High Frequency Mutations in pfdhfr and pfdhps of Plasmodium falciparum in Response to Sulfadoxine-Pyrimethamine: A Cross-Sectional Survey in Returning Chinese Migrants From Africa.

Background: Sulfadoxine-pyrimethamine (SP) is recommended for intermittent preventive treatment in Africa against Plasmodium falciparum infection. However, increasing SP resistance (SPR) of P. falciparum affects the therapeutic efficacy of SP, and pfdhfr (encoding dihydrofolate reductase) and pfdhps (encoding dihydropteroate synthase) genes are widely used as molecular markers for SPR surveillance. In the present study, we analyzed single nucleotide polymorphisms (SNPs) of pfdhfr and pfdhps in P. falciparum isolated from infected Chinese migrant workers returning from Africa. Methods: In total, 159 blood samples from P. falciparum-infected workers who had returned from Africa to Anhui, Shangdong, and Guangxi provinces were successfully detected and analyzed from 2017 to 2019. The SNPs in pfdhfr and pfdhps were analyzed using nested PCR. The genotypes and linkage disequilibrium (LD) were analyzed using Haploview. Results: High frequencies of the Asn51Ile (N51I), Cys59Arg(C59R), and Ser108Asn(S108N) mutant alleles were observed, with mutation frequencies of 97.60, 87.43, and 97.01% in pfdhfr, respectively. A triple mutation (IRN) in pfdhfr was the most prevalent haplotype (86.83%). Six point mutations were detected in pfdhps DNA fragment, Ile431Val (I431V), Ser436Ala (S436A), Ala437Gly (A437G), Lys540Glu(K540E), Ala581Gly(A581G), Ala613Ser(A613S). The pfdhps K540E (27.67%) was the most predominant allele, followed by S436A (27.04%), and a single mutant haplotype (SGKAA; 62.66%) was predominant in pfdhps. In total, 5 haplotypes of the pfdhfr gene and 13 haplotypes of the pfdhps gene were identified. A total of 130 isolates with 12 unique haplotypes were found in the pfdhfr-pfdhps combined haplotypes, most of them (n = 85, 65.38%) carried quadruple allele combinations (CIRNI-SGKAA). Conclusion: A high prevalence of point mutations in the pfdhfr and pfdhps genes of P. falciparum isolates was detected among Chinese migrant workers returning from Africa. Therefore, continuous in vitro molecular monitoring of Sulfadoxine-Pyrimethemine combined in vivo therapeutic monitoring of artemisinin combination therapy (ACT) efficacy and additional control efforts among migrant workers are urgently needed.

Stability and bioavailability of vitamin D3 encapsulated in composite gels of whey protein isolate and lotus root amylopectin.

A gel delivery system was developed in the present work using whey protein isolate and lotus root amylopectin via regulating pH. The texture, thermodynamics, rheology and microstructure of gels were evaluated. Results showed that pH at 7.0 induced a more compact and stable gel structure than other pH. The composite gel formed at pH 7.0 was accordingly employed to encapsulate vitamin D3. Results exhibited that the encapsulation of composite gel of whey protein isolate and lotus root amylopectin could enhance the storage stability of vitamin D3 and protect vitamin D3 from photochemical degradation. Moreover, this encapsulation could control the release of vitamin D3 in simulated intestinal fluid. Animal experiments exhibited that the bioavailability was significantly increased after vitamin D3 was encapsulated by the composite gel. This work indicated that the whey protein isolate-lotus root amylopectin gel is a good delivery system to improve the stability and bioavailability of vitamin D3.

Characteristics of Imported Malaria and Species of Plasmodium Involved in Shandong Province, China (2012-2014).

Malaria remains a serious public health problem in Shandong Province, China; therefore, it is important to explore the characteristics of the current malaria prevalence situation in the province. In this study, data of malaria cases reported in Shandong during 2012-2014 were analyzed, and Plasmodium species were confirmed by smear microscopy and nested-PCR. A total of 374 malaria cases were reported, 80.8% of which were reported from 6 prefectures. Of all cases, P. falciparum was dominant (81.3%), followed by P. vivax (11.8%); P. ovale and P. malariae together accounted for 6.4% of cases. Notably, for the first time since 2012, no indigenous case had been reported in Shandong Province, a situation that continued through 2014. Total 95.2% of cases were imported from Africa. The ratio of male/female was 92.5:1, and 96.8% of cases occurred in people 20-54 years of age. Farmers or laborers represented 77.5% of cases. No significant trends of monthly pattern were found in the reported cases. All patients were in good condition after treatment, except for 3 who died. These results indicate that imported malaria has increased significantly since 2012 in Shandong Province, especially for P. falciparum, and there is an emergence of species diversity.

[Epidemiological analysis of malaria prevalence in Shandong Province in 2014].

OBJECTIVE: To understand the malaria epidemic situation and characteristics in Shandong Province in 2014, so as to provide evidences for taking targeted strategies and measures for malaria elimination. METHODS: The data of malaria epidemic and malaria cases of Shandong Province in 2014 were collected from Information Management System for Infectious Diseases Report and Information Management System for Parasitic Diseases Control and Prevention. The epidemiological characteristics of malaria situation and the diagnosis and treatment of malaria cases were analyzed by Microsoft Excel 2007. RESULTS: A total of 150 malaria cases were reported in Shandong Province in 2014, which increased by 14.50% compared with that in 2013 (131 cases). All the cases were imported from other countries except one imported from Yunnan Province in China, and most of the imported cases were from Africa (142 cases, 95.30%). All the cases were confirmed in Shandong Provincial Reference Laboratory and there were 121 cases (80.67%) infected with Plasmodium falciparum, 16 cases (10.67%) infected with P. vivax, 9 cases (6.00%) infected with P. ovale and 4 cases (2.67%) infected with P. malariae. The cases were mainly distributed in Tai'an (40 cases, 26.67%), Yantai (17 cases, 11.33%), Weihai (13 cases, 8.67%), Jining (11 cases, 7.33%) and Heze (11 cases, 7.33%) cities. CONCLUSIONS: There have been no local malaria cases reported in Shandong Province in the continuous 3 years. However, the reported number of imported malaria cases shows an increasing trend in the province in recent years, and the species of infected Plasmodium are diverse. Imported malaria from other countries is the key of malaria control in Shandong Province at present.

Plasma Level of D-dimer is an Independent Diagnostic Biomarker for Deep Venous Thrombosis in Patients with Ischemic Stroke.

This study was to determine the clinical diagnostic value of D-dimer for DVT in patients with ischemic stroke. During July 2013 to December 2014, a cohort study of ischemic stroke patients who presented with symptoms of DVT in upper or lower extremities was performed, with a total of 255 patients at baseline. D-dimer levels were measured from each patient using Colour Doppler Ultrasonography (CDUS), and all patients underwent venous duplex examinations. In ours study, 56 patients were diagnosed as DVT (22.0%). When compared to the patients without-DVT, a significantly increased trend of plasma D-dimer levels was found in stroke patients with DVT [3.07 (IQR, 2.26-4.05)mg/L VS. 0.54 (IQR, 0.27-1.14) mg/L; P<0.0001]. From the analysis results of the ROC curve, optimal cutoff value was 1.51 mg/L for diagnosing of DVT (sensitivity: 91.1 %; specificity: 85.4%; the AUC: 0.914 [95%CI, 0.878-0.950; P<0.001]). If cut-off value of 0.5 mg/L, the diagnosis sensitivity was 100%, the specificity was 46.2%, and the positive predictive value was 34.3%. In addition, 36.1% (92/255) stroke patients who suspected with DVT did not need perform CDUS, and those patients could be excluded by plasma D-dimer tested. Collectively, plasma D-dimer level may have a guiding meaning for diagnosing DVT in ischemic stroke patients, and the D-dimer assay is a reliable method for ruling out DVT.

[The Effects of NF-kappaB Signalling on the TNF-α induced Ratios of MMPs to TIMPs in Chondrocytes].

OBJECTIVES: To explore the influence of the NF-κB inhibitor (bay11-7082) on tumor necrosis factor-α (TNF-α)-induced different ratios of matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) in chondrocytes. METHODS: Chondrocytes were isolated from the knee joint of a 1-day old mouse by trypsin digestion method. Hematoxylin-Eosin (HE) stain was used to show the morphology of isolated chondrocytes; Semi-quantitative PCR was applied to analyze the influence of bay11-7082 on gene expressions of TNF-α-induced MMPsand TIMPsin chondrocytes; Zymography was used to elucidate activities of the gelatinases induced by TNF-α and/or bay11-7082. RESULTS: TNF-α up-regulated gene expressiosn of the MMPsand TIMPs(P<0.05). The ratios of MMPs/TIMPswere mostly increased except the part of MMP-1. Bay11-7082 could reduce TNF-α-induced MMPsand TIMPsgene expressions, and could make the increased ratio of MMPs/TIMPsdropped to the normal level of chondrocytes. Similar results were observed at the protein level of the gelatinases by zymography. CONCLUSIONS: TNF-α-induced high ratios of MMPs/TIMPs could partiallyexplain over-degradation of cartilage extracellular matrix in osteoarthritis (OA). Blockage of NF-κB with bay11-7082 might provide a possible therapeutic strategy for the OA deterioration.

[Detection of Genetic Mutations Associated with Drug Resistance in Imported Plasmodium falciparum].

Objective: To investigate the mutation of genes associated with drug resistance (Pfcrt, Pfmdr1, Pfdhfr and K13） in imported Plasmodium falciparum in Shandong Province. Methods: Blood was collected from 94 falciparum malaria cases who returned from Africa in 2014. Genomic DNA for P. falciparum was extracted from the blood samples and nested PCR was performed using primers specifically designed for Pfcrt, Pfmdr1, Pfdhfr and K13. The PCR products were sequenced. Gene mutations were analyzed by sequence alignment. Results: The 94 imported cases were from 18 African countries. Nested PCR was successful on DNA from all the blood samples except for Pfcrt amplification in one sample. Sequence analysis revealed three types of mutations Pfcrt K76T （36.6%, 34/93）, Pfmdr1 N86Y （21.3%, 20/94）, and Pfdhfr S108N （98.9%, 93/94） （χ2=127.5， P<0.05）. K13 C580Y mutation was not found. Co-occurrence of K76T, N86Y, and S108N was found in 6 blood samples （6.5%）, which were imported from Liberia（2）, Angola（1）, Equatorial guinea（1）, Congo（1）, and Guinea（1）. Co-occurrence of K76T and S108N mutations was found in 28 samples（30.1%）, and that of N86Y and S108N in 14 samples （15.1%）. Forty-four samples（47.3%） harbored S108N mutation only, and one sample was null for any of the mutations. Conclusion: There are mutations in Pfcrt, Pfmdr1, and Pfdhfr in imported Plasmodium falciparum in Shandong Province. No mutation was found for the K13 gene.

[Survey of infection situation of intestinal parasites of rural residents in plain area of Shandong Province].

OBJECTIVE: To understand the current situation of infections of intestinal parasites of rural residents in four cities namely Dongying, Weifang, Jining and Heze of Shandong Province. METHODS: Twenty-four villages were randomly selected as study areas. The Kato-Katz technique was applied to test the stool samples of adult residents and the cellophane tape anus method was applied to test the infection of Enterobius vermicularis of children aged 12 years or below. Fifty families were randomly selected from each village and surveyed with questionnaires for the general situation of the family, and the knowledge of prevention and control of parasites, and healthy behaviors of the family members. RESULTS: Totally 8,227 adult residents and 1,313 children were investigated and the total infection rate of intestinal parasites was 0.55% (45 cases). The infection rates of Ascaris lumbricoides, hookworm, Trichuris trichura, E. vermicularis and Clonorchis sinensis were 0.15% (12 cases), 0.06% (5 cases), 0.09% (7 cases), 1.37% (18 cases) and 0.04% (3 cases), respectively. Totally 3,767 residents were surveyed with questionnaires, and the awareness rate of the knowledge of prevention and control of parasites was 28.72% (1,082 cases), the formation rates of washing hands before meal, washing hands after toilet, washing fruit and vegetables before eating, and never drinking unboiled water were 60.66% (2,285 cases), 50.17% (1,890 cases), 48.71% (1,835 cases), and 87.07% (3,280 cases), respectively. CONCLUSION: In the plain area of Shandong Province, the infection rates of A. lumbricoides, hookworm, T. trichura and C. sinensis are low but the infection rate of E. vermicularis of children is relatively high; the awareness rates of the knowledge of parasites as well as the formation rates of healthy behaviors are low. Therefore, the health education and promotion should be strengthened.

[Survey of intestinal parasitic infections and related knowledge and behavior of residents in Jiaodong area of Shandong Province].

OBJECTIVE: To understand the status of intestinal parasitic infections and the related knowledge and behavior in residents of Jiaodong area of Shandong Province, so as to provide the evidence for making an appropriate preventive and control strategy. METHODS: A total of 18 villages from 6 counties in Jiaodong area were selected as investigation sites according to the stratified sampling method. The feces samples of the permanent residents aged above 3 years were collected and examined by Kato-Katz technique to find the intestinal parasite eggs, and the children under 12 years old were examined by the method of cellophane anal swab to detect the Enterobius vennrmicularis eggs. In addition, 50 households in each survey sites were randomly selected to investigate the basic family situation and the condition of awareness on prevention knowledge and formation of correct behavior of residents by using a structured questionnaire. RESULTS: Totally 6 163 residents involved in the feces examinations, and the total infection rate of intestinal parasites was 6.91%. The infection rates of Trichuris trichiura, Ascaris lumbricoides and hookworm were 6.56%, 0.62% and 0.21%, respectively. The infection rate of E. vermicularis in children under 12 years old was 0.51%. The eggs of Clonorchis sinensis and Taenia solium were not found in this survey. The awareness rate of knowledge about preventing parasitic diseases was 49.54%. The formation rates of washing hands before eating, washing hands after using the toilet, never eating raw fruit and vegetable without washing clean, never working in the field with bare feet, and never drinking unboiled water were 97.78%, 91.95%, 88.81%, 92.42% and 86.48% respectively. CONCLUSIONS: The infection rate of intestinal parasites is low in Jiaodong area, but there is a significant difference among different counties. The awareness rate of knowledge about preventing parasitic diseases is low, but the formation rate of healthy behavior is high. In the future, the health education and the strategy of taking medicine among the key population should be enhanced, and the project of reconstructing safe water supply and lavatory should be advanced.

[Analysis of malaria situation and discussion of control strategy in Shandong Province, 2013].

OBJECTIVE: To understand the malaria situation of Shandong Province in 2013, so as to provide the evidence for formulating targeted prevention and control strategy and measures. METHODS: The data of malaria cases of Shandong Province in 2013 were collected from the Information Management System for Infectious Diseases Report and Information Management System for Parasitic Diseases Control and Prevention. The data of epidemiological characteristics of malaria situation and the diagnosis and treatment of malaria cases were analyzed by Microsoft Excel 2007. RESULTS: There were 131 malaria cases reported in 2013, all of them were imported cases, and 127 cases (96.95%) were imported from African countries. A total of 116 cases (88.55% ) were falciparum malaria cases. Totally 97.71% of the cases were male and the average age of malaria cases was 39 years. A total of 61.83% of the cases were peasants and 65.65% of the cases only received junior high school education. The distribution of malaria cases was concentrated in Tai'an City (32 cases), Yantai City (19 cases) and Weihai City (17 cases),totally acounting for 53.13%. There was no significant seasonal variation in the reporting time of the cases. The median time from on- set to seeing doctor was four days and the median time from seeing doctor to being diagnosed was one day. Totally 35.88% of the cases were misdiagnosed when the first visit to a doctor. All of the cases were laboratory confirmed and 100% of them received the standard treatment after diagnosis. CONCLUSIONS: All of the malaria cases were imported cases in Shandong Province in 2013. To control the imported malaria in Shandong Province, it is necessary to further strengthen the multi-sectoral cooperation, health education, malaria screening and professional training.

[Large trophozoites in blood smear of falciparum malaria: one case report].

This paper reports one case of atypical falciparum malaria imported from Africa, whose blood smear contains many large trophozoites, with punctiform or massive brown pigment granules, the body shape of the plasmodium is similar to that of Plasmodium vivax and Plasmodium ovale. After the gene detection by PCR, the case was diagnosed as falciparum malaria. As large trophozoites were rarely seen in the peripheral blood of non-severe falciparum malaria cases, much attention should be paid to the identification of Plasmodium falciparum and other plasmodia in microscopic examinations.

TCAB1: a potential target for diagnosis and therapy of head and neck carcinomas.

BACKGROUND: WRAP53, including α, ß and γ isoforms, plays an important role not only in the stability of p53 mRNA, but also in the assembly and trafficking of the telomerase holoenzyme. It has been considered an oncogene and is thought to promote the survival of cancer cells. The aim of this study was to detect the role of TCAB1 (except WRAP53α) in the occurrence and development of head and neck carcinomas. METHODS: Immunohistochemistry was used to detect the TCAB1 expression in clinical specimen sections and performed western blotting to check the TCAB1 expression levels in cell lines. TCAB1 was depleted using shRNA lentivirus and the knockdown efficiency was assessed using q-PCR and Western blotting. We performed CCK-8 assays and flow cytometry to check the cell proliferation potential and used the trans-well assay to test the invasion ability in vitro. Xenografts were used to detect the tumor formation potential in vivo. Moreover, we performed cDNA microarray to investigate the candidate factors involved in this process. RESULTS: We observed a notable overexpression of TCAB1 in head and neck carcinoma clinical specimens as well as in carcinoma cell lines. Knockdown of TCAB1 decreased the cellular proliferation potential and invasion ability in vitro. cDNA microarray analysis suggested the possible involvement of several pathways and factors associated with tumorigenesis and carcinoma development in the TCAB1-mediated regulation of cancers. Furthermore, the xenograft assay confirmed that the depletion of TCAB1 would inhibit tumor formation in nude mice. The immunohistochemistry results of the mice tumor tissue sections revealed that the cells in shTCAB1 xenografts showed decreased proliferation potential and increased apoptotic trend, meanwhile, the angiogenesis was inhibited in the smaller tumors form shTCAB1 cells. CONCLUSIONS: Our study demonstrated that depletion of TCAB1 decreased cellular proliferation and invasion potential both in vitro and in vivo. The data indicated that TCAB1 might facilitate the occurrence and development of head and neck carcinomas. In future, TCAB1 might be useful as a prognostic biomarker or a potential target for the diagnosis and therapy of head and neck carcinomas.

[Analysis of results of technique competition for diagnosis of parasitic diseases in Shandong Province].

OBJECTIVE: To understand the capacity of Plasmodium detection and helminth detection and the mastery degree of basic knowledge of parasitic diseases. METHODS: Three professionals from each city were selected as contestants. The content of the competition contained three parts. The first part included making blood slides and Giemsa staining of Plasmodium, and identification of species and number with microscopy, the second part included making stool slides with Kato-Katz technique and identification of common helminth eggs with microscopy, and the third part was basic knowledge of parasitic diseases. RESULTS: Totally 51 contestants took part in the competition. The average score of the test of making blood slides was 14.8 +/- 3.3, and the passing rate was 82.4%. The average score of the identification of species and number of Plasmodium with microscopy was 19.2 +/- 9.3, and the passing rate was 29.4%. The average score of the test of making stool slides was 9.3 +/- 0.7, and the passing rate was 100%. The average score of the identification of common helminth eggs with microscopy was 28.0 +/- 2.6, and the passing rate was 100%. The average score of basic knowledge of parasitic diseases was 76.3 +/- 11.9, and the passing rate was 88.2%. The average score of the test of making blood slides in the female was higher than that in the male (15.7vs.13.5, P < 0.05), and the average score of the test of making blood slides in the intermediate title contestants was higher than that in the junior title contestants (16.1 vs.14.1, P < 0.05). The average score of the basic knowledge of parasitic diseases in the contestants from cities was higher than that in the contestants from towns (83.2 vs. 72.6, P < 0.05), and the average score of basic knowledge of parasitic diseases in the contestants from high economic level cities was higher than that in the contestants from low economic level cities (82.4 vs. 71.5, P < 0.01). CONCLUSIONS: For professionals in Shandong Province, the capacity of helminth detection was strong and the basic knowledge of parasitic diseases was mastered well, while the capacity of Plasmodium detection was weak.

[Investigation on awareness status of malaria control knowledge of primary and secondary school students in Shandong Province].

OBJECTIVE: To understand the awareness status of malaria control knowledge of primary and secondary school students in malaria endemic areas of Shandong Province, so as to provide the baseline information for formulating the malaria control strategy. METHODS: A cross-sectional survey was conducted in 5 Type II malaria-endemic counties in Shandong Province. A structured questionnaire survey was administrated to students in primary and secondary schools. RESULTS: A total of 1 884 students were completed with the questionnaires and all were effective. The total awareness rate of malaria control knowledge was 65.9%, and 54.7% of the students knew the transmission route of malaria and only 31.5% of the students were aware of the preventive methods of malaria. There were significant differences of the awareness scores of malaria control knowledge among different malaria endemic areas but there were no significant differences between the awareness rates of male and female students and between two different education levels. CONCLUSIONS: The awareness of malaria control knowledge of primary and secondary school students in Shandong Province is poor; therefore, the health education of malaria control knowledge for primary and secondary school students should be strengthened.

[Survey of infections of intestinal parasites and related factors in north-west Shandong Province].

OBJECTIVE: To understand the infection status of intestinal parasites and related knowledge and behavior factors of the residents in north-west Shandong Province, so as to provide the evidence for taking targeted preventive measures. METHODS: Eighteen villages were randomly selected as survey spots by the stratified multi-stage sample method. The Kato-Katz technique was used to detect intestinal parasite eggs among the residents and the cellophane tape anus test was used to detect Enterobius vermicularis eggs among 3-12 years old children. Questionnaires were applied to investigate related knowledge and behavior factors about the intestinal parasite infections in the residents. RESULTS: Totally 6 366 residents were detected for intestinal parasites and the infection rate was 0.28% (18 cases). Totally 895 children were detected for E. vermicularis and the infection rate was 5.70% (51 cases). Totally 2 915 residents were investigated by questionnaires and the awareness rate of knowledge about preventing parasitic diseases was 26.72%. The formation rates of washing hands before meal and after WC, washing fruit and vegetable before eating, never drinking unboiled water were 55.42%, 42.87%, 43.54% and 83.04% respectively. The awareness rate of knowledge about preventing parasitic diseases of 3-12 years old children was 12.24%; and the formation rates of washing hands before meal and after WC were 47.04% and 30.44% respectively. CONCLUSIONS: The total infection rate of intestinal parasites is low but the E. vermicularis infection rate is high among children in north-west Shandong Province. The awareness rate of knowledge about preventing parasitic diseases and the formation rates of healthy behaviors are all low. Therefore, the targeted health education should be taken to increase the awareness rate and guide the residents to develop their healthy behaviors.

[Analysis of malaria endemic situation in Shanxian County from 2002 to 2011].

OBJECTIVE: To analyze the endemic situation of malaria in Shanxian County, Shandong Province, China in the last 10 years, so as to understand the epidemiological characteristics of the disease and provide the evidence for the establishment of control strategy to eliminate malaria. METHODS: The data related to the endemic situation of malaria in Shanxian County from 2002 to 2011 were collected and analyzed. RESULTS: From 2002 to 2011, 125 cases of malaria were reported, and the annual incidences were in the range of 0.18/100,000-2.00/100,000. Totally 60.80% of the cases focused on 3 townships, namely Fugang, Huanggang and Caozhuang. All the 125 cases were new vivax malaria cases, among them, 121 were locally infected, and the other 4 were imported. The epidemic season was from June to October, and the peak time was from July to September. There were more male cases than female cases. The ages of the cases were from 1 to 83 years old, and the incidence in those aged from 46-60 years old was higher. CONCLUSIONS: The malaria incidence in Shanxian County is on the rise, and the 3 townships in the south are the key areas for control. The control measures including the surveillance of floating population and mosquitoes, and malaria control health education should be strengthened.

Disruption of the blood-brain barrier after generalized tonic-clonic seizures correlates with cerebrospinal fluid MMP-9 levels.

BACKGROUND: Increasing evidence suggests seizures cause blood-brain barrier (BBB) dysfunction including decreased seizure threshold and higher onset potential of future seizures. However, the mechanisms underlying BBB damage in seizures remains poorly understood. Evidence in human and animal models shows BBB disruption is associated with activation of matrix metalloproteinase-9 (MMP-9) after cerebral ischemia and inflammation. The objective of this study was to determine whether MMP-9 concentrations in cerebral spinal fluid (CSF) are associated with BBB disruption in patients after epileptic seizures. METHODS: Thirty-one patients with generalized tonic-clonic (GTC) seizures were included in the study: 20 had recurrent GTC seizures (RS), and 11 had a single GTC seizure (SS) episode. Twenty-five adult non-seizure patients were used as controls. CSF samples were collected by lumbar puncture within 24 h after seizure cessation (range: 3-15 h, mean 6.2 h). CSF MMP-9 levels were determined by an enzyme-linked immunosorbent assay (ELISA). MMP enzyme activity was measured by gelatin zymography. The CSF/serum albumin ratio (albumin quotient, QAlb) was used as a measure of blood-brain barrier permeability. RESULTS: We found significantly higher CSF MMP-9 concentrations in seizure patients compared with controls (P < 0.001). CSF MMP-9 levels and QAlb values were higher in RS patients compared with SS and controls. Moreover, CSF MMP-9 concentration showed strong correlation between QAlb values (r = 0.76, P < 0.0001) and between CSF leukocyte counts (r = 0.77, P < 0.0001) in patients after seizures. Gelatin zymography showed MMP-9 proteolytic activity only in GTC seizure patients. CONCLUSIONS: Our results suggest MMP-9 plays a role in BBB dysfunction, characterized by invasion of leukocytes into the CSF during seizures.

[Control strategy and practice of soil-transmitted parasitic diseases in Shandong Province].

OBJECTIVE: To explore the sustainable development control strategies on soil-transmitted parasitic diseases appropriate to current epidemic characteristics so as to effectively reduce the epidemic level and harm to people in Shandong Province. METHODS: This project was led by the Shandong Medical Department, governed and instructed by the Shandong Institute of Parasitic Diseases, concretely implemented by the centers for disease control and prevention in counties or cities. All the work was carried out according to the Control Programming of National Key Parasitic Diseases, and with the combination of routine and key control strategies according to the actual situation. RESULTS: The average infection rate of soil-transmitted parasitic diseases in Shandong Province was 18.26% in 2003. During the 2007 to 2009 period, 3,115,194 people from 74 counties in 9 cities received anthelmintic medicine. The numbers receiving health education were 39 866 923 in county, 34,730,663 in city, 3,2000 in province, respectively. The coverage rate of non-hazardous sanitary latrines was 58.05%. In 2009, 6,581 people were surveyed from 7 counties or cities and the infection rate of soil-transmitted parasitic diseases was 7.61%. During three years, 30 provincial training classes were held and 2,130 people attended, 52 municipal classes were held and 3110 people attended, and 403 county classes were held and 12,789 people attended. In the whole province, the infection rate of soil-transmitted parasitic diseases reduced to 7.10% in 2009, with the reduction rate of 61.12%, reaching the national objective. CONCLUSIONS: The comprehensive control model for soil-transmitted parasitic diseases is very successful in Shandong Province.

[Epidemiological analysis of malaria prevalence in Shandong Province in 2012].

OBJECTIVE: To understand the characteristics of malaria prevalence and epidemic in Shandong Province in 2012 so as to provide the evidence for improving the work of the elimination of malaria. METHODS: The epidemiological data of malaria cases collected from the Disease Surveillance Information Reporting System of Chinese Center for Disease Control and Prevention were analyzed with the descriptive epidemiological method for epidemiological characteristics of malaria. RESULTS: A total of 93 malaria cases were reported in Shandong Province in 2012 with the incidence of 0.097 per 100 thousand, with a reduction of 19.83% as compared to 2011. There were 93 imported cases which decreased by 4.12% compared with 97 cases in 2011 and it was the first year that there was no local infection. Jining, Qingdao and Weihai cities reported more cases, with 62.37% (58/93) of the total number of the whole province. Totally 93.55% of malaria cases were imported from Africa, most from Equatorial Guinea, Nigeria and Angola. There were 3 cases of imported ovale malaria firstly reported. CONCLUSIONS: There were no local malaria cases reported in Shandong Province in 2012, but the imported malaria prevention and control was still not optimistic. In order to achieve the goal of malaria elimination in Shandong Province, it needs to continue to strengthen epidemic management, professional training and work supervision, strengthen management, advocacy and detection on the floating population, and explore multisectoral coordination mechanisms.

[Effects of integrated malaria control measures in Shandong Province, 2010].

A total of 117 malaria patients were reported in Shandong Province, 2010 and the annual incidence was 0.13 per hundred thousand. Totally 23 cases of malaria were reported in Shanxian County, which was the most; and 6 patients who came back from Africa were reported in Daiyue County, which was the second. A total of 296 230 fever patients were examined with blood tests, and the positive rate was 0.03%. Totally 101 diapause patients were administered with medicine, and the administered rate was 95.28% and the regular administered rate was 100%. For the present patients, the regular administered rate was 100%. There were 73 malaria epidemic foci and they were all treated, and the area of residual spraying was 51.98 hm2. The malaria epidemic was steady declined in Shandong Province. Although the prevention and control work achieved desired results, the monitor for mobile population and mosquitoes still should be strengthened to prevent the malaria epidemic increasing or outbreak.