Assessment of Malaria Microscopy Competency at Primary Health Institutions in the Chongqing Municipality.

Background: In April 2019, Chongqing passed the national malaria elimination assessment. However, around 30 imported malaria cases are still being reported every year, and Anopheles sinensis was widely distributed in Chongqing, meaning the risk of malaria resurgence still exists. Early diagnosis and treatment for malaria cases are effective measures to prevent malaria resurgence. The primary health institutions are the first station where potential malaria cases may seek treatment. The competency with which primary health institutions diagnose malaria will directly affect the timeliness of malaria diagnosis. Nowadays, most primary health institutions in Chongqing use microscopy to confirm malaria cases. This study assessed the microscopy competence of primary health institutions, studied and analyzed the results, and provided a scientific basis for malaria prevention and control after malaria elimination in Chongqing. Methods: According to the stratified sampling principle, four plasmodium microscopy technicians (156 in total) were selected from each of the 39 districts/counties of Chongqing to test the plasmodium microscopy competence. Descriptive statistical analysis, correlation analysis, spatial self-correlation analysis, and ROC curve analysis were carried out on the test results. Result: The average of the technicians' test scores was 4.33 ± 0.47 (min: 3, mid: 4.5, max: 5); The spatial clustering of the scores was significant (MoranI = 0.338, Z = 3.618, P < 0.01). The test scores were positively correlated with the "level of work institutions" (R = 0.21, P < 0.01) but were negatively correlated with "age" (R = -0.31, P < 0.01). The highest Sensitivity of the technicians' microscopy was in qualitative diagnosis (98.92%, CI: 98.00-99.69%). The Delong's test showed that the diagnostic efficiency of the technicians' microscopy to P. falciparum was the best (P < 0.01), however to P. ovale was the worst (P < 0.01). Conclusion: The microscopy technicians in primary health institutions in Chongqing have good microscopy competency in qualitative diagnosis, but there were deficiencies in the identification of plasmodium species. Township level health institutions in Central China have weaker microscopy than those in other areas.

Pressure-Induced Modulation of Electronic and Optical Properties of Surface O-Functionalized Ti2C MXene.

Functionalized MXenes have gained increasing interest in the fields of thermoelectric materials, hydrogen storage, and so forth. In this work, pressure-induced band modulation and optical properties of the Ti2CO2 monolayer are investigated by using density functional theory with the hybrid (HSE06) functional. The calculation reveals that Ti2CO2 MXenes under pressure are stable because of the positive E coh. Ti2CO2 undergoes a semiconductor-to-metal phase transition at about 7 GPa. The metallization of Ti2CO2 mainly results from the Ti-d state. Research indicates that there exist strong interactions between Ti-d and C-p, and Ti-d and O-p states, which are further confirmed by the charge analysis. In addition, the absorption is enhanced in the visible region with increasing pressure. We also observed some new absorption peaks in the visible region.

[Survey and analysis of major human parasitic diseases in Chongqing City].

OBJECTIVE: To investigate the epidemic of major human parasitic diseases in Chongqing City, so as to provide a reference for developing prevention and control strategies. METHODS: According to the unified methods formulated by the national investigation scheme and stratified cluster random sampling, 36 rural pilots and 50 urban pilots were selected in Chongqing City. The number of the objects investigated in individual pilot was defined over 250. RESULTS: Totally 22 263 residents were detected. The overall infection rate of intestinal parasites was 5.41%. The infection rates of Ascaris lumbricoides, hookworm, Trichuris trichiura, and Enterobius vermicularis were 1.20%, 4.23%, 0.13% and 0.47% respectively. Only 0.22% of the infections were co-infections. The infection rate of overall intestinal parasites was statistically higher in the females than that in the males (χ2 = 15.19, P < 0.05), and the infection rates were significantly different among various age groups, occupations, education levels, and regions (χ2 = 15.19, 396.72, 421.07, 347.79, all P < 0.05). CONCLUSIONS: The infection rates of major human parasites in Chongqing show an obviously decreasing tendency compared with the rates of the past twice of national surveys. In the future, the controlling practices are obliged to focus on reducing the infection rates of soil-borne parasites.

[Epidemiological analysis and control strategy discussion for overseas imported malaria cases reported in Chongqing City from 2011 to 2015].

OBJECTIVE: To analyze the epidemiological characteristics of overseas imported malaria reported in Chongqing City from 2011 to 2015, so as to provide the evidence for improving the imported malaria control strategies. METHODS: The epidemiological data of overseas imported malaria cases were collected and analyzed descriptively for the species, original countries, diagnosis and treatment in Chongqing City from 2011 to 2015. RESULTS: A total of 148 overseas imported malaria cases were reported in Chongqing City from 2011 to 2015, in which 96 (65.54%) cases were falciparum malaria, and 37 (24.32%) cases were vivax malaria; 125 (84.46%) cases were infected in Africa, and the rest of 23 (15.54%) cases were infected in Southeast Asia. Most of the patients were 30 to 50 years old male workmen, and the ratio of male to female was 11.42:1. There was no obvious seasonal distribution among the reported timelines of the cases; however, there were two small peaks from June to August and from January to February. The median interval time of imported malaria cases from malaria onset to see a doctor was 1 day and from seeing the doctor to get malaria diagnosis was 2 days. The patients' first selected institutions were county medical institutions (50 cases, 33.78%), then provincial medical institutions (36 cases, 24.325%) and private doctors (20 cases, 13.51%), and only 79 (53.38%) patients got malaria diagnoses in their first selected institutions. The standard treatment were provided to 142 (95.54%) cases. There were 43 (29.05%) patients had serious complications and three patients were dead. CONCLUSIONS: It is very important to enhance the multi-sector's collaboration to establish the collaborative investigation mechanism for screening malaria patients, and strengthen malaria health education for overseas workers and training courses in primary care medical institutions.

Misdiagnosis of aortic dissection: experience of 361 patients.

Aortic dissection (AD) is a life-threatening condition that requires immediate diagnosis and surgical correction. Patients with acute AD usually present clinically with an insignificant medical history, leading to a high probability of misdiagnosis. The aim of the present study was to investigate the number of misdiagnoses of patients with AD in order to understand this problem and to avoid future misdiagnosis in the emergency department. Clinical data from 361 patients with AD admitted between January 2003 and June 2008 were reviewed as part of a retrospective chart review. Diagnosis of AD was made using either chest x-ray, computed tomography, magnetic resonance imaging, or angiography. Fifty-one patients had an initial misdiagnosis (14.1%), later found to have experienced AD. The condition may clinically present in a varied number of manifestations, including syncope, chest pain, abdominal pain, back pain, acute congestive heart failure, or alternatively with minimal symptoms. Persons of any age can experience an AD, with key clinical manifestations of pain. Echocardiography can be used for primary examination of patients with suspected AD; however, a definite diagnosis is usually made using computed tomographic or magnetic resonance angiography. Care should be taken, particularly in the emergency department, to maintain a level of suspicion for AD diagnosis in order to avoid the potential for misdiagnosis.