Evaluation of combined epiretinal membrane removal with intravitreal triamcinolone injection utilizing ectopic inner foveal layer staging scheme.

OBJECTIVE: To investigate the macular morphological and visual outcomes of combined idiopathic epiretinal membrane (iERM) removal with triamcinolone acetonide (TA) injection based on consideration of the ectopic inner foveal layer (EIFL) staging scheme. METHODS: Retrospective case-control study. The clinical data of 84 eyes of 84 patients who underwent vitrectomy for iERM between 2018 and 2022 were reviewed. The enrolled subjects were divided into the TA and non-TA groups. Fifty-one eyes received intravitreal TA injection following vitrectomy and ERM peeling (TA group), and 33 were only treated by standard vitrectomy and ERM peeling (non-TA group). Preoperative and postoperative EIFL stages, central foveal thickness (CFT), and best-corrected visual acuity (BCVA) were compared between both groups. RESULTS: After a mean follow-up of 7.69 ± 3.68 months, both groups exhibited significant improvement in EIFL stages (P < 0.01), with no discernible advantage observed in the TA group. The TA and non-TA groups demonstrated improvement in the EIFL stages in 56.86 and 63.64% of eyes, respectively (P = 0.43). The CFT and BCVA significantly improved in both groups at the final visit (P < 0.01). However, CFT in the non-TA group displayed a more significant reduction during the follow-up (P < 0.03). Subgroup analysis revealed no significant differences in postoperative CFT and BCVA between the two groups in cases with or without continuous EIFL (P > 0.10). CONCLUSION: Our findings indicate that combined intravitreal TA injection following ERM removal conferred no significant benefits in alleviating macular thickening or improving visual acuity in iERM.

[Results of Soil-transmitted Nematode Monitoring in Henan Province in 2011-2015].

To understand the endemic situation of soil-transmitted nematodiasis (Ascaris lumbricoides, Trichuris trichiura and Ancylostoma sp.) in Huaiyang County, Henan Province. Over 1 000 fecal samples from inhabitants in Huaiyang County of Henan Province were collected each year during 2011-2015, in which the soil-transmitted nematodes eggs and other intestinal helminth eggs were examined by Kato-Katz technique. The helminth-positive samples were examined by filter paper culture method to identify the species of hookworm. The cellophane swab method was used to detect Enterobius vermicularis eggs in children aged 3～12 years. Soil samples were collected from vegetable field, lavatory, courtyard and kitchen of 10 families randomly selected in each year to examine Ascaris eggs by a modified saturated sodium nitrate floatation method. In 2011-2015, 5 229 people were examined and 54 person infected with intestinal helminths were found. Five intestinal helminthes, A. lumbricoides, T. trichiura, Ancylostoma duodenale, Enterobius vermicularis and Trichostrongylus orientalis were found with 13, 2, 9, 29 and 1 infection person respectively. All showed mild infection and no multiple infections were found. There was no significant difference between the year 2015 which had the highest soil-transmitted nematode infection rate 0.6%（7/1 134） and the year 2013 which had the lowest infection rate 0.3%（3/1 037）（P>0.05）. The infection rate of intestinal helminths was highest in group of <10 years（2.8%, 25/905）, followed by the groups of >70 years（1.6%, 4/256） and 30～40 years（1.2%, 8/671）（P>0.05）. The average infection rate of E. vermicularis was 1.8%（18/993） The infection rate of E. vermicularis was relatively higher in kindergarten kids（1.6%, 6/366） and students（1.3%, 13/1 005） than that in farmers（0.3%, 10/3 782）（P<0.01）. No Ascaris eggs were found in the 200 randomly collected soil samples. The intestinal helminth infection status maintaines at low level in Henan Province during 2011-2015.

[The Impact of the Malaria National Strategy Application Program of the Global Fund on Malaria Elimination in Henan Province].

Objective: To analyze the impact of the national strategy application （NSA） program of the global fund on malaria elimination in Henan Province. Methods: The internal control system on project, fund and supplies was developed to ensure the normalized implementation of NSA program in Henan Province. The multi-channel communication platform including telephone, e-mail and so on was established for data's progressively reporting, review and summary. The training, supervision and assessment were implemented to ensure that the data was real and correct. The data derived from the NSA program and other project involved with malaria control in the Province from 2009 to 2012 was collected and compared. Changes on human resources, financial input, supplies purchasing and the main malaria control measures before and after the implementation of the program were analyzed. Results: A total of 29.72 million yuan financial support which accounted for more than half of the total financial input on malaria control at the same time in the Province was provided by the NSA program. A total of 3 966 microscopists and 61 415 health workers from primary health care received skill training on malaria dectection and control. After implementation of the program, there was an increase in the diagnosis rate by blood test from 2009 （45.67%, 738/1 616） to 2012 （99.36%, 155/156） （χ2=161.91. P＜0.01）. The malaria incidence showing a step-wise decline from 2009 to 2012 which were 1.71/100 000, 0.94/100 000, 0.34/100 000 and 0.17/100 000 respectively, with an increase in imported cases（χ2=1 310.70, P＜0.01） and no report of indigenous malaria cases in 2012, for the first time. The reported cases in counties of the NSA program during 2009-2012 constituted 98.08%（1 585/1 616）, 92.75% （831/896）, 80.25% （252/314） and 67.31% （105/156） of all malaria cases reported in that year in the Province （χ2=300.38, P＜0.01）. The awareness rates on malaria prevention and treatment among residents and students were 94.65% （25 246/26 673） and 93.73% （16 328/17 421） in 2012, both significantly higher than the baseline in 2009 （63.88%, 5 755/9 009; 53.39%, 3 170/5 937） （χ2=5 594.01, P＜0.01; χ2=5 221.53, P＜0.01）. Conclusion: The implementation of the NSA program has motivated the elimination of malaria in Henan Province.

[ Effect of Malaria Prevention and Control in Henan Province from 2010 to 2014].

During 2010-2014 a total of 1 779 malaria cases were reported in Henan Province, including 958 indigenous cases, and 821 imported cases, with 12 deaths. No indigenous malaria cases were reported during 2012-2014, but the number of imported cases showed a trend of increase, rising from 106 cases in 2010 to 216 in 2014. Blood examination was conducted in 5 210 428 patients with fever during 2010-2014. A total of 4 829 anophelines were captured, of which 4 741 were Anopheles sinensis and 88 were Anopheles anthropophagus. A total of 28 067 patients were given pre-transmission medications. In addition, 3 112 staff for Plasmodium microscopical examinations and 783 epidemiological researchers received training in the five years. Seventy-two counties (cities, districts) passed the evaluation for malaria elimination. Future work should focus on the enhancement of inspection and management of imported malaria to prevent its further dissemination and to achieve the final goal of malaria elimination in the province.

[The Role of Medical Institutions in the Control of Imported Malaria Since the Initiation of Malaria Elimination Program in Henan Province].

Objective: To retrospectively overview the diagnosis and treatment of malaria during 2010-2014 in Henan Province and understand the role of medical institutions in imported malaria control. Methods: Information on malaria epidemic situation as well as its diagnosis and treatment during 2010-2014 in Henan Province was collected from the infectious disease surveillance system and information management system for the prevention and treatment of parasitic disease. Descriptive analysis was performed to determine the role of medical institutions in the reporting, diagnosis and treatment of malaria. Results: A total of 821 imported malaria cases were reported during 2010-2014 in Henan Province, among whom 12 died, with a case fatality rate of 1.7%. The 12 deaths were all due to falciparum malaria and from Africa. The number of cases reported by medical institutions and disease control agencies were 432（52.6%） and 389（47.4%）, respectively. Among the 569 imported malaria cases with diagnosis records, 380 were determined to be malaria at first-diagnosis, with a diagnostic accuracy of 66.8%（380/569）. The accuracy of first diagnosis by medical institutions（49.2%, 178/362） was significantly lower than that by disease control agencies（97.6%, 202/207）（χ2=139.147, P<0.01）. The accuracy of first diagnosis by medical institutions at the town-ship level or below, the county level, the city/prefecture level and the provincial level was 14.2%（18/127）, 43.4% （23/53）, 73.6%（67/97） and 76.9%（70/91）, respectively（χ2=112.764, P<0.01）. However, there was no significant difference in the accuracy among disease control agencies of the above levels（χ2=0.380, P＞0.05）. The cases diagnosed by medical institutions and disease control agencies constituted 48.9%（278/569） and 51.1%（291/569）, respectively, with no significant difference（χ2=0.594, P＞0.05）. In addition, the cases diagnosed by medical institutions at the town-ship level or below, the county level, the city/prefecture level and the provincial level constituted 1.2%（7/569）, 3.7%（21/569）, 12.5%（71/569） and 31.5%（179/569）, respectively（χ2=299.143, P<0.01）. Similar results were also obtained for disease control agencies of the above levels（χ2=91.569, P<0.01）. Conclusion: There are considerable differneces of the first diagnosis accuracy and the diagnosis rate among medical institutions of different levels. Medical institutions of lower levels, which establish a diagnosis mainly based on microscopic examination, have lower diagnosis rate than the disease control agencies at same levels.

[Tracing Investigation of One Vivax Malaria Case by Detecting the Gene Encoding Circumsporozoite Protein in Henan].

A vivax malaria case in Henan Province was diagnosed as an indigenous case firstly in June 2013, and replased in April 2014. The clinical data of this case were collected and the epidemiological investigation was conducted. The blood samples were examined by Giemsa-stained blood smear, rapid diagnostic test strip (RDT) and nested PCR. This patient stayed at Myanmar for about one week in May 2013, had the symptoms of chills, fever and sweating in June, and was diagnosed as vivax malaria. After treated with artesunate, the symptoms disappeared. The CSP sequence was amplified from the blood samples of the first and second attack, and there was no difference in the central repeat domain of CSP gene. The identity of our two CSP gene sequences to that of Myanmar isolates (GenBank accessssion No. ABS95455, ABS95456) was 95.1% and 100%, while their nucleotide sequence was with 88.8% and 67.1% identity with that of Henan isolates (accessssion No. KP888996, KP889000), respectively. This patient is therefore confirmed as an imported relapse case of Plasmodium vivax infection.

[Estimation of water clarity in offshore marine areas based on modified semi-analysis spectra model].

The main objectives of the research described in the present paper are to develop a semi-analysis model of water clarity for case 2 waters without inputting the absorption and scattering coefficient, which are not easy to be obtained for offshore marine areas so far. Based on the Zsd (Secchi depth)inversion theory, a simple semi-analysis spectra model was established for offshore seawater clarity by analyzing the relationship between vertical diffuse attenuation coefficient K(d) (490) and the beam attenuation coefficient c(490) with remote sensing reflectance. This semi-analysis spectra model needed two band reflectance ratios on- ly, while tidal correction was produced for this model to improve the precision of the retrieving results. The semi-analysis spectra model was applied to ASD hyperspectral reflectance data measured in the Pearl River Estuary Ecological Zone (October 21, 23, 2012, November 2, 2012; N=20) and the Xuwen Coral Reef Protection Zone (January 13, 14, 2013, N=25) which covered different water body of tidal times and different pollution sources. The results indicated that the changing tendency of predicted values was consistent with the synchronous measurement values after comparing them. However, water clarity calculated by the ASD hyperspectral reflectance measured in spring tidal time, generated 0. 4 m deviation compared with in-situ water clarity, while water clarity calculated by the ASD hyperspectral reflectance measured in neap tidal time is close to the in-situ water clarity. So the tidal correction coefficient of 0.4 was further applied for the model. After modification, the coefficient of determination between the inversed and measured water clarity was 0. 663, the average absolute error was 0. 14 m and the average relative error was 19.5%. Research demonstrated that this semi-analysis inversion algorithm just needs two band reflectance ratio to complete the inversion of water clarity, which is simple and works relatively well for lower clarity (less than 2 meters) waters compared to He' (2004) and Doron' (2011) algorithms.

[Diagnosis and treatment for three imported Plasmodium malariae malaria cases in Henan Province].

Giemsa-stained blood film microscopy, CareStart rapid detection and PCR were used to detect the three cases who returned from Angola and Equatorial Guinea to Henan Province. Onset of malaria symptoms for two patients occurred 15 d and 27 d after their return from Angola, respectively. Two months after returning home, another case relapsed who had suffered from malaria in Equatorial Guinea. All three patients had the symptoms such as irregular fever, headache, chills and so on. Two cases had elevated total bilirubin and splenomegaly. The cases were confirmed as P. malariae infection by microscopic morphological examination. Amplified bands were produced by 18S rRNA nested PCR, which was the same with P. malariae in size, whereas the results of CareStart repaid detection test were all negative. They were cured by using artemisinin-based combination therapy (ACT).

[Laboratory detection on two cases with imported Plasmodium ovale infection].

OBJECTIVE: To compare the laboratory tests of the imported Plasmodium ovale infection and analyse the genetic character. METHODS: After Giemsa staining and microscopy, CareStart rapid detection and nested PCR were used to detect two cases with P. ovale infection returning from Congo (Brazzaville) in Henan Province. Sequencing was performed after PCR amplification using the 18S rRNA genus-specific primers. Their genetic characteristics were analyzed and the sequence homology analysis was performed in the NCBI. RESULTS: The two cases were confirmed as P. ovale infection by morphological examination microscopically. Amplified bands were produced by 18S rRNA nested PCR, which was the same with P. ovale in size, whereas the results of CareStart rapid detection test were all negative. A sequence of 906 bp in length was obtained by sequencing their 18S rRNA genes in which GC accounted for 35.4%, and the sequence showed 99% homology to the corresponding part of the known P. ovale 18S rRNA gene (GenBank accession No. AB182492). CONCLUSION: Both the nested PCR and microscopy confirm the infection of P. ovale. A negative result of CareStart rapid detection can not ruled out the Plasmodium infection.

[Polymorphism analysis on the genotypes of circumsporozoite protein of Plasmodium vivax with PRC-RFLP].

Thirty-seven blood samples from Plasmodium vivax-infected patients were collected in Henan Province in 2011. The gene for circumsporozoite protein (PvCSP) was amplified by nested PCR. According to the epidemiological data, among the 37 Plasmodium vivax malaria cases, 26 were indigenous cases and 11 were imported cases. A fragment of 750 bp was obtained in the 37 blood samples. The 750 bp PCR product was digested with restriction endonuclease Alu-I and Mva-I, and genetic polymorphism was investigated with PCR-RFLP. PCR-RFLP analysis of PvCSP revealed that the parasites were PV-I type (97.3%, 36/37) and PV-II type (2.7%, 1/37). 26 samples from indigenous cases were exclusively PV-I type with PV-I-b type (57.7%, 15/26) and PV-I-a type (42.3%, 11/26). Among 11 samples from imported cases, PV-I-a type accounted for 90.9% (10/11), and 1 PV-II type accounted for 9.1% (1/11), no PV-I-b type were detected.

Lipid management in ischaemic stroke or transient ischaemic attack in China: result from China National Stroke Registry III.

OBJECTIVES: The aims of the study were to assess the management of low-density lipoprotein cholesterol (LDL-C) and the goal achievement, as well as to investigate the association between baseline LDL-C level, lipid-lowering treatment (LLT), and stroke recurrence in patients with ischaemic stroke or transient ischaemic attack (TIA). DESIGN: Our study was a post hoc analysis of the Third China National Stroke Registry (CNSR-III). SETTING: We derived data from the CNSR-III - a nationwide clinical registry of ischaemic stroke and TIA based on 201 participating hospitals in mainland China. PARTICIPANTS: 15,166 patients were included in this study with demographic characteristics, etiology, imaging, and biological markers from August 2015 to March 2018. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was a new stroke, LDL-C goal (LDL-C<1.8mmol/L and LDL-C<1.4mmol/L, respectively) achievement rates, and LLT compliance within 3, 6, and 12 months. The secondary outcomes included major adverse cardiovascular events (MACE) and all caused death at 3 and 12 months. RESULTS: Among the 15,166 patients, over 90% of patients received LLT during hospitalization and 2 weeks after discharge; the LLT compliance was 84.5% at 3 months, 75.6% at 6 months, and 64.8% at 12 months. At 12 months, LDL-C goal achievement rate for 1.8mmol/L and 1.4mmol/L was 35.4% and 17.6%, respectively. LLT at discharge was associated with reduced risk of ischemic stroke recurrence (HR=0.69, 95% CI: 0.48-0.99, p=0.04) at 3 months. The rate of LDL-C reduction from baseline to 3-month follow-up was not associated with a reduced risk of stroke recurrence or major adverse cardiovascular events (MACE) at 12 months. Patients with baseline LDL-C ≤1.4mmol/L had a numerically lower risk of stroke, ischemic stroke and MACE at both 3 months and 12 months. CONCLUSIONS: The LDL-C goal achievement rate has increased mildly in the stroke and TIA population in mainland China. Lowered baseline LDL-C level was significantly associated with a decreased short- and long-term risk of ischemic stroke among stroke and TIA patients. LDL-C<1.4mmol/L might be a safe standard for this population.

[Epidemiological analysis of imported malaria in Henan Province in 2011].

OBJECTIVE: To analyze the epidemiological characteristics of imported malaria in Henan Province in 2011, and provide scientific basis for the control of imported malaria. METHODS: Data of imported malaria were collected and analyzed by SPSS11.5 in 2011. RESULTS: 145 imported malaria cases were reported. Among them, 110 (75.9%) were falciparum malaria, 31 (21.4%) were vivax malaria, 3 (2.1%) were quartan malaria, and 1 (0.7%) was ovale malaria. The ratio of males to females was 47.3:1 (142/3). The average age was (37.7 +/- 9.4) years old. 113 patients returned from Africa, accounted for 77.9% of the total. The main reason for going abroad among the cases was labor export (82.8%, 120/145). The cases were reported every month. The median interval from symptom appearing to diagnosis was 4 d, only 19 patients (13.1%) were diagnosed within 24 h. Eighty-six cases (63.2%) were reported by municipal medical units and CDC. Forty cases (29.4%) were reported by county level medical units and CDC. A total of 143 cases recovered with chemotherapy and two cases died. CONCLUSION: In order to avoid the death of malaria cases and reduce the risk of secondary transmission, malaria screening and health education for those returned from malaria-endemic areas should be strengthened and the diagnosis and treatment capabilities be improved at county medical units.

The role of hippocampus in memory reactivation: an implication for a therapeutic target against opioid use disorder.

Purpose of the review: The abuse of opioids induces many terrible problems in human health and social stability. For opioid-dependent individuals, withdrawal memory can be reactivated by context, which is then associated with extremely unpleasant physical and emotional feelings during opioid withdrawal. The reactivation of withdrawal memory is considered one of the most important reasons for opioid relapse, and it also allows for memory modulation based on the reconsolidation phenomenon. However, studies exploring withdrawal memory modulation during the reconsolidation window are lacking. By summarizing the previous findings about the reactivation of negative emotional memories, we are going to suggest potential neural regions and systems for modulating opioid withdrawal memory. Recent findings: Here, we first present the role of memory reactivation in its modification, discuss how the hippocampus participates in memory reactivation, and discuss the importance of noradrenergic signaling in the hippocampus for memory reactivation. Then, we review the engagement of other limbic regions receiving noradrenergic signaling in memory reactivation. We suggest that noradrenergic signaling targeting hippocampus neurons might play a potential role in strengthening the disruptive effect of withdrawal memory extinction by facilitating the degree of memory reactivation. Summary: This review will contribute to a better understanding of the mechanisms underlying reactivation-dependent memory malleability and will provide new therapeutic avenues for treating opioid use disorders.

Protective effects of upregulated HO-1 gene against the apoptosis of human retinal pigment epithelial cells in vitro.

AIM: To investigate the protective effect of heme oxygenase-1 (HO-1) against H2O2-induced apoptosis in human ARPE-19 cells. METHODS: The lentiviral vector expressing HO-1 was prepared and transfected into apoptotic ARPE-19 cells induced by H2O2. Functional experiments including cell counting kit-8 (CCK-8) assay, flow cytometry (FCM) and mitochondrial membrane potential assay were conducted. RESULTS: The ultrastructure of ARPE-19 cells was observed using transmission electron microscope (TEM). It was found that exogenous HO-1 significantly ameliorated H2O2-induced loss of cell viability, apoptosis and intracellular levels of reactive oxygen species (ROS) in ARPE-19 cells. The overexpression of HO-1 facilitated the transfer of nuclear factor erythroid-2-related factor 2 (Nrf2) from cytoplasm to nucleus, which in turn upregualted expressions HO-1 and B-cell lymphoma-2 (Bcl-2). Furthermore, HO-1 upregulation further inhibited H2O2-induced release of cysteinyl aspartate specific proteinase-3 (caspase-3). CONCLUSION: Exogenous HO-1 protect ARPE-19 cells against H2O2-induced oxidative stress by regulating the expressions of Nrf2, HO-1, Bcl-2, and caspase-3.

A case of group infections with Paraginimus species in Henan, Central China.

In July of 2012, mass infections with Paragonimus species were detected in the Henan province sickening 11 of 51 people. In May 2011, these individuals had participated in an excursion during which freshwater crabs were caught and served after being toasted. Before the group infections with Paraginimus species was confirmed, 5 of the 11 patients had been misdiagnosed as tuberculosis (TB) and treated with an anti-TB drug regimen for six months. The most common and typical manifestations were eosinophilia (11/11, 100%) and pulmonary manifestations including, among others, stethalgia and cough (7/11 63.6%). Sero-examination revealed that all 11 patients were seropositive for Paragonimus species. Surprisingly, in our case, one patient presented with hemoptysis and eggs in respiratory secretions, and this is the first time P. skrjabini eggs are detected in the sputum of a patient from the Henan province. Paragonimus metacercariae were collected from 6 of 11 (54.5%) crabs caught at the infection site and were identified as Paraginiumus skrjabini by morphological and molecular examinations. Epidemiological and laboratory evidence confirmed that this is a case of group infection with P. skrjabini. As one of the most neglected tropical diseases (NTD), paragonimiasis should be differentiated diagnosed from TB to avoid the delay of treatment. To our knowledge, this is the second report of a case of group infections with Paraginimus species in Henan, Central China. The first case was reported in 1995. As a kind of food-borne parasitic disease, paragonimiasis should be included in the public health education agenda.

Association of Chemoradiotherapy Regimens and Survival Among Patients With Nasopharyngeal Carcinoma: A Systematic Review and Meta-analysis.

Importance: The role of induction chemotherapy (IC) or adjuvant chemotherapy (AC) in the treatment of locoregionally advanced nasopharyngeal carcinoma (NPC) remains controversial. Objectives: To update meta-analyses on the association of survival outcomes with IC and AC regimens in patients with locoregionally advanced NPC and assess whether the current evidence is conclusive by a trial sequential analysis (TSA) approach. Data Sources: PubMed, Embase, and Web of Science were searched for articles published from inception until June 1, 2019. Study Selection: Randomized clinical trials that assessed the efficacy of radiotherapy with or without chemotherapy among previously untreated patients and patients with nondistant metastatic NPC. Data Extraction and Synthesis: Data were extracted by 2 investigators from each trial independently and synthesized by the 2 investigators. All trial results were combined and analyzed by a fixed- or random-effects model. Main Outcomes and Measures: Overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS), and locoregional recurrence-free survival (LRFS). Results: A total of 8036 patients (median age, 46.5 years; 5872 [73.1%] male) from 28 randomized clinical trials were included in the analysis. Pooled analyses revealed that concurrent chemoradiotherapy (CCRT) was significantly associated with improved OS, PFS, DMFS, and LRFS compared with radiotherapy across all subgroups. The TSA confirmed the treatment outcomes of CCRT compared with radiotherapy. The additional IC regimen was associated with an improvement in OS (hazard ratio [HR], 0.84; 95% CI, 0.74-0.95), PFS (HR, 0.73; 95% CI, 0.64-0.84), DMFS (HR, 0.67; 95% CI, 0.59-0.78), and LRFS (HR, 0.74; 95% CI, 0.64-0.85). These findings were consistent in subgroup analyses of multicenter trials with sample sizes greater than 250, years of survival rate of 5 or greater, median follow-up longer than 5 years, or low risk of bias. However, the additional AC regimen was not associated with a survival benefit in OS (HR, 0.98; 95% CI, 0.78-1.23), PFS (HR, 0.86; 95% CI, 0.70-1.07), DMFS (HR, 0.84; 95% CI, 0.64-1.10), or LRFS (HR, 0.80, 95% CI, 0.59-1.09). The TSA provided sound evidence on the additional benefit of IC but not AC. Conclusions and Relevance: These data suggest a significant association of survival outcomes with CCRT in patients with locoregionally advanced NPC. The addition of IC instead of AC could achieve survival benefits. The potential therapeutic gain of AC should be explored in the future.

Epidemiological survey of echinococcosis in Tibet Autonomous Region of China.

BACKGROUND: The echinococcosis is prevalent in 10 provinces /autonomous region in western and northern China. Epidemiological survey of echinococcosis in China in 2012 showed the average prevalence of four counties in Tibet Autonomous Region (TAR) is 4.23%, much higher than the average prevalence in China (0.24%). It is important to understand the transmission risks and the prevalence of echinococcosis in human and animals in TAR. METHODS: A stratified and proportionate sampling method was used to select samples in TAR. The selected residents were examined by B-ultrasonography diagnostic, and the faeces of dogs were tested for the canine coproantigen against Echinococcus spp. using enzyme-linked immunosorbent assay. The internal organs of slaughtered domestic animals were examined by visual examination and palpation. The awareness of the prevention and control of echinococcosis among of residents and students was investigated using questionnaire. All data were inputted using double entry in the Epi Info database, with error correction by double-entry comparison, the statistical analysis of all data was processed using SPSS 21.0, and the map was mapped using ArcGIS 10.1, the data was tested by Chi-square test and Cochran-Armitage trend test. RESULTS: A total of 80 384 people, 7564 faeces of dogs, and 2103 internal organs of slaughtered domestic animals were examined. The prevalence of echinococcosis in humans in TAR was 1.66%, the positive rate in females (1.92%) was significantly higher than that in males (1.41%), (χ2 = 30.31, P < 0.01), the positive rate of echinococcosis was positively associated with age (χ2trend = 423.95, P < 0.01), and the occupational populations with high positive rates of echinococcosis were herdsmen (3.66%) and monks (3.48%). The average positive rate of Echinococcus coproantigen in TAR was 7.30%. The positive rate of echinococcosis in livestock for the whole region was 11.84%. The average awareness rate of echinococcosis across the region was 33.39%. CONCLUSIONS: A high prevalence of echinococcosis is found across the TAR, representing a very serious concern to human health. Efforts should be made to develop an action plan for echinococcosis prevention and control as soon as possible, so as to control the endemic of echinococcosis and reduce the medical burden on the population.

The max-intracerebral hemorrhage score predicts long-term outcome of intracerebral hemorrhage.

AIMS: Little is known about the performance of the maximally treated intracerebral hemorrhage (max-ICH) score in predicting unfavorable long-term functional outcome and death in patients with intracerebral hemorrhage (ICH) in China. We aimed to validate the performance of the max-ICH score and compared it with other recognized scores. METHODS: We derived data from the China National Stroke Registry (CNSR). Receiver-operating characteristic (ROC) analysis and Hosmer-Lemeshow test were used to measure the score performance. We compared the performance of max-ICH score with six recognized models, including the ICH score, ICH functional outcome score (ICH-FOS), Essen-ICH score, modified intracerebral hemorrhage (MICH) score, intracerebral hemorrhage grading scale (ICH-GS), and functional outcome (FUNC) score. RESULTS: A total of 2581 patients with spontaneous ICH were enrolled in the study. The max-ICH score was similar or superior to the six existing scores in predicting long-term unfavorable functional outcome after ICH with good discrimination (AUC 0.83, 95% confidence interval [CI] 0.81-0.84) and calibration (Hosmer-Lemeshow P = 0.19). For predicting death, the AUC of max-ICH was 0.81 (95% CI 0.79-0.83). CONCLUSIONS: The easy-to-use max-ICH score is a reliable tool to predict unfavorable long-term (12-month) functional outcome and death after intracerebral hemorrhage in the Chinese population.