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10 June 2020, Volume 18 Issue 2 Previous Issue    Next Issue

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Course of malaria control and elimination in Anhui Province  XU Xian, ZHANG Tao, JIANG Jing-jing, LI Wei-dong∗ 2020, 18 (2):  65-69,80.  Abstract ( 750 )   PDF (1347KB) ( 1997 )   In 2019, Anhui Province qualified for the national malaria elimination assessment, which signifies a new historical stage for malaria prevention and control in Anhui. This article aims at reviewing the history of malaria epidemic and the course of prevention and control efforts in Anhui Province since the founding of the People's Republic of China with regard to the epidemic characteristics, prevention and control strategies as well as implemented specific control measures for malaria in four chronological stages. Related Articles | Metrics

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Thinking on endemic characteristics and control strategy at the stage of postinterruption of schistosomiasis in China  ZHANG Shi-qing 2020, 18 (2):  70-74.  Abstract ( 652 )   PDF (731KB) ( 2299 )   This paper analyses the endemic characteristics of schistosomiasis, including infectious sources, infection of schistosoma, intermediate hosts, at the stage of post-interruption(2020- 2030) of schistosomiasis in China. Based on the analysis and estimation of the changes of endemic factors and characteristics, countermeasures were proposed targeting at the goal of elimination of schistosomiasis by 2030 in China. Related Articles | Metrics

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Interpretation of 2019 Guideline of Prevention and Treatment for Chronic Hepatitis B  LIU Lei, LI Lei 2020, 18 (2):  75-80.  Abstract ( 629 )   PDF (1030KB) ( 2412 )   The paper intends to interpret 2019 Guideline of Prevention and Treatment for Chronic Hepatitis B. In order to better understand the guideline(2019 edition) and guide clinical practice, we highlighted the differences between the version of 2019 and 2015 pertinent to the changes in clinical diagnostic indicators, modified antiviral treatment strategies, and the treatment recommendations for special patients. The indications for antiviral therapy are further expanded, in which recommendation of potent agent with low resistance as first-line drugs is emphasized, and the guidance to medication of special population is specified. Related Articles | Metrics

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Analysis on the surveillance results of schistosomiasis prevalence in Hubei Province from 2015 to 2019  SHAN Xiao-wei, XIAO Ying∗, LIU Si, LIU Jian-bing, SU Zheng-ming 2020, 18 (2):  81-86.  Abstract ( 609 )   PDF (813KB) ( 1522 )   Objective To understand the prevalence status of schistosomiasis in Hubei Province through analyzing the surveillance data generated from 2015 to 2019 for guidelines in following monitoring tasks. Methods In compliance with the Scheme of Schistosomiasis Surveillance in Hubei Province(2015 edition), we carried out monitoring in regular manner as well as surveillance on the specific sites and risk monitoring in 207 areas under the 13 administrative cities across the province.  The surveillance consisted of local residents, floating population, infection status in livestock and snails. The surveillance data in each year were analyzed. Results Positive rate of blood test was decreased from 2. 75% ( 4 470 / 173 558) in 2015 to 2. 09% (2 169 / 103 885) in 2019 in local residents, and infection rate of local residents was fallen to 0 in 2019 from 0. 07% (120 / 173 558) in 2015. No acute infection occurred in the five years of period. The positive rate of blood test in floating population was decreased from 1. 06% (98 / 9 249) in 2015 to 0. 79% (100 / 12 602) in 2019, and the infection rate was 0. 02% (2 / 9 249) in 2015, and dropped to 0 in the remaining 4 years. From 2015 to 2019, a total of 7 880 heads of livestock, in which 5 325 were cattle, underwent schistosomiasis screening. The results showed no infection. During the past five years, a total area of 94 297. 8 hm2 was investigated, which revealed an area of 34 263. 05 hm2 with snails. A total of 876 392 live snails were captured, and no infectious snails were found. The average density of live snails was decreased from 0. 291 5 / frame to 0. 124 1 / frame, and the occurrence rate of snails was fallen from 9. 54% in 2015 to 6. 19% in 2019. Totally, 2 035 aliquots of wild feces were tested, indicated no positive results. A total of 49 water areas were monitored for snail distribution, and 6 942 kg of flotsam obtained demonstrated absence of snail attachment. Risk monitoring on 252 sites with snails revealed 12 areas at level I risk by positive findings in the wild feces. Conclusion Schistosomiasis prevalence tended to decline in Hubei Province from 2015 through 2019, and the endemic status remained at the lowest level in history. However, transmission risks are still higher in some areas, and strengthened efforts are needed in controlling the cattle being raised. Related Articles | Metrics

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Morphological and molecular characteristics of Ascaridia galli isolates from Huangshan area  RAO Tian-yu△, SHEN Xi△, ZHU Zhi-wei, XU Wei, ZHAO Jin-hong∗ 2020, 18 (2):  87-92.  Abstract ( 752 )   PDF (9199KB) ( 212 )   Objective To identify the taxonomy for Ascaridia galli by investigating its morphological and molecular characteristics and phylogenetic analysis. Methods The Ascaridia galli was isolated from the small intestines of chickens collected in Huangshan area, Anhui Province, and observed under light microscope and scanning electron microscope for the morphology. Then genes ITS and COⅠ of Ascaridia galli were amplified, cloned and analyzed for homology and phylogeny. Results Morphological observation showed that the Ascaridia galli was milky white after fixing the dead body. The tail was straight for the female, curly for the male. Three lips, measuring equally in size, arose at the head, and 10 pairs of papillae were seen at the tail of male. The length of COⅠ and ITS genes were 655 bp and 1 034 bp, respectively. Phylogenetic trees based on COⅠ and ITS genes revealed that Ascaridia galli isolates from Huangshan area had the highest homology with those from other countries or regions, with COⅠ and ITS identity being up to 100% and 99. 9% respectively. This nematode Ascaridia galli was clustered in one clade. Conclusion Analysis of the morphological and molecular characteristics for Ascaridia galli can lay a foundation for identification, prevention and control of this species. Related Articles | Metrics

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Retrospective investigation and analysis of human trichinosis outbreaks in Yunnan Province YOU Xiao-di, WU Fang-wei∗ 2020, 18 (2):  93-96,101.  Abstract ( 671 )   PDF (1843KB) ( 1580 )   Objective To understand the characteristics of human trichinellosis outbreaks in Yunnan Province, so as to supply references to the treatment and control of trichinellosis. Methods Historical reports on human trichinellosis outbreaks in Yunnan Province since 2000 were retrieved from the database, including CNKI, CQVIP and Wanfang Data. Then the data were analyzed regarding epidemiological distribution, infection fashion and clinical diagnosis and treatment. Results Twenty-one episodes of outbreaks of human trichinellosis, with a cumulative involvement of 2 256 cases and 3 deaths, were reported in Yunnan Province since 2000. The outbreaks mainly occurred in winter and spring seasons, and were primarily associated with rural areas in western and southwestern Yunnan. The infection most occurred in ethnic minorities living in the provincial border areas, and the majority of the patients were young adults. Main cause of infection was intake of raw or undercooked pork. Of 1 976 cases with clear symptom records, the incubation period of the patient was as short as 12 h and as long as 25 d. Clinical manifestations generally included muscle pain(1 655 cases, 83. 76% ), fever(1 612 cases, 81. 58% ), fatigue(998 cases, 50. 51% ), facial and eyelid edema(659 cases, 33. 35% ), abdominal pain and diarrhea, digestive tract symptoms( 509 cases, 25. 76% ) and respiratory symptoms such as cough and expectoration( 122 cases, 6. 17% ). Four outbreaks were misdiagnosed as food poisoning, acute gastroenteritis, conjunctivitis and other conditions at early stage. Conclusion The outbreak of trichinellosis is an important public health emergency in Yunnan Province. Our findings suggest that governments and health sectors at all levels should strengthen publicity on the prevention and control of trichinellosis, including raising the awareness of population in disease prevention and modifying diet habits to eventually reduce the risks of such infection. Related Articles | Metrics

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Investigation and analysis on the job satisfaction in tuberculosis control professionals in Anhui Province  ZHU Qing-qing, FANG Xue-hui, LI Ling, KAN Xiao-hong, YAO Song∗ 2020, 18 (2):  97-101.  Abstract ( 772 )   PDF (804KB) ( 1139 )   Objective To understand the job satisfaction in tuberculosis control staff working in city and county institutions in Anhui Province for reference evidence in construction of human resources across the province. Methods A questionnaire survey was conducted on all tuberculosis control professionals working in city and county institutions in our province from August 1 to 31, 2019. A total of 622 questionnaires were retrieved, of which 605 were valid. Then the questionnaires were analyzed on the personnel satisfaction with the leadership behavior, institutional management system, work pay, working environment and pressure, interpersonal relationship at work, subjective willingness to work, and job promotion opportunities. Results The average scoring on general job satisfaction was 3. 84±0. 58 in the tuberculosis control staff in Anhui Province, which was between satisfaction and just so-so. Most staff were satisfied with the leadership behaviors and interpersonal relationship at work, yet less satisfied with their pay for job and opportunities for job promotion. In different groups of professionals, males, younger staff, and those with working years≤5 years, with senior academic titles, at leadership position, working in municipal hospitals and with annual income≥100,000 RMB yuan had higher satisfaction in general. However, female and middle-aged staff, personnel with working years≥26 years, with intermediate academic titles and ordinary staff were lower in satisfaction with their job. Conclusion The findings suggest that our efforts should be paid on following construction of the professional teams in anti-tuberculosis field in hierarchy fashion by inspiring the vitality of the professionals with intermediate academic titles, establishing a fairer, reasonable and effective incentive system via income regulation in all professionals either working in cities or counties in Anhui Province Related Articles | Metrics

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Clinical analysis of imported malaria in 368 cases  XU Yuan-yuan, LI Lei 2020, 18 (2):  102-104.  Abstract ( 697 )   PDF (768KB) ( 1242 )   Objective To analyze the epidemiological and clinical characteristics of imported malaria for evidence in clinical diagnosis and treatment. Methods Retrospective analysis was performed regarding the epidemiological and clinical characteristics in 368 cases of imported malaria admitted to and treated in our hospital between January 2007 and December 2019. Results The 368 patients were imported malaria from African counties, and diagnosed by laboratory examination, in whom 103 were infected with Plasmodium falciparum, 95 with Plasmodium vivax, 31 with Plasmodium ovale, 112 with  Plasmodium malariae and another 27 with mixed infection. 366 cases were males(99. 5% ). All patients had symptoms of chills and fever. 97. 6% of the patients were diagnosed within 5 days after onset, and received timely treatment. 364 patients were cured(98. 9% ), and death occurred in 4(1. 1% ). Artemtherin was administered in increased dose and prolonged course without obvious adverse effects. Conclusion Clinicians should be alert to cases of imported malaria. Early diagnosis and prompt treatment can improve the prognosis of patients. Related Articles | Metrics

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Clinical effect of ultrasound-guided puncture and catheterization in the treatment of liver abscess  TANG Wei-zhong, ZHAO Yi-wen, ZHAI Da-ming 2020, 18 (2):  105-107.  Abstract ( 709 )   PDF (1314KB) ( 1909 )   Objective To analyze the advantages and precautions of interventional drainage in the treatment of liver abscess. Methods From September 2015 to September 2019, 49 cases of liver abscess were treated by percutaneous puncture and catheterization in the ultrasound department of our hospital. The purulent cavity was treated by puncture and catheterization drainage, concurrent purulent cavity washing, drug injection and anti infection treatment according to drug sensitivity test. Results In this study, 49 patients were successfully punctured. The percentage of leukocytes and neutrophils decreased significantly(P<0. 05). The diameter of abscess was significantly smaller than that before operation( P< 0. 05). The body temperature of 25 patients returned to normal within 3 days, 16 patients returned to normal within 3~ 7 days, and 8 patients returned to normal after 7 days. All the patients could tolerate the treatment of catheterization, the drainage time was 3~ 28 days, average 13. 5 days, no complications such as bile leakage, infection and pneumothorax occurred during and after operation, and there was no recurrence. Conclusion Ultrasound-guided percutaneous drainage of liver abscess has gradually replaced the treatment of high-dose drugs or surgery, and the clinical effect is reliable, less complications, which has obvious advantages in clinical treatment of liver abscess. Related Articles | Metrics

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Application effect of continuous nursing on advanced schistosomiasis  ZHANG Guan-zhen, ZHANG Yun, HUANG Ni-li, YU Xiu-juan 2020, 18 (2):  108-110.  Abstract ( 584 )   PDF (765KB) ( 884 )   Objective To observe the effect of continuous nursing on patients with advanced schistosomiasis. Methods A total of 52 advanced schistosomiasis patients discharged from our hospital between April and July of 2018 were included, and randomly divided into control group and observational group( n= 26 for each group). Patients in the control group received general guidance and routine health education upon discharge, and those in the observational group were given additional continuous nursing besides the general guidance and health education. The two groups were analyzed concerning the treatment compliance, quality of life and nursing satisfaction after 6 months. Results The total compliance rate was 88.46% (23 / 26) for the observational group and 46. 15% (12 / 26) for the control group. The difference was significant between groups( χ2 = 5. 95, P< 0. 05). The scores of physical function, psychological function, social function and material state function were higher in the observational group than in the control group(t = 23. 411 ~ 62. 682, P<0. 05). The total satisfaction with nursing 96. 15% (25 / 26) and 65. 38% (17 / 26), respectively for the observational group and control group (χ2 = 3. 03, P<0. 05). Conclusion Continuous nursing measures are worthy of recommendation, for they are conducive to patients with advanced schistosomiasis in improving their treatment compliance, quality of life and nursing satisfaction. Related Articles | Metrics

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Mixed infection of malaria: report of 6 cases with attack at different incubation  WANG Wei-ming, CAO Yuan-yuan, YANG Meng-meng, GU Ya-ping, XU Sui, ZHOU Hua-yun∗, ZHU Guo-ding 2020, 18 (2):  111-114.  Abstract ( 804 )   PDF (784KB) ( 711 )   Objective To investigate and analyze the mixed infection of malaria in 6 imported cases with different incubation period for evidence to plan prevention and control measures for imported malaria. Methods Information of the 6 imported cases was collected from the case registration and management system of malaria besides clinical case data from primary medical institutions, microscopic examination and recheck findings by PCR performed in provincial reference laboratory. Results All of the 6 malaria cases had a history of living abroad, and the shortest time of living abroad was 10 days and the longest 1 229 days. After returning to China, they never went abroad again. The first onset for the 6 cases ranged from 1 to 10 days after their return, initially diagnosed as Plasmodium falciparum infection, and discharged following antimalarial medication. The interval was 22 ~ 133 days between discharge from hospital and the second attack. Three of the six cases were diagnosed as coinfection with P. falciparum and P. malariae, and another three as coinfection with P. falciparum and P.ovale. The infected plasmodium species in twice attacks in the 6 cases were subjected to microscopic examination and PCR recheck performed in the provincial reference laboratory. All patients were followed for over one year after discharge from the second attack, and well recovered. Conclusion The 6 cases of imported malaria with different incubation period are associated with P. falciparum and P. ovale infection or mixed P. malariae infection. The findings suggest that prevention and control of such cases should be strengthened in the future in order to consolidate efforts in elimination of malaria. Related Articles | Metrics

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An investigation on the contribution factors of Oncomelania hupensis snail-existent non-endemic areas of schistosomiasis(SENEAS) in Bowang District, Ma'anshan City,Anhui Province  ZHAN Ti, CUI Dai-wen, XIANG Ke-xia, WANG Wei-chun, ZHU Ying-fu, DUAN Yong-mei 2020, 18 (2):  115-117.  Abstract ( 710 )   PDF (799KB) ( 877 )   Objective To explore the forming cause of the Oncomelania hupensis snail-existent non-endemic areas of schistosomiasis(SENEAS) in Bowang District, Ma'anshan City, and to provide the scientific evidence for schistosomiasis control measures in the area. Methods Field surveys were carried out in SENEAS in Bowang District for the infection rate of population and livestock, and the distribution of Oncomelaniasnails. In lab investigation, Oncomelania snails collected from SENEAS in Bowang District were randomly divided into two groups. They were exposed to Schistosoma japonicum miracidia and the ratio of snail to miracidia were 1 ∶ 20 and 1 ∶ 40, respectively. The same measures were used in Oncomelaniasnails from endemic areas in Huashan District as control groups. All snails were bred at room temperature for 90 days. Snail infection rate were observed and compared. Results In field research, we have investigated 568 people, 40 livestock , and 1 100 Oncomelaniasnails in SENEAS. The infection rate of population and livestock were both 0, and no positive snails were found. In lab investigation, the infection rate of snails in SENEAS were significantly lower than those in endemic areas in both 1 ∶ 20 group and 1 ∶ 40 group. Conclusion In SENEAS in Bowang District, Oncomeania snails can successfully infected by Schistosoma japonicummiracidia. We believed that the main reason of SENEAS is that there were no sufficient amount of infection source imported, and the low susceptibility to Schistosoma japonicum miracidia of local Oncomeaniasnails. Related Articles | Metrics

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Investigation and analysis of Clonorchis sinensis and soil-transmitted nematode infections in Xing'an County of Guangxi  LI Hai-yan, HE Bin, TANG Wen-qian, PAN Hai, ZHANG Li-juan, YANG Jian-jun, SHI Yun-liang, JIANG Zhi-hua∗ 2020, 18 (2):  118-120,131.  Abstract ( 636 )   PDF (1400KB) ( 951 )   Objective To understand the infection status of Clonorchis sinensis and soil nematode infection in Xing'an County for scientific evidences to plan effective control and preventive strategies. Methods Survey areas were separately chosen from 5 administrative villages. Modified Kato thick smear method was used to examine fecal eggs in population, and further culturing of the hookworms was carried in subjects with positive findings using test tube filter paper culture method. Pinworm eggs were detected in children aged from 3 to 9 years using cellophane tape anal swab. Small wild fish was captured in the natural water environment, and pressed in between glass slides to undergo detecting metacercaria of Clonorchis sinensis. Results Totally, 1 045 people were investigated. The total infection rate was 4. 40% (46 / 1 045), without mixed infection. The infection rate was 4. 40% for both males and females(21 / 477; 25 / 568), and 0. 57% (6 / 1 045), 2. 68% (28 / 1 045), 0. 48% (5 / 1 045) and 0. 67% (7 / 1 045) respectively, for Clonorchis sinensis, hookworm, whipworm and pinworm. Infection degree was generally mild except for one case with moderate infection of hookworm. Metacercaria of Clonorchis sinensis was detected 12% of the small wild fish(12 / 100). Conclusion Infection of Clonorchis sinensisand soil-borne nematode remains in a lower endemic level in Xing'an County. Hookworm is the main species of infection in local population, which needs intensive control. In addition, certain endemic risk of clonorchiasis still exists in our area. Related Articles | Metrics

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Research process of wisdom classroom and analysis on the hot-spot of knowledge under studies  ZHANG Yong-jun, YANG Ming, YANG Tao, ZHENG Lan-rong, HUANG Yue-e∗ 2020, 18 (2):  121-123,126.  Abstract ( 754 )   PDF (2603KB) ( 1144 )   Objective To investigate the research process of wisdom classroom and the current hot-spot of knowledge under studies associated with the intelligence classes in mainland China. Methods Publications on the research of wisdom classroom were retrieved in the China National Knowledge Infrastructure( CNKI) database from 2006 through 2019, and analyzed on bibliometric indicators and knowledge map basis regarding annual publishing trend, source organization of the papers, distribution of high-frequency authors, discipline category, high - frequency keywords, hot-spot clustering and evolution of the hot-spot. Results A total of 2 390 publications on the research of wisdom classroom were retrieved. Research on the wisdom classroom tended to rapidly increase year by year, and peaked in 2019. The institutions and authors with the highest publications were Zhong Shao-chun and Xie Yue-guang from Northeast Normal University. As far as discipline was concerned, wisdom classroom received higher attention from educational sectors. Analysis on the highfrequency keywords showed that the " Teaching mode" ranked the first on list of hot-spot on wisdom classroom, and analysis on the knowledge map indicated that the wisdom classroom was clustered on 7 hot-spots since 2006. Current research was focused on the themes such as " Internet plus" , " Teachers ' role" and " Core literacy" . Conclusion Research on the wisdom classroom is promising, tending to change in hot-spot from macro to micro level based on practical application. This should be the tendency by deeply incorporating wisdom classroom with diverse disciplines in this field of study. Related Articles | Metrics

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Thinking about the teaching of infectious diseases from the epidemic situation of novel coronavirus pneumonia  YANG Jin-sun∗, QUAN Bin 2020, 18 (2):  124-126.  Abstract ( 611 )   PDF (755KB) ( 1096 )   Covid-19 epidemic has been spreading rapidly in China and around the world since December 2019. As the sixth batch of medical team members from Hubei Province, we participated in the diagnosis and treatment of COVID-19 in Wuhan and thought about the teaching work of infectious diseases. In infectious diseases in the process of teaching, we should be to teach medical students to deeply understand the importance of epidemiology study course, abide by relevant laws and regulations of infectious diseases strictly, completes the standard protection strictly, to keep pace with the times constantly update knowledge, strengthen the public health thinking in clinical medical students must, etc. As teachers, we should also enrich the teaching content of infectious diseases and improve the teaching methods. Related Articles | Metrics

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Research progress in patients of hemorrhagic fever with renal syndrome and HLA gene polymorphism LIU Gan, YANG Jin-sun∗, SUN En-tao∗ 2020, 18 (2):  127-131.  Abstract ( 572 )   PDF (763KB) ( 1370 )   Hemorrhagic fever with renal syndrome ( HFRS) is a natural focus disease originated from animal infection. The pathogenesis of HFRS is controlled by many factors, in which the pathogenic immune plays a major role. Studies demonstrated that HFRS was closely connected with human leukocyte antigen(HLA) gene polymorphism, and the genetic correlation and course severity of HFRS were affected by HLA gene polymorphism at a certain level. This paper aims at reviewing the research progress in HFRS and HLA gene polymorphism in order to provide a scientific basis for early clinical screening and diagnosis of HFRS as well as assessment of the disease risks. Related Articles | Metrics