A Google Earth-based database management for schistosomiasis control in Zanzibar.

Schistosomiasis remains a serious health problem in Africa. Although a strong, coordinated agenda for research on this disease has been in place for the last 50 years in Zanzibar, data storage, retrieval of survey data and management remain problem areas. We investigated the use of Google Earth (GE) in conjunction with a hand-held, global positioning system as a pilot project for managing schistosomiasis control. In this way, risk areas can be surveyed and followed up by visualizing both the distribution of human infections and that of the intermediate snail host together with environmental information. A platform with three spatial databases was created: i) Distribution of infected humans; ii) Distribution of the intermediate snail host in ponds (infected and not infected specimens); iii) Distribution of the intermediate snail host in streams (infected and non-infected specimens). The GE spatial database increased the efficiency of follow-up case treatment as well as snail control and contributed also to the discovery of previously unknown areas in need of snail control. We conclude that this platform is advantageous not only by being useful for management and visualization of spatial data, but also because it is easy to operate and available free of charge.

[Study on differences of Ainsliaea fragrans from different sources based on UFLC-Q-TOF-MS/MS and PCA analysis].

A rapid and accurate method of UFLC-Q-TOF-MS/MS combined with multivariate statistical analysis was established for the identification of Ainsliaea fragrans from different origins in this study. The A. fragrans from different producing areas of Jiangxi, Yunnan, Henan and Jiangsu were determined by UFLC-Q-TOF-MS/MS in the negative ion mode. And the data of the study were analyzed by the Markerview and other software for the PCA and OPLS-DA cluster analysis as well as t test. The results of the principal component analysis(PCA)showed that the main components from different origins were well distinguished. And the results of multivariate statistical showed the differences and similarities between different producing areas. Besides, 40 different compounds were identified in the negative ion mode. This method for identifying A. fragrans from different producing areas has the advantages of rapid accuracy and simplicity, which laid the foundation for the evaluation of the quality of the A. fragrans.

[Analysis of imported malaria situation in Liyang City, Jiangsu Province].

OBJECTIVE: To analyze the epidemic characteristics of imported malaria in Liyang City, so as to provide the evidence for formulating appropriate control strategies and measures. METHODS: The malaria epidemic situation reports, case epidemiological investigations and the follow-up materials of counterparts returned together with the cases were collected and analyzed in Liyang City from 2007 to 2014. RESULTS: Totally 53 imported malaria cases were reported and they were all laboratory confirmed in Liyang City from 2007 to 2014. Forty-nine cases (92.5%) were imported from African countries, 37 cases (69.8%) were Plasmodium falciparum infection, and 37 cases (69.8%) had overseas incidence history. Forty cases (75.5%) were aged between 30 and 49 years, and 52 cases (98.1%) were male, 42 cases (79.2%) were farmers. These cases were distributed in all the 10 towns and there were no obvious seasonal variation for onset time. The median time from onset to seeing a doctor was 3 d, and the median time from seeing a doctor to being diagnosed was 0 d. The first visit health facilities by the patients were various, and the diagnostic health facilities were all the medical institutions at the county level or above, and the standardized treatment rate was 100%. CONCLUSION: During the last 5 consecutive years, there have been no local infected malaria cases in Liyang City, and the remarkable results have been achieved in malaria elimination. However, there are still many imported malaria cases, and the infected species are diverse. Therefore, the imported malaria is still the key of malaria prevention and control.

Ionic liquid-based ultrasound-assisted extraction and aqueous two-phase system for analysis of caffeoylquinic acids from Flos Lonicerae Japonicae.

In this work, an ionic liquid-based ultrasonic-assisted extraction (ILUAE) method was developed to extract caffeoylquinic acids (CQAs) from Flos Lonicerae Japonicae (FLJ). ILUAE parameters were optimized by response surface methodology, including IL concentration, ultrasonic time, and liquid-solid ratio. Optimized ILUAE approach gained the highest extraction yields of 28.53, 18.21, 3.84mg/g for 3-O-caffeoylquinic acid (C1), 3,5-di-O-caffeoylquinic acid (C2), 3,4-di-O-caffeoylquinic acid (C3), respectively. C1-C3 are the three most abundant CQAs compounds in FLJ. The method showed comparable extraction yield and shorter extraction time compared with conventional extraction techniques. Subsequently, an aqueous two-phase system (ATPS) was applied in extraction solutions. Two trace CQAs, 5-O-caffeoylquinic acid (C4) and 4,5-di-O-caffeoylquinic acid (C5), were significantly enriched with signal to noise values increasing from less than 10 to higher than 1475. The results indicated that ILUAE and ATPS are efficient and environmentally-friendly sample extraction and enrichment techniques for CQAs from herbal medicines.

[Pharmacokinetics and tissue distribution of α-hederin sodium salt in rats].

To study the pharmacokinetics and tissue distribution characteristics of α-hederin sodium salt in rats. 100 mg•kg⁻¹ α-hederin sodium salt was given to the rats by intragastric administration, and LC-MS/MS method was used to determine its concentration at different time in plasma and tissues. Plasma and tissue samples were treated with methanol protein deposition method. Main pharmacokinetic parameters were as follows： tmax (0.97±1.23) h, Cmax (222.53±57.28) µg•L⁻¹, AUC0-t (1 262±788.9) h•µg•L⁻¹, T1/2 (17.94±9.50) h. α-hederin can be detected in heart, liver, spleen, lung, kidney, brain, muscle and adipose. The results showed that α-hederin sodium salt was absorbed fast and eliminated slowly in rats after oral administration. It was widely distributed in body tissues and livers kept the highest concentrations among various tissues at different time, so it can be speculated that α-hederin may have certain targeting property on livers.

Formulations, hemolytic and pharmacokinetic studies on saikosaponin a and saikosaponin d compound liposomes.

The aim of this study was to develop and optimise a saikosaponin a and saikosaponin d compound liposome (SSa-SSd-Lip) formulation with reduced hemolysis and enhanced bioavailability. A screening experiment was done with Plackett-Burman design, and response surface methodology of five factors (EPC/SSa-SSd ratio, EPC/Chol ratio, water temperature, pH of PBS, and ultrasound time) was employed to optimise the mean diameter, entrapment efficiency of SSa and SSd, and the reduction of hemolysis for SSa-SSd-Lip. Under the optimal process conditions (EPC/SSa-SSd ratio, EPC/Chol ratio, water temperature and pH of PBS were 26.71, 4, 50 °C and 7.4, respectively), the mean diameter, the entrapment efficiency of SSa, the entrapment efficiency of SSd and the hemolysis were 203 nm, 79.87%, 86.19%, 25.16% (SSa/SSd 12.5 mg/mL), respectively. The pharmacokinetic studies showed that the SSa-SSd-Lip had increased circulation time, decreased Cl, and increased AUC, MRT and T1/2ß (p < 0.05) for both SSa and SSd after intravenous administration in comparison with solution.

[Survey on status of staff for Plasmodium microscopy examinations in Changzhou City].

OBJECTIVE: To understand the current state of staff for Plasmodium microscopy examinations in Changzhou City in the early stage of eliminating malaria action, so as to provide the evidence for achieving the target of malaria elimination. METHODS: The staff for Plasmodium microscopy examinations from medical institutions and centers for disease control and prevention at different levels were investigated by questionnaires and tests of the malaria related theory and microscopic operation. RESULTS: Totally 95 people were investigated, and among them, 40.0% had college degree and 45.3% were university educated. There were 18.9% of them working on Plasmodium microscopy examinations for less than 1 year, 40.0% for 2-5 years, 18.9% for 6-10 years and 22.1% for more than 10 years. The numbers of person-time of provincial and municipal level training, district-level training, and unit-level training in the last year were 0.57, 0.59, and 0.14, respectively. Totally 18.9% of them had the experience of finding Plasmodium at work, and 97.9% of them considered it was necessary or very necessary to do Plasmodium microscopy examinations. However, 57.9% and 8.4% of them considered Plasmodium microscopy examinations increased their work load and work difficulty, respectively. The average correct rates of knowledge tests on malaria before and after training were 72.5% and 91.6% respectively (P < 0.05). The average mark of Plasmodium microscopic tests was 25.3 points (full mark being 50 points), and the passing rate (> or = 30 points) was 58.9%. CONCLUSION: The working experience of staff for Plasmodium microscopy examinations in Changzhou City is relatively poor, and the related training should be enhanced.

[Knowledge and practice on schistosomiasis control of boatmen along Yangtze River].

OBJECTIVE: To understand the knowledge and practice on schistosomiasis control of boatmen along the Yangtze River, so as to provide the evidence for making up schistosomiasis control measures for them. METHODS: In the anchor spots along the Yangtze River in Xinbei District, Changzhou City, a questionnaire survey was carried out for boatmen's knowledge and practice on schistosomiasis control. Among the boatmen of different genders, ages and education levels, the awareness rates of schistosomiasis control knowledge and the formation rates of correct behavior were compared. RESULTS: A total of 702 boatmen of 231 boats were surveyed. The total awareness rate of schistosomiasis control knowledge was 84.19%. Among the groups with different education levels, the awareness rates were significantly different (chi2 =14.42, P < 0.05). The total formation rate of correct behavior on schistosomiasis control was 43.16%. Between men and women groups, and among groups with different ages, the formation rates were significantly different (chi2 = 21.95, 15.00, P < 0.05 for all). Totally 94.81% of the boats discharged the excrement into water directly. CONCLUSION: The formation rate of correct behavior on schistosomiasis control of boatmen was low, thus the health promotion should be enhanced for them.

[Surveillance of echinococcosis in Liyang City from 2008 to 2012].

OBJECTIVE: To investigate the Echinococcus infection of people and domestic animals in Liyang City, so as to provide the evidence for the establishment of control measures of echinococcosis. METHODS: The formerly confirmed cases and clue cases were investigated. The Echinococcus antibody in serum of children aged from 7 to 12 years old and adults in key towns and control towns was detected with ELISA, and the antigen in fecal samples of dogs in key towns was also detected. B ultrasound was applied to examine the ELISA positive cases, family member and the neighbored people around them. The sheep in the market were dissected and examined for Echinococcus. RESULTS: The Echinococcus antibody positive rates were 0.93% and 0.52% in children and adults, respectively. The Echinococcus antigen positive rate was 0.95% in dogs. There were no significant difference between the positive rates of the children and adults (CHI2 = 2.124, P > 0.05). No cases were found by ultrasonic examination and no Echinococcus infection was found in the sheep. CONCLUSION: The people with Echinococcus antibody in serum and dogs with antigen in their feces are found in the surveillance of echinococcosis, therefore, there exists the complete chain of transmission in local. Thus, in the prevention and control work for the disease, the monitoring of dog feces, quarantine of sheep from other regions, as well as the population health education in key areas should be strengthened.

[Application of saTScan in detection of schistosomiasis clusters in marshland and lake areas].

OBJECTIVE: To detect the schistosomiasis clusters in marshland and lake areas in 2008, so as to provide the reference for schistosomiasis control and the methodology for detection of cluster areas of related diseases. METHODS: SaTScan was used to detect the schistosomiasis clusters based on the spatial database from GIS and related variables, including the number of current patients and population in endemic areas. RESULTS: A total of 5 clusters including 39 counties (districts) were detected by SaTScan, the RRs and the Log-likelihood ratios of 3 clusters among them were over 3 and 1 000 (P < 0.05), respectively. The one with the highest RR and Log-likelihood ratio was located in the boundary of Hubei and Hunan provinces, and the cluster range there was the biggest. From there to the downstream of the Yangtze River, the area and RRs of the 5 clusters became smaller and smaller. CONCLUSION: The 5 provinces in the marshland and lake areas are still the key spatial clusters of schistosomiasis, especially near the boundary of Hubei and Hunan provinces.

[Snail habitats detection in the marshland of Eastern Dongting Lake Area, based on China-Brazil Earth Resources Satellite-02B CCD data].

OBJECTIVE: To detect the snail habitats from the marshland of Eastern Dongting Lake Area, using the Remote Sensing (RS) and Geographic Information System (GIS) technology based on the China-Brazil Earth Resources Satellite-02B (CBERS-02B) CCD images. METHODS: According to the two typical traits of snail habitats in marshland including "water in summer and land in winter" and "no grass, no snails", the "water in summer and land in winter" region and the vegetation coverage region were calculated by RS image processing respectively. The two regions mentioned above were then overlapped to confirm the snail habitats through comparing with the data from field survey under spatial overlapping of Arcgis as the last step. RESULTS: In Eastern Dongting Lake area, the "water in summer and land in winter" region and vegetation coverage region were predicted based on the formula normalized difference water index (NDWI) > 0.01 and normalized difference vegetation index (NDVI) > 0.36, respectively. The snail habitat was determined by theme overlay of the two regions said above. The agreement rate between the prediction and the geospatial data of field survey was 93.55%, which demonstrated the final results were credible and reliable. CONCLUSION: CBERS-02B image could be used to detect the snail habitats and to monitor the changes of them, so as to find out the characteristics of distribution and the trends of diffusion. The snail index (discriminant 1 and 2) seemed to be suitable for the detection of snail habitats in the marshland of Lake area and used for the programs of snail control.

[Spatial characteristic of distribution of Oncomelania hupensis in mountainous regions].

OBJECTIVE: To analyze the spatial characteristic on the distribution of Oncomelania hupensis in mountainous regions. METHODS: Based on the geographic database of snail distribution in Puge county, Sichuan province, spatial autocorrelation analysis and spatial scan statistics were applied to analyze the spatial characteristic of snail distribution. RESULTS: With regard to the rate of frame with snails, the global Moran's I indicator was 0.095 (P < 0.05), which indicated the spatial autocorrelation of snail distribution in Puge county. Data from the local spatial autocorrelation analysis showed that there were 28 snail habitats with statistically significant differences on local indicators of spatial autocorrelation (LISA) value (P < 0.05), among which existed high-high, low-low, low-high and high-low four types of correlation model. The Spatial Scan Statistics had in total identified 24 snail habitat clusters (P < 0.05), including 14 high rate clusters and 10 low rate clusters, and the result was similar to that of LISA analysis. CONCLUSION: There were spatial autocorrelation and spatial aggregation of snail distribution in mountainous regions, meanwhile spatial heterogeneity of snail distribution also existed. This law could be explored for better control of snails.

[Clinical and laboratory criteria for identification of early-onset stroke associated pneumonia: a prospective trial].

OBJECTIVE: To investigate the significance of first determined contents of procalcitonin (PCT), C-reactive protein (CRP), soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) and the clinical pulmonary infection score (CPIS) in the detection of early-onset pneumonia (EOP) developed in patients suffering from stroke. METHODS: From June 2009 to June 2010, 244 stroke patients admitted to the emergency intensive care unit (EICU) in Shanghai Fifth People's Hospital were included in this prospective study. Patients were excluded if they were discharged or died in 24 hours of admission, or pneumonia was diagnosed at the admission. The serum levels of PCT, CRP and sTREM-1 were determined, and the CPIS was calculated in all patients on the day of admission. RESULTS: Among all 244 stroke patients, EOP was diagnosed in 105 of them, and 74 developed severe EOP. The serum levels of PCT, CRP, sTREM-1 and the CPIS in patients with EOP were significantly higher than those in patients who did not develop EOP [PCT (µg/L): 4.20 (0.83,7.75) vs. 0.19 (0.12,0.41); CRP (mg/L): 56.0 (18.5,105.5) vs. 9.0 (7.0,15.0) ; sTREM-1 (ng/L): 56.0 (24.5,111.5) vs. 10.0 (8.0,16.0); CRIS: 4.0 (2.5,4.0) vs. 2.0 (1.0,2.0), all P<0.01], and the levels of PCT, CRP, sTREM-1 and the CPIS in patients with severe EOP were significantly higher than those in patients with mild EOP [PCT (µg/L): 6.10 (3.40,8.83) vs. 0.61 (0.42,1.67); CRP (mg/L): 80.5 (31.5,113.0) vs. 21.0 (12.0,43.0); sTREM-1 (ng/L): 89.0 (53.8,132.8) vs. 21.0 (14.0,43.0); CPIS: 4.0 (3.0,5.0) vs. 2.0 (2.0,3.0), all P<0.01]. The cutoff point, sensitivity and specificity of each indicator to predict EOP were 89.5% and 79.1% in PCT>0.43 µg/L, 78.1% and 78.4% in CRP>16 mg/L, 81.9% and 84.9% in sTREM-1>19 ng/L, 75.2% and 79.9% in CPIS>2. Using PCT>0.43 µg/L combined with CPIS>3 to predict EOP, the sensitivity and specificity reached 81.9% and 92.1% respectively. The cutoff point, sensitivity and specificity of indicators to identify severe EOP were 87.8% and 83.9% in PCT>2.15 µg/L, 70.3% and 77.4% in CRP>43 mg/L, 81.1% and 90.3% in sTREM-1>51 ng/L, 67.6% and 83.9% in CPIS>3. Using PCT>2.15 µg/L combined with sTREM-1>56 ng/L to predict severe EOP, the sensitivity and specificity reached 82.4% and 100.0% respectively. CONCLUSION: The first PCT is an effective indicator to predict EOP. The first CPIS is an index for screening EOP. PCT combined with CPIS may improve the specificity to predict EOP. The first sTREM-1 is a good indicator to identify severe EOP. Combination of first PCT and sTREM-1 may greatly improve the specificity to predict severe EOP.

[Integrated detection and analysis on the clusters of schistosomiasis based on geographic information system].

OBJECTIVE: To detect and analyze the clusters of schistosomiasis on marshland and lake areas based on geographic information system (GIS) in 2008 and to provide suggestions for the development of integrated methodology on the detection of clusters on related diseases. METHODS: Moran's I of global spatial autocorrelation, Getis-Ord Gi of local spatial autocorrelation and SaTScan were used to detect the schistosomiasis clusters based on GIS and comparison of the results for different methods were performed. RESULTS: Results from the global Moran's I tests for all the marshland and lake areas related to the schistosomiasis were statistically significant (P < 0.05) and indicated spatial heterogeneity;the z-score outcomes as calculated by Getis-Ord Gi indicated high cluster that 50 clusters were categorized at the 0.05 significance level and the z-score of these 45 clusters were more than 0. Results of SaTScan statistics appeared the same as local spatial autocorrelation and almost showing the existence of 5 cluster areas. CONCLUSION: The geographical distribution of clusters where schistosomiasis was prevalent showed that it was closely corresponded to the middle and lower Yangtse river and in particular, many clusters were located near the boundary of Hubei and Hunan province.

[Impact of the changing water level on the variance of Oncomelania hupensis populations in Lake Area with general additive model].

OBJECTIVE: To explore the impact and regularity of snail population after changing of water level and to develop effective control and prediction programs. METHODS: A typical snail habitat closed to Changjiang county in Yueyang city, Hunan province was selected as the survey field. Data on water level and the changing trend of snail population during 2001 - 2009 including the average water level, maximum and minimum water levels, snail and infected snail densities, proportion of sampling frames with living and infected snails etc. were collected. The distribution of water level and snail indexes were described and a general additive model (GAM) for the relationships between these indexes were also fitted. RESULTS: Impacts of the average water level and the watered-out days in current year in the surveyed field on the snail density were statistically significant (P<0.01), showing a quadratic curve association. The snail density remained at the lowest level when the average water level was at 25.0 m and the surveyed field watered-out days was 120. The average water level in current year and the field watered-out days in the past year showed statistically significant impacts on the infected snail density (P<0.001), the proportion of sampling frames with infected snails (P<0.05) and living snails (P value neared 0.05), presented a quadratic curve, a cubic curve or even a more complicated piecewise curve association. Both the infected snail density and the proportion of sampling frames with infected snails remained at the lowest level when the average water level was at 25.0 m and the watered-out days in the past year was 110, while the proportion of sampling frames with living snails kept the lowest level when the average water level was at 25.0 m and the watered-out days in the past year was 160. CONCLUSION: The water level and the field watered-out days affected the development of snail population directly. The changing water level had an impact on snail population change, which mainly presented as nonlinear smooth function relation. Impact of the field watered out days on the infected snail density and the proportion of sampling frames with living snails and infected snails showed a hysteresis effect. The snail density was predicted to be retaining a high level when the water level was 24.0 m and the field watered-out days was 3 months. It had obvious advantages to fit the relationship of the changing water level and the snail indexes with a GAM which could get closer to the reality as well as easier to find and explain the potential associations and regulations.