Neuroprotective effect of bispectral index-guided fast-track anesthesia using sevoflurane combined with dexmedetomidine for intracranial aneurysm embolization.

Dexmedetomidine has sedative, anxiolytic, analgesic, anti-sympathetic, and anti-shivering effects. Dexmedetomidine might be effective in combination with sevoflurane for anesthesia, but prospective randomized controlled clinical trials with which to verify this hypothesis are lacking. In total, 120 patients who underwent embolization of an intracranial aneurysm were recruited from Anhui Provincial Hospital and Renmin Hospital of Wuhan University of China and randomly allocated to two groups. After intraoperative administration of 2% to 3% sevoflurane inhalation, one group of patients received pump-controlled intravenous injection of 1.0 µg/kg dexmedetomidine for 15 minutes followed by maintenance with 0.3 µg/kg/h until the end of surgery; the other group of patients only underwent pump-controlled infusion of saline. Bispectral index monitoring revealed that dexmedetomidine-assisted anesthesia can shorten the recovery time of spontaneous breathing, time to eye opening, and time to laryngeal mask removal. Before anesthetic induction and immediately after laryngeal mask airway removal, the glucose and lactate levels were low, the S100ß and neuron-specific enolase levels were low, the perioperative blood pressure and heart rate were stable, and postoperative delirium was minimal. These findings indicate that dexmedetomidine can effectively assist sevoflurane for anesthesia during surgical embolization of intracranial aneurysms, shorten the time to consciousness and extubation, reduce the stress response and energy metabolism, stabilize hemodynamic parameters, and reduce adverse reactions, thereby reducing the damage to the central nervous system. This trial was registered at the Chinese Clinical Trial Registry (http://www.chictr.org.cn/) (registration number: ChiCTR-IPR-16008113).

[Spatial-time cluster analysis of distribution of schistosomiasis in Jiangling County].

OBJECTIVE: To analyze the spatial-time distribution characteristics of schistosomiasis in Jiangling County, Hubei Province from 2006 to 2011. METHODS: The surveillance data of schistosomiasis of Jiangling County from 2006 to 2011 were collected, and a spatial database was established. The spatial-time permutation cluster analysis was performed by SaTScan 9.1.1 to detect the spatial-time cluster areas of schistosomiasis, and a risk map was drawn by ArcGIS 10.0. RESULTS: Compared to 2006, the infection rates of human, cattle and Oncomelania hupensis snails decreased by 47.67%, 93.34% and 52.41%, respectively in 2011. The space-time permutation clustering analysis of the infection rates of human, cattle and snails showed 4, 3 and 4 clusters, respectively, and all the clustered areas were distributed in inner embankment areas. CONCLUSIONS: From 2006 to 2011, the schistosomiasis endemic situation presents a decline trend in Jiangling County. The detected cluster areas are the important areas for schistosomiasis control. The space-time permutation statistics could be used in the analysis of endemic situation of schistosomiasis.

[Effect of Parasep® feces centrifuge tube method on detecting schistosome eggs].

OBJECTIVE: To evaluate the effect of the Parasep® feces centrifuge tube method on detecting schistosome eggs. METHODS: A total of 803 residents aged from 6-65 years were selected in 2 schistosomiasis endemic villages, Jiangling County, Hubei Province, and their stool samples were collected and detected parallelly by the Kato-Katz technique, nylon silk egg hatching method, and Parasep® feces centrifuge tube method at the same time. RESULTS: Among the 803 people, 15 cases were found of schistosome egg positive, and the positive rate was 1.87%. The positive rates of the Kato-Katz technique, nylon silk egg hatching method, and Parasep® feces centrifuge tube method were 0.75%, 1.49% and 1.12%, respectively. The schistosome eggs got with the Parasep® feces centrifuge tube method were clear and easy to identify. CONCLUSION: In low endemic areas of schistosomiasis, the Parasep® feces centrifuge tube method can be used as schistosomiasis japonica etiology diagnosis method.

[Cost-effectiveness evaluation on comprehensive control measures carrying out in schistosomiasis endemic areas with regard to different layers of administrative villages stratified by infection situation of human and domestic animals. I. Cost-effectiveness study in inner embankment of marshland and lake regions from 2006 to 2010].

OBJECTIVE: To evaluate the cost-effectiveness of the comprehensive control measures carrying out in schistosomiasis endemic inner embankment of marshland and lake regions from 2006 to 2010, so as to provide the reference for further rational allocation of limited health resources and ultimately speeding up the procedure of schistosomiasis elimination. METHODS: With reference to the requirements of the national schistosomiasis transmission control and phase goals for schistosomiasis control in Hubei Province, Jiangling County, one schistosomiasis control pilot of Hubei Province combined with the National Health and Family Planning Commission and Ministry of Agriculture, was selected for the study. A definition of the infection rates of human and domestic animals was used for endemic villages stratified by different layers (i.e., the village with the infection rates of human and domestic animals ≥ 3% belonged to the first layer, ≥ 1% belonged to the second layer; < 1% belonged to the third layer). By using the stratification method and cost-effectiveness analysis, the endemic villages stratified with the different layers were investigated and all the data of schistosomiasis endemic situation, cost and effectiveness of schistosomiasis control were collected and comprehensively analyzed from 2006 to 2010. RESULTS: In the effectiveness of schistosomiasis control, by the end of 2010, there were no first layer villages, there were 114 second layer villages, and there were 18 third layer villages in Jiangling County. In the former first layer villages, the schistosomiasis patients decreased year by year ultimately to 0; but in the second and third layer villages, the schistosomiasis patients increased. In the fecal treatment and management, the coverage rates of harm less sanitary latrines were 27.45% in 2009 and 48.74% in 2010 respectively in the second layer villages, whereas there were no harmless sanitary latrines in the first and third layer villages. In the 5 years, the input of comprehensive control measures was 10 266 3900 Yuan, much higher than the human and buffalo examinations and treatments, Oncomelania hupensis snail investigation and elimination (4 183 000 Yuan) and other labor inputs (2 239 500 Yuan). In the ratio of cost-effectiveness, the annual ratio of unit cost (1% reduction of human and buffalo infection and 1 hm2 reduction of snail areas) increased yearly. In addition, the semi-logarithmic stability trend analysis of health inputs and cost showed that there was a stable balance between inputs and cost in the different layers (logarithmic values of any two layers of pair-wise comparison were < 1, and in the third layer villages, the annual average logarithmic values of 5 years were < 1). Whereas, in the first and second layer villages, the annual average cost was fluctuated (the costs was higher than the inputs). CONCLUSION: The schistosomiasis situation is reduced year by year in Jiangling County from 2006 to 2010. Whereas, the main infection source (buffaloes) still exists and the present control measures including fecal management should be further strengthened. In the resource allocation, in the field of health, the annual distribution of key inputs and unit-cost control also has a further space of adjustment.

[Laparoscopic surgical treatment for schistosomiasis liver fibrosis portal hypertension combined with calculous cholecystitis].

OBJECTIVE: To evaluate the curative effect of laparoscopic cholecystectomy (LC) in the treatment of schistosomiasis liver fibrosis portal hypertension combined with calculous cholecystitis. METHODS: The clinical data of 196 cases of schistosomiasis liver fibrosis portal hypertension combined with calculous cholecystitis (Child A 160 cases, Child B 36 cases) treated with LC were collected and analyzed from June 2006 to June 2013. RESULTS: Among the 196 cases, there were 154 cases of schistosomiasis liver fibrosis portal hypertension combined with chronic calculous cholecystitis, and 42 cases of schistosomiasis liver fibrosis portal hypertension combined with acute calculous cholecystitis. Totally 189 patients underwent LC successfully, but 7 were transited to the general operation because of LC failure, including 3 cases of adhesion around gallbladder and ambiguous dissection of gallbladder triangle, and 4 cases of intraoperative bleeding and the bleeding was difficult to stop under the laparoscopy. All the 196 patients were cured. CONCLUSION: LC is effective and safe in the treatment of schistosomiasis liver fibrosis portal hypertension combined with calculous cholecystitis.

[Classification and grading of environments with Oncomelania hupensis snails inside embankment of marshland and lake areas].

OBJECTIVE: To classify and grade the environments with Oncomelania hupensis snails inside embankment in marshland and lake areas, so as to improve the work efficiency and realize the systematic management. METHODS: The schistosomiasis endemic area Liaodi and Xiongdi villages in Jiangling County, Hubei Province were selected as the experiment villages, and the environments with snails in the two villages were divided into sections with a length of 500 m, then the snail situation were surveyed by the systematic sampling method with 10 m and 50 m a frame respectively. The environments were classified according to the discovery of infected snails and wild fecal contamination, and the numbers of sites with snails and their areas in different classes were recorded. Meanwhile, the data of sites with infected snails in Jingzhou City during the recent 5 years were collected and graded according to the average density of snails, so as to discuss the correlativity between the grades of environments with snails and the numbers of sites with infected snails and the occurrence rate of frames with snails. RESULTS: There were 1 967 sites with infected snails in Jingzhou City during the recent 5 years, and there was a positive correlation between the grades of environments with snails and the occurrence rate of frames with snails (r(s) = 0.77, P < 0.01), when the grade was 5, the constituent ratio of numbers of sites with infected snails was 3.1%, and when the grade was 2-3, the ratio raised to 56.3%. There were 39 sites with snails in the two villages, the Class 1, 2 and 3 environments included 1, 18 and 20 sites, with the areas of 1080, 51,640 m2 and 41,220 m2, respectively. There were no statistically significant difference between the grades divided by snail survey with 10 m and 50 m a frame ( chi2 = 4.667, P > 0.05), but the time-consuming of the former was 3 times of the latter. CONCLUSIONS: The classification and grading of the environments with snails inside embankment in marshland and lake areas can master the key point of the snail survey. The subsection and setting frames at a suitable distance can save time and manpower, improve work efficiency, as well as understand the distribution of snail status of the environment with snails, which can realize the sort management of the snail environments inside embankment.

[Scrotal calculi: advances in clinical research].

Scrotal calculi are freely mobile calcified bodies or stones located between the layers of the tunica vaginalis of the testis. The literature on this relatively rare benign lesion consists mostly of case reports. In most cases, scrotal calculi are found incidentally during ultrasound examination. Now with the application of high-frequency ultrasonography, the detection rate of scrotal calculi is gradually increasing. This article summarizes the etiology, pathogenesis, clinical manifestations, diagnosis, and treatment of scrotal calculi.

[Construction and operation of network laboratory for schistosomiasis diagnosis in Jianglin County].

OBJECTIVE: To build a high quality diagnosis system for schistosomiasis surveillance in the situation of low infection in Jianglin County. METHODS: The network laboratory for schistosomiasis diagnosis was built according to the national criteria in Jianglin County in 2012. RESULTS: The network laboratory for schistosomiasis diagnosis was established successfully and the operation was quiet well. CONCLUSION: The establishment and operation of the laboratory play an important role in the realization of schistosomiasis elimination.

[Surveillance of endemic situation of schistosomiasis in a national surveillance site in Jiangling County from 2005 to 2011].

OBJECTIVE: To understand the dynamics of schistosomiasis japonica in a national surveillance site in Jiangling County, Hubei Province, China, so as to provide the evidence for formulating the intervention strategy of schistosomiasis control in the whole county. METHODS: The surveillance was performed in the surveillance village according to The National Surveillance Scheme of Schistosomiasis japonica, and the results were analyzed statistically from 2005 to 2011. RESULTS: The schistosome infection rates in residents and cattle decreased from 1.83% and 11.67% in 2005 to 0.91% and 0 in 2011, respectively. The density of living Oncomelania hupensis snails, the density of infected snails, and the infection rate of snails decreased from 4.02/0.1 m2, 0.014 5/0.1 m2, and 0.36% in 2005 to 0.70/0.1 m2, 0.000 3/0.1 m2, and 0.04% in 2011, respectively. CONCLUSIONS: The transmission of schistosomiasis in the surveillance site shows a gradually decreasing trend year by year, but the prevalence is still not stable. Therefore, the comprehensive interventions with the main effort for the infectious source control still need to be strengthened.

[Relationship between schistosome serum test positive rate of residents and positive rate of Oncomelania snails in a national schistosomiasis surveillance site of Jiangling County].

OBJECTIVE: To explore the relationship between schistosome serum test positive rate of residents and positive rate of Oncomelania snails in a national schistosomiasis surveillance site of Jiangling County. METHODS: According to the national schistosomiasis monitoring scheme, the data of surveillance including the schistosome serum test positive rates of residents and positive rates of Oncomelania snails from 2005 to 2011 were collected and analyzed statistically. RESULTS: From 2005 to 2011, the schistosome serum test positive rates of residents were 26.09%, 11.84%, 10.37%, 10.09%, 12.08%,9.61%, and 6.00%, respectively; the schistosome positive rates of Oncomelania snails were 0.36%, 0.08%, 0.15%, 0.129%, 0.067%, 0.091%, and 0.045%, respectively. There was a significant positive correlation between them (r = 0.929, P < 0.01). CONCLUSION: There is a positive correlation between schistosome serum test positive rate of residents and positive rate of Oncomelania snails. Therefore, we should strengthen the snail control.

[Molluscicidal effect of 10% LDS in fields].

OBJECTIVE: To evaluate the molluscicidal effects of 10% salt of quinoid-2', 5-dichloro-4'-nitrosalicylanilide (LDS) on Oncomelania hupensis in the fields, so as to provide the evidence for the application of LDS in the fields. METHODS: The fields where O. hupensis density was relative high were selected as the experimental area and the different concentrations of LDS were used for molluscicidal effects with the immersion, insufflation and powdering methods, and 50% wettable powder of niclosamide ethanolamine salt (WPN) was used as the control. RESULTS: With the immersion method for 3 days, the snail death rates of LDS (0.1, 0.2 g/m3) were lower than those of WPN (2 g/m3, P < 0.01), but the snail death rates of LDS (0.4, 0.6, 0.8 g/m3) were similar with those of WPN (2 g/m3, P > 0.05). With the insufflation and powdering methods for 7 days, the snail death rates of LDS (0.2, 0.4 g/m2) were lower than those of WPN (2 g/m2, P < 0.01), but the snail death rates of LDS (0.6, 0.8, 1.0 g/m2) were similar with those of WPN (2 g/mI2, P > 0.05). CONCLUSION: LDS has some molluscicidal effect.

Transmission risks of schistosomiasis japonica: extraction from back-propagation artificial neural network and logistic regression model.

BACKGROUND: The transmission of schistosomiasis japonica in a local setting is still poorly understood in the lake regions of the People's Republic of China (P. R. China), and its transmission patterns are closely related to human, social and economic factors. METHODOLOGY/PRINCIPAL FINDINGS: We aimed to apply the integrated approach of artificial neural network (ANN) and logistic regression model in assessment of transmission risks of Schistosoma japonicum with epidemiological data collected from 2339 villagers from 1247 households in six villages of Jiangling County, P.R. China. By using the back-propagation (BP) of the ANN model, 16 factors out of 27 factors were screened, and the top five factors ranked by the absolute value of mean impact value (MIV) were mainly related to human behavior, i.e. integration of water contact history and infection history, family with past infection, history of water contact, infection history, and infection times. The top five factors screened by the logistic regression model were mainly related to the social economics, i.e. village level, economic conditions of family, age group, education level, and infection times. The risk of human infection with S. japonicum is higher in the population who are at age 15 or younger, or with lower education, or with the higher infection rate of the village, or with poor family, and in the population with more than one time to be infected. CONCLUSION/SIGNIFICANCE: Both BP artificial neural network and logistic regression model established in a small scale suggested that individual behavior and socioeconomic status are the most important risk factors in the transmission of schistosomiasis japonica. It was reviewed that the young population (≤15) in higher-risk areas was the main target to be intervened for the disease transmission control.

[Study on physical deviation factors on laser induced breakdown spectroscopy measurement].

In order to eliminate the deviation between the measured LIBS spectral line and the standard LIBS spectral line, and improve the accuracy of elements measurement, a research of physical deviation factors in laser induced breakdown spectroscopy technology was proposed. Under the same experimental conditions, the relationship of ablated hole effect and spectral wavelength was tested, the Stark broadening data of Mg plasma laser induced breakdown spectroscopy with sampling time-delay from 1.00 to 3.00 micros was also studied, thus the physical deviation influences such as ablated hole effect and Stark broadening could be obtained while collecting the spectrum. The results and the method of the research and analysis can also be applied to other laser induced breakdown spectroscopy experiment system, which is of great significance to improve the accuracy of LIBS elements measuring and is also important to the research on the optimum sampling time-delay of LIBS.

[Evaluation of the comprehensive schistosomiasis control measures with emphasis on infection source of replacing cattle with machine].

OBJECTIVE: To evaluate the effect of comprehensive measures with an emphasis on schistosomiasis infection source control by replacing cattle with machine. METHODS: In 2011, 2 villages from each of Jingzhou District, Jianli County and Jiangling County, Hubei Province, were selected as intervention group where the comprehensive measures were implemented, while 2 villages from Shishou City served as control with routine control activities. A cluster random sampling was carried out in the 8 villages with more than 300 people in each village were sampled. Stool examination using modified Kato-Katz was applied for identification of the infected persons and hatching test for cattle survey. The systemic sampling was applied for snail survey, fecal specimens from the field were examined by hatching test. Each sample was examined three times. Data were collected for the analysis of control effect between intervention and control groups in 2007 (baseline), 2009 (before implementation of comprehensive measures) and 2011 (post-intervention). RESULTS: In intervention villages, the overall prevalence in human reduced significantly from 3.6% (135/3 772) in 2007 and 2.0% (63/3 116) in 2009 to 0.9% (21/2 396) in 2011 (chi2 = 43.411, chi2 = 11.840, P < 0.05). Until 2011, there were no cattle in intervention group; the prevalence decreased by 52.6% in human and about 100% in cattle from 2010 to 2011. In control group, the infection rate in residents in 2007, 2009 and 2011 was 4.5% (64/1 410), 2.6% (34/1 294) and 1.8% (24/1,320), respectively (chi2 = 16.178, P < 0.05), and 5.1% (8/158) in 2007, 1.6% (3/187) in 2009 and 1.6% (3/189) in 2011 in cattle, respectively (chi2 = 3.387, P > 0.05). The infection rate in human and cattle fell by 25.0% and 5.9% from 2010 to 2011, respectively. There was a significant difference in human infection rate between the intervention and control groups after intervention (chi2 = 6.309, P < 0.05). No infected snails were detected in intervention and control groups. No positive feces from the field was found in the intervention group, 7.5% positive rate was recorded in the control. CONCLUSION: The comprehensive measures focused on infection source control by replacing cattle with machine can effectively control Schistosoma japonicum transmission, with a significant decrease of the prevalence in human and cattle.

[Environmental distribution and disposal measures of infected Oncomelania snails in Jingzhou City].

A survey of Oncomelania snail distribution was carried out with the systematic sampling method in combination with the environmental sampling method. A questionnaire survey was performed to find out the sites where stool examination-positive patients were infected. The results showed that there were 1 721 infected snail spots in Jingzhou City. Most of infected snail spots (94.1%) were only 500 m far away from the nearest residential areas from 2004 to 2010. About 97% of patients considered that the sites where they were infected with schistosome were only 400 meters far away from their residential areas. In conclusion, the survey with a questionnaire method in patients with positive stool examinations can quickly identify the environments with infected snails.

Successful outcome of an integrated strategy for the reduction of schistosomiasis transmission in an endemically complex area.

Schistosomiasis is one of the major public health problems in the People's Republic of China (and elsewhere), seriously threatening health as well as social and economic development. An integrated control strategy, emphasising transmission control but also aimed at reducing greenhouse gases, was carried out in Jiangling county, Hubei province from 2007 to 2009. Three villages were chosen for a pilot study involving removal of cattle from neighbouring, snail-infested grasslands, improving sanitation and construction of units for household biogas production in addition to routine control measures. Both prevalence and intensity of infection in the snails in the neighbourhood were greatly reduced after two years of implementation, while the prevalence of schistosomiasis in humans in the three villages had been reduced by 29%, 34% and 24%, respectively. The removal of cattle and construction of biogas production units had an additional positive effect in that the annual, average emission of greenhouse gases such as methane (CH4) and carbon dioxide (CO2) were reduced by an estimated 7.8 and 80.2 tons, respectively.

[Effect of replacing cattle with machine on schistosomiasis control in 3 endemic villages of Jiangling County].

OBJECTIVE: To evaluate the effect of the comprehensive measures centered on replacing cattle with machine on schistosomiasis control in 3 villages of Jiangling County. METHODS: Three villages namely Jinqi, Yugu, Huazhang where the comprehensive measures being implemented were chosen as investigated sites, the schistosome infection situation of human, cattle and Oncomelania snails before and after the implementation were surveyed, meanwhile, the degree of satisfaction of the residents were investigated by questionnaire. RESULTS: In 2009, the schistosome infection rates of Jinqi, Yugu and Huazhang were 1.87%, 2.72% and 2.89% respectively, and after the implementation, the infection rates of the 3 villages decreased to 0.67%, 1.91% and 1.75%, respectively in 2011. In Jinqi Village and Yugu Village where all cattle were replaced, no snails were found since 2011, while in Huazhang Village where there were still 35 head of cattle, no cattle was infected and the area with infected snails was 0.52 hm2. The total degree of satisfaction on the measures was 89.21%. CONCLUSION: The effect of the comprehensive measures centered on replacing cattle with machine on schistosomiasis control is significant, and its implementation still depends on some necessary supporting measures.

[Investigation on behavior of schistosomiasis patients in Jiangling County].

A cross-sectional study in a highly endemic area of Jiangling County, Hubei Province showed that the main infested water contact behavior was agricultural production (92.5%), and the re-infection and multi-infection were serious.

Studies on the defect structure for Cu2+ in CdSe nanocrystals.

The defect structure for Cu(2+) in CdSe nanocrystals is theoretically studied by analyzing the spin Hamiltonian parameters of this impurity center. This center is ascribed to Cu(2+) occupying the octahedral interstitial site, rather than the tetrahedral substitutional Cd(2+) site proposed by previous work. The Cu(2+) center exhibits slight tetragonal elongation distortion (characterized by the elongation parameter rho approximately 0.03) due to the Jahn-Teller effect. The theoretical spin Hamiltonian parameters and optical transition show good agreement with the experimental data. The above unusual defect structure (occupation and symmetry) for Cu(2+) in CdSe nanocrystals is discussed, as compared with the conventional trigonally distorted tetrahedral Cu(2+) centers in bulk II-VI semiconductors.

Investigations of the local structures and spin Hamiltonian parameters for the trigonal Rh4+ and Ir4+ centers in rhombohedral BaTiO3.

The local structures and spin Hamiltonian parameters (g factors and the hyperfine structure constants) of the Rh(4+)(4d(5)) and Ir(4+)(5d(5)) centers in rhombohedral BaTiO(3) are theoretically investigated from the formulas of these parameters for a nd(5) (n=4 and 5) ion with low spin (S=1/2) in a trigonally distorted octahedron. From the calculations, the impurity ions are found not to occupy exactly the host Ti(4+) site in BaTiO(3) but to suffer a slight inward shift ( approximately 0.13A) towards the center of the oxygen octahedron along the C(3) axis, yielding much smaller trigonal distortion as compared with that of the host Ti(4+) site. The theoretical spin Hamiltonian parameters based on the above impurity axial shifts are in good agreement with the observed values.