RESUMEN
OBJECTIVES: To validate and use the Chinese Version of the M. D. Anderson Symptom Inventory Gastrointestinal Cancer Module (MDASI-GI-C) to assess the symptom burden of Chinese-speaking patients with gastrointestinal cancer. METHODS: In total, 527 patients with postoperative or advanced digestive tract tumors were enrolled in the trial, who had definitive diagnoses and different treatments in our cancer center. MDASI-GI-C was administered to these patients between February and December 2017. The item-scale correlations and internal consistency were evaluated. Construct validity was established by factor analysis. Hierarchical cluster analysis was performed. RESULTS: Cronbach's alpha of the symptom severity and interference subscales was 0.842 and 0.859, respectively. Construct validity revealed a four-factor structure. Known-group validity was established by comparing the MDASI-GI-C scores between patients having different Karnofsky Performance Status scores (≤70 or >70), which were observed to have significant differences. The overall mean subscale scores for the core and interference subscales were 1.63 ± 2.02 and 2.17 ± 2.34, respectively. Fatigue, disturbed sleep, and lack of appetite had the highest scores for most serious symptoms. No significant differences in age, working status, and educational level were found. CONCLUSIONS: MDASI-GI-C is a reliable and valid tool for assessing cancer-related symptoms in Chinese-speaking patients with digestive tract tumors, facilitates the understanding of the common symptoms of patients with digestive tract tumors, and enables timely management of these symptoms. Cognitive debriefing demonstrated that the patients found MDASI-GI-C to be an easy-to-use and understandable instrument.
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Neoplasias Gastrointestinales/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Evaluación de Síntomas , TraduccionesRESUMEN
Objective: To analyze the sequence of Plasmodium vivax merozoite surface protein-1(PvMSP-1) and allele polymorphism in imported and local vivax malaria parasites in Yunnan Province. Methods: Blood samples on filter paper were collected from imported and local vivax malaria cases in Yunnan Province during August 2012 and September 2015 and information of epidemiological history was recorded. Plasmodium DNA was extracted by a DNA extraction kit, and the block 5 region in PvMSP-1 gene was amplified by PCR. The PCR products were sequenced and blasted with reference sequences M75674, AAN86237, M60807, ABJ53045, AAN86238 and BAA18977. The sequence polymorphism in block 5 region of PvMSP-1 was analyzed with MEGA 5.04 and Arlequin3.5.1 softwares. The conserved sites, genetic distances among sequences and Shannon-wiener index among alleles were calculated. The clustering tree was drawn according to the genetic distances between the amino-acid sequences. Results: A total of 847 blood samples were collected from the malaria cases, comprising of 61 samples from local cases, 66 from imported cases from Africa, and 720 from Myanmar. The block 5 region in PvMSP-1 was successfully amplified in 278 samples, and sequencing was successfully made in 206 of them. The peptide coded by the block 5 region had a length of 193 to 222 aa. The amino acid sequence alignment showed that in 206 samples the proportion of genotypes of Sal-1, Belem and Recombine was 59.2%(122/206),23.3%(48/206) and 17.5%(36/206), respectively. The proportion of Sal-1 genotype in imported cases from Myanmar and Africa and in local cases was 58.8%(104/177),73.3%(11/15) and 50%(7/14), respectively. The genotypes Sal-1, Belem and Recombine had 51, 9 and 6 different alleles. The 66 alleles had a Shannon Wiener index (H') of 0.955 and an expected heterozygosis (He) of 0.567. The 206 DNA sequences had a 665-bp homologous locus, comprising of 75 conserved sites (11.3%,75/665) and 590 variable sites (88.7%, 590/665). The genetic distances between sequences were all less than 0.4. The clustering analysis showed that the 206 sequences were clustered into two categories with three branches. The homology of Recombine with Belem genotype was 91%-92%, higher than with Sal-1 genotype (82%-83%). Conclusion: The block 5 region in PvMSP-1 gene from local and imported Plasmodium vivax in Yunnan Province has varied forms of alleles, and the Sal-1 genotype is predominant among the three genotypes.
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Plasmodium vivax , África , Alelos , Secuencia de Aminoácidos , China , Genotipo , Malaria Vivax , Proteína 1 de Superficie de Merozoito , Mianmar , Reacción en Cadena de la Polimerasa , Polimorfismo GenéticoRESUMEN
BACKGROUND: This paper seeks to assess the function of malaria control consultation and service posts (MCCSPs) that are located on the border areas of Yunnan province, P.R. China, as a strategy for eliminating malaria among the mobile and migrant population in these areas. METHODS: A retrospective descriptive analytical study was conducted. Blood smear examinations conducted at all MCCSPs in Yunnan from 2008 to 2014 were analysed. A cross-sectional survey was conducted in 2014 to understand how the MCCSPs function and to elucidate the quality of the blood smear examinations that they conduct. RESULTS: Out of the surveyed MCCSPs, 66 % (39/59), 22 % (13/59), and 12 % (7/59) were attached to local township hospitals, village health clinics, and the county centre for disease control and prevention or private clinics, respectively. More than 64 % (38/59) of the posts' staff were part-time workers from township hospitals and village health facilities. Less than 31 % (18/59) of the posts' staff were full-time workers. A total of 35 positive malaria cases were reported from seven MCCSPs in 2014. Four MCCSPs were unable to perform their functions due to under staffing in 2014. There was a small fluctuation in blood smear examinations from January 2008 to June 2009, with two peaks during the period from July 2009 to October 2010. The number of blood smear examinations has been increasing since 2011. The yearly mean number of blood smear examinations in each post increased from 44 per month in 2011 to 109 per month in 2014, and the number of positive malaria cases detected by blood smear examinations has declined (χ 2 = 90.67, P = 0.000). The percentage of people from Yingjiang county getting blood smear examinations increased between 2008 and 2014, while percentages of the mobile population including Myanmar people, people from other provinces, and people from other Yunnan counties getting blood smear examinations decreased. CONCLUSION: MCCSPs face challenges in the phase of malaria elimination in Yunnan, China. New case detection strategies should be designed for MCCSPs taking into account the current trends of migration.
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Instituciones de Salud/estadística & datos numéricos , Malaria/prevención & control , Derivación y Consulta/estadística & datos numéricos , Recolección de Muestras de Sangre/estadística & datos numéricos , China , Estudios Transversales , Humanos , Estudios Retrospectivos , Migrantes/estadística & datos numéricosRESUMEN
Objective: To understand the endemic situation of chloroquine-resistant falciparum malaria in Yunnan Province by analyzing the polymorphism of the 72-76 amino-acid coding sequence within exon 2 region of Plasmodium falciparum chloroquine resistant transporter (Pfcrt) gene ï¼referred to as the 72-76 coding regionï¼ in malaria patients. Methods: The filter paper blood samples and relative information of falciparum malaria cases were collected in 13 prefectures of Yunnan Province ï¼excluding Diqing, Wenshan, Zhaotong prefecturesï¼ from August 2012 to September 2015. The source of infection was determined by epidemiological investigation and the place of case discovery was confirmed according to the endemic registration in the Infectious Diseases Reporting Manage System, Chinese Center for Disease Control and Prevention. The exon2 region of Pfcrt gene was amplified by nested PCR and sequenced. The polymorphism of the 72-76 coding region was analyzed with MEGA 5.04. The variable sites and genetic distance between sequences were calculated. The constituent ratio of the polymorphism in sub-populations was analyzed with IBM SPSS Statistics 21 software. Results: Two hundred and thirty-two blood samples were collected in the period and source of infection included Yunnan of China, Africa and Myanma. Nested-PCR resulted in positive products in 210 samples. Sequence analysis showed the presence of chloroquine-sensitive genotypeï¼CVMNKï¼ï¼15.2%, 32/210ï¼ and mutated chloroquine-resistant genotypeï¼CVIET, SVMNT and CVMNTï¼ï¼76.2%, 160/210; 6.7%, 14/210; 1.9%, 4/210ï¼ 72-76 coding regions. The proportion of the CVMNK type was 100%ï¼32/32ï¼ in cases with the range of 19-55 years, 46.9% ï¼15/32ï¼ in farmers, and 59.4% ï¼19/32ï¼ in patients with infection source in Southeast Asia, all significantly higher than those of other cases in the same groupsï¼0; 31.3%, 10/32; and 37.5%, 12/32 respectively, χ2=13.674, 8.478, 6.292, P<0.05ï¼. The proportion of the CVIET and SVMNT genotypes in patients with infection source in Myanma and Cambodia was 81.3%ï¼130/160ï¼ and 78.6%ï¼11/14ï¼ respectively, significantly higher than those in patients with infection source in Yunnan Provinceï¼6.3%, 10/160; 21.4%, 3/14ï¼ï¼χ2=6.519 and 6.620, P<0.05ï¼. In samples with Africa infection source, the proportion of CVIET was 12.5%ï¼20/160ï¼, with no detection of SVMNT. There was a 145 bp homologous locus among the 210 exon2 regions, of which the conservative sites accounted for 95.2%ï¼138/145ï¼ and variable sites for 4.8%ï¼7/145ï¼. The genetic distance between the 210 sequences ranged 0.000-0.036ï¼0.012±0.005ï¼. The genetic distances from genotypes CVIET, SVMNT and CVMNT to the chloroquine-sensitive genotype CVMNK wereï¼0.029±0.015ï¼, ï¼0.021±0.013ï¼ and ï¼0.014±0.001ï¼ respectively. 178 cases with chloroquine-resistant P. falciparum distributed in all the 13 prefectures. Among them, the regions with top detection rate of chloroquine-resistant genotypes were Dehongï¼51.7%, 92/178ï¼, Baoshanï¼24.7%, 44/178ï¼ and Lincangï¼5.6%, 10/178ï¼ bordering on Myanmar and Kunming (4.5%, 8/178). Conclusion: There are three chloroquine-resistant genotypes of the 72-76 coding region in falciparum malaria cases in Yunnan Province, which distribute in 81.3%ï¼13/16ï¼ of prefectures in the Province.
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Plasmodium falciparum , África , Secuencia de Aminoácidos , Antimaláricos , Secuencia de Bases , China , Cloroquina , Resistencia a Medicamentos , Exones , Genotipo , Haplotipos , Humanos , Malaria , Malaria Falciparum , Proteínas de Transporte de Membrana , Mianmar , Sistemas de Lectura Abierta , Reacción en Cadena de la Polimerasa , Polimorfismo Genético , Proteínas ProtozoariasRESUMEN
Objective: To investigate the polymorphism of Plasmodium falciparum K13 gene kelch domain region and provide basis for understanding the artemisinin resistance of falciparum malaria in Yunnan Province. Methods: The filter blood samples and relative information of falciparum malaria cases were collected in 16 prefectures of Yunnan Province from January 2013 to December 2015. The source of infection was determined by epidemiological investigation and the place of case discovery was confirmed according to the China Information System for Disease Control and Prevention Epidemic Registration. The K13 gene kelch domain region was amplified by nested PCR, sequenced, and blasted against the reference strain 3D7ï¼PF3D7_1343700ï¼. The K13 gene kelch domain region polymorphism was analyzed with Mega 5.04. The variable sites and genetic distance between sequences were analyzed. The constituent ratio of amino acid mutation sites was calculated and analyzed with χ2 test. Results: A total of 202 blood samples were collected from 2013 to 2015, comprising 190 from imported cases, 12 from local cases in Yunnan Province. The constitutent ratio of infection cases were 30.7% ï¼62/202ï¼, 34.2% ï¼69/202ï¼ and 35.1% ï¼71/202ï¼ respectively, increased year by year. The K13 gene kelch domain was successfully amplified from 192 samples and 190 were successfully sequenced, detecting missense mutation of K13 gene in 66 samples, the mutation rate was 34.7% ï¼66/190ï¼. The detection rate of K13 gene mutation was 40.9% ï¼27/66ï¼, 37.9% ï¼25/66ï¼ and 21.2% ï¼14/66ï¼ respectively, decreased year by year. In this study, ten types of mutations were detected, which were F446I, A578S, N458Y, P574L, A676D, G449A, C469Y, V494I, E556D and S16L. The highest mutation rate occurred in F446I which was 72.7% ï¼48/66ï¼. The proportion of F446I mutation type was 58.3% ï¼28/48ï¼ in an age-range of 18-56 years, 70.8% ï¼34/48ï¼ in farmers, and 91.7% ï¼44/48ï¼ in patients with infection source in Southeast Asia, all significantly higher than that of other groups with the same characteristics ï¼41.7%, 20/48; 29.2%, 14/48; and 8.3%, 4/48, respectivelyï¼ï¼χ2=4.633, 5.556 and 5.152, both Pï¼0.05ï¼. There was a 248 bp homologous sequence in the 190 sequences, composed of 235 conservative sites ï¼94.8%ï¼, 13 variable sites ï¼5.2%ï¼, 5 parsim-info sites ï¼2.0%ï¼, and 8 singleton sites ï¼3.2%ï¼. The genetic distance among the 190 sequences ranged 0.000-0.036, with an average of 0.001±0.001. Conclusion: There are 10 types of mutations in the K13 kelch domain in Yunnan Province, the predominant mutation type was F446I.
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Artemisininas , Plasmodium falciparum , Antimaláricos , China , Resistencia a Medicamentos , Humanos , Secuencia Kelch , Malaria Falciparum , Mutación , Reacción en Cadena de la Polimerasa , Polimorfismo Genético , Proteínas ProtozoariasRESUMEN
OBJECTIVE: To assess the quality of microscopy-based malaria diagnosis in Yunnan Province from August 2012 to October 2014, and analyze the relevant factors. METHODS: Blood samples were collected from patients diagnosed as malaria by microscopy in county-level laboratories of Yunnan Province. The blood smears and blood filter paper samples were prepared and submitted to the provincial malaria diagnosis reference laboratory for further confirmation by both microscopy and the genetic approach. Coincidence rates for species identification between county and provincial laboratories were analyzed using the SPSS 21.0 software. RESULTS: From August 2012 to October 2014, 1 400 malaria cases were diagnosed with microscopy in 72 counties of Yunnan Province. Among them, the cases of falciparum malaria, vivax malaria, and unclassified malaria accounted for 18.4% (252/1,400), 79.3% (1,105/1,400) and 3.1% (43/1,400), respectively. The percentage of unclassified malaria cases reached a peak in 2012 (3.5%, 9/257). The coincidence rate for species identification with microscopy between county-level and provincial-level laboratories was 70.1% (845/1,216) in 2012, being the lowest during 2012-2014, and the coincidence rate for diagnosis of positive infection was 77.6% (943/1,216). Similarly, the coincidence rates for species identification and for positive infection between county-level laboratories using microscopy and the provincial-level laboratory using the genetic approach were 81.3% (150/185) and 85.0% (157/185) respectively in 2012, being also the lowest during 2012-2014. In the provincial laboratory, the inconsistency rate for species identification between microscopy and the genetic approach was 8.7% (97/1 120), predominately the infection-negative results by microscopy versus falciparum malaria, vivax malaria or mixed infection revealed by the genetic approach (57.7%, 56/97). The sampling coverage rate in counties was the lowest in November 2012 (46.9%, 82/175). The blood smear preparation scored 69.8, 70.4 and 78.8 (P < 0.05) in 2012, 2013 and 2014, respectively. CONCLUSION: The quality of laboratory malaria diagnosis has been significantly improved in most counties of Yunnan Province since 2013.
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Malaria , China , Coinfección , Humanos , MicroscopíaRESUMEN
Given the threat of climate change towards scleractinian corals, there is an urgent need to understand their physiological mechanisms of acclimation to increasing temperatures. To gain insight into this process, two mesocosm-based experiments were conducted in Southern Taiwan with the model reef-building coral Pocillopora damicornis. In the first study, temperature was gradually elevated to 32 °C, though reduced to ambient levels at night, in order to simulate a temperature profile that can characterize intertidal reefs of Southern Taiwan. All corals acclimated to such conditions over the course of the month-long experiment, as evidenced by a variety of physiological and sub-cellular responses. In the second experiment, corals were exposed continually to 31.5 °C for two weeks, and, in contrast to results from the first study, the majority of the corals died, revealing that prolonged exposure to this temperature is lethal for this dominant reef builder of many regions of the Pacific Ocean.