A Multicentre Randomized Controlled Clinical Study of Cross Electro-Nape-Acupuncture (CENA) for the Treatment of Pseudobulbar Palsy in Patients with Tracheotomy Intubation for Severe Cerebral Haemorrhage.

Objective: The objective is to evaluate the clinical efficacy of cross electro-nape-acupuncture (CENA) in the treatment of pseudobulbar palsy in patients with tracheotomy intubation for severe cerebral haemorrhage and to provide an innovative acupuncture method for the treatment of such patients. Methods: A total of 126 patients from six trial centres who met the inclusion criteria were randomly divided into three groups according to the random number table method in the ratio of 1 : 1 : 1, with 42 patients in each group, and the three groups were divided into CENA group, electro-acupuncture group, and acupuncture group. Each group's acupuncture treatment lasted for 30 minutes, and the needles were removed at the end of the treatment. Acupuncture was performed once a week on Sunday only and twice a day from Monday to Saturday, a total of 4 weeks of treatment. The SWT, FDA, ChSWAL-QOL, and TCRGS scores of the three groups of patients before and after treatment were compared to evaluate the effect of CENA on remodelling the function of swallowing reflex and cough reflex and promoting the recovery of dysarthria and swallowing quality of life in pseudobulbar palsy in patients with tracheotomy intubation for severe cerebral haemorrhage. Results: After treatment, the WST and TCRGS grade scores decreased and the FDA and ChSWAL-QOL scores increased significantly in all three groups compared with the pretreatment scores and were statistically significant. There was a significant difference between the three groups for these four indicators after treatment; the comparison between groups showed significant differences in the CENA group compared to the electro-acupuncture and acupuncture groups. The efficiency of the CENA group was significantly better than that of the electro-acupuncture and acupuncture groups. Conclusion: Compared with the acupuncture and electro-acupuncture groups, the CENA could better promote the remodelling of swallowing function and cough reflex function, promote the recovery of dysarthria, and better improve the quality of life of patients with pseudobulbar palsy from tracheotomy intubation in severe cerebral haemorrhage.

A multidisciplinary, integrated approach for the elimination of schistosomiasis: a longitudinal study in a historically hyper-endemic region in the lower reaches of the Yangtze River, China from 2005 to 2014.

BACKGROUND: Although great success has been achieved, schistosomiasis remains a major public health concern in China, and the remaining core endemic regions are concentrated along the middle and lower reaches of the Yangtze River. In this longitudinal study, we evaluated the effectiveness of a multidisciplinary, integrated approach for schistosomiasis elimination in a historically hyper-endemic region in the lower reaches of the Yangtze River, China over the 10-year period from 2005 through 2014. METHODS: A three-step roadmap for schistosomiasis elimination was designed in the study site, and multidisciplinary, integrated interventions were implemented by the health, agriculture, water resources development, land and resources, and forestry sectors from 2005 to 2014, including chemotherapy for infected individuals, health education, management of the source of Schistosoma japonicum infection, and intermediate host snail control. The annual number of schistosomiasis patients, S. japonicum infection in humans, bovines and Oncomelania hupensis snails, and water infectivity were observed to assess the effectiveness of the multidisciplinary, integrated approach for the elimination of schistosomiasis. RESULTS: There was a tendency towards a gradual decline in both the number of schistosomiasis cases and the prevalence of S. japonicum human infection across the study period from 2005 through 2014. No S. japonicum human infection was detected since 2012, and no acute infection was seen since 2006. During the study period, no infection was found in bovines, and a 0.03% overall infection rate was observed in O. hupensis snails. Since 2009, no infected snails were identified, and the area of both snail habitats and infected snail habitats appeared a reduction over the study period. Following the 3-year multidisciplinary, integrated control, infection control was achieved, and transmission control was achieved after 6-year implementation, with all infected snails and water infectivity eliminated; in addition, the 10-year implementation resulted in interruption of schistosomiasis transmission in the study site in 2014. CONCLUSIONS: The results of the present 10-year longitudinal study demonstrate that the multidisciplinary, integrated approach is effective for the elimination of schistosomiasis as a public health problem in the lower reaches of the Yangtze River, China.

[Integration and demonstration of key techniques in surveillance and forecast of schistosomiasis in Jiangsu Province III Development of a machine simultaneously integrating mechanized environmental cleaning and automatic mollusciciding].

OBJECTIVE: To develop a machine simultaneously integrating mechanized environmental cleaning and automatic mollusciciding and to evaluate its effectiveness of field application, so as to provide a novel Oncomelania hupensis snail control technique in the large-scale marshlands. METHODS: The machine simultaneously integrating mechanized environmental cleaning and automatic mollusciciding, which was suitable for use in complex marshland areas, was developed according to the mechanization and automation principles, and was used for O. hupensis snail control in the marshland. The effect of the machine on environmental cleaning and plough was evaluated, and the distribution of living snails was observed at various soil layers following plough. The snail control effects of plough alone and plough followed by mollusciciding were compared. RESULTS: The machine could simultaneously complete the procedures of getting vegetation down and cut vegetation into pieces, plough and snail control by spraying niclosamide. After plough, the constituent ratios of living snails were 36.31%, 25.60%, 22.62% and 15.48% in the soil layers at depths of 0-5, 6-10, 11-15 cm and 16-20 cm respectively, and 61.91% living snails were found in the 0-10 cm soil layers. Seven and fifteen days after the experiment, the mortality rates of snails were 9.38% and 8.29% in the plough alone group, and 63.04% and 80.70% in the plough + mollusciciding group respectively (χ²7 d = 42.74, χ²15 d = 155.56, both P values < 0.01). Thirty days after the experiment, the densities of snails were 3.02 snails/0.1 m² and 0.53 snails/ 0.1 m² in the soil surface of the plough alone group and the plough + mollusciciding group, which decreased by 64.92% and 93.60%, respectively, and the decrease rate of snail density was approximately 30% higher in the plough + mollusciciding group than that in the plough alone group. CONCLUSIONS: The machine simultaneously integrating mechanized environmental cleaning and automatic mollusciciding achieves the integration of mechanical environmental cleaning and automatic niclosamide spraying in the complex marshland areas, which provides a novel technique of field snail control in the large-scale setting in China.

[Integration and demonstration of key techniques in the surveillance and forecast of schistosomiasis in Jiangsu Province II Molluscicidal effect of 5% niclosamide ethanolamine granules in large-scale settings].

OBJECTIVE: To evaluate the field molluscicidal effect of 5% niclosamide ethanolamine granules, so as to provide a novel Oncomelania hupensis snail control approach for emergency treatment of high-risk settings. METHODS: Snail control tests with spraying of 5% niclosamide ethanolamine granules were conducted in two settings of 2 counties, and the dose-, time- and setting-specific field molluscicidal effects were tested. RESULTS: In the small-scale setting, spraying of 5% niclosamide ethanolamine granules at doses of 30, 40 and 50 g/m2 resulted in 54.55%, 68.41% and 73.45% 1-day snail mortality, 57.27%, 68.59% and 80.28% 3-day snail mortality, and 63.49%, 77.58% and 85.55% 7-day snail mortality, respectively, and no significant differences were detected in 1- and 3-day snail mortality caused by spraying of 5% niclosamide ethanolamine granules at doses of 30 and 40 g/m2 (all P > 0.05), while significant difference was found in the 7-day snail mortality (χ2 = 4.549, P < 0.05). In addition, spraying of 5% niclosamide ethanolamine granules at doses of 40 and 50 g/m2 resulted in comparable 1-, 3- and 7-day snail mortality (all P > 0.05). In the large-scale setting, spraying of 5% niclosamide ethanolamine granules at a dose of 40 g/m2 resulted in 85.29% and 87.70% 3-day snail mortality, 83.89% and 91.02% 7-day snail mortality, and 83.41% and 91.84% 15-day snail mortality in the environment-cleaning group and non-cleaning group, respectively. The overall snail mortality was 90.02% in the environment-cleaning group 3 to 15 days after spraying, which was significantly higher than that (84.28%) in the non-cleaning group (χ2 = 9.950, P < 0.05). After 15 days of spraying with 5% niclosamide ethanolamine granules at a dose of 40 g/m2, the densities of living snails reduced from 19.90 and 19.83 snails/0.1 m2 to 0.60 and 2.60 snails/0.1 m2 in the environment-cleaning group and non-cleaning group, with 96.98% and 86.89% reductions, respectively. CONCLUSION: The appropriate dose of 5% niclosamide ethanolamine granules is 40 g/m2 for snail control in the field, and environment cleaning of vegetation with a height of more than 50 cm may improve the molluscicidal efficacy.

[Investigation on knowledge, attitude and practice (KAP) of college students on food-borne parasitic diseases].

OBJECTIVE: To understand the status of knowledge, attitude, practice (KAP) on food-borne parasitic diseases of college students, so as to provide the basis for the development of strategies on health education. METHODS: A total of 1,114 college students in Yangzhou Polytechnic College were selected through the randomly stratified cluster sampling method, and then were investigated by questionnaires to understand their KAP on food-borne parasitic diseases. RESULTS: The awareness rates on food-borne parasitic diseases and their harms were 42.2% and 41.7% respectively in these investigated students. The awareness rates of the students with different genders, ages, regions (in Jiangsu Province) and majors were significantly different (all P < 0.01), and those of the male, 17 to 19 years age group, being born in south Jiangsu and students with mechanical engineering major were relatively low. Except the 3 items namely not keeping pets at home (32.0%), cutting raw and cooked food separately (28.6%), and washing hands before meals (67.1%), the formation rates of health behaviors of the other 9 items were all ≥ 80.0%. In the formation rates of not eating drunken shrimps and crabs, not eating barbecued foods, not eating half-cooked food, not prefer seeking novelty, there were statistically significant differences among the students with different genders, ages, regions and majors (all P < 0.05), and the rates of the male, 21 to 23 years age group, being born in south Jiangsu and students with mechanical engineering were relatively low. The formation rate of right attitude of the students were ≥ 84.8%, and in the rates of right attitude on "would not eat the foods that might be infected with the food-borne parasites", "would suggest others not to eat the foods that might be infected with the food-borne parasites", and "would give up special preferences or bad habits", there were statistically significant differences among the students with different genders and majors (all P < 0.01), and the rates of the male and students with mechanical engineering major were relatively low. CONCLUSIONS: The awareness rate of food-borne parasitic diseases of college students is relatively low , while the formation rates of health behaviors and right attitude are relatively high. So, the targeted, differentiated health education should be taken to improve their awareness of disease prevention and self-protection.

[Evaluation of effect of prevention and control system for imported falciparum malaria in Hanjiang District].

OBJECTIVE: To analyze the current situation of the comprehensive prevention and control system for imported falciparum malaria in Hanjiang District and evaluate its effect. METHODS: According to the Management Scheme on Control of Imported Falciparum Malaria in Yangzhou City, the comprehensive prevention and control system for imported falciparum malaria was implemented, and the relevant malaria data were collected and analyzed statistically. The data included plasmodium blood test ratio of fever patients among exported labors and those returned, the ratio of laboratory-confirmed cases among all reported cases of falciparum malaria, the ratio of falciparum malaria patients who received the standard treatment within 24 hours after onset, etc from 2010 to 2012. RESULTS: After the implementation of the comprehensive prevention and control system, the confirmation ratio of falciparum malaria cases within 24 hours following first visit has reached 60.47%, the average time from first visit to confirmation has shortened to 1.8 d, and the average time from onset to confirmation has shortened to 3.7 d. The health education coverage ratio was 100%, the health knowledge awareness ratio was 95.56%, the ratio of patients seeking treatment on own initiative was 100%, the laboratory-confirmed ratio was 100%, and the ratio of standard treatment after malaria diagnosis was 100%. CONCLUSION: The comprehensive prevention and control system carried out by Hanjiang District has made remarkable achievements.

[Establishment and application of imported falciparum malaria control system in Yangzhou City].

To aim at the characteristics of epidemic situation that the imported falciparum malaria cases increased year by year in Yangzhou City, an imported falciparum malaria control system was established. This control system was based on enhancing the management of returned labor service export persons from falciparum malaria endemic areas, the active medical remind service, the diagnostic capability and health education, and the cooperation of medical personnel and patients, and also avoiding diagnosis delay and misdiagnosis and promoting the treatment in time so as to decrease the serious patients and prevent them from death. After the application of the control system, there were 164 imported falciparum malaria cases from the returned persons of labor service export. The time from the attack of the disease to the diagnosis confirmed decreased from 6.8 days before the application of the system to 2.7 days after the application, and the rate of serious patients was 1.8% and there were no death cases.

[Surveillance of schistosomiasis in Yanjiang Village, Hanjiang District, 2005-2010].

The endemic situation of schistosomiasis and Oncomelania snail status in Yanjiang Village, Hanjiang District decreased significantly from 2005 to 2010. However, the surveillance in key population such as fishmen and boatmen still needs to be strengthened.

[Study on surveillance and early-warning system of schistosomiasis in first phase of east route of South-to-North Water Diversion Project. III. Indexes of surveillance and early-warning and risk assessment].

OBJECTIVE: To establish the index system of surveillance and early-warning on schistosomiasis and to provide the scientific basis for risk assessment and emergency plan in first phase of east route of South-to-North Water Diversion Project. METHODS: The Delphi method and the multidimensional synthetic evaluation were used in the evaluation of indexes of surveillance and early-warning on schistosomiasis in the east route of the project. RESULTS: There were 53 indexes evaluated in the index system, and among them, there were 3 first grade indexes, 10 second grade indexes and 40 third grade indexes. The indexes on Oncomelania snails were the most important. According to the habitation position of snails, the four grades on surveillance and early-warning of schistosomiasis were established in the east route. The grade I of the early-warning meant that snails crossed the first level of the pumping station. The grade II meant that snails crossed N 32 degrees 54'. The grade III meant that snails crossed N 33 degrees 03' or Jinhu pumping station. The grade IV meant that snails crossed N 33 degrees 15' or Hongze Station. Other 4 indexes on schistosome infection in people and livestock were confirmed as indicative indexes. According to the relationship among the indexes, the evaluation methods were determined on the risk of schistosomiasis transmission. CONCLUSIONS: The index system of surveillance and early-warning and the methods of risk assessment of schistosomiasis have been confirmed in first phase of east route of South-to-North Water Diversion Project. The primary index is related to snails and the supplementary is related to schistosome infection in people and livestock in the system.