Therapeutic options for premature ovarian insufficiency: an updated review.

Primary ovarian insufficiency (POI) is a rare gynecological condition. This disease causes menstrual disturbances, infertility, and various health problems. Historically, hormone replacement therapy is the first-line treatment for this disorder. Women diagnosed with POI are left with limited therapeutic options. In order to remedy this situation, a new generation of therapeutic approaches, such as in vitro activation, mitochondrial activation technique, stem cell and exosomes therapy, biomaterials strategies, and platelet-rich plasma intra-ovarian infusion, is being developed. However, these emerging therapies are yet in the experimental stage and require precise design components to accelerate their conversion into clinical treatments. Thus, each medical practitioner bears responsibility for selecting suitable therapies for individual patients. In this article, we provide a timely analysis of the therapeutic strategies that are available for POI patients and discuss the prospects of POI therapy.

Exploration of animal models to study the life cycle of Fasciola hepatica.

The parasite Fasciola hepatica is an important zoonotic parasite. The development of an animal model of F. hepatica's life cycle is critical for studying the biological characteristics of the parasite in snails and mammals. Eggs of F. hepatica of bovine origin were cultured, and metacercariae were obtained after infection of Galba pervia snails. The life cycle system of F. hepatica was initiated in 2 different animals by orally infecting rabbits, SD rats and Kunming mice with the metacercariae. The animals' survival after infection, parasite migration in the animals and pathological damage to the liver were observed. We discovered that rabbits died due to acute suppurative hepatitis 60­69 days after infection, and eggs were found in the feces on day 63 of infection. The liver of SD rats showed punctate lesions on day 3 of infection, and further changes occurred as the infection progressed. However, liver repair was observed at week 9. SD rats survived for more than a year after infection and continued the F. hepatica life cycle. The liver lesions in Kunming mice after infection were similar but more severe than those in SD rats. Death was observed on the 31st post-infection day. We discovered that while rabbits, SD rats and Kunming mice can all be used as animal models of F. hepatica, SD rats are more suitable experimental animals in terms of tolerance and pathological response.

A new diagnostic technique for identifying Angiostrongylus spp. larvae in intermediate snail species by examining the buccal cavity.

BACKGROUND: Angiostrongyliasis is a zoonotic parasitic disease caused by the rat lungworm Angiostrongylus cantonensis. The intermediate hosts of A. cantonensis are gastropods, and snail species such as Pomacea canaliculata play a key role in the transmission of human angiostrongyliasis. Detecting A. cantonensis infection in snails is an important component of epidemiological surveillance and the control of angiostrongyliasis. METHODS: In this study, a new method for diagnosing A. cantonensis infection in gastropods was developed by recovering larvae from the buccal cavity of three snail species. The entire buccal cavity of a snail was extracted, and the tissue was pressed between two microscope slides to observe whether A. cantonensis larvae were present. Our new method was compared with traditional pathogenic detection methods of lung microscopy, tissue homogenization, and artificial digestion. We artificially infected 160 P. canaliculata, 160 Cipangopaludina chinensis, and 160 Bellamya aeruginosa snails with A. cantonensis. Then, the four different detection methods were used to diagnose infection in each snail species at 7, 14, 21, and 28 days post exposure. RESULTS: We found no significant difference in the percentages of infected P. canaliculata snails using the four methods to detect A. cantonensis larvae. The radula pressing method had a mean detection rate of 80%, while the lung microscopy (81.3%), tissue homogenization (83.8%), and artificial digestion (85%) methods had slightly greater detection rates. Similarly, the percentages of infected C. chinensis snails that were detected using the radula pressing (80%), tissue homogenization (82.1%), and artificial digestion (83.8%) methods were not significantly different. Finally, the percentages of infected B. aeruginosa snails that were detected using the radula pressing (81.3%), tissue homogenization (81.9%), and artificial digestion (81.4%) methods were not significantly different. These results showed that the radula pressing method had a similar detection rate to traditional lung microscopy, tissue homogenization, or artificial digestion methods. CONCLUSIONS: This study demonstrates a new method for the qualitative screening of gastropods that act as intermediate hosts of A. cantonensis (and other Angiostrongylus species), provides technical support for the control of human angiostrongyliasis, and furthers research on A. cantonensis.

Latest advances in the study of non-coding RNA-mediated circadian rhythm disorders causing endometrial cancer.

Endometrial cancer (EC) is one of the most common gynecological cancers, and its risk factors include obesity and metabolic, genetic, and other factors. Recently, the circadian rhythm has also been shown to be associated with EC, as the severity of EC was found to be related to night work and rhythm disorders. Therefore, circadian rhythm disorders (CRDs) may be one of the metabolic diseases underlying EC. Changes in the circadian rhythm are regulated by clock genes (CGs), which in turn are regulated by non-coding RNAs (ncRNAs). More importantly, the mechanism of EC caused by ncRNA-mediated CRDs is gradually being unraveled. Here, we review existing studies and reports and explore the relationship between EC, CRDs, and ncRNAs.

Effects of treatment with stem cell-derived extracellular vesicles in preclinical rodent models of intrauterine adhesion: A meta-analysis.

Background: Intrauterine adhesion (IUA) results from serious complications of intrauterine surgery or infection and mostly remains incurable. Small extracellular vesicles (sEVs) derived from mesenchymal stem cells (MSCs) have emerged as a potential new approach for the treatment of IUA; however, their impact is not fully understood. Here, we performed a meta-analysis summarizing the effects of sEVs on IUA in preclinical rodent models. Methods: This meta-analysis included searches of PubMed, EMBASE, Cochrane, and the Web of Science databases from January 1, 1997, to April 1, 2022, to identify studies reporting the therapeutic effect of sEVs on rodent preclinical animal models of IUA. We compared improvements in endometrial thickness, endometrial gland number, fibrosis area, embryo number, vascular endothelial growth factor (VEGF), transforming growth factor ß1 (TGFß1), and leukemia inhibitory factor (LIF) levels after treatment. Results: Our search included 100 citations, of which 7 met the inclusion criteria, representing 231 animals. Compared with that in the control group, the fibrosis area in the sEV-treated group was significantly reduced (standardized mean difference (SMD) = -6.87，95 % confidence interval (CI) = -9.67 to -4.07). The number of glands increased after the intervention (95 % CI, 3.72-7.68; P = 0.000). Endometrial thickness was significantly improved in the sEV-treated group (SMD = 2.57, 95 % CI, 1.62-3.52). Conclusions: This meta-analysis is highlighting that sEV treatment can improve the area of endometrial fibrosis, as well as VEGF, and LIF level, in a mouse IUA model. This knowledge of these findings will provide new insights into future preclinical research.

Melatonin enhances autologous adipose-derived stem cells to improve mouse ovarian function in relation to the SIRT6/NF-κB pathway.

BACKGROUND: Premature ovarian insufficiency (POI) is the main cause of female infertility. Adipose-derived stem cells (ADSCs) are ideal candidates for the treatment of POI. However, some deficient biological characteristics of ADSCs limit their utility. This study investigated whether melatonin (MLT)-pretreated autologous ADSCs were superior to ADSCs alone in the treatment of the POI mouse model. METHODS: Autologous ADSCs were isolated and cultured in MLT-containing medium. Surface markers of ADSCs were detected by flow cytometry. To determine the effect of MLT on ADSCs, CCK-8 assay was used to detect ADSCs proliferation and enzyme-linked immunosorbent assay (ELISA) was used to detect the secretion of cytokines. The POI model was established by intraperitoneal injection of cyclophosphamide and busulfan. Then, MLT-pretreated autologous ADSCs were transplanted into mice by intraovarian injection. After 7 days of treatment, ovarian morphology, follicle counts, and sex hormones levels were evaluated by hematoxylin and eosin (H&E) staining and ELISA, and the recovery of fertility was also observed. The expressions of SIRT6 and NF-κB were detected by immunohistochemical (IHC) staining and quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS: Flow cytometry showed that autologous ADSCs expressed CD90 (99.7%) and CD29 (97.5%). MLT can not only promote the proliferation of ADSCs but also boost their secretory function, especially when ADSCs were pretreated with 5 µM MLT for 3 days, improving the interference effect. After transplantation of autologous ADSCs pretreated with 5 µM MLT, the serum hormone levels and reproductive function were significantly recovered, and the mean counts of primordial follicle increased. At the same time, the expression of SIRT6 was remarkably increased and the expression of NF-κB was significantly decreased in this group. CONCLUSIONS: MLT enhances several effects of ADSCs in restoring hormone levels, mean primordial follicle counts, and reproductive capacity in POI mice. Meanwhile, our results suggest that the SIRT6/NF-κB signal pathway may be the potential therapeutic mechanism for ADSCs to treat POI.

Repair abilities of mouse autologous adipose-derived stem cells and ShakeGel™3D complex local injection with intrauterine adhesion by BMP7-Smad5 signaling pathway activation.

BACKGROUND: The objective was to explore the therapeutic effect of autologous adipose-derived stem cells (ADSCs) combined with ShakeGel™3D transplantation to activate the BMP7-Smad5 signaling pathway to treat intrauterine adhesions (IUA). METHODS: Autologous ADSCs were isolated and then merged with ShakeGel™3D. The IUA model was established by mechanical injury. The third generation of autologous ADSCs was injected directly into the uterus in combination with ShakeGel™3D. After 7 days of treatment, endometrial morphology, number of endometrial glands, endometrial fibrosis area, and fibrosis biomarker analysis by RT-PCR and IHC were examined. BMP7 and phosphorylation of Smad5 were also detected, and the recovery of infertility function in treated mice was evaluated. RESULTS: Fluorescence-activated cell sorting (FACS) showed that autologous ADSCs expressed CD105 (99.1%), CD29 (99.6%), and CD73 (98.9%). Autologous ADSCs could still maintain a good growth state in ShakeGel™3D. Histological examination revealed that the number of endometrial glands increased significantly, and the area of fibrosis decreased. At the same time, the expression of BMP7 and Smad5 in the ADSCs + Gel group was significantly upregulated, and the final reproductive function of this group was partly recovered. CONCLUSIONS: Autologous ADSCs can be used in combination with ShakeGel™3D to maintain functionality and create a viable three-dimensional growth environment. The combined transplantation of autologous ADSCs and ShakeGel™3D promotes the recovery of damaged endometrial tissue by increasing BMP7-Smad5 signal transduction, resulting in endometrium thickening, increased number of glands, and decreased fibrosis, leading to restoration of partial fertility.

Using Mesenchymal Stem Cells to Treat Female Infertility: An Update on Female Reproductive Diseases.

Female infertility impacts the quality of life and well-being of affected individuals and couples. Female reproductive diseases, such as primary ovarian insufficiency, polycystic ovary syndrome, endometriosis, fallopian tube obstruction, and Asherman syndrome, can induce infertility. In recent years, translational medicine has developed rapidly, and clinical researchers are focusing on the treatment of female infertility using novel approaches. Owing to the advantages of convenient samples, abundant sources, and avoidable ethical issues, mesenchymal stem cells (MSCs) can be applied widely in the clinic. This paper reviews recent advances in using four types of MSCs, bone marrow stromal cells, adipose-derived stem cells, menstrual blood mesenchymal stem cells, and umbilical cord mesenchymal stem cells. Each of these have been used for the treatment of ovarian and uterine diseases, and provide new approaches for the treatment of female infertility.

Helminth infections and risk factor analysis among residents in Eryuan county, Yunnan province, China.

Whilst infections with soil-transmitted helminths are common across China, the public-health significance of Schistosoma japonicum and food-borne helminths is more focalized. Only few studies have investigated the local epidemiology of helminth infections in rural China, including risk factor analysis. We collected stool and blood samples from 3220 individuals, aged 5-88 years, from 35 randomly selected villages in Eryuan county, Yunnan province, China. Stool samples were subjected to the Kato-Katz technique and examined for helminth eggs. Blood samples were tested for Trichinella spp., S. japonicum and cysticerci-specific antibodies. Data on individual and family-level risk factors were collected using questionnaires. The prevalence of Ascaris lumbricoides, Taenia spp., Trichuris trichiura and hookworms was 15.4%, 3.5%, 1.7% and 0.3%, respectively. The seroprevalence of Trichinella spp. was 58.8% and that of cysticercosis 18.5%. The egg positivity rate of S. japonicum in the 13 known endemic villages was 2.7%, and the corresponding seroprevalence was 49.5%. We observed a strong spatial heterogeneity in the families' economic status. S. japonicum infections were more prevalent among the Han than Bai nationality (odds ratio (OR)=3.77, 95% confidence interval (CI)=1.97-7.23) and tobacco growers (OR=3.66, 95% CI=1.77-7.60) and was only found at elevations below 2150 m above sea level. A. lumbricoides and Taenia spp. infections were more prevalent at altitudes above 2150 m when compared to lower settings (OR=1.51, 95% CI=1.24-1.84 and OR=5.32, 95% CI=3.42-8.28, respectively). The opposite was found for T. trichiura (OR=0.31, 95% CI=0.14-0.70). Our findings can guide the design and spatial targeting of control interventions against helminth infections in Eryuan county.

[Research of water contact and labor practice of residents in plateau mountain schistosomiasis endemic areas in Yunnan Province].

OBJECTIVE: To understand the status of water contact and labor practice of residents in plateau mountain schisto- somiasis endemic areas in Yunnan Province, so as to provide the evidence for formulating the strategy of prevention and control of schistosomiasis in the next step of work. METHODS: A total of 412 residents aged 6-65 years old in 2 villages were randomly sampled and investigated with questionnaires for their water contacts and labor practices in plateau valley schistosomiasis endem- ic areas. Then the schistosome infection status of the residents was surveyed with the indirect hemagglutination assay (IHA). RE- SULTS: Among the 412 residents investigated, the rate of water contact was 88.35%, and the main causes of water contact were watering, and swimming and playing. The percentages of residents who had schistosomiasis history were 1.16%, 0.00%, 30.80%, 3.85%, and 0 in them who had swimming and playing water-contacts, bathing, watering, washing hands, and others, respectively (χ2 = 38.96, P < 0.01). The positives of IHA in the above-mentioned residents were 18.60%, 0.00%, 37.60%, 23.08%, and 0, respectively (χ2 = 12.61, P < 0.05). CONCLUSIONS: The productive infested water contact is the main way of schistosome infection. Therefore, the changes of labor practices and water contact of the residents are very important for the ef- fective prevention and control of schistosomiasis transmission.

[Research of freely grazing and wild feces behaviors in schistosomiasis endemic areas of plateau mountain area in Yunnan Province].

OBJECTIVE: To understand the situation of the freely grazing and wild feces behaviors of residents in plateau mountain area of schistosomiasis endemic areas in Yunnan Province. METHODS: Two villages of Xidian and Moguang in Heqing County, Yunnan Province were selected as the study area and the questionnaire surveys were performed to the randomly selected villagers aged 6 to 65 years with the sampling ratio of 30%. Then the respondents were tested for the infection of schistosomiasis by indirect hemagglutination assay (IHA). RESULTS: Totally 412 residents were surveyed. In all the responds, the ratios of "captive breed", "freely grazing "unknown" and "no response" were 55.34%, 4.85%, 26.94% and 12.86% respectively; and the ratios of "no grazing", "less than 5/week" and "no less than 5/week" were 75.49%, 16.02% and 8.50% respectively; and the ratios of "no wild feces", "less than 5/week", "no less than 5/week" and "no answer" were 68.45%, 27.67%, 2.91% and 0.97% respectively. CONCLUSIONS: Freely grazing and wild feces behaviors of residents in schistosomiasis endemic area of Heqing County are widespread, could heavily affect the control of schistosomiasis in Heqing County. The further work is to strengthen the management of human and animal feces and grazing and consolidate the results of the prevention and control of schistosomiasis and finally achieve the aim of the transmission interruption.

[Effect of comprehensive schistosomiasis control measures based on infection source control in mountainous areas of Yunnan Province].

OBJECTIVE: To evaluate the effect of comprehensive schistosomiasis control measures based on infection source control in plateau mountain areas of Yunnan Province. METHODS: From 2006 to 2004, four administrative villages were selected as test areas from plateau canyon and plateau basin endemic areas in Jindun Town, Heqing County, two villages each type, and the comprehensive control measures were implemented, including the examination and treatment of schistosomiasis, Oncomelania hupensis snail survey and control, health education, improving drinking water and lavatories, banning grazing, constructing sanitary pen of livestock, replacing cattle with machine, etc. The schistosome infection state and snail status in 2006 were treated as the baseline information, and the effect of the comprehensive measures were evaluated. Results The infection rate of human in plateau canyon areas decreased from 4.94% in 2006 to 0.06% in 2014, and that of livestock decreased from 1.11% to 0. In plateau basin areas, there was only 1 case of schistosomiasis found in Xiaolian Village in 2007, and no any other cases found in the other years, the infection rates of livestock dropped from 7.38% to 0. Compared with 2006, the snail areas in the two type areas decreased by 74.89% and 75.30%, respectively, meanwhile, the percentage of snail area, the occurrence rate of frames with snails, as well as the average density of living snails also decreased, and no infected snails were found since 2008. Xidian and Xinzhuang villages in plateau canyon area reached the criteria of schistosomiasis transmission controlled in 2009, and Xiao-lian and Kangfu villages in plateau basin reached the criteria of transmission interrupted in 2014. CONCLUSIONS: The comprehensive schistosomiasis control measures based on infection source control can effectively control the endemic situation of schistosomiasis in plateau areas of Yunnan Province. In the future, we should pay an equal attention to the infection sources control and snail control to consolidate and amplify the achievement of schistosomiasis control.

Bcl-2 family members inhibit oxidative stress-induced programmed cell death in Saccharomyces cerevisiae.

Selected antiapoptotic genes were expressed in baker's yeast (Saccharomyces cerevisiae) to evaluate cytoprotective effects during oxidative stress. When exposed to treatments resulting in the generation of reactive oxygen species (ROS), including H(2)O(2), menadione, or heat shock, wild-type yeast died and exhibited apoptotic-like characteristics, consistent with previous studies. Yeast strains were generated expressing nematode ced-9, human bcl-2, or chicken bcl-xl genes. These transformants tolerated a range of oxidative stresses, did not display features associated with apoptosis, and remained viable under conditions that were lethal to wild-type yeast. Yeast strains expressing a mutant antiapoptotic gene (bcl-2 deltaalpha 5-6), known to be nonfunctional in mammalian cells, were unable to tolerate any of the ROS-generating insults. These data are the first report showing CED-9 has cytoprotective effects against oxidative stress, and add CED-9 to the list of Bcl-2 protein family members that modulate ROS-mediated programmed cell death. In addition, these data indicate that Bcl-2 family members protect wild-type yeast from physiological stresses. Taken together, these data support the concept of the broad evolutionary conservation and functional similarity of the apoptotic processes in eukaryotic organisms.

Spectral- and time-domain optical coherence tomography measurements of macular thickness in young myopic eyes.

PURPOSE: To evaluate the variation in macular retinal thickness and volume in young Chinese myopic patients using time-domain optical coherence tomography (Stratus TD-OCT) and spectral-domain optical coherence tomography (Cirrus HD-OCT). METHODS: Ninety-two eyes of 92 myopic subjects were recruited in this study. Based upon spherical equivalence (SE), subjects were divided into two groups: the low to moderate myopia group (-0.5 D ≤ SE < -6.0 D), and the high myopia group (SE ≥ -6.0 D). Stratus TD-OCT and Cirrus HD-OCT were used to compare macular retinal thickness and volume between the two groups. Bland-Altman analysis and Pearson correlation were used to measure agreement between the two OCT systems. RESULTS: Average macular retinal thickness and total macular volume measured by Cirrus HD-OCT and Stratus TD-OCT of the low to moderate myopia group were 283.52 ± 12.14 µm and 245.38 ± 8.55 µm, respectively, and 10.08 ± 0.37 mm3 and 6.85 ± 0.26 mm3, respectively, and the high myopia groups were 269.58 ± 10.72 µm and 235.65 ± 7.54 µm, respectively, and 9.71 ± 0.36 mm3 and 6.52 ± 0.25 mm3, respectively. The measurements of the two OCTs showed that macular retinal thickness of the parafovea was significantly lower in the high myopia group compared with the low to moderate myopia group, except at the fovea (all P-values less than 0.001, except at the fovea). Using the Bland-Altman method and Pearson correlation, measurements of macular thickness in nine macular retinal subfields and total macular volumes showed good agreement between the two OCTs in myopic eyes (all P-values less than 0.001), with better agreement in the low to moderate myopia group than in the high myopia group. CONCLUSIONS: The average macular retinal thickness of the fovea did not vary with myopia, while the total volume and retinal thickness of the parafovea were thinner with increasing myopia. There was good agreement between the two OCTs in myopic eyes in all macular subfields, and the Cirrus HD-OCT system provided thicker macular retinal thickness measurements than the Stratus TD-OCT system. VIRTUAL SLIDES: The virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1683223414107652.

The influence of corneal astigmatism on retinal nerve fiber layer thickness and optic nerve head parameter measurements by spectral-domain optical coherence tomography.

BACKGROUND: To evaluate the influence of corneal astigmatism (CA) on retinal nerve fiber layer (RNFL) thickness and optic nerve head(ONH) parameters measured with spectral-domain optical coherence tomography (OCT) in high myopes patients before refractive surgery. METHODS: Seventy eyes of 35 consecutive refractive surgery candidates were included in this study. The mean age of the subjects was 26.42 ± 6.95 years, the average CA was -1.17 diopters (D; SD 0.64; range -0.2 to-3.3D), All subjects in this study were WTR CA. 34 eyes were in the normal CA group with a mean CA was -0.67 ± 0.28D, 36 eyes were in the high CA group with an average CA of -1.65 ± 0.49D. All subjects underwent ophthalmic examination and imaging with the Cirrus HD OCT. RESULTS: No significant difference was noted in the average cup-to-disk ratio, vertical cup-to-disk ratio and cup volume (all P values > 0.05). Compared with the normal CA group, the high CA group had a larger disc area and rim area, thinner RNFL thickness in the temporal quadrant, and the superotemporal and inferotemporal peaks were farther to the temporal horizon (All P values < 0.05). There were no significant differences between the two groups in global average RNFL thickness, as well as superior, nasal and inferior quadrant RNFL thickness (all P values > 0.05). CONCLUSIONS: The degree of with-the-rule CA should be considered when interpreting ONH parameters and peripapillary RNFL thickness measured by the Cirrus HD OCT. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1148475676881895.

[Effect of comprehensive control and management of schistosomiasis at plateaus regions in Yunnan Province].

OBJECTIVE: To evaluate the effect of comprehensive control and management of schistosomiasis at plateaus regions in Yunnan Province. METHODS: Xiaolian and Kangfu villages at plateaus regions where schistosomiasis was endemic were selected as study areas from 2006 to 2011, the schistosomiasis comprehensive control measures were conducted, and these measures included the health education, chemotherapy, stool and water management, grazing forbidden, Oncomelania snail control, etc. combined with the infrastructure of farmland water conservancy, agricultural comprehensive development, adjustment of industry structure, returning farmland to forest, ditch hardening, and aquaculture. RESULTS: At Xiaolian Village, no schistosomiasis patient and livestock were found from 2008; and at Kangfu Village, no schistosomiasis patient was detected from 2006 and no schistosomiasis domestic animal was found from 2008. In 2011, the snail area, percent of frames with living snails, the number of snails, average concentration of living snails, and the highest concentration of living snails descended by 69.99%, 81.86%, 88.86%, 89.71%, 57.95% at Xiaolian Village, and descended by 27.65%, 1.11%, 94.71%, 92.16%, 88.00% at Kangfu Village, respectively, compared with those in 2006. The ratios of infected snail area to snail area were 68.91% in 2006 and 69.13% in 2007 at Xiaolian Village, and 61.73% in 2006 and 43.24% in 2007 at Kangfu Village. There were no infected snails from 2008 in the two villages. CONCLUSION: The comprehensive control and management measures can effectively control the schistosomiasis prevalence at plateaus regions.

[Investigation on outbreak of angiostrongyliasis cantonensis due to consumption of snail food in Dali City].

OBJECTIVE: To investigate the potential cause of an outbreak of eosinophilic meningitis in Dali City in March, 2011. METHODS: A retrospective investigation was performed among 18 consumers who had meal together. The clinical documents of inpatients were analyzed and the diagnoses were checked. The outpatients were investigated through a case survey. Pomacea snails on sale were examined for the infection status of Angiostrongylus cantonensis. RESULTS: Of 18 persons, 16 consumed Pomacea snail food and 9 were infected with an infection rate of 56.3%. The two persons who did not consumed snail food were not infected. Serum samples of seven patients were examined for antibody to Angiostrongylus cantonensis in peripheral blood and 3 were proved positive (42.9%). The snails consumed by the patients came from the market, and the surveillance data showed that the infection rate of Angiostrongylus cantonensis of Pomacea snails was 7.3%. CONCLUSION: According to the epidemiological survey, clinical manifestations, and laboratory examinations, the outbreak of eosinophilic meningitis is due to the consumption of Pomacea snails infected with Angiostrongylus cantonensis.

Human angiostrongyliasis outbreak in Dali, China.

BACKGROUND: Several angiostrongyliasis outbreaks have been reported in recent years but the disease continues to be neglected in public health circles. We describe an outbreak in Dali, southwest China in order to highlight some key problems for the control of this helminth infection. METHODOLOGY/PRINCIPAL FINDINGS: All available medical records of suspected angiostrongyliasis patients visiting hospitals in Dali in the period 1 October 2007-31 March 2008 were reviewed, and tentative diagnoses of varying strengths were reached according to given sets of criteria. Snails collected from local markets, restaurants and natural habitats were also screened for the presence of Angiostrongylus cantonensis. A total of 33 patients met criteria for infection, and 11 among them were classified as clinically confirmed. An additional eight patients were identified through a surveillance system put in operation in response to the outbreak. The epidemic lasted for 8 months with its peak in February 2008. Of the 33 patients, 97.0% complained of severe headache. 84.8% patients had high eosinophil cell counts either in the peripheral blood or in cerebrospinal fluid (CSF). Three-quarters of the patients were treated with a combination of albendazole and corticosteroids, resulting in significantly improved overall conditions. Twenty-two patients reported the consumption of raw or undercooked snails prior to the onset of the symptoms, and approximately 1.0% of the Pomacea canaliculata snails on sale were found to be infected with A. cantonensis. The snails were also found in certain habitats around Dali but no parasites were detected in these populations. CONCLUSIONS/SIGNIFICANCE: The import and sale of infected P. canaliculata is the likely trigger for this angiostrongyliasis outbreak. Awareness of angiostrongyliasis must be raised, and standardized diagnosis and treatment are needed in order to provide clinicians with a guide to address this disease. Health education campaigns could limit the risk, and a hospital-based surveillance system should be established in order to detect future outbreaks.

Spatial risk profiling of Schistosoma japonicum in Eryuan county, Yunnan province, China.

Bayesian spatial risk profiling holds promise to enhance our understanding of the epidemiology of parasitic diseases, and to target interventions in a cost-effective manner. Here, we present findings from a study using Bayesian variogram models to map and predict the seroprevalence of Schistosoma japonicum in Eryuan county, Yunnan province, China, including risk factor analysis. Questionnaire and serological data were obtained through a cross-sectional survey carried out in 35 randomly selected villages with 3,220 people enrolled. Remotely-sensed environmental data were derived from publicly available databases. Bivariate and non-spatial Bayesian multiple logistic regression models were used to identify associations between the local seroprevalence and demographic (i.e. age and sex), environmental (i.e. location of village, altitude, slope, land surface temperature and normalized difference vegetation index) and socio-economic factors. In the spatially-explicit Bayesian model, S. japonicum seroprevalence was significantly associated with sex, age and the location of the village. Males, those aged below 10 years and inhabitants of villages situated on steep slopes (inclination =20 degrees ) or on less precipitous slopes of >5 degrees above 2,150 m were at lower risk of seroconversion than their respective counterparts. Our final prediction model revealed an elevated risk for seroconversion in the plains of the eastern parts of Eryuan county. In conclusion, the prediction map can be utilized for spatial targeting of schistosomiasis control interventions in Eryuan county. Moreover, S. japonicum seroprevalence studies might offer a convenient means to assess the infection pressure experienced by local communities, and to improve risk profiling in areas where the prevalence and infection intensities have come down following repeated rounds of praziquantel administration.