Association between cancer health literacy and cancer-related behavior of residents in Shandong, China.

Health literacy is closely related to the incidence of major chronic diseases and its related behaviors such as cancer-related behaviors. This study explored how the cancer health literacy level affects cancer-related behaviors. About one to two villages from six cities of Shandong province were selected as sample areas. Professionals conducted face-to-face interviews with the participants. Finally, 1200 residents completed 1085 effective questionnaires. Data were analysed from a cross-sectional survey in 2019, which included 1085 residents in six cities/counties of Shandong province, China. The result showed that residents with high cancer health literacy were more likely to eat fruits and vegetables frequently, avoid eating moldy food and take exercise. Besides, they were more likely to engage in health education and have a higher willingness to pay for cancer screenings. Most residents in Shandong province have a basic level of cancer health literacy. Improving the cancer health literacy of the population can be an effective strategy to promote a healthier lifestyle, thereby reducing the incidence rates related to cancers.

Association between the location of social medical insurance and social integration among China's elderly rural migrants: a nationwide cross-sectional study.

BACKGROUND: Universal social medical insurance coverage is viewed as a major factor in promoting social integration, but insufficient evidence exists on the integration of elderly rural migrants (ERM), generally aged 60 years and above, in low- and middle-income countries. To address this problem, we explore the relationship between the location of social medical insurance (SMI), such as a host city, and social integration in the context of Chinese ERM. METHODS: This study is based on data from the 2017 National Internal Migrant Dynamic Monitoring Survey in China. The study participants were Chinese ERM. An integration index was constructed to measure the degree of social integration in a multi-dimensional manner using a factor analysis method. This study used descriptive statistics and one-way analysis of variance to explore the differences in social integration between ERM with SMI from host cities and hometowns. Stepwise multiple linear regression analysis was used to test the correlation between SMI location and social integration level in the overall sample. Finally, the results were verified by propensity score matching. RESULTS: It was found that 606 (18.2%) of the insured ERM chose host city SMI, while 2727 (81.8%) chose hometown SMI. The level of social integration was lower among ERM with hometown SMI (-1.438 ± 32.795, F = 28.311, p ≤ 0.01) than those with host city SMI (6.649 ± 34.383). Among the dimensions of social integration, social participation contributed more than other factors, with a contribution rate of 45.42%. Host city SMI increased the probability of the social integration index by 647% among ERM (k-nearest neighbor caliper matched (n = 4, caliper = 0.02), with a full sample ATT value of 6.47 (T = 5.32, SE = 1.48, p < 0.05)). CONCLUSIONS: ERM with host city SMI have a higher social integration level than those with hometowns SMI. That is, host city SMI positively affects social integration. Policymakers should focus on the access of host city SMI for ERM. Removing the threshold of host city SMI coverage for ERM can promote social integration.

Comparison of the efficacy of low-molecular-weight heparin and fondaparinux sodium after total knee arthroplasty: a retrospective cohort study.

BACKGROUND: Low-molecular-weight heparin (LMWH) and fondaparinux sodium (FPX) are routinely used to prevent deep vein thrombosis (DVT) after total knee arthroplasty (TKA). In this study, we compared the effects of these agents in preventing post-TKA DVT. METHODS: Clinical data of patients who underwent unilateral TKA for unicompartmental knee osteoarthritis at the Ningxia Medical University General Hospital between September 2021 and June 2022 were retrospectively analyzed. Based on the anticoagulation agent used, the patients were divided into LMWH and FPX groups (34 and 37 patients, respectively). Changes in perioperative coagulation-related indicators, d-dimer and platelet count, perioperative complete blood count, amount of blood loss, lower-limb DVT, pulmonary embolism, and allogeneic blood transfusion were determined. RESULTS: Intergroup differences in d-dimer or fibrinogen (FBG) levels before and 1 or 3 days after surgery were not significant (all p > 0.05); within-group pairwise comparisons indicated significant differences (all, p < 0.05). Intergroup differences in preoperative prothrombin time (PT), thrombin time, activated partial PT, and international normalized ratio were not significant (all p > 0.05), whereas significant differences were detected on postoperative days 1 and 3 (all p < 0.05). Intergroup differences in platelet counts before and 1 or 3 days after surgery were not significantly different (all p > 0.05). Pairwise comparisons of hemoglobin and hematocrit levels between patients in the same group before and 1 or 3 days after surgery revealed significant differences in both groups (all p < 0.05); however, intergroup differences were not significant (all p > 0.05). Although intergroup differences in visual analog scale (VAS) scores before and 1 or 3 days after surgery were not significant (p > 0.05), we detected significant intragroup differences in VAS scores before and 1 or 3 days after surgery (p < 0.05). The treatment cost ratio was significantly lower in the LMWH group than in the FPX group (p < 0.05). CONCLUSION: Both LMWH and FPX can effectively prevent DVT after TKA. There are some suggestive signals that FPX may have more beneficial pharmacological effects and clinical significance, while LMWH is cheaper and therefore more economical.

Estimates of the global, regional, and national burden of atrial fibrillation in older adults from 1990 to 2019: insights from the Global Burden of Disease study 2019.

Background: Atrial fibrill ation (AF) is a predominant public health concern in older adults. Therefore, this study aimed to explore the global, regional, and national burden of AF in older adults aged 60-89 between 1990 and 2019. Methods: The morbidity, mortality, disability-adjusted life years (DALYs), and age-standardized rates of AF were refined from the Global Burden of Diseases study 2019. The epidemiological characteristics were assessed based on numerical values, age-standardized rates per 100,000 person-years, and estimated annual percentage changes (EAPC). Results: Globally, a total of 33.31 million AF cases, 219.4 thousand deaths, and 65.80 million DALYs were documented in 2019. There were no appreciable changes in EAPC from 1990 to 2019. The disease burden of AF differed significantly across different territories and countries. At the national level, China exhibited the highest number of incident cases [818,493 (562,871-1,128,695)], deaths [39,970 (33,722-46,387)], and DALYs [1,383,674 (1,047,540-1,802,516)]. At the global level, high body mass index (BMI) and high systolic blood pressure (SBP) were two predominant risk factors contributing to the proportion of AF-related deaths. Conclusion: AF in older adults remains a major public health concern worldwide. The burden of AF varies widely at both national and regional levels. From 1990 to 2019, the cases of incidences, deaths, and DALYs have shown a global increase. The ASIR, ASMR, and ASDR have declined in the high-moderate and high SDI regions; however, the burden of AF increased promptly in the lower SDI regions. Special attention should be paid to the main risk factors for high-risk individuals with AF, which can help control systolic blood pressure and body mass index within normal limits. Over all, it is necessary to illustrate the features of the global AF burden and develop more effective and targeted prevention and treatment strategies.

Construction of an evaluation index system of public health emergency preparedness capacity in county-level centers for disease control and prevention / 预防医学

Objective@#To construct an evaluation index system of public health emergency preparedness capacity in county-level centers for disease control and prevention (CDC), so as to provide the evidence for improving the public health emergency preparedness capacity in county-level CDC.@*Methods@#An index system framework was created based on review of health emergency policies, laws and regulations released in China from 2003 to 2023. The importance, sensitivity and accessibility of indicators were scored and screened through two rounds of Delphi expert consultations, and the weights of indicators were calculated using precedence charts. The efficiency of Delphi expert consultations was evaluated using the active coefficient, authority coefficient and coordination coefficient. @*Results@#Eighteen experts participated in consultations, including 9 men, 15 with educational levels of master degree and higher, 12 with preventive medicine or public health as the specialty, and 12 with deputy senior professional titles and higher. The active coefficients of two rounds of consultations were 100.00% and 94.44%, and the authority coefficients were 0.83 and 0.84, respectively. The coordination coefficients of secondary and tertiary indicators during the second round consultation were 0.341 and 0.241, which were both higher than those during the first round (both P<0.05). The final evaluation index system included 8 primary indicators, 21 secondary indicators and 58 tertiary indicators. Among primary indicators, health emergency organization and management (0.203 1), health emergency team building (0.203 1) and financial support for health emergency (0.203 1) had the highest weights, and of secondary indicators, completion degree of health emergency administration regulations (initial weight/global weight: 0.750 0/0.152 3), health emergency team building (0.750 0/0.152 3) and financial support for emergency (0.750 0/0.152 3) had the highest weights, while among tertiary indicators, defining the duty of health emergency administration sectors had the highest weight (0.750 0/0.114 2). @*Conclusion@#The created evaluation index system is feasible for evaluation of the public health emergency preparedness capacity in county-level CDC.

The evolution of mental health related policies in China: A bibliometric analysis, 1987-2020.

Background: Since 1987, the Chinese government has promoted public mental health by continuously implementing mental health related policies. This research attempts to reveal the distribution and characteristics of mental health related policies. In addition, it can help stakeholders evaluate whether the environment for policy implementation has improved and identify key points in the development of the overall mental health system. Methods: We used a bibliometric approach to analyze the evolution of mental health related policies in China from 1987 to 2020. A total of 239 mental health related policies were collected from Beida Fabao and official Internet websites of governmental departments. Co-wording, social networks, and citation analysis were applied to explore the evolutionary features of such policies. Results: The evolution of policy development showed that the number of mental health related policies in China has been increasing and their content has been enriched. Over time, mental health related policies not only gradually expanded its focus on common mental disorders, but also included an increasing number of keywords related to service provision, organization and administration. However, most policies were implemented independently by separate agencies and the number of policies jointly implemented by different agencies only accounted for 32.64% of all the policies implemented. The Ministry of Health (MOH) is at the core of the collaborative network associated with implementing mental health related policies in China. Conclusion: The environment associated with the implementation of mental health related policies in China is gradually improving. However, cross-sector collaboration among different agencies needs to be strengthened and financial support for related resources needs more attention. A clear division of responsibilities among various agencies and a sustainable financing mechanism are essential to the development and implementation of mental health related policies.

Lifestyle choices mediate the association between educational attainment and BMI in older adults in China: A cross-sectional study.

As the Chinese population ages, unhealthfully high body mass index (BMI) levels in older adults are becoming a public health concern as an unhealthfully high BMI is an ill-being condition and can contribute to the risk of disease. Education and lifestyle choices affect BMI; however, the evidence on the relationships and interactions among these factors remains unclear. This study aimed to investigate the mediating effect of lifestyle choices on educational attainment and BMI among older adults in China. Using the Chinese Family Panel Studies (CFPS) 2018 panel data, this study integrated personal- and family-level economic data libraries, including 7,359 adults aged ≥60 years. Lifestyle parameters included smoking amount and screen time. Height and weight values were used to calculate BMI. The chi-square test, binary logistic regression analysis, stepwise regression analysis, and bootstrapping mediating effect tests were used for data analysis. Single-factor chi-square test revealed differences in BMI levels among groups defined by sex, age, residence, marital status, per capita annual household income, education years, and lifestyle choices. Binary logistic regression showed that age, residence, education years, smoking amount, and screen time influenced BMI. Stepwise regression results showed that education years, smoking amount, and screen time were associated with BMI (t = 3.907, -4.902, 7.491, P < 0.001). The lifestyle variables had partial mediating effects on BMI. The mediating effect of lifestyle on BMI was 0.009, while smoking amount was 0.003, and screen time was 0.006. Unhealthfully high BMI levels are increasing among older adults in China and are affected by many factors. Lifestyle factors and educational attainment can interact, affecting BMI. Interventions should consider lifestyle factors and education attainment to help maintain healthy BMI and reduce unhealthfully high BMI incidence.

Influence of Public Health Services on the Goal of Ending Tuberculosis: Evidence From Panel Data in China.

Background: The World Health Organization has proposed an initiative to "end tuberculosis (TB)." Unfortunately, TB continues to endanger the health of people worldwide. We investigated the impact of public health services (PHS) in China on TB incidence. In this way, we provided policy ideas for preventing the TB epidemic. Methods: We used the "New Public Management Theory" to develop two indicators to quantify policy documents: multisector participation (MP) and the Assessable Public Health Service Coverage Rate (ASCR). The panel data from 31 provinces in Chinese mainland were collected from 2005 to 2019 based on 1,129 policy documents and the China Statistical Yearbook. A fixed-effect model was used to determine the impact of MP and the ASCR on TB incidence. Results: From 2005 to 2019, the average MP increased from 89.25 to 97.70%, and the average ASCR increased from 53.97 to 78.40% in Chinese mainland. However, the development of ASCR between regions was not balanced, and the average level in the western region was lower than that in the eastern coastal provinces. With an increase in MP and the ASCR, the TB incidence had been decreasing gradually in recent years. The panel analysis results showed that MP (ß = -0.76, p < 0.05). and ASCR (ß = -0.40, p < 0.01) had a negative effect on TB incidence, respectively. Even if the control variables were added, the negative effects of MP (ß = -0.86, p < 0.05) and ASCR (ß = -0.35, p < 0.01) were still statistically significant. Conclusions: Promoting the participation of multiple departments, as well as emphasizing the quality of PHS delivery, are important ways to alleviate the TB epidemic. The settings of evaluation indices for PHS provision should be strengthened in the future.

Impact of new health care reform on enabling environment for children's health in China: An interrupted time-series study.

Background: Creating an enabling environment (EE) can help foster the development and health of children. The Chinese government implemented a new health care reform (NHR) in 2009 in a move to promote an EE for health. The purpose of this study was to evaluate the impact of the NHR on EE for children's health. Methods: An interrupted time-series analysis was used to evaluate the changes in the EE before and after 2009 in China. This study analysed the EE through five quantitative indicators, including policy element coverage rate (PECR), service meeting with children's needs rate (SMCNR), multisector participation rate (MPR), and accountability mechanism clarity rate (AMCR), based on the content analysis of available public policy documents (updated as of 2019) from 31 provinces in mainland China, and the number of health care personnel of maternity and child care centres per 10 000 population (HP per 10 000 population), based on the 2002-2019 China Health Statistical Yearbook and China Statistical Yearbook. Results: The average values of PECR, SMCNR, and MPR increased rapidly to 90.96%, 82.46%, and 81.31%, respectively, in 2019, representing a higher value compared to the AMCR (7.38%). The NHR promoted the EE, in which HP per 10 000 population showed the fastest increase (ß1 = 0.03, P < 0.01; ß3 = 0.10, P < 0.01), followed by SMCNR (ß1 = 0.94, P < 0.01; ß3 = 1.83, P < 0.01), AMCR (ß1 = 0.13, P < 0.01; ß3 = 0.24, P = 0.14), MPR (ß1 = 1.35, P < 0.01; ß3 = 2.47, P < 0.01) and PECR (ß1 = 1.43, P < 0.01; ß3 = 1.47, P < 0.01). Conclusions: The NHR has a positive impact on the EE, especially on the human resources and service provision for children. Efforts should be intensified to improve the clarity of the accountability mechanism of the health-related sectors.

The Impacts of Regional Regulatory Policies on the Prevention and Control of Chronic Diseases in China: A Mediation Analysis.

Regional regulatory policies (RPs) are a major factor in the prevention and control of chronic diseases (PCCDs) through the implementation of various measures. This study aimed to explore the impacts of RPs on PCCDs, with a focus on the mediating roles of community service. The soundness of the regulatory mechanism (SORM) was used to measure the soundness of RPs based on 1095 policy documents (updated as of 2015). Coverage provided by community service institutions (CSIs) and community health centres (CHCs) was used to represent community service coverage derived from the China Statistical Yearbook (2015), while the number of chronic diseases (NCDs) was used to measure the effects of PCCDs based on data taken from the 2015 China Health and Retirement Longitudinal Study survey. To assess the relationship between SORM, NCDs and community service, a negative binomial regression model and mediation analysis with bootstrapping were conducted. Results revealed that there was a negative correlation between SORM and NCDs. CSIs had a major effect on the relationship between RPs and PCCDs, while CHCs had a partial mediating effect. RPs can effectively prevent and control chronic diseases. Increased effort should also be aimed at strengthening the roles of CSIs and CHCs.

Are Essential Women's Healthcare Services Fully Covered? A Comparative Analysis of Policy Documents in Shanghai and New York City from 1978-2017.

This study aimed to analyze the changes in the 10 major categories of women's healthcare services (WHSs) in Shanghai (SH) and New York City (NYC) from 1978 to 2017, and examine the relationship between these changes and maternal mortality ratio (MMR). Content analysis of available public policy documents concerning women's health was conducted. Two indicators were designed to represent the delivery of WHSs: The essential women's healthcare service coverage rate (ESCR) and the assessable essential healthcare service coverage rate (AESCR). Spearman correlation was used to analyze the relationship between the two indicators and MMR. In SH, the ESCR increased from 10% to 90%, AESCR increased from 0% to 90%, and MMR decreased from 24.0/100,000 to 1.01/100,000. In NYC, the ESCR increased from 0% to 80%, the AESCR increased from 0% to 60%, and the MMR decreased from 24.7/100,000 to 21.4/100,000. The MMR significantly decreased as both indicators increased (p < 0.01). Major advances have been made in women's healthcare in both cities, with SH having a better improvement effect. A common shortcoming for both was the lack of menopausal health service provision. The promotion of women's health still needs to receive continuous attention from governments of SH and NYC. The experiences of the two cities showed that placing WHSs among policy priorities is effective in improving service status.

Intrinsic ferromagnetism with high temperature, strong anisotropy and controllable magnetization in the CrX (X = P, As) monolayer.

2D ferromagnetic (FM) materials with high temperature, large magnetocrystalline anisotropic energy (MAE), and controllable magnetization are highly desirable for novel nanoscale spintronic applications. Herein by using DFT and Monte Carlo simulations, we demonstrate the possibility of realizing intrinsic ferromagnetism in 2D monolayer CrX (X = P, As), which are stable and can be exfoliated from their bulk phase with a van der Waals layered structure. Following the Goodenough-Kanamori-Anderson (GKA) rule, the long-range ferromagnetism of CrX is caused via a 90° superexchange interaction along Cr-P(As)-Cr bonds. The Curie temperature of CrP is predicted to be 232 K based on a Heisenberg Hamiltonian model, while the Berezinskii-Kosterlitz-Thouless transition temperature of CrAs is as high as 855 K. In contrast to other 2D magnetic materials, the CrP monolayer exhibits a significant uniaxial MAE of 217 µeV per Cr atom originating from spin-orbit coupling. Analysis of MAE reveals that CrP favors easy out-of-plane magnetization, while CrAs prefers easy in-plane magnetization. Remarkably, hole and electron doping can switch the magnetization axis in between the in-plane and out-of-plane direction, allowing for the effective control of spin injection/detection in 2D structures. Our results offer an ideal platform for realizing 2D magnetoelectric devices such as spin-FETs in spintronics.

Discovery of a ferroelastic topological insulator in a two-dimensional tetragonal lattice.

Ferroelasticity and band topology are two intriguing yet distinct quantum states of condensed matter materials. Their coexistence in a single two-dimensional (2D) lattice, however, has never been observed. Here, we found that the 2D tetragonal HfC monolayer allowed simultaneous presence of ferroelastic and topological orders. By using first-principles calculations, we found that it could allow a low switching barrier with reversible strain of 17.4%, indicating that the anisotropic properties are achievable experimentally for a 2D tetragonal lattice. More interestingly, the tuning of topological behaviors with strain led to spin-separated and gapless edge states, that is, the quantum spin Hall effect. These findings from the coupling of two quantum orders offer insights into ferroelastic control over topological edge states for achieving multifunctional properties in next-generation 2D nanodevices.

Hypertension and physical activity in middle-aged and older adults in China.

There are few studies examining the association between levels of physical activity and hypertension in middle-aged and older adults in China. Data were drawn from the Chinese Health and Retirement Longitudinal Study (using four-stage stratified probability-proportional-to-size sampling), involving 7113 individuals aged 45 years and older from 28 provinces of China. Hypertension was defined as a systolic BP ≥ 130 mm Hg, or diastolic BP ≥ 80 mm Hg, or self-reported use of anti-hypertensive medications. The awareness, treatment, and control among hypertensive participants were 53.12%, 43.37%, and 10.03%, respectively. The prevalence of hypertension was 56.12% among all the participants, higher in main city zones (58.68%) than villages (55.52%) and other areas (55.78%, p < 0.0001). Participants who were overweight (BMI ≥ 24: AOR 4.08, 95% CI 3.21-5.20, P < 0.0001; BMI ≥ 28: 10.03, 7.56-13.31, P < 0.0001), and drinking more than once a month (1.28, 1.12-1.46, P < 0.0001) were more likely to have hypertension. The decision tree model was established to analyze the importance of different levels of physical activity on hypertension prevention. Participants who usually participated in moderate-to-vigorous activity for more than 10 minutes (vigorous: 0.82, 0.73-0.91, P = 0.0004; moderate: 0.83, 0.75-0.92, P = 0.0006) were less likely to have hypertension. The results of the decision tree showed that the vigorous physical activity seemed to be more important than moderate and light activity to induce beneficial effects on prevention of hypertension. The strength of our study is in using the decision tree to clearly rank the importance of those key factors affecting hypertension.

Differences and determinants in access to essential public health services in China: a case study with hypertension people and under-sixes as target population.

BACKGROUND: Since 2009, health reform had launched in China and essential public health services were provided for all residents to ensure service equity and accessibility, and to achieve sustained population-wide health improvement. This study aimed to investigate the differences and determinants among populations with different characteristics access to essential public health services in China, especially hypertension people and children aged 0-6 years. METHODS: A cross-sectional study with socio-demographic data analysis was undertaken to estimate distribution characteristics of receiving essential public health services of hypertension patients and children. Regular follow-ups and effective blood pressure control reflected the effective management for hypertension patients, and for children, public services provided were vaccination on schedule and regular physical check-up. Logistic regression was used to determine the predictors for effective management. RESULTS: A total of 1 505 hypertension patients and 749 children were involved; 39.14% of hypertension participants could control their blood pressure in the normal range, and the rate in urban areas (43.61%) was higher than that in rural (31.88%). And 34.68% of them could receive more than 4 times follow-ups by the medical technician. Of 754 children, 79.84% could receive the periodic physical examination and 98.40% had vaccinated regularly. Children living in rural areas were more likely to have regular check-ups (83.96%) and regular vaccination (nearly 99%). Overall, geographic location and education level were the determinants of people access to essential public health services. CONCLUSIONS: Implementation of the health reform since 2009 has headed China's public health system in the right direction and promoted the improvement of public health system development. Our study highlights the growing needs for more public health services in China, and China's public health system needs to be greatly improved in terms of its quality and accessibility.

[Luring effect of the fermented Laminaria japonica to Oncomelania hupensis].

OBJECTIVE: To study the attraction effect of the food attractants on Oncomelania hupensis. METHODS: Oncomelania snail food was prepared with the fermented kelp (Laminaria japonica) mixed with corn starch. Snails were fed with the food and kept for 12, 24, 36, and 48 h at 15, 25, 35 degrees C respectively. Meanwhile, snail-killing effect was tested by granules containing jack-in-the-pulpit (Arisama heterophyllum) with or without the fermented kelp under the condition of 25 degrees C, 30% or 60% soil humidity. RESULTS: The snail-attracting rate of the fermented kelp was affected by the temperature, highest under 25 degrees C and lowest under 35 degrees C at any time point, with a rate of 80.3% in 48 h at 25 degrees C which was higher than that of the control (17.0%) (P<0.01). The snail mortality rate in the group using jack-in-the-pulpit with fermented kelp (85.3%) was higher than that of the group without fermented kelp (26.8%) (P<0.05). The mortality under 60% of soil humidity was higher than that under 30% humidity (P<0.01). CONCLUSION: The fermented kelp shows a strong luring effect to the Oncomelania snails.

[Preliminary study on molluscicidal effect of active components from Centipeda minima].

The active components from Centipeda minima were extracted by water or ethanol, and identified by FTIR spectroscopy and UV-visible spectrophotometer. The molluscicidal effect of aqueous extract and ethanol extract from Centipeda minima against Oncomelania hupensis was determined as referring to the WHO guidelines for laboratory molluscicidal test. Treated with over 2.0 g/L aqueous extract and ethanol extract for five days, the mortality of O. hupensis was up to 100%, and their LC50, for snails was 0.50 g/L and 0.62 g/L, respectively. The molluscicidal activity of aqueous extract was higher than that of ethanol extract. The main components of aqueous extract and ethanol extract were sesquiterpenes lactones and sterols.

The toxic activities of Arisaema erubescens and Nerium indicum mixed with Streptomycete against snails.

The comparative molluscicidal activities of Arisaema erubescens tuber extracts and Nerium indicum leaf extracts mixed with Streptomycete violacerruber dilution (SD) against the snail Oncomlania hupensis and the responses of the isozymes, esterase (EST) and superoxide dismutase (SOD) to the A. erubescens extracts and the mixtures were investigated. The molluscicidal activity of A. erubescens water extracts mixed with S. violacerruber dilution was 4-5 times higher than a single A. erubescens or S. violacerruber dilution after 24-h exposure, and is also higher than that of N. indicum leaf water extracts mixed with S. violacerruber dilution. At the end of exposure to the N-butanol extracts of A. erubescens tubers (NEAT), the EST activity in snail liver decreased and some enzyme bands (EST 1 and EST 3 in exposure to NEAT) disappeared but the activities of SOD 1 increased. The effect was more obvious in mixture treatment than in single NEAT or SD treatment. The results indicated that molluscicidal activities of plant and microorganism could be more effective than single plant. The decline of the detoxic ability in snail liver cells could be the reason of the snail dying.