Construction of a surveillance and early warning index system for schistosomiasis transmission risk along the middle and lower reaches of the Yangtze River basin / 中国血吸虫病防治杂志

OBJECTIVE@#To establish a surveillance and early warning index system for schistosomiasis transmission risk along the middle and lower reaches of the Yangtze River basin, so as to provide insights into creation of a sensitive and highly efficient surveillance and early warning system for schistosomiasis.@*METHODS@#National and international publications, documents, laws and regulations pertaining to schistosomiasis control were retrieved with keywords including schistosomiasis, surveillance, early warning and control interventions from 2008 to 2022, and a thematic panel discussion was held to preliminarily construct surveillance and early warning index system for schistosomiasis transmission risk along the middle and lower reaches of the Yangtze River basin. The index system was then comprehensively scored and screened using the Delphi method, and the weight of each index was determined using analytic hierarchy process and the modified proportional allocation method. In addition, the credibility of the Delphi method was evaluated using positive coefficient, authority coefficient, degree of concentration and degree of coordination of experts.@*RESULTS@#Following two rounds of expert consultation, a surveillance and early warning index system for schistosomiasis transmission risk in endemic areas along the middle and lower reaches of the Yangtze River basin was preliminarily constructed, including 3 primary indicators, 9 secondary indicators and 41 tertiary indicators. The normalized weights of primary indicators epidemics, natural and social factors and comprehensive control were 0.639 8, 0.145 6 and 0.214 6, respectively, and among all secondary indicators, snail status (0.321 3) and schistosomiasis prevalence (0.318 5) had the highest combined weights, while social factors had the lowest combined weight (0.030 4). Of all tertiary indicators, human egg-positive rate (0.041 9), number of acute schistosomiasis cases (0.041 5), number of stool-positive bovine and sheep (0.041 1), and prevalence of Schistosoma japonicum in free-ranging livestock (0.041 1) had the highest combined weights. During two rounds of consultation, the positive coefficient of experts was both 100%, and the authority coefficient was both 0.9 and greater, while the coordination coefficients were 0.338 to 0.441 and 0.426 to 0.565 (χ2 = 22.875 to 216.524, both P values < 0.05).@*CONCLUSIONS@#The established surveillance and early warning index system for schistosomiasis transmission risk along the middle and lower reaches of the Yangtze River basin is of great scientific values and authority, which may provide insights into construction of the sensitive and highly efficient surveillance and early warning system for schistosomiasis in the context of low prevalence and low intensity of infection in China.

Discussion on implementation of public health standards adopted in centers for disease control and prevention / 中华流行病学杂志

As the most important phase in standardization activity, implementation saves as the essence. CDC in China are the major institutions undertaking disease control and prevention. Implementing the standards of public health provides technical basis for CDC to complete the task of disease control and prevention. In the study, spot conversation and questionnaire were used to investigate the implementation of standards on public health in CDC. Results showed that the staff of CDC got to know the standards through the Internet. The departments of CDC which conducted training and sent staff to attend training courses accounted for 50.00%(25/50) and 34.00%(17/50), respectively. State mandatory rule is still the main reason for relevant departments to implement the standards of the public health. Government promotion activities facilitate the implementation of Standards, and the degree of familiarity with Standards affects the implementation as well. The paper summarizes the existing problems, such as the lack of coordination between departments of public health at provincial level or below, lack of access to standards, and the need to strengthen the training of the standard implementation etc. It puts forward some suggestions to strengthen the implementation of public health Standards.

The clinical value of China Savin pollen extract used for skin prick test / 临床耳鼻咽喉头颈外科杂志

The aim of this study is to evaluate the effectiveness and safety of China Savin pollen extract which was used for skin prick test (SPT) in the diagnosis of China Savin pollen allergy. Patients with diagnosis of allergic diseases were collected from Allergy Department of Peking Union Medical College Hospital. All patients were given SPT with China Savin pollen extract, and the mean wheal diameter (MWD) was measured after 15 minutes. Receiver operating characteristic curve (ROC) analysis was performed based on the results of serum specific immunoglobulin E (sIgE). The effectiveness of SPT in the diagnosis of China Savin pollen allergy was evaluated under different diagnostic cutoff values. Adverse events were also recorded to evaluate the safety. A total of 1 029 patients were enrolled in this study without drop out case. There were 1 007 patients in full analysis set (FAS) and 765 patients in per protocol analysis set (PPS). The elimination rate was 25.66%. The area under the ROC curve of FAS is 0.814 (95%: 0.788-0.839); which of PPS is 0.829 (95%: 0.801-0.857). Based on the ROC curve of PPS, the optimal and the 95% specificity diagnostic cutoff values of MWD were 3.25 mm and 4.75 mm respectively. Based on different diagnostic cutoff value (3.00, 3.25 and 4.75 mm), the sensitivities of SPT with China Savin pollen extract were 0.740 0 (95%: 0.701 6-0.778 4), 0.700 (95%: 0.659 8-0.740 2) and 0.532 (95%: 0.488 3-0.575 7) respectively, whereas the specificity was gradually increased in sequence, which was 0.769 8 (95%: 0.719 1-0.820 5), 0.826 4 (95%: 0.780 8-0.872 0) and 0.950 9 (95%: 0.924 9-0.976 9) respectively. There were 7 adverse events observed among 6 patients (rate: 0.583%, 6/1 029). The manifestation was mild. There was no severe adverse event. SPT with China Savin pollen extract is an effective and safe tool for the diagnosis of China Savin pollen allergy. The effectiveness of diagnosis could be improved based on integration of medical history and different diagnostic threshold values of SPT.

Clinical effect of two targeted drugs in treatment of advanced hepatocellular carcinoma: A comparative analysis / 临床肝胆病杂志

ObjectiveTo investigate the clinical effect of the targeted drug sunitinib in the treatment of advanced hepatocellular carcinoma (HCC). MethodsA total of 48 patients with advanced HCC who were admitted to Chang′an Hospital form September 2015 to September 2016 were enrolled and divided into control group and observation group, with 24 patients in each group. The patients in the control group were given oral sorafenib, and those in the observation group were given oral sunitinib. The patients were followed up for 1 year, and the clinical outcome, improvement in clinical symptoms, and adverse events were recorded. The t-test was used for comparison of continuous data between groups, and the Mann-Whitney U test was used for comparison of categorical data between groups. ResultsThe disease control rate (DCR) in the observation group was 68.42% (13/19), and among these 13 patients, 4 achieved effective remission and 9 had stable disease; the DCR in the control group was 76.19%, and there was no significant difference in DCR between the two groups (P＞0.05). There was a significant difference in the incidence rate of hand-foot skin reaction between the observation group and the control group (0% vs 12.5%, U=31.07, P＜0.05). The observation group had a significantly higher incidence rate of neutropenia than the control group (25% vs 16.67%, U=29.87, P＜0.05). Both groups experienced digestive tract reactions (nausea and vomiting) and abnormal liver function; since the digestive tract reactions were tolerable, no special treatment was given, and the patients with abnormal liver function were given liver-protecting drugs, so all adverse events were effectively alleviated. ConclusionSunitinib has a good clinical effect in the treatment of advanced HCC, and further studies with a larger sample size are needed to investigate the long-term clinical effect of sunitinib and combined treatment.

Screening and analysis on the differentially expression genes between diploid and autotetraploid watermelon by using of digital gene expression profile

Abstract Synthetic polyploids are key breeding materials for watermelon. Compared with diploid watermelon, the tetraploid watermelon often exhibit wide phenotypic differences and differential gene expression. Digital gene expression (DGE) profile technique was performed in this study to present gene expression patterns in an autotetraploid and its progenitor diploid watermelon, and deferentially expressed genes (DEGs) related to the abiotic and biotic stress were also addressed. Altogether, 4,985 DEGs were obtained in the autotetraploid against its progenitor diploid, and 66.02% DEGs is up-regulated. GO analysis shows that these DEGs mainly distributed in metabolic process, cell and catalytic activity. KEGG analysis revealed that these DEGs mainly cover metabolic pathways, secondary metabolites and ribosome. Moreover, 134 tolerance related DEGs were identified which cover osmotic adjustment substance, protective enzymes/protein, signaling proteins and pathogenesis-related proteins. This study present the differential expression of stress related genes and global gene expression patterns at background level in autotetraploid watermelons. These new evidences could supplement the molecular theoretical basis for the better resistance after the genome doubling in the gourd family.

Resumo Poliploides sintéticos são materias fundamentais para melhoramento genético da melancia. Comparativamente ao seu homólogo diploide, a melancia tetraploide apresenta amplas diferenças genotípica e fenotípica e diferença de expressão gênica. A expressão gênica digital ou DGE (digital gene expression) foi utilizada neste estudo para representar o perfil de expressão gênica da melancia autotetraploide e seu progenitor diploide e a expressão diferencial de genes relacionados ao estresse biótico e abiótico. Os resultados mostraram que 4.985 DEGs foram observados no organismo autotetraploide, sendo que, deste total, 66.02%foram supra-regulados. A análise de ontologia gênica (GO) mostrou que estes DEGs estão relacionados principalmente com processos metabólicas, célula e atividade catalítica, abrangendo de acordo com a análise de genes e genoma (KEGG) rotas metabólicas, metabolismo secundário e ribossomos. Além disso, 134 genes de defesa foram identificados, abrangendo substâncias de ajuste osmótico, enzimas/proteínas de proteção, proteínas sinalizadoras e proteínas relacionadas à patogênese. Este estudo mostrou a expressão diferencial de genes relacionados ao estresse e o perfil global de expressão gênica de melancia autotetraploide, estes resultados podem complementar, a nível molecular, o entendimento do fator resistência após a duplicação do genoma em cucurbitáceas.

Progress and prospect of diagnosis and treatment of hepatic fibrosis by integrated traditional Chinese and Western medicine therapy / 临床肝胆病杂志

In recent years, non-invasive methods for assessment of hepatic fibrosis have attracted more and more attention, and the application of non-invasive diagnostic techniques such as serum markers and transient elastography (FibroScan) for hepatic fibrosis is reviewed. Anti-fibrosis treatments should integrate etiological treatment, anti-inflammatory and liver-protecting therapy, and inhibiting the synthesis of extracellular matrix and degrading excessively deposited extracellular matrix. Antiviral treatment is the basis for resisting hepatic fibrosis due to chronic viral hepatitis. In this aspect, traditional Chinese medicine (TCM) has advantages in inhibiting the synthesis of extracellular matrix and degrading excessively deposited extracellular matrix, because it effects on multiple links, at multiple levels, and against multiple targets. So integrated traditional Chinese and Western medicine therapy is a promising treatment strategy. However, the benefit of integrative therapy against hepatic fibrosis still needs to be supported by rigorously designed, multicenter, large-sample clinical studies, and the mechanism of anti-fibrosis TCM treatment deserves further studies.