized as a major problem in some Tibetan communities with up to 6% of villagers infected in some villages. In western China, 5-30% of the population are seropositive against E. granulosus antigens, indicating that a large number of individuals have been exposed to the parasite. Although echinococcosis control programs have been initiated in some countries in Central Asia, control efforts are generally fragmented and uncoordinated. Monthly deworming of dogs with praziquantel (PZQ), as a key measure to control the Echinococcus parasites, has been used in western China. However, the approach has proven difficult in local semi-nomadic communities. Additional control measures including health education, domestic livestock animal treatment/vaccination and dog vaccination are needed in CE-endemic areas to accelerate progress.

Genome-wide sequencing of small RNAs reveals a tissue-specific loss of conserved microRNA families in Echinococcus granulosus.

BACKGROUND: MicroRNAs (miRNAs) are important post-transcriptional regulators which control growth and development in eukaryotes. The cestode Echinococcus granulosus has a complex life-cycle involving different development stages but the mechanisms underpinning this development, including the involvement of miRNAs, remain unknown. RESULTS: Using Illumina next generation sequencing technology, we sequenced at the genome-wide level three small RNA populations from the adult, protoscolex and cyst membrane of E. granulosus. A total of 94 pre-miRNA candidates (coding 91 mature miRNAs and 39 miRNA stars) were in silico predicted. Through comparison of expression profiles, we found 42 mature miRNAs and 23 miRNA stars expressed with different patterns in the three life stages examined. Furthermore, considering both the previously reported and newly predicted miRNAs, 25 conserved miRNAs families were identified in the E. granulosus genome. Comparing the presence or absence of these miRNA families with the free-living Schmidtea mediterranea, we found 13 conserved miRNAs are lost in E. granulosus, most of which are tissue-specific and involved in the development of ciliated cells, the gut and sensory organs. Finally, GO enrichment analysis of the differentially expressed miRNAs and their potential targets indicated that they may be involved in bi-directional development, nutrient metabolism and nervous system development in E. granulosus. CONCLUSIONS: This study has, for the first time, provided a comprehensive description of the different expression patterns of miRNAs in three distinct life cycle stages of E. granulosus. The analysis supports earlier suggestions that the loss of miRNAs in the Platyhelminths might be related to morphological simplification. These results may help in the exploration of the mechanism of interaction between this parasitic worm and its definitive and intermediate hosts, providing information that can be used to develop new interventions and therapeutics for the control of cystic echinococcosis.

The genome of the hydatid tapeworm Echinococcus granulosus.

Cystic echinococcosis (hydatid disease), caused by the tapeworm E. granulosus, is responsible for considerable human morbidity and mortality. This cosmopolitan disease is difficult to diagnose, treat and control. We present a draft genomic sequence for the worm comprising 151.6 Mb encoding 11,325 genes. Comparisons with the genome sequences from other taxa show that E. granulosus has acquired a spectrum of genes, including the EgAgB family, whose products are secreted by the parasite to interact and redirect host immune responses. We also find that genes in bile salt pathways may control the bidirectional development of E. granulosus, and sequence differences in the calcium channel subunit EgCavß1 may be associated with praziquantel sensitivity. Our study offers insights into host interaction, nutrient acquisition, strobilization, reproduction, immune evasion and maturation in the parasite and provides a platform to facilitate the development of new, effective treatments and interventions for echinococcosis control.

Solid lipid nanoparticle suspension enhanced the therapeutic efficacy of praziquantel against tapeworm.

Hydatid disease caused by tapeworm is an increasing public health and socioeconomic concern. In order to enhance the therapeutic efficacy of praziquantel (PZQ) against tapeworm, PZQ-loaded hydrogenated castor oil solid lipid nanoparticle (PZQ-HCO-SLN) suspension was prepared by a hot homogenization and ultrasonication method. The stability of the suspension at 4°C and room temperature was evaluated by the physicochemical characteristics of the nanoparticles and in-vitro release pattern of the suspension. Pharmacokinetics was studied after subcutaneous administration of the suspension in dogs. The therapeutic effect of the novel formulation was evaluated in dogs naturally infected with Echinococcus granulosus. The results showed that the drug recovery of the suspension was 97.59% ± 7.56%. Nanoparticle diameter, polydispersivity index, and zeta potential were 263.00 ± 11.15 nm, 0.34 ± 0.06, and -11.57 ± 1.12 mV, respectively and showed no significant changes after 4 months of storage at both 4°C and room temperature. The stored suspensions displayed similar in-vitro release patterns as that of the newly prepared one. SLNs increased the bioavailability of PZQ 5.67-fold and extended the mean residence time of the drug from 56.71 to 280.38 hours. Single subcutaneous administration of PZQ-HCO-SLN suspension obtained enhanced therapeutic efficacy against tapeworm in infected dogs. At the dose of 5 mg/kg, the stool-ova reduction and negative conversion rates and tapeworm removal rate of the suspension were 100%, while the native PZQ were 91.55%, 87.5%, and 66.7%. When the dose reduced to 0.5 mg/kg, the native drug showed no effect, but the suspension still got the same therapeutic efficacy as that of the 5 mg/kg native PZQ. These results demonstrate that the PZQ-HCO-SLN suspension is a promising formulation to enhance the therapeutic efficacy of PZQ.

A pilot study for control of hyperendemic cystic hydatid disease in China.

BACKGROUND: Cystic hydatid disease (CHD) is a global parasitic zoonosis caused by the dog tapeworm, Echinococcus granulosus. The disease is hyperendemic in western China because of poor economic development; limited community knowledge of CHD; widespread, small-scale household animal production; home killing of livestock; and the feeding of dogs with uncooked offal. METHODOLOGY/PRINCIPAL FINDINGS: A control program focusing on monthly praziquantel (PZQ) treatment of all registered dogs and culling unwanted and stray dogs has been designed to control CHD in hyperendemic areas in China. A pilot field control project in two counties (Hutubi and Wensu) in Xinjiang, China showed that after 4 years of treatment, the prevalence of dogs with E. granulosus was reduced from 14.7% and 18.6%, respectively, to 0%, and this caused a 90%-100% decrease of CHD in sheep born after commencement of the control program. CONCLUSIONS/SIGNIFICANCE: The strategy aimed at preventing eggs being released from dogs into the environment by treating animals before adult tapeworms are patent can decrease E. granulosus transmission and considerably reduce hyperendemic CHD. Monthly treatment of dogs with PZQ and culling unwanted and stray dogs have been shown to be an efficient, highly cost-effective and practicable measure for implementation in rural communities. As a result, the Chinese Ministry of Health has launched an extensive CHD control program in 117 counties in western China using this control strategy.