[Pre-operative prognostic nutritional index as a predictive factor for prognosis in non-metastatic renal cell carcinoma treated with surgery].

OBJECTIVE: To evaluate the implications of the prognostic nutrition index (PNI) in non-metastatic renal cell carcinoma (RCC) patients treated with surgery and to compare it with other hematological biomarkers, including neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and systemic immune inflammation index (SII). METHODS: A cohort of 328 non-metastatic RCC patients who received surgical treatment between 2010 and 2012 at Peking University First Hospital was analyzed retrospectively. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cutoff values of the hematological biomarkers. The Youden index was maximum for PNI was value of 47.3. So we divided the patients into two groups (PNI≤ 47. 3 and >47. 3) for further analysis. Categorical variables [age, gender, body mass index (BMI), surgery type, histological subtype, necrosis, pathological T stage and tumor grade] were compared using the Chi-square test and Student' s t test. The association of the biomarkers with overall survival (OS) and disease-free survival (DFS) was analyzed using Kaplan-Meier methods with log-rank test, followed by multivariate Cox proportional hazards model. RESULTS: According to the maximum Youden index of ROC curve, the best cut-off value of PNI is 47. 3. Low level of PNI was significantly associated with older age, lower BMI and higher tumor pathological T stage (P < 0.05). Kaplan-Meier univariate analysis showed that lower PNI was significantly correlated with poor OS and DFS (P < 0.05). In addition, older age, lower BMI, tumor necrosis, higher tumor pathological T stage and Fuhrman grade were significantly correlated with poor OS (P < 0.05). Cox multivariate analysis showed that among the four hematological indexes, only PNI was an independent factor significantly associated with OS, whether as a continuous variable (HR=0.9, 95%CI=0.828-0.978, P=0.013) or a classified variable (HR=2.397, 95%CI=1.061-5.418, P=0.036). CONCLUSION: Low PNI was a significant predictor for advanced pathological T stage, decreased OS, or DFS in non-metastatic RCC patients treated with surgery. In addition, PNI was superior to the other hematological biomar-kers as a useful tool for predicting prognosis of RCC in our study. It should be externally validated in future research before the PNI can be used widely as a predictor of RCC patients undergoing nephrectomy.

[Current status and challenges for taeniasis and cysticercosis control in China].

In the WHO new road map for neglected tropical diseases 2021-2030, the disease-specific targets are classified into control, elimination as a public health problem, elimination and eradication, and taeniasis and cysticercosis are targeted for control. The overall prevalence of taeniasis and cysticercosis is low in China, and varies remarkably in regions and populations; however, there are many challenges for elimination of taeniasis and cysticercosis in China. Based on previous taeniasis and cysticercosis control programs, developing a sensitive taeniasis and cysticercosis surveillance-response system, updating criteria for diagnosis of taeniasis and cysticercosis, proposing a national guideline for treatment of taeniasis and cysticercosis, and strengthening interdisciplinary and intersectoral communications and collaborations are urgently needed under the One Health concept.

[Prevalence of soil - borne nematode infections among residents living in urban/town areas of China in 2015].

OBJECTIVE: To understand the prevalence of soil-borne nematode infections among residents living in urban/town areas of China, so as to provide insights into the control and elimination of soil-borne nematodiasis. METHODS: A total of 5 epidemic areas were classified in China according to the prevalence of human Clonorchis sinensis infections captured from the 2014-2015 national survey on major human parasitic diseases in China, and the total sample size was estimated according to the binomial distribution and Poisson's distribution. Then, the total sample size was allocated proportionally to each province (autonomous region, municipality) of China based on the percentage of residents living in urban and town areas, and the number of survey sites in each province (autonomous region, municipality) was proportionally assigned according to the percentages of residents living in urban and town areas. Then, stratified sampling was performed at county, township and community levels according to the number of sampling sites in each province (autonomous region, municipality), and the survey site (community) was defined as the smallest sampling unit. All permanent residents in the survey sites were selected as the study subjects, and their stool samples were collected for identification and counting of parasite egg using a Kato-Katz technique. The prevalence and intensity of each parasite species were calculated. RESULTS: From 2014 to 2015, among the 133 231 residents detected in 31 provinces (autonomous regions, municipalities) of China, the overall prevalence of soil-borne nematode infections was 1.23% (1 636/133 231), and the prevalence rates of hookworm, Ascaris lumbricoides and Trichuris trichiura infections were 0.77% (1 032/133 231), 0.32% (426/133 231) and 0.17% (224/133 231), respectively. The highest prevalence of soil-borne nematode infections was seen in Jiangxi (4.03%, 82/2 034) and Chongqing (4.03%, 524/13 012), followed by in Hainan (3.47%, 72/2 075). The prevalence of soilborne nematode infections was 1.07% (662/62 139) in men and 1.37% (974/71 092) in women, and the greatest prevalence was found in residents at ages of 65 to 70 years (2.56%, 219/8 569). With regard to occupations and education levels, herdsmen (2.47%, 2/81) and illiterate residents (3.33%, 226/6 795) were found to have the highest prevalence of soil-borne nematode infections, respectively. In addition, mild infections were predominantly identified in hookworm-, A. lumbricoides- and T. trichiura-infected individuals (all > 90%). CONCLUSIONS: The overall prevalence of soil-borne nematodiasis remains low in urban and town areas of China; however, human infections are widespread. According to the epidemiological features, health education combined with deworming are recommended to reduce the prevalence of soil-borne nematode infections among residents living in urban and town areas of China.

[National surveillance on Enterobius vermicularis infections among children at ages of 3 to 9 years in China from 2016 to 2018].

OBJECTIVE: To understand the epidemic status of Enterobius vermicularis infections among children aged 3 to 9 years in China, so as to provide scientific basis for the formulation of the prevention and control strategies for enterobiasis. METHODS: The national surveillance of enterobiasis was performed in 736 national surveillance sites (counties) from 30 provinces (municipalities/autonomous regions) in China from 2016 to 2018. All surveillance sites were classified into parts according to the geographical directions, including the eastern, western, southern, northern and middle parts, and a township was randomly selected from each part. Then, an administrative village was randomly selected from the township, and 200 permanent residents at ages of over 3 years living in the administrative village were randomly selected using the cluster sampling method. A total of 1 000 residents were examined in each surveillance site. E. vermicularis infections were detected among children at ages of 3 to 9 years using the modified Kato-Katz technique and the adhesive cellophane-tape perianal swab method, and the prevalence of infections was calculated and compared. RESULTS: The prevalence of E. vermicularis infections was 2.50%, 2.84% and 2.46% among children at ages of 3 to 9 years in the 736 surveillance sites from 30 provinces (municipalities/autonomous regions) in China from 2016 to 2018, and there was no gender-specific prevalence of E. vermicularis infections (P > 0.05). Enterobiasis was main prevalent in the southern and southwestern part of China (Jiangxi, Guangxi, Guangdong, Sichuan, Fujian, Chongqing and Hainan), with 5.00% prevalence and greater, and the highest prevalence was seen in Jiangxi and Guangxi for successive 3 years. In addition, the prevalence of E. vermicularis infections was higher in children with the Han ethnicity than in those with the minority ethnicity, and a high prevalence was found in children at ages of 4 to 7 years, and a low prevalence seen in children at ages of 3, 8 and 9 years. CONCLUSIONS: The prevalences of E. vermicularis infections have not changed much among children at ages of 3 to 9 years in China from 2016 to 2018, and high prevalence is seen in southern and southwestern China, which should be given a high priority.

[Establishment of an evaluation system for the field assessment of the Kato-Katz technique in detection of soil-transmitted nematodiasis].

OBJECTIVE: To establish an evaluation system for the field assessment of the Kato-Katz technique in detecting soiltransmitted nematodes, so as to provide insights into the field application of the Kato-Katz technique. METHODS: The initial evaluation indicators were determined through literature search, brainstorming and expert consultation. The evaluation indicatorswere improved and the weight of each indicator was decided through three rounds of expert consultation by using the Delphimethod. In addition, the expert authority coefficient and the coordination coefficient of each indicator were calculated at eachround of expert consultations. RESULTS: The recovery rates of the questionnaire were 100.00%, 100.00% and 89.29% at the firstto the third round of the expert consultations, respectively, and the expert authority coefficients were all more than 0.85 at eachround. The final evaluation system included 4 first-level indicators and 15 second-level indicators. In the first-level indicators, "detecting effect" and "funds investment" had the mean weighted value of 4.53 and 4.49, which were relatively higher than that of"person-time investment" and "operability" (both 4.34). Among the second-level indicators under each first-level indicator, thefour most significant indicators included "ability of personnel in egg discrimination", "cooperation of village cadres and doctors","Person-time on testing" and "organizational start-up cost", with the mean weighted values of 4.74, 4.43, 4.39 and 4.17, respectively. The coordination coefficients were 0.39 to 0.65, 0.28 to 0.58 and 0.45 to 0.65 at the first to the third round of the expertconsultations, respectively, and there were significant differences in the coordination coefficients at all three rounds of the consultations (all P < 0.05). CONCLUSIONS: An evaluation system for the field assessment of the Kato-Katz technique in detecting soiltransmitted nematodes is successfully established, among which "ability of personnel in egg discrimination" and "cooperation ofvillage cadres and doctors" have the greatest mean weighted values of the significance.

[Establishment and role of national clonorchiasis surveillance system in China].

Clonorchiasis is one key food-borne parasitic disease in China. Owing to several years'efforts and preparation, the national clonorchiasis surveillance system in China has been established preliminarily since 2016. In this article, the necessity to establish the national clonorchiasis surveillance system is explained. Then, the structure, content and corresponding methods of the surveillance system are briefly introduced. Key points in the surveillance are summarized and the development of surveillance in future is discussed. Furthermore, the contribution of clonorchiasis surveillance in China to the world is also analyzed.

Immune effect and safety evaluation of vaccine prepared by dendritic cells modified by rAAV-carrying BCSG1 gene.

The immune effect and safety evaluation of rAAV (recombinant adeno-associated virus)-containing Bcsg1 (breast cancer-specific gene 1) (rAAV/Bcsg1)-transfected DC (dendritic cell) (rAAV/Bcsg1-DC) vaccine in immunotherapy for (BCSG1) (+) BC was assessed. Immune effect of cytotoxic T lymphocytes (CTLs) on Bcsg1 (+) BC cells, and rAAV gene residuals in mature CTL cells and culture medium were determined. Nude mouse xenograft tumor model was established to assess the inhibition effects of DC-activated CTLs on tumor growth. DC cell surface markers were highly expressed in rAAV/Bcsg1 group and lysate-DC group, and rAAV/Bcsg1-DC-CTL showed stronger cytotoxic activity targeting Bcsg1 (+) BC cells. The rAAV/Bcsg1-DC vaccine-treated groups showed lower mean tumor weight, higher tumor inhibition rates and slower tumor growth. rAAV/Bcsg1-DC can induce highly efficient CTL-targeting Bcsg1 antigen without rAAV gene residuals.

MMP-9 is increased in the pathogenesis of gastric cancer by the mediation of HER2.

Human epidermal growth factor receptor 2 (HER2) overexpression is not only closely associated with the tumor growth, but is also related to tumor invasion. We here aimed to investigate the mechanism of HER2 mediation in the pathogenesis of gastric cancer. The human gastric cancer cell lines SGC-7901, MKN-45, AGS, the immortalized cell line GES-1 derived from normal gastric mucosa. Cell transfection and selection of stable cell lines and the gene and protein levels of HER2 and Matrix metalloproteinase-9 (MMP-9) were examined to determine the molecular relationship between them in the pathogenesis of gastric cancer. The human gastric cancer cell lines SGC-7901, MKN-45, AGS, the immortalized cell line GES-1 derived from normal gastric mucosa. Cell transfection and selection of stable cell lines and the gene and protein levels of HER2 and MMP-9 were examined to determine the molecular relationship between them in the pathogenesis of gastric cancer. We demonstrated that vector-based shRNA significantly knocked down the expression of HER2 and considerably inhibited both the migration and invasion of gastric cancer cells. HER2 knockdown resulted in the downregulation of the expression of MMP-9, whereas HER2 overexpression improved the transcription of MMP-9 through the activation of an MMP-9 promoter. The promoter region of MMP-9 between -2500 and -2000 bp was found to be crucial for the upregulation of HER2-mediated transcription. Furthermore, a truncated promoter (-70 to +63) did not display any transcriptional activity. Cell invasion activity was almost completely inhibited when MMP-9 was knocked down. Conversely, the overexpression of MMP-9 partly rescued the invasion ability of cell strains with knockdown HER2. These findings help further understanding of the molecular mechanisms through which HER2 promotes malignancy, and suggest that targeting both HER2 and MMP-9 may be required to effectively block HER2 signaling in gastric cancer therapy.

WITHDRAWN: Expression analysis of Sca-1 and its significance in lung cancers.

Ahead of Print article withdrawn by publisher. The purpose of the present study was to determine the expression of Sca-1, the stem cell marker, among various lung cancers and evaluate their utility. Immunohistochemistry was done in 151 surgically resected lung cancer specimens or biopsies, including 76 cases of adenocarcinoma, 50 cases of squamous cell carcinoma, 15 cases of small cell carcinoma, 6 cases of adenosquamous cell carcinoma and 4 cases of large cell carcinoma. The results showed that 88 (58.3%) cases were Sca-1 positive. Further analysis showed that in cases of adenocarcinoma, the rate of lymph node invasion and poor differentiation level of Sca-1(+) specimens were respectively higher than those of Sca-1(-) specimens. In cases with small cell carcinoma and squamous cell carcinoma, the rates of lymph node invasion of Sca-1(+) specimens were respectively higher than those of Sca-1(-) specimens. Survival analysis showed that for patients with adenocarcinoma and small cell carcinoma, the average survival time of Sca-1(+) patients was significantly shorter than that of Sca-1(-) patients. Further mutation analysis showed that EGFR mutation rates in Sca-1 (-) adenocarcinoma patients were significantly higher than those of Sca-1 (+) patients, while p53 and KRAS mutation rates in Sca-1 (-) adenocarcinoma and squamous cell carcinoma patients were respectively lower than those of Sca-1 (+) patients. Western blots analysis showed that expression of a Src family tyrosine kinase, Fyn, was positively related with Sca-1 expression levels. These results suggested that Sca-1 expression in some human lung cancers was related with malignancy phenotype and survival time. Keywords: Sca-1 expression, stem cancer cell, lung cancer, malignancy phenotype.

Human lung cancer cell line SPC-A1 contains cells with characteristics of cancer stem cells.

Cancer stem cells (CSCs) play important roles in occurrence, development, recurrence and metastasis of cancer. Isolation and identification of CSCs have been performed from some cancer tissues or cells. In this paper, human lung adenocarcinoma stem cells were induced and isolated from SPC-A1 cells and their characteristics were determined. SPC-A1 cells were cultured in serum-free medium and epidermal growth factor and basic fibroblast growth factor were added into the medium to induce the formation of multicellular tumor spheroids. The results showed that floating multicellular tumor spheroids (named pulmospheres) were formed 5-10 d after the induction of SPC-A1 cells. Real-time PCR analysis showed that in the pulmospheres, the marker of bronchioalveolar stem cells, Clara cell secretary protein and the marker of AT2 cells, alveolar surfactant protein C were highly expressed. Furthermore, such embryonic stem cell markers as octamer-binding transcription factor 4 (OCT-4), Bmi-1, and thyroid transcription factor -1 (TTF-1) were also highly expressed. Some miRNAs as hsa-miR-126, hsa-miR-145, hsa-let-7g, hsa-let-7d, hsa-let-7c, hsa-let-7e and hsa-miR-98, which were lowly expressed in SPC-A1 cells, were not expressed in the pulmospheres. Cell cycle analysis showed that 94.29 % of the pulmosphere cells were in G1 stages. Further study showed that these cells possessed higher proliferation and invasion activity than SPC-A1 cells. Tumorigenicity activity experiments on BALB/c nude mice showed that 1 × 103 of the pulmosphere cells could form tumors with similar pathological features with lung adenocarcinoma. In conclusion, lung adenocarcinoma stem cells were enriched in the pulmosphere cells and were with high tumorigenicity.

Recent researches in triazole compounds as medicinal drugs.

Triazole compounds containing three nitrogen atoms in the five-membered aromatic azole ring are readily able to bind with a variety of enzymes and receptors in biological system via diverse non-covalent interactions, and thus display versatile biological activities. The related researches in triazole-based derivatives as medicinal drugs have been an extremely active topic, and numerous excellent achievements have been acquired. Noticeably, a large number of triazole compounds as clinical drugs or candidates have been frequently employed for the treatment of various types of diseases, which have shown their large development value and wide potential as medicinal agents. This work systematically reviewed the recent researches and developments of the whole range of triazole compounds as medicinal drugs, including antifungal, anticancer, antibacterial, antitubercular, antiviral, anti-inflammatory and analgesic, anticonvulsant, antiparasitic, antidiabetic, anti-obesitic, antihistaminic, anti-neuropathic, antihypertensive as well as other biological activities. The perspectives of the foreseeable future in the research and development of triazole-based compounds as medicinal drugs are also presented. It is hoped that this review will serve as a stimulant for new thoughts in the quest for rational designs of more active and less toxic triazole medicinal drugs.

A methodology of characterizing status and trend of land changes in oases: a case study of Sangong River watershed, Xinjiang, China.

Land change is often studied with Markov models to develop a probability transition matrix. The existing methods dependent on such matrixes cannot effectively characterize some important aspects associated with land change such as status, direction, trend and regional variations. This study presents mathematical models to quantify these elements, defining unbalanced, quasi-balanced and balanced status, one- and two-way transitions and the rising or falling trends. Using these models and remote-sensing imageries, the landscape was studied for a case area, the oasis of Sangong River in Xinjiang, Northwest China where typical arid conditions prevail. Land expansion and contraction among various land types and for the entire oasis were analyzed for the periods of 1978-1987, 1978-1998 and 1987-1998. The changes were closely related to a strong economic growth after the land-reform campaign and adoption of the market economy in China in the 1980s to early 1990s, a process not strictly Markovian that requires stationarity and randomness. Information on land-change status and trend is important for a better understanding of the underlying driving processes but also for land-use planning and decision-making.

Citrus and Coffee Strains of Xylella fastidiosa Induce Pierce's Disease in Grapevine.

Xylella fastidiosa causes citrus variegated chlorosis (CVC) disease in Brazil and Pierce's disease of grapevines in the United States. Both of these diseases cause significant production problems in the respective industries. The recent establishment of the glassy-winged sharpshooter in California has radically increased the threat posed by Pierce's disease to California viticulture. Populations of this insect reach very high levels in citrus groves in California and move from the orchards into the vineyards, where they acquire inoculum and spread Pierce's disease in the vineyards. Here we show that strains of X. fastidiosa isolated from diseased citrus and coffee in Brazil can incite symptoms of Pierce's disease after mechanical inoculation into seven commercial Vitis vinifera varieties grown in Brazil and California. Thus, any future introduction of the CVC strains of X. fastidiosa into the United States would pose a threat to both the sweet orange and grapevine industries. Previous work has clearly shown that the strains of X. fastidiosa isolated from Pierce's disease- and CVC-affected plants are the most distantly related of all strains in the diverse taxon X. fastidiosa. The ability of citrus strains of X. fastidiosa to incite disease in grapevine is therefore surprising and creates an experimental system with which to dissect mechanisms used by X. fastidiosa in plant colonization and disease development using the full genome sequence data that has recently become available for both the citrus and grapevine strains of this pathogen.

Development of a K562 cell-based assay for screening anticancer agents.

AIM: To develop a leukemia cell line K562-based assay for high-throughput screening. METHODS: The screening was carried out on 96-well plates with monitoring cell proliferation by a combined 3-[4,5-dimethylthiazol-2-yl]-5-[3-carboxymethoxyphenyl]-2-[4-sulfophenyl]-2H-tetrazolium (MTS)/phenazine methosulfate (PMS) method. Conditions for evaluating effects on the proliferation of K562 cells by individual compounds on the 96-well plates were optimized. RESULTS: A set of 800 small organic compounds was screened for anticancer activity by this cell-based assay, with consumption of each compound at 500 ng. Eleven compounds were identified with >80 % inhibitory activity at 5 mg/L, among which 9 compounds were confirmed by subsequent testing at multiple concentrations. The most potent compound showed an IC50 at 170 nmol/L, and there were total of 7 compounds showed IC50 less than 10 micromol/L. CONCLUSION: The high-throughput method using K562 cell line is fast, economical, effective, and practical in identifying inhibitors as potential therapeutic agents for cancer.

[On cleanliness of hands in diminution of Ascaris lumbricoides infection in children].

OBJECTIVE: To study the relationship between cleanliness of children's hands and diminution of Ascaris lumbricoides infection. METHODS: Before the study all persons positive for ascaris eggs in the preliminary survey were treated with albendazole. Hand-washing habit before meal and after defecation was kept in children of experimental group, but not in the control group. Kato thick smear stool examination was done once every two months for one year to compare the new infection rates in children without ascaris infection in the two groups, and the reinfection rates in the cured negative cases were also compared between them in half a month after chemotherapy. RESULTS: All the new infection rates as well as reinfection rates of each reexamination in the experimental group were significantly lower than that of the control group (P < 0.001). Reexamination one year later showed that the ascaris infection rate of the experimental group was 35.2%, reducing by 48.5% as compared with 68.3% before the operation of the project; while ascaris infection rate of the control group was 73.7%, increasing by 78.0% as compared with 41.4% before the operation of the project. CONCLUSION: Washing hands with toilet soap to keep hands clean can significantly reduce ascaris infection rate.

[Effects of Chinese materia medica in activating blood and stimulating menstrual flow on the endocrine function of ovary-uterus and its mechanisms].

Effects of Salvia miltiorrhiza (SM), Ligusticum chuanxiong (LC) and Artemisia anomale (AA) on the endocrine function of ovary-uterus were studied. In immature Wistar rats, SM increased the level of estradiol (E2) in plasma (131.8 +/- 7.4 pg/ml, P less than 0.01), the weight of uterus (35.3 +/- 4.5 mg, P less than 0.05) and the ovarian PGF2 alpha content (495.0 +/- 41.7 pg/ova., P less than 0.05), but the ovarian PGE2 content was reduced (2198.3 +/- 139.0 pg/ova, P less than 0.01), as compared with that in the control (96.6 +/- 3.2 pg/ml, 23.3 +/- 2.6 mg, 339.0 +/- 30.0 pg/ova, and 3840.8 +/- 480.0 pg/ova. respectively). LC and AA had no influence except that they decrease PGE2 content in ovary (2534.8 +/- 351.3 and 2629.7 +/- 290.7 pg/ova). AA decreased the receptor binding capacity for E2 in uterus (P less than 0.05). SM stimulated the ovulation in immature mice pre-treated with PMSG. LC and AA had no significant effect on ovulation. In pseudopregnant rats (with PMSC-hCG), SM, LC and AA all inhibited the function of corpus luteum, decreased the level of progesterone in plasma (11.1 +/- 2.8, 15.5 +/- 2.5, 19.3 +/- 5.6, respectively, 55.4 +/- 5.4 ng/ml in control, P less than 0.01) and hCG/LH receptor binding capacity of ovary (P less than 0.01). In pseudopregnant animals treated with AA, endogenous PGE2 content of ovary (50.2 +/- 2.7 pg/ml ova.) and the formation of PGE2 form AA in vitro in ovary (1765 +/- 166 pg/mg ova.) were reduced. The PGF2 alpha content in uterus was increased.(ABSTRACT TRUNCATED AT 250 WORDS)

[Treatment of soil-transmitted helminth infections by anthelmintics in current use].

The efficacy of broad-spectrum anthelmintics in current use was studied in Hengshan County, Hunan Province. The vermicides under study include albendazole (400mg, single dose), mebendazole composite (mebendazole 100 mg and levamisole 25mg bid x 3d), oxantel pyrantel pamoate composite (pyrantel pamoate 150 mg and oxantel pamoate 150 mg bid x 2d), and pyrantel pamoate composite (base 10 mg/kg, single dose). Therapeutic effect assessed 2 weeks after medication revealed Ascaris egg negative rates or cure rates (CR) of 97.5-100% for the former 3 regimens, and 80.9% for the latter one; while CR for hookworm infection were 95.4%, 78.6-100%, 96.7% and 83.3%, respectively. A follow-up survey pursued 4 weeks post treatment showed no significant difference in CR for the above regimens. Judging from CR in Trichuris trichiura infection, pyrantel pamoate composite was recommended as the drug of choice (89.3%), which was followed by mebendazole composite (64.6-83.8%) and albendazole (28.2-42.6%), whereas pyrantel pamoate was inefficacious. Obvious egg reduction rates were evidenced post application of the above drugs in trichuriasis treatment except pyrantel pamoate at single dose.