Progress of schistosomiasis control in People’s Republic of China in 2021 / 中国血吸虫病防治杂志

This report presented the endemic status of schistosomiasis and analyzed the data collected from the national schistosomiasis prevention and control system and national schistosomiasis surveillance sites in the People’s Republic of China at a national level in 2021. Among the 12 provinces (municipality and autonomous region) endemic for schistosomiasis in China, Shanghai Municipality, Zhejiang Province, Fujian Province, Guangdong Province and Guangxi Zhuang Autonomous Region continued to consolidate the achievements of schistosomiasis elimination, and Sichuan and Jiangsu provinces maintained the criteria of transmission interruption, while Yunnan, Hubei, Anhui, Jiangxi and Hunan provinces maintained the criteria of transmission control by the end of 2021. A total of 451 counties (cites, districts) were found to be endemic for schistosomiasis in China in 2021, with 27 571 endemic villages covering 73 250 600 people at risk of infections. Among the 451 endemic counties (cities, districts), 75.17% (339/451), 22.17% (100/451) and 2.66% (12/451) achieved the criteria of elimination, transmission interruption and transmission control of schistosomiasis, respectively. By the end of 2021, 29 037 cases with advanced schistosomiasis were documented in China. In 2021, 4 405 056 individuals received serological tests and 72 937 were sero-positive. A total of 220 629 individuals received stool examinations and 3 were positive. In 2021, snail survey was performed in 19 291 endemic villages in China and Oncomelania snails were found in 7 026 villages, accounting for 36.42% of all surveyed villages, with 12 villages identified with emerging snail habitats. Snail survey was performed at an area of 686 574.46 hm2 and 191 159.91 hm2 snail habitats were found, including 1 063.08 hm2 emerging snail habitats and 5 113.87 hm2 reemerging snail habitats. In 2021, 525 878 bovines were raised in the schistosomiasis endemic areas of China, and 115 437 received serological examinations, with 231 positives detected. Among the 128 719 bovines received stool examinations, no positives were identified. In 2021, there were 19 927 schistosomiasis patients receiving praziquantel chemotherapy, and 729 113 person-time individuals and 256 913 herd-time bovines were given expanded chemotherapy. In 2021, snail control with chemicals was performed in 117 372.74 hm2 snail habitats, and the actual area of chemical treatment was 65 640.50 hm2, while environmental improvements were performed in snail habitats covering an area of 1 244.25 hm2. Data from the national schistosomiasis surveillance sites of China showed that the mean prevalence of Schistosoma japonicum infections were both zero in humans and bovines in 2021, and no S. japonicum infection was detected in snails. The results demonstrate that the overall endemic status of schistosomiasis remained at a low level in China in 2021; however, the progress towards schistosomiasis elimination was slowed and the areas of snail habitats rebounded mildly. Strengthening researches on snail diffusion and control, and improving schistosomiasis surveillance and forecast are recommended to prevent reemerging schistosomiasis.

Spatio-temporal distribution characteristics of Oncomelania hupensis in Anhui Province from 2011 to 2020 / 中国血吸虫病防治杂志

OBJECTIVE@#To analyze the spatial-temporal distribution characteristics of Oncomelania hupensis snails in Anhui Province from 2011 to 2020, to provide insights into precision control of O. hupensis snails in Anhui Province.@*METHODS@#O. hupensis snail distribution data were collected in Anhui Province from 2011 to 2020 and descriptively analyzed, including actual area of snail habitats, area of emerging snail habitats and area of Schistosoma japonicum-infected snails. The actual area of snail habitats and area of emerging snail habitats were subjected to spatial autocorrelation analysis, hotspot analysis, standard deviation ellipse analysis and space-time scanning analysis, and the clusters of snail distribution and settings at high risk of snail spread were identified in Anhui Province from 2011 to 2020.@*RESULTS@#The actual area of snail habitats gradually decreased in Anhui Province from 2011 to 2020. The actual area of snail habitats were 26 238.85 hm2 in Anhui Province in 2020, which were mainly distributed in marshland and lake regions. There was a large fluctuation in the area of emerging snail habitats in Anhui Province during the period from 2011 to 2020, with the largest area seen in 2016 (1 287.65 hm2), and 1.96 hm2 emerging infected snail habitats were detected in Guichi District, Chizhou City in 2020. Spatial autocorrelation and hotspot analyses showed spatial clusters in the distribution of actual areas of snail habitats in Anhui Province from 2011 to 2020 (Z = 3.00 to 3.43, all P values < 0.01), and the hotspots were mainly concentrated in the marshland and lake regions and distributed along the south side of the Yangtze River, while the cold spots were mainly concentrated in the mountainous regions of southern Anhui Province. There were no overall spatial clusters in the distribution of areas of emerging snail habitats (Z = -2.20 to 1.71, all P values > 0.05), and a scattered distribution was found in local regions. Standard deviation ellipse analysis showed relatively stable distributions of the actual areas of snail habitats in Anhui Province from 2011 to 2020, which was consistent with the flow direction of the Yangtze River, and the focus of the distribution of areas of emerging snail habitats shifted from the lower reaches to upper reaches of Anhui section of the Yangtze River. Space-time scanning analysis identified two high-value clusters in the distribution of actual areas of snail habitats in lower and middle reaches of Anhui section of the Yangtze River from 2011 to 2020, and two high-value clusters in the distribution of areas of emerging snail habitats were identified in mountainous and hilly regions.@*CONCLUSIONS@#There were spatial clusters in the distribution of O. hupensis snails in Anhui Province from 2011 to 2020, which appeared a tendency of aggregation towards the south side and upper reaches of the Yangtze River; however, the spread of O. hupensis snails could not be neglected in mountainous and hilly regions. Monitoring of emerging snail habitats should be reinforced in mountainous and hilly regions and along the Yangtze River basin.

Analysis of the new WHO guideline to accelerate the progress towards elimination of schistosomiasis in China / 中国血吸虫病防治杂志

On February 2022, WHO released the evidence-based guideline on control and elimination of human schistosomiasis, with aims to guide the elimination of schistosomiasis as a public health problem in disease-endemic countries by 2030 and promote the interruption of schistosomiasis transmission across the world. Based on the One Health concept, six evidence-based recommendations were proposed in this guideline. This article aims to analyze the feasibility of key aspects of this guideline in Chinese national schistosomiasis control program and illustrate the significance to guide the future actions for Chinese national schistosomiasis control program. Currently, the One Health concept has been embodied in the Chinese national schistosomiasis control program. Based on this new WHO guideline, the following recommendations are proposed for the national schistosomiasis control program of China: (1) improving the systematic framework building, facilitating the agreement of the cross-sectoral consensus, and building a high-level leadership group; (2) optimizing the current human and livestock treatments in the national schistosomiasis control program of China; (3) developing highly sensitive and specific diagnostics and the framework for verifying elimination of schistosomiasis; (4) accelerating the progress towards elimination of schistosomiasis and other parasitic diseases through integrating the national control programs for other parasitic diseases.

Clinical treatment outcomes and their changes in extremely preterm twins: a multicenter retrospective study in Guangdong Province, China / 中国当代儿科杂志

OBJECTIVES@#To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China.@*METHODS@#A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups.@*RESULTS@#Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05).@*CONCLUSIONS@#There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.

Salivary biochemical indices related to early childhood caries / 华西口腔医学杂志

OBJECTIVES@#This study aimed to compare the salivary biochemical indices between caries-free individuals and those with early childhood caries (ECC), and construct a saliva-based caries diagnostic model by analyzing the correlation between salivary biochemical indices and caries severity.@*METHODS@#A total of 120 children aged 4-6 years were selected and divided into two groups: individuals with ECC (C group, @*RESULTS@#The NO@*CONCLUSIONS@#Salivary biochemical indices can contribute to the diagnosis and risk assessment of ECC.

Tongqiao Huoxuetang Improves Neurological Deficits in CIRI Rats by Regulating Glu-Gln Circulation to Reduce Glutamate Excitotoxicity of Astrocytes / 中国实验方剂学杂志

Objective:To observe and compare the protective effects of Tongqiao Huoxue decoction （TQHX） prepared by three methods against cerebral ischemia-reperfusion injury （CIRI）， and to explore its mechanism through the glutamate （Glu） metabolic pathway in astrocytes. Method:The male SD rats of SPF grade were subjected to CIRI model induction by the modified middle cerebral artery occlusion method. The model rats were randomly divided into a model group， a sham operation group， and water-decocted， wine-decocted， and alcohol-extracted TQHX （6.3 g·kg^-1·d^-1） groups. The rats were treated correspondingly for 7 days. Those in the sham operation group and the model group were treated with an equal volume of normal saline by gavage. After the final treatment， the neurological function of rats was assessed by the modified neurological severity score （mNSS）. Hematoxylin-eosin （HE） staining was used to observe the morphological changes of ischemic brain tissues in rats. High-performance liquid chromatography （HPLC） was used to detect glutamate （Glu） in ischemic brain tissues. The expression of glutamate transporter-1 （GLT-1） and glial fibrillary acidic protein （GFAP） and co-expression of glutamine synthetase （GS） and GFAP in ischemic brain tissues were detected by immunofluorescence assay. Western blot was used to detect the protein expression of GFAP， GLT-1， and GS. Result:Compared with the sham operation group， the model group showed increased mNSS （<italic>P</italic><0.01）， large necrosis of cerebral cortex in ischemic brain tissues with disordered cell arrangement， obscure boundary， intracellular edema， and inflammatory infiltration， elevated Glu in ischemic brain tissues （<italic>P</italic><0.01）， declining GLT-1-GFAP co-expression and GS-GFAP co-expression （<italic>P</italic><0.01）， up-regulated expression of GFAP protein， and reduced protein expression of GLT-1 and GS（<italic>P<</italic>0.05，<italic>P<</italic>0.01）. Compared with the model group， the TQHX groups showed decreased mNSS （<italic>P<</italic>0.01）， relieved injury in the cerebral cortex and hippocampal nerve cells in ischemic brain tissues， reduced Glu expression（<italic>P<</italic>0.05，<italic>P<</italic>0.01）， elevated co-expression of GLT-1 and GFAP （<italic>P<</italic>0.05，<italic>P<</italic>0.01）， and up-regulated protein expression of GFAP and GLT-1（<italic>P<</italic>0.05，<italic>P<</italic>0.01）. The co-expression of GS and GFAP （<italic>P<</italic>0.05，<italic>P<</italic>0.01）and the expression of GS （<italic>P<</italic>0.01）were increased in the wine-decocted and alcohol-extracted TQHX groups. Compared with the water-decocted TQHX group， the alcohol-extracted group showed increased GLT-1-GFAP and GS-GFAP co-expression（<italic>P<</italic>0.05）； the wine-decocted and alcohol-extracted TQHX groups exhibited elevated GS protein expression （<italic>P<</italic>0.05）； the alcohol-extracted TQHX group displayed declining Glu content （<italic>P</italic><0.01） and increased protein expression of GFAP and GLT-1 （<italic>P<</italic>0.05， <italic>P<</italic>0.01）. Compared with the wine-decocted TQHX group， the alcohol-extracted TQHX group showed increased protein expression of GFAP and GLT-1（<italic>P<</italic>0.05，<italic>P<</italic>0.01）. Conclusion:TQHX prepared by three methods can improve neurological deficits in CIRI rats. The effect is presumedly achieved by promoting the further activation of astrocytes， increasing the expression of GLT-1 and GS， promoting the clearance of Glu accumulated in the synaptic cleft by astrocytes through the Glu-glutamine （Gln） circulation， and reducing the excitotoxicity of Glu. The alcohol-extracted TQHX group was superior to the water-decocted and wine-decocted TQHX groups in reducing the content of Glu in ischemic brain tissues， promoting the activation of astrocytes， and enhancing the protein expression of GLT-1 and GS.

Mortality analysis and time trend of prostate cancer in China from 2004 to 2008 / 上海预防医学

Objective:To obtain the temporal and spatial trends on prostate cancer mortality in China from 2004 to 2018. Methods:The data of prostate cancer mortality was collected from 605 national disease surveillance sites and age-standardized according to the demographic structure of China in 2000. The crude mortality rate （CMR） and age-standardized mortality rate （ASMR）， and the ratio of ASMRs of rural to urban areas（RR）， were calculated to analyze the distributions of the mortality of prostate cancer stratified by age， sex， region （rural/urban areas， eastern/central/western areas） or time. Results:The temporal trend on the CMR of prostate cancer from 2004 to 2018 increased significantly （APC=5.23%，P<0.001）， whereas the trend on the ASMR did not change （APC=0.65%，P=0.336）. The ASMR of urban areas was higher than that of rural areas（P<0.05）. The temporal trend on the ASMR of urban or rural did not change（P>0.05）. The same trend was detected for the RR value （P>0.05）. The ASMR of eastern urban areas was higher than that of the central or the western urban areas. The ASMR of eastern rural areas was higher than that of central and western areas. In the eastern areas， both the temporal trends for the ASMRs of the urban and the rural increased （The urban： APC=1.6%， P=0.015； the rural： APC=1.02%， P=0.013）. However， the RR values for the East， the Center or the West did not change. The ASMR of the people over 60 years old was higher than that of the people under 60 years old. However， the temporal trends on the ASMRs of the group under 60 years old or the group over 60 years did not change （P>0.05）. The ASMR of the people under 60 years old in 2018 was significantly lower than that in 2004（P=0.004）. Conclusion:A significant correlation exists between the death of prostate cancer and age. The mortality of prostate cancer in urban is higher than that in rural. The current screening strategy for prostate cancer has a limited impact on the prognosis of prostate cancer patients in China. Stratified refinement of prostate cancer screening strategies for people aged over 60 years in urban areas and the causal prophylaxis of prostate cancer are priorities for future prostate cancer prevention and control.

Comparison of lung cancer mortality between rural and urban areas in the mainland of China from 2004 to 2018 / 上海预防医学

Objective:To analyze the trend of mortality from lung cancer in urban and rural areas of Chinese mainland from 2004 to 2018. Methods:Cancer cases from 2004 to 2018 coded as C33-C34 according to the International Classification of Diseases-10th Revision （ICD-10） were collected from the Chinese national mortality surveillance system. The crude mortality rate （CMR）， age-standardized mortality （ASMR） and annual percentage change （APC） were calculated to analyze the mortality trend of lung cancer in rural and urban areas. Results:From 2004 to 2018， the CMR of lung cancer was 41.11/105， and the ASMR was 27.91/105， with no significant tendency of upward or downward. The CMR of lung cancer in urban areas was 46.03/105， and the ASMR was 30.33/105， with an APC of -0.82%. The CMR of lung cancer in rural areas was 38.54/105， and the ASMR was 26.66/105， with an APC of 1.73%. The difference between urban and rural CMR was significant. The CMR of lung cancer in urban eastern， central and western areas were 50.27/105， 44.59/105 and 40.64/105， respectively. The APC of eastern and central urban areas were -1.05% and -1.08%， respectively. The CMR of lung cancer in rural eastern， central and western areas were 45.82/105， 38.26/105 and 28.90/105， respectively， with an increasing trend. The CMR of lung cancer was significantly different between urban and rural areas of eastern， central and western areas of China. The CMR of lung cancer in urban males and females were 63.17/105 and 28.42/105， respectively. The CMR of lung cancer in rural males and females were 52.83/105 and 23.62/105， respectively. The ASMR of lung cancer in rural men and women increased by 1.18% and 1.09%， respectively. The ASMR of lung cancer in urban men and women decreased by 0.61% and 1.35%， respectively. The CMR of lung cancer between males and females in urban and rural was significantly different. The CMR rate of lung cancer increased with age， with the peak in the age group above 60 years old. The ASMR rate of lung cancer showed a decreasing trend in the group under 60 years old in both urban and rural areas. While in rural areas， the ASMR of lung cancer showed an increasing trend in the group over 60 years old. There were significant variations in lung cancer CMR between rural and urban areas in groups aged 0-19， 40-59， and over 60 years. Conclusion:The CMR of lung cancer in China is different between urban and rural areas from 2004 to 2018， which may be affected by smoking， ageing， industrialization and gender. Identifying high-risk populations， especially those in rural areas and providing early intervention can help to reduce the mortality rate of lung cancer.

Mortality and trend analysis of bladder cancer in China from 2004 to 2008 / 上海预防医学

Objective:To analyze bladder cancer mortality in China from 2004 to 2018. Methods:The dataset of bladder cancer mortality from 2004 to 2018， based on 605 national surveillance sites and regularly published by the Chinese Center for Disease Control and Prevention， was collected and age-standardized according to the demographic structure of China in 2000. The crude mortality rate （CMR）， the age-standard mortality rate （ASMR）， and the ratio of ASMRs of rural to urban areas（RR）were calculated to analyze the distributions of the mortality of bladder cancer stratified by age， sex， region （rural/urban areas， eastern/central/western areas） or time. Results:The CMR of bladder cancer in China from 2004 to 2018 was 1.69/105， and the ASMR was 1.09/105. The temporal trend on the CMR of bladder cancer from 2004 to 2018 increased significantly （APC=2.91%，P<0.001）， whereas the trend on the ASMR decreased a little （APC=-1.29，P=0.008）. The temporal trend on the CMR of bladder cancer in the males increased （APC=3.29%，P<0.001）， whereas the trend on the ASMR did not change. The temporal trend on the CMR of bladder cancer in the female increased （APC=2.12%，P<0.001）， whereas the trend on the ASMR decreased （APC=-1.94，P=0.008）. Both the CMR and ASMR of urban areas were higher than those of rural areas （P<0.05）. However， the temporal trend on the ASMR of bladder cancer in the urban decreased significantly （APC=-2.05%，P=0.002）， mainly exhibited in eastern and western urban. The ASMR of eastern urban areas was higher than that of western urban areas. The temporal trend on the ASMR of bladder cancer in the rural did not change （P>0.05）， and no differences in the ASMR were detected between eastern， central and western rural areas. The gaps between rural and urban areas in the eastern （P<0.001） or western （P=0.002） region reduced. Although the temporal trend on the ASMR in urban people over 40 years old decreased significantly， the ASMR of urban people over 60 years old was much higher than that of other age groups in the urban or any age groups in rural areas. Conclusion:The age group over 60 years old in the urban is the major target population for bladder cancer prevention and treatment. Screening， diagnosis and treatment for bladder cancer in rural should be strengthened.

Mortality analysis of primary liver cancer in the mainland of China from 2004 to 2018 / 上海预防医学

Objective:To determine the mortality and changing trend of primary liver cancer by using the death data of Chinese mainland from 2004 to 2018. Methods:The death certificate data was collected from China National Mortality Surveillance System from 2004 to 2018. The crude mortality rate（CMR）and age-standardized mortality rate（ASMR）of primary liver cancer in different ages， regions and living environments were calculated by Joinpoint regression model to analyze the basic situation and mortality trend. Results:From 2004 to 2018， there were 556 241 primary liver cancer deaths in China， with a CMR of 25.18/105 and an ASMR of 17.98/105. It suggested that the mortality of primary liver cancer was on a decreasing trend. During the 15 years， the ASMR of primary liver cancer was 15.56/105 in urban areas and 19.29/105 in rural areas. In urban areas， CMR was 32.89/105 in males and 12.14/105 in females， respectively； while in rural areas， CMR was 38.39/105 in males and 14.02/105 in females， respectively. The CMR in eastern， central and western urban regions was 22.25/105， 22.66/105 and 23.50/105， respectively. The CMR in the rural areas of these three regions was 27.82/105， 26.98/105 and 23.85/105， respectively. The patients were divided into four age groups： 0-19 years old， 20-39 years old， 40-59 years old， and more than 60 years old. The CMR of four groups in urban areas was 0.14/105， 2.59/105， 24.51/105 and 91.80/105. In rural areas， the CMR of four groups was 0.17/105， 4.05/105， 32.16/105 and 103.02/105. Conclusion:From 2004 to 2018， the mortality rate of liver cancer in China has a decreasing trend. However， the primary liver cancer death burden is still serious because of the large population base， severe aging population problem， and significant urban-rural and male-female disparities in China.

Progress of researches on the application of risk assessment models in assessment of the schistosomiasis transmission risk / 中国血吸虫病防治杂志

With the deepening of the schistosomiasis research, risk assessment models have been widely used in schistosomiasis research and control. This paper reviews the theoretical basis and applications of common schistosomiasis risk assessment models and the Bayesian model, so as to provide insights into national schistosomiasis elimination program in China.

Analysis on epidemiological characteristics of current advanced schistosomiasis cases in China based on the Epidemiological Dynamic Data Collection Platform (EDDC) / 中国血吸虫病防治杂志

Objective To investigate the epidemiological characteristics of current advanced schistosomiasis cases in China, so as to provide the scientific evidence for the precision management and medical care of advanced schistosomiasis. Methods The baseline data pertaining to the current advanced schistosomiasis cases in China were collected from the Epidemiological Dynamic Data Collection Platform (EDDC) operated by the Chinese Center for Disease Control and Prevention. The demographic characteristics, population and regional distribution and medical care of advanced schistosomiasis cases were analyzed with a descriptive method. Results A total of 31 889 cases with advanced schistosomiasis were reported in China by the end of June, 2019, and these cases were mainly identified in Hubei Province (7 737 cases) followed by in Jiangxi Province (7 256 cases), Hunan Province (5 615 cases), Anhui Province (5 236 cases) and Jiangsu Province (2 908 cases), accounting for 90.2% (28 752/31 889) of total cases in China. The current advanced schistosomiasis cases had a male/female ratio of 1.5∶1, and a mean age of (67.0 ± 11.2) years, with 92.6% (29 521/31 889) detected in individuals at ages of over 50 years. There were 97.6% (31 109/31 889) of the cases with an educational level of junior high school and lower, and 95.2% (30 359/31 889) with an occupation of farmers. Ascites (72.6%, 23 164/31 889) and splenomegaly types (26.3%, 8 386/31 889) were predominant in current advanced schistosomiasis cases in China, and there was a significant difference in the constituent ratio of disease types among current advanced schistosomiasis cases with different age groups (χ2 = 362.31, P < 0.01), with the ascites type as the predominant type of advanced schistosomiasis. Among the current advanced schistosomiasis cases, 88.9% (28 358/31 889) and 18.7% (5 973/31 889) had received medical treatment and surgical treatment, respectively. Conclusions The current advanced schistosomiasis cases are predominantly reported in five marshland and lake endemic provinces of China where schistosomiasis is not eliminated, and are mostly categorized as the ascites and megalosplenia types, with minor differences seen in gender and disease-type distributions. Precision medical care should be reinforced according to the epidemiological features of the current advanced schistosomiasis cases, and early screening and standard management and follow-up is required.

Endemic status of schistosomiasis in People’s Republic of China in 2020 / 中国血吸虫病防治杂志

This report presented the endemic status of schistosomiasis in the People’s Republic of China at a national level in 2020, and analyzed the data collected from the national schistosomiasis prevention and control system and national schistosomiasis surveillance sites. Among the 12 provinces (municipality and autonomous region) endemic for schistosomiasis in China, Shanghai Municipality, Zhejiang Province, Fujian Province, Guangdong Province and Guangxi Zhuang Autonomous Region continued to consolidate the achievements of schistosomiasis elimination, and Sichuan and Jiangsu provinces maintained the criteria of transmission interruption, while Yunnan, Hubei, Anhui, Jiangxi and Hunan provinces maintained the criteria of transmission control by the end of 2020. A total of 450 counties (cites, districts) were found to be endemic for schistosomiasis in China, with 28 376 endemic villages covering 71 370 400 people at risk of infections. Among the 450 endemic counties (cities, districts), 74.89% (337/450), 21.87% (98/450) and 3.33% (15/450) achieved the criteria of elimination, transmission interruption and transmission control of schistosomiasis, respectively. By the end of 2020, 29 517 cases with advanced schistosomiasis were documented in China. In 2020, 11 117 655 individuals received inquiry examinations and 1 798 580 were positive; 5 263 082 individuals received serological tests and 83 179 were sero-positive. A total of 273 712 individuals received stool examinations and 3 were positive, including one case of acute schistosomiasis. In 2020, snail survey was performed in 19 733 endemic villages in China and Oncomelania snails were found in 7 309 villages, accounting for 37.04% of all surveyed villages, with 15 villages identified with emerging snail habitats. Snail survey covered an area of 736 984.13 hm2 and 206 125.22 hm2 snail habitats were found, including 1 174.67 hm2 emerging snail habitats and 1.96 hm2 habitats with infected snails. In 2020, 544 424 bovines were raised in the schistosomiasis-endemic areas of China, and 147 887 received serological examinations, with 326 positives detected, while 130 673 bovines received stool examinations, with no positives identified. In 2020, there were 19 214 patients with schistosomiasis receiving praziquantel chemotherapy, and 964 103 person-time individuals and 266 280 herd-time bovines were given expanded chemotherapy. In 2020, molluscicide treatment was performed in 136 141.92 hm2 snail habitats, and the actual area of chemical treatment was 71 980.22 hm2, while environmental improvements were performed in snail habitats covering an area of 1 464.03 hm2. Data from the national schistosomiasis surveillance sites of China showed that the mean prevalence of Schistosoma japonicum infections were both zero in humans and bovines in 2020, and no S. japonicum infection was detected in snails. The results demonstrate that the overall endemic status of schistosomiasis remains at a low level in China and the goal of the National Thirteenth Five-Year Plan for Schistosomiasis Control was achieved as scheduled; however, the endemic situation of schistosomiasis rebounded in local areas. Precision schistosomiasis control and intensified monitoring of the endemic situation and transmission risk of schistosomiasis are required to be performed to facilitate the progress towards elimination of schistosomiasis steadily.

Endemic status of schistosomiasis in People’s Republic of China in 2019 / 中国血吸虫病防治杂志

This report presented the endemic status of schistosomiasis in the People’s Republic of China at a national level in 2019, and analyzed the data collected from the national schistosomiasis prevention and control system and 455 national schistosomiasis surveillance sites. Among the 12 provinces (municipality and autonomous region) endemic for schistosomiasis in China, Shanghai, Zhejiang, Fujian, Guangdong and Guangxi continued to consolidate the achievements of schistosomiasis elimination, Sichuan Province achieved transmission interruption, Jiangsu newly achieved the standard of transmission interruption and 5 provinces of Yunnan, Hubei, Anhui, Jiangxi and Hunan maintained transmission control by the end of 2019. There were 450 endemic counties (cities, districts) endemic for schistosomiasis, including 28 500 endemic villages covering 70 667 800 people at risk of infections. Among the 450 endemic counties (citis, districts), 66.89% (301/450), 28.44% (128/450) and 4.67% (21/450) kept the criteria of elimination, transmission interruption and transmission control of schistosomiasis, respectively. By the end of 2019, a total of 30 170 advanced schistosomiasis cases were documented in China. In 2019, a total of 12 090 712 individuals received inquiry examinations and 1 740 764 were positive; 5 158 369 individuals received serological tests and 89 753 were seropositive. A total of 327 475 individuals received stool examinations and 5 were positive, including one case of acute schistosomiasis. In 2019, snail survey was performed in 19 726 endemic villages in China and Oncomelania snails were found in 7 322 villages, accounting for 37.12% of all surveyed villages, with 6 villages with emerging snail habitats. Snail survey covered an area of 585 286.24 hm2 and 174 270.42 hm2 snail habitats were found, including emerging snail habitats of 64.20 hm2; however, no infected snails were identified. In 2019, a total of 605 965 bovines were raised in the schistosomiasis endemic areas of China, and 183 313 received serological examinations, with 1 176 positives detected, while 134 978 bovines received stool examinations, with 7 positives identified. In 2019, there were 28 557 patients with schistosomiasis receiving praziquantel chemotherapy, and expanded chemotherapy was given to 1 008 083 person-times; there were 7 bovines with schistosomiasis receiving praziquantel chemotherapy, and 296 053 herd-times expanded chemotherapy was given to bovines. In 2019, snail habitats at an area of 128 754.26 hm2 were given chemical treatment, and the actual area of chemical treatment was 69 605.55 hm2, while environmental improvements were performed in snail habitats covering an area of 2 847.00 hm2. Data from the 455 national schistosomiasis surveillance sites of China showed that the mean Schistosoma japonicum infection rates were both zero in humans and bovines in 2019, and no infected snails were found. The results demonstrate that the overall endemic situation of schistosomiasis remains at a lower infection level in China; however, there is still a risk of schistosomiasis transmission. To achieve the target set in the National Thirteenth Five-Year Plan for Schistosomiasis Control and consolidate the achievements of schistosomiasis control, precision control on schistosomiasis still needs to be reinforced in China.

Challenges of schistosomiasis control in China during the coronavirus disease 2019 (COVID-19) epidemic / 中国血吸虫病防治杂志

Objective To investigate the implementation of schistosomiasis control activities in China during the coronavirus disease 2019 (COVID-19) epidemic, so as to evaluate the impact of COVID-19 epidemic on the national schistosomiasis control program in China. Methods On April 2020, 3 counties (districts) were randomly selected from each of the 12 schistosomiasis-endemic provinces (municipality, autonomous region), and a questionnaire survey was conducted to investigate the implementation of schistosomiasis control activities in these counties (districts) from January to March 2020. Then, the impact of the COVID-19 epidemics on the national schistosomiasis control program of China was evaluated using a comparative analysis approach. Results Among the 36 counties (cities, districts) sampled from 12 provinces (municipality, autonomous region), 66.67% were at a high and medium risk of COVID-19 epidemics. The implementation of schistosomiasis control activities assignment, human schistosomiasis examination and treatment, snail control with chemical treatment and health education reduced by 44.26% to 91.56% as compared to 2019 during the same time period, and the schistosomiasis control program was more affected by COVID-19 in transmission-controlled provinces. The gross funds invested into the schistosomiasis control program reduced by 23.39% in relative to the expected, while the total expenditure increased by 41.22%. In addition, all 36 surveyed counties (districts) considered that the COVID-19 epidemic had a short-term impact on the schistosomiasis control program, with the most predominant impact on schistosomiasis control activities assignment, human resources and monitoring of endemic situation of schistosomiasis. Conclusions The COVID-19 epidemics affect the routine schistosomiasis control program across the endemic-foci of China. Policy and financial support should be strengthened to ensure the completion of the schistosomiasis control program.

Assessment of schistosomiasis transmission risk along the Yangtze River basin after the flood disaster in 2020 / 中国血吸虫病防治杂志

Objective To evaluate the impact of the flood disaster on schistosomiasis transmission along the Yangtze River basin in 2020, so as to provide insights into schistosomiasis prevention and control in flood-affected areas. Methods The data pertaining to the endemic situation of schistosomiasis were collected from 5 provinces of Hunan, Hubei, Jiangxi, Anhui and Jiangsu from 2013 to 2019, including Schistosoma japonicum infections in humans and livestock and snail distribution, and the warning water levels and actual water status were collected in water regions locating in these 5 provinces. The cumulative numbers of S. japonicum egg-positive individuals and bovines during the period from 2013 to 2019, the area of snail habitats in 2019 and the water level on July 12, 2020 were estimated at a county level and employed as parameters for classification of schistosomiasis transmission risk. Then, the cumulative value of each risk index was calculated to assess the risk of schistosomiasis transmission risk. Results After the flood disaster along the Yangtze River basin in 2020, there were 10, 5 and 9 counties (districts) at high risk of schistosomiasis transmission in 5 provinces of Hunan, Hubei, Jiangxi, Anhui and Jiangsu based on number of egg-positive individuals, number of egg-positive bovines and snail distribution, respectively. Based on comprehensive risk indices, there were 10 (8 in Dongting Lake regions of Hunan Province and 2 in Poyang Lake regions of Jiangxi Province) and 15 counties (districts) (4 in Hubei Province, 7 in Hunan Province and 4 in Jiangxi Province) identified at grades 5 and 4 risk of schistosomiasis transmission. Conclusions Dongting Lake regions and Poyang Lake regions are the most severely flood-affected schistosomiasis-endemic foci of China in 2020, and the flood disaster may facilitate the transmission of schistosomiasis in affected areas. Therefore, schistosomiasis control requires to be intensified after the flood disaster to prevent the rebound of the disease.

Clinical Analysis of 66 Patients with Essential Thrombocytopenia / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical characteristics of essential thrombocytopenia (ET) patients with positive mutations including JAK2, CALR, MPL, or negative mutations.@*METHODS@#A total of 66 newly diagnosed ET cases from January 2016 to December 2018 in Department of Hematology, Huaian No.1 People's Hospital affiliated to Nanjing Medical University were analyzed. Statistical analysis data included the patient's sex, age, symptoms, thrombosis and embolism events, spleen omegaly, platelet count (Plt), leukocyte (WBC) count, hemoglobin (Hb), fibrinogen (FIB), thrombus elastic diagram (TEG), serum potassium, blood glucose (GLU), lactate dehydrogenase (LDH), JAK2, CALR and MPL mutations, treatment options, and efficacy.@*RESULTS@#All the patients were not MPL-positive, and divided in three groups: JAK2 mutation (46 cases, 69.7%), CALR mutation (9 cases, 13.6%) and gene negative mutation (11 cases, 16.7%) group. The average age of patients in the JAK2 mutation group was 63.2 years old, and significantly higher than that in the CALR mutation group (51.8 year) and gene negative group (50.2 year) (P＜0.05). Compared with the JAK2 mutation group and gene negative group, the CALR mutation group had lower WBC count (6.3×10/L vs 13.79×10/L) (P=0.003) (6.3×10/L vs 9.70×10/L) (P=0.009). Also the Hb level of patients in CALR mutation group was lower than the JAK2 mutation group (121.22 g/L vs 136.2 g/L) (P=0.036). However, there was higher tumor burden in the CALR mutation group, compared with the gene negative mutation group (300.11 U/L vs 227.4 U/L) (P=0. 033). There was no significant difference among the three groups, such as the Plt counts, serum potassium level, GLU level and FIB level (P＞0.05). In addition, thrombus and embolism appeared in 30.3% (20/66) cases. 18.2% (12/66) cases were complicated with hyperkalemia, which significantly correlated with Plt counts (r=0.518). TEG was performed in 34 patients, of which 41.2% (14/34) had abnormal TEG and 55.9% (19/34) were accompanied by Plt count ＞ 1 000 ×10/L, but there was no significant correlation between them (r=0.134). After routine clinical treatment, all the 66 cases achieved partial or complete hematological remission, but the disease usually repeated. Until now 4.5% (3/66) cases had been converted to myelofibrosis (MF) all with JAK2 mutation, but without advancing to acute myeloid leukemia.@*CONCLUSION@#ET patients with JAK2 mutation have higher incidence, moreover were in older age. However, the patients with CALR mutations display lower WBC count and Hb level, but higher tumor burden. In short, the multiple gene mutations of ET showed different clinical features closely relates with the prognosis, thus providing guidance for the clinical diagnosis and treatment.

Effect of Gualou Xiebai Banxiatang on Expression of Gal-3 in Rats After Myocardial Infarction / 中国实验方剂学杂志

Objective:To observe the effect of Gualou Xiebai Banxiatang（GXBT） on cardiac function and myocardial fibrosis in rats after myocardial infarction. Method:The 36 male SD rats were randomly divided into blank group, sham group and surgical group, and 6 males in blank group and sham operation group. The model of phlegm obstruction in myocardial infarction of rats was replicated by ligation of left anterior descending coronary artery and high fat diet, and the successful rats were randomly divided into 3 groups: model group, GXBT group and acertil group. In the sham group, only the threading was not ligated. The blank group and the sham group and the model group were given 10 mL·kg-1·d-1 of normal saline, and 2.68 g·kg-1·d-1 of the GXBT group were given intragastric administration，and 0.36 mg·kg-1·d-1 was given intragastrically in acertil group. After 4 weeks of model, the heart function was detected by heart ultrasound to verify the success of the model. After 8 weeks, the heart function of the heart of the rat was detected by heart ultrasound again, and then the samples were sacrificed. The pathological changes of the myocardial cells of the rats were observed with hematoxylin-eosin(HE) staining， and the degree of myocardial fibrosis in the rats was observed by Masson staining. The changes of serum B-type natriuretic peptide (BNP) and galectin-3 (Gal-3) in rat serum were detected by enzyme-linked immunosorbent assay（ELISA） method, and the expression of Gal-3, Collagen Ⅰ (Col-Ⅰ) and Collagen Ⅲ (Col-Ⅲ) was detected by Western blot. Result:Compared with blank group and sham group, the left ventricular ejection fraction (EF) and short-axis shortening rate (FS) of model group were significantly decreased (P<0.01)， the infiltration of inflammatory cells, the increase of the myocardial collagen fibers, the contents of BNP and Gal-3 in the serum were increased (P<0.05). The expression of Gal-3,Col-Ⅰ and Col-Ⅲ in the myocardial tissue increased significantly (P<0.01). Compared with the model group, EF and FS of GXPD were significantly increased (P<0.05), the morphological structure of myocardial cells was improved, the collagen fiber was decreased. The expression of BNP and Gal-3 in serum decreased significantly (P<0.05), and the content of Gal-3, Col-Ⅰ and Col-Ⅲ in myocardial tissue was decreased (P<0.05). Conclusion:Gualou Xiebai Banxiatang can improve cardiac function, reduce myocardial fibrosis and slow down the process of heart failure after myocardial infarction in rats with myocardial infarction. Its mechanism may be related to the decrease of Gal-3 expression.

Significance of Targeted Sequencing Assay for Patients with Suspected Myeloid Malignancies / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical significance of the targeted next-generation sequencing assay for patients with suspected myeloid malignancies.@*METHODS@#A total of 39 hematopenia patients with suspected myeloid malignamies in Department of Hematology of The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from January 2018 to April 2019 were treated, 20 hot spot genes of myelodysplastic syndrome (MDS) were detected.@*RESULTS@#Regarding the diagnostic type, there were 7 cases of idiopathic cytopenia of undetermined significance (ICUS), 8 cases of clonal cytopenias of undetermined significance (CCUS) and 24 cases of myeloid myeloid malignancies which included 18 cases of MDS, 4 cases of myelodysplastic/myeloproliferative neoplasms (MDS/MPN) and 2 cases of acute myeloid leukemia. Positive mutation was detected in 70.8% (17/24) of myeloid malignancy patients , and 72.7% (16/22) in MDS and MDS/MPN patients. The main mutation types were ASXL1, TET2 and RUNX1. Compared with gene negative group, there were no significant differences in sex, age (＜60 years old or ≥60 years old), proportion of bone marrow blast cells (＜5% or≥5%) and cytogenetics (good, medium and poor) (P＞0.05). Furthermore, all 8 CCUS patients showed positive mutation, and the incidence of double or multiple mutation in CCUS group was significantly lower than that of the MDS and MDS/MPN group (37.5% vs 54.5%) (P=0.002). The mutation types between the two groups were similar, and there was no significant difference in variant allele frequency (P＞0.05).@*CONCLUSION@#Our results suggest that there are high rates of double or multiple mutations in myeloid malignancies, especially in patients with MDS and MDS/MPN. Targeted sequencing assay can improve the diagnosis of myeloid malignancies, and guide clinical treatment.

Diagnostic value of nucleic acid detection in schistosomiasis japonica: a meta-analysis / 中国血吸虫病防治杂志

Objective To quantitatively evaluate the diagnostic value of variable-temperature and isothermal nucleic acid amplification techniques in the detection of schistosomiasis japonica using a meta-analysis. Methods The publications pertaining to the nucleic acid detection of schistosomiasis japonica were searched in electronic databases, including Chinese National Knowledge Infrastructure (CNKI), Wanfang Data, PubMed and ScienceDirect, and the compilations and proceedings of schistosomiasis were manually searched. In addition, the citations of publications associated with the nucleic acid detection of schistosomiasis japonica were traced using a document tracing method. The retrieved literatures were screened according to the inclusion and exclusion criteria, and data were extracted from the included literatures. The quality of the included literatures was assessed using the software RevMan version 5.3, and a meta-analysis was performed using the software MetaDiSc version 1.4. Results A total of 19 publications covering 24 groups of studies were enrolled, including 5 Chinese publications and 14 English publications. There were 17 groups of studies reporting the comparison between the variable-temperature nucleic acid amplification technique and the golden standard, and 7 groups of studies showing the comparison between the isothermal nucleic acid amplification technique and the golden standard. Assessment of the literature quality indicated a minor overall bias of the included literatures, and the Deek funnel plot showed a possible publication bias in the documents reports variable-temperature nucleic acid amplification techniques. There was a heterogeneity caused by non-threshold effect among the studies associated with the variable-temperature amplification technique, and the random effects model was therefore used to combine the effects. The pooled sensitivity and specificity of the variable-temperature amplification technique were 0.81 (0.79 to 0.83) and 0.73 (0.71 to 0.74) for the diagnosis of schistosomiasis japonica, and area under the SROC curve was 0.944 3. There was no heterogeneity among the studies associated with the isothermal amplification technique, and the fixed effects model was therefore used to combine the effects. The pooled sensitivity and specificity of the isothermal amplification technique were 0.96 (0.94 to 0.98) and 0.95 (0.94 to 0.97) for the diagnosis of schistosomiasis japonica, and area under the SROC curve was 0.989 9. Conclusions Both variable-temperature and isothermal nucleic acid amplification techniques have a high efficiency for the diagnosis of schistosomiasis japonica, and the isothermal amplification technique shows a relatively higher accuracy than the variable-temperature amplification technique.