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The intelligent platform for comprehensive management of tuberculosis in Shandong province (hereinafter referred to as the ‘intelligent platform’) is built with microservice architecture, and has technical features such as high performance, lightweight, concurrent programming model, standard library support, cross-platform, debugging and testing friendly, and integration with container technology. The construction of intelligent platforms relies on cloud architecture-related technologies to segment physical computing, storage, and network resources, supporting customers to use various terminals to obtain services from any location. The intelligent platform integrates advanced technologies such as information technology, artificial intelligence and big data analysis, which can strengthen the publicity and education of tuberculosis prevention and control knowledge, improve the detection of tuberculosis patients, improve the diagnostic efficiency, strengthen the overall management of tuberculosis patients during drug taking, and improve the efficiency of the daily work of tuberculosis prevention and control in the province. According to the statistics of patient management since the operation of the intelligent platform, the patient notification rate is 93.5%, the rate of taking medication on time is 77.4%, and the rate of regular medication use is 95.6%. The platform has great potential to improve the level of tuberculosis prevention and control, strengthen the management of medical resources and promote the intellectualization of the health system, which is of great significance for the effective control and prevention of tuberculosis.

To ensure successful pumping and excellent crack resistance, special SFRC was prepared through optimizing the matrix, the shape and size of fibers. The pumpability, shrinkage, cracking, direct tensile strength and toughness were considered. According to the vertically pumping results, the prepared SFRC can be continuously pumped up to a concrete tower with the height over 300 m. Test results demonstrate that steel fiber can diminish the dry shrinkage of concrete in later period, and can improve the mechanical behaviors of concrete matrix. Results of cracking test indicate that the crack resistance is increased by 40% approximately due to the addition of steel fiber to concrete beam. It is also found that in the full-scale model test of main tower, the maximum crack width, cracking length and run-through crack number of anchorage zone poured by SFRC are all less than those of anchorage zone poured by contrast concrete. Therefore, the prepared SFRC is suitable for anchorage zone of the concrete tower and can be used in other zones suffering complex forces. [ABSTRACT FROM AUTHOR]

In order to explore the status of soil heavy metal pollution and environmental quality in west Hunan, relevant areas of Phoenix County were selected as the study area. Using data from 440 soil samples collected in the study area from June to August 2022, the pH value of the soil and contents of eight heavy metal elements, namely, As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn, were analyzed. The PMF model was used for traceability analysis and geochemical evaluation of soil environmental quality. The results showed that the average values of soil heavy metals ω (Zn), ω (Cr), ω (Pb), ω (Ni), ω (Cu), ω (As) , ω (Cd), and ω (Hg) were 81.02, 64.67, 31.63, 29.27, 25.52, 9.93, 0.28, and 0.13 mg·kg -1 , respectively. The soil in the study area was mainly weakly acidic, and the contents of the Cd and Hg elements were relatively high compared to the national soil background values and were highly variable. The contents of the Hg and Cd elements in forest land were higher than that in other land uses. The PMF model results showed that the contribution rates of heavy metal pollution sources in the study area were mining sources (37.4%), atmospheric sedimentation sources (7.7%), natural sources (41.1%), and agricultural activity sources (13.8%) and provided suggestions on pollution control measures according to the spatial distribution of the four types of pollution sources. Through the comprehensive assessment of soil environmental geochemistry, the study area was divided into three types of plots, namely, non-risk areas (94.27 km 2 ), accounting for 76.38%; risk-controllable areas (27.45 km 2 ), accounting for 22.24%; and high-risk areas (1.7 km 2 ), accounting for 1.38%. This study provided data support for the prevention and control measures of land pollution in the research area, as well as the delineation of the prevention and control scope.

The naturally high background value region of Cd derived from the weathering of carbonate has received wide attention. Due to the significant difference in soil physicochemical properties, soil Cd content, and bioavailability of different parent materials in the karst area, there are certain limitations in using the total soil Cd content to classify the environmental quality of cultivated land. In this study, surface soil and maize samples of eluvium and alluvial parent material in typical karst areas were collected systematically; the contents of maize Cd, soil Cd, pH, and oxides were analyzed, the Cd geochemical characteristics of different parent soils and the influencing factors of their bioavailability were revealed, and scientific and effective arable land use zoning suggestions based on the prediction model were suggested. The results showed that the physicochemical properties of different parent material soils in the karst area were obviously different. The alluvial parent material soil had low Cd content but high bioavailability, and the maize Cd exceeding rate was high. The maize Cd bioaccumulation factor was significantly negatively correlated with soil CaO, pH, Mn, and TC, and the correlation coefficients were -0.385, -0.620, -0.484, and -0.384, respectively. Compared with the multiple linear regression prediction model, using the random forest model to predict the maize Cd enrichment coefficient had higher accuracy and precision. Furthermore, a new scheme for the safe utilization of cultivated land at the plot scale based on soil Cd and predicted crop Cd content was proposed in this study, making full use of arable land resources to ensure crop safety.

Objective: To understand the epidemiological features and changing patterns of intestinal parasitic diseases in Jiangxi Province from 1989 to 2014, so as to provide scientific evidence for formulating the preventive and control strategy for intestinal parasitic diseases., Methods: The data regarding the status of intestinal parasitic diseases in Jiangxi Province were captured from the 1989 national survey on the distribution of human parasites in China and the 2014 national survey on major human parasitic diseases in China, and the status of human intestinal parasite infections was compared between the two surveys in Jiangxi Province., Results: The prevalence rate of human intestinal parasite infections was 79.59% and 9.64% in Jiangxi Province in 1989 and 2014, with a decline rate of 87.89% during the 25-year period ( χ 2 = 30 870.5, P < 0.01). There were 24 and 20 species of human intestinal parasites detected in Jiangxi Province in 1989 and 2014, respectively, with totally 26 species detected during the two surveys. In Jiangxi Province, the 3 most highly prevalent human intestinal parasites included Ascaris lumbricoides (71.06%), hookworm (17.61%) and Enterobius vermicularis (17.59%) in 1989, and E. vermicularis (13.73%), hookworm (4.66%), whipworm (0.95%) in 2014. A higher rate of human intestinal parasite infections was found in females than in males in both surveys in Jiangxi Province ( P < 0.01), and the prevalence of human intestinal parasite infections reduced by 82.50% to 95.31% in different age groups in Jiangsu Province during the 25-year period., Conclusions: The prevalence of human intestinal parasite infections shows a remarkable decline tendency in Jiangxi Province, and soil-transmitted nematodes remain the main species of human intestinal parasites in Jiangxi Province.

Objective: To analyze the status and trends of soil-transmitted nematode infections in Jiangxi Province from 1989 to 2014, so as to provide the evidence for generating the strategy of soil-transmitted nematode prevention and control., Methods: The data of three epidemiological surveys on human parasitic diseases (in 1989, 2002 and 2014) were classified and analyzed. The stool examination by Kato-Katz's thick smear method was adopted for the investigation of soil-transmitted nematode infections., Results: The total infection rate of soil-transmitted nematodes decreased by 91.89% from 77.67% in 1989 to 6.30% in 2014, in which the infection rate of Ascaris lumbricoides decreased by 98.78% from 71.11% to 0.87%, the infection rate of Trichuris trichiura decreased by 96.80% from 29.67% to 0.95%, and the infection rate of hookworm declined by 73.57% from 17.63% to 4.66%. The infection rates of soil-transmitted nematodes in the female were higher than those in the male in three surveys. In different ecological districts, the infection rates of soil-transmitted nematodes in the female were also higher than those in the male, except in Zhe-Min Ecological District in 2002 and 2014. A declined trend of the infection was showed in all age-groups in the three surveys, but it slowed down by the growth of age, i.e., the reduction rate was 97.03% in the age group of < 10 years while 80.62% in the age group of >70 years. In 2014, the number of persons infected with soil-transmitted nematodes occupied 65.4% of the whole number of persons infected with intestinal parasites., Conclusions: The mean infection rates of soil-transmitted nematodes decrease obviously in human population in different ecological districts, but the soil-transmitted nematodes are still the main species in intestinal parasite infections. The sequence of dominant species changes from A. lumbricoides , hookworm and T. trichiura in 1989 to hookworm, T. trichiura and A. lumbricoides in 2014. The rural female and elder people are the key population, while hookworm is the key species for the prevention and control of soil-transmitted nematodes.

Objective: To evaluate the efficacy and safety of three different spinal rotation manipulations for the treatment of lumbar disc herniation., Methods: From September 2011 to April 2013,180 patients diagnosed as lumbar disc herniation were randomly divided into seat fixed rotation group (A), lateral position rotation group (B) and supine position rotation group (C) by using a digital table. Finally 10 patients were excluded and dropped, 170 patients were included in the study. There were 57 patients in group A, 57 patients in group B and 56 patients in group C. Baseline demographic characteristics of patients, clinical findings and indexes of health status had no statistically differences among three groups (P > 0.05). The manipulation was performed every other day, and the treatment duration for all patients was 3 weeks. Body pain (BP), Physical function (PF) in SF-36, Oswestry Disability Index (ODI) and adverse reactions were observed statistically 6 weeks, 3 months, 6 months, one year and two years after finishing treatment., Results: BP, PF scores in 3 groups were significantly improved and ODI scores were significantly lower than those before treatment and the differences were statistically significant (P < 0.05); However, there was no significant difference among three groups in the BP, PF and ODI scores (P > 0.05). There were no obvious and serious adverse reactions among these groups., Conclusion: Based on the theory of dislocation of bone joints in TCM, three kinds of spinal rotation manipulations can be used safely for the treatment of lumbar disc herniation, and the efficacy was similar.

Objective: To evaluate the effects of a novel molluscicide, the salt quinoid-2', 5-dichloro-4'-nitrosalicylanilide from niclosamide (LDS), with 10% wettable powder, in main schistosomiasis epidemic areas of China, including Hunan, Jiangxi, Hubei, Anhui, Jiangsu, Sichuan, Yunnan and Zhejiang Province., Methods: In the immersion test, 6 effective concentrations of 10% LDS were tested respectively: 0.1, 0.2, 0.4, 0.6, 0.8, 1.0 g/m3 in the field; at the same time, 50% wettable powder of niclosamide ethanolamine salt (WPN) with effective concentrations of 1.0 g/m was used as the molluscicide control, and the fresh water as the blank control, then the mortality rates of 0. hupensis snails were recorded at 24 h, 48 h and 72 h after the immersion. In the spraying test and powder-spraying test, 5 effective dosages of 10% LDS were tested respectively: 0.2, 0.4, 0.6, 0.8, 1.0 g/m2, while 50% WPN 1.0 g/m2 was used as the molluscicide control, and the fresh water as the blank control in the field for 1 d, 3 d and 7 d, then the mortality rates of O. hupensis snails were recorded at 1 d, 3 d and 7 d after the spraying and powder-spraying., Results: The snail mortality rates of LDS using the immersion test for 72 h were more than 95% in the field of eight provinces (0.1 g/m in Sichuan, Jiangxi, Jiangsu and Zhejiang provinces, 0.2 g/m3 in Yunnan, Hunan and Hubei provinces, and 0.4 g/min Anhui Province); the snail mortality rates of LDS using the spraying test for 7 d were more than 85% (0.2 g/m2 in Hunan, Hubei, Jiangxi and Zhejiang provinces, 0.4 g/m2 in Sichuan and Anhui provinces, 0.6 g/m2 in Yunnan and Jiangsu provinces). The snail mortality rates of LDS the powder-spraying test for 7 d were more than 85% (0.6 g/m2 in Yunnan, Sichuan, Hubei, Jiangxi, Anhui, Jiangsu and Zhejiang provinces). According to the standards of "Efficacy test methods and evaluation of molluscicide for pesticide registration (NY/T 1617-2008)", LDS is a qualified molluscicide., Conclusions: LDS has good molluscicidal effects through the immersion, spraying and powder-spraying test in the fields. It is suitable for a variety of environments to control O. hupensis snails of schistosomiasis endemic areas in China. The recommended dosages of LDS are 0.1-0.2 g/m3 by the immersion method, 0.2-0.4 g/m2 by the spraying method, and 0.4-0.6 g/m2 by the powder-spraying method in the fields.

Objective: To understand the characteristics of schistosome cercarial infested water contact of residents in Poyang Lake endemic areas after the operation of Three Gorges Project, so as to provide the evidence for formulating a well-directed control strategy., Methods: The residents in two villages in schistosomiasis endemic areas were selected and surveyed for their activities of infested water contacts by questionnaire., Results: The proportion and frequency of infested water contacts of residents in Poyang Lake region were high and the average rate of infested water contacts was 69.77%, and 98.96% of infested water contacts occurred in spring, summer and autumn. The main ways of infested water contacts were fishing/swimming/playing for adult men, washing clothes/fishing for adult women, and swimming/playing for school children, respectively. The rates of infested water contacts were 73.33%, 71.63% and 61.87% in adult men, women and school children, respectively. The frequencies of infested water contacts > 1 time/week, 1 time/week-1 time/month, and < 1 time/month were 62.61%, 23.74% and 13.66% respectively., Conclusions: The infested water contacts mainly occurs in spring, summer and autumn, and the main way of infested water contacts was fishing. Farming and mowing grass, which had been the primary way, now become the secondary way for the adult residents.

Objective: To explore the impact and change regularity of Oncomelania hupensis snails and vegetation in the marshlands of Poyang Lake caused by the impoundment of the Three Gorges Project., Methods: By using the methods of stratified systematic sampling and pinpoint navigation, the succession of vegetation was observed and the distribution of O. hupensis snails was investigated in a period of 8 years on 4 typical marshlands in Poyang Lake. The regularity of changes in vegetation and 0. hupensis snails was analyzed on the marshlands at high, medium and low elevations, respectively., Results: After the impoundment of Three Gorges Project, the average flooding days of these 4 marshlands in 2004 and in 2008 were reduced of 74.8 and 65.8 days compared with those in 2002, the year just before the impoundment of the project, respectively. The change of spatial distribution pattern and the succession of dominant species of vegetation on the marshlands of Poyang Lake have taken place since 2005, and several vegetations showed a trend of moving toward the center of the lake. The hygrophilous vegetation has degenerated and gradually been replaced by mesophily meadow in the marshland area above 14 m elevation. Carex, Phalaris arundinacea and Polygonum appeared in large area and expanded slowly towards the center of the lake on the marshland below 14 m elevation. O. hupensis snails were mostly found under the Carex association. The tendency of decreasing in density of snails and of migration of snail habitats towards low terrain was observed., Conclusions: The impoundment of Three Gorges Project has had a significant impact on hydrological regimes, and a new succession of vegetation has taken place in the marshlands of Poyang Lake. O. hupensis snails and the mesophily vegetation show a trend of migrating slowly to the areas of low elevation in the marshlands.

Objective: To analyze the status of prevalence and control of schistosomiasis in Jiangxi Province from 2002 to 2012., Methods: Endemic status and control effectiveness during the period from 2002 to 2012 was analyzed by using a combination of field survey, data collection and retrospective investigation., Results: From 2002 to 2012, schistosomiasis control made significant achievements in Jiangxi Province. The number of counties which have reached the criteria of transmission interruption of schistosomiasis increased from 19 in 2002 to 22 in 2012. The number of patients with schistosome infection decreased from 128 331 in 2002 to 73 102 in 2012. The positive rate of serological test and fecal examination in residents decreased from 12.2% and 4.2% in 2002 to 5.2% and 0.4% in 2012, respectively. Acute infection reduced from 146 cases in 2002 to 3 cases in 2012, but advanced cases increased by 42.4%. The positive rate of fecal examination in cattle reduced from 4.7% in 2002 to 1.3% in 2012. The density of living snails and infected snails significantly decreased to 0.083 5/0.1 a? and 0.000 037/0.1 m2 in 2012, respectively. However, the snail-ridden areas slightly increased. Jiangxi Province reached the criteria of endemic control for schistosomiasis in 2008. During 2002-2012, control activities were intensified. Examination and chemotherapy for human increased by 65.2% and 65.5%, while 23.4% and 251.1% for cattle. Mean while, area with snail control activities increased by 617.8%. An integrated strategy of infection source control was implemented in the Province., Conclusion: During 2002 to 2012, endemic index of schistosomiasis in Jiangxi showed a steady decline after 2005. Currently, schistosomiasis prevalence shows a low level. The endemic indicators of infection in human and livestock as well as Oncomelania snails have been kept stable at low level.

Objective: To elucidate the necessity of para-aortic lymph nodal dissection in D2 lymphadenectomy for gastric cancer in N3 stage., Methods: A total of 278 gastric cancer patients staged N3 who underwent gastrectomy between January 2003 and December 2007 were enrolled. There were 180 male and 98 female patients, and the patients' age were 26-93 years (median was 61 years). All patients had undergone surgical treatment. There were R0 resection in 246 cases and R1 resection in 32 cases. Lymph node dissection included D1 lymphadenectomy with 125 cases, D2 lymphadenectomy with 109 cases and D2+para-aortic lymph nodal dissection(PAND) with 44 cases. The surgical approach were total gastrectomy (98 cases) and subtotal gastrectomy (180 cases). Potential prognostic factors were analyzed., Results: The lymph node metastasis of each station was high in gastric cancer patients staged N3 and 34.1% patients had the para-aortic lymph nodal metastasis. Borrmann type (HR = 1.350, 95%CI: 1.018-1.790, P = 0.037), curability (HR = 1.580, 95%CI: 1.076-2.322, P = 0.020), depth of invasion (HR = 1.697, 95%CI: 1.005-2.864, P = 0.048), metastatic lymph node ratio (HR = 1.631, 95%CI: 1.261-2.111, P = 0.000), extranodal metastasis (HR = 1.336, 95%CI: 1.027-1.738, P = 0.031), postoperative adjuvant chemotherapy (HR = 1.312, 95%CI: 1.015-1.696, P = 0.038), extent of lymphadenectomy (HR = 1.488 and 2.114, P = 0.054 and 0.000) and number of retrieved lymph node (HR = 1.503 and 2.112, P = 0.025 and 0.000) were found to be factors correlated to overall survival. In multivariate analysis, only Borrmann type (HR = 1.399, 95%CI: 1.050-1.863, P = 0.022), metastatic lymph node ratio (HR = 1.353, 95%CI: 1.016-1.802, P = 0.039) and extent of lymphadenectomy (HR = 1.725, 95%CI: 1.111-2.678, P = 0.015) were independent prognostic factors for gastric cancer patients in N3 stage., Conclusions: Patients in N3 stage should at least have 30 lymph node examined. D2 lymph node dissection plus PAND may improve the overall survival for gastric cancer patients in N3 stage.

Objective: To evaluate the values of surface electromyography (sEMG) in the treatment of adolescent idiophathic scoliosis (AIS) with non-surgical therapy., Methods: From October 2011 to May 2012, the data of 33 patients with AIS underwent traditional spinal balanced therapy were analyzed. There were 14 males and 19 females with an average age of (15.40 +/- 3.01) years,ranging in Cobb angle from 13 degrees to 40 degrees, course of disease more than 3 months. X-rays showed 21 cases were type C and 9 cases were type S. Preoperative and postoperative 6 months, Cobb angle, the ratio of averaged electromyography paramete (AEMG), security of treatment were observed., Results: Thirty cases (90.9%) accomplished the treatment and detection. No harmful effects to vital sign was found and no fracture, dislocation, apopsychia, infection of pin hole was found. There was positive correlation between the ratio of AEMG and Cobb angle (P = 0.003). The ratio of AEMG decreased after treatment,and indicated the improvement of myosthenic otherness., Conclusion: sEMG can be used as a objective examination in evaluating difference of muscle electricity activity on both concaved and convex sides for patients of AIS, so it is a qualified objective examination for effectiveness evaluation and assessment aggravation risk, and has great value in clinic.

Objective: To clarify new features of hydrological regime in the Poyang Lake after runs of the Three Gorges Project and its impact on the prevalence of schistosomiasis in this region., Methods: It is collected information of Three Gorges Project, average daily water level from 2002 to 2012 at Duchang hydrological station in Poyang Lake and the data of prevalence and control of schistosomiasis in 12 endemic counties along the lake. It was analyzed the trends of prevalence of schistosomiasis under the changed condition of hydrologic situation., Results: Effects of impoundment of Three Gorges reservoir running on water level of Poyang Lake are mainly shown in: Water levels of the lake are suppressed throughout the year which was characterized by high water level in flood season dropped, lower water level appeared in the spring, water withdrew earlier and quicker in the fall and to an even lower level in dry season. After impoundment of Three Gorges Project, infection rate of Schistosomajaponica in human and in bovine decreased by 92.65% and 76.37% respectively in endemic areas around the lake. The density of Oncomelania snails decreased by 94.21%. Prevalent of schistosomiasis in this region showed a significant downward trend., Conclusions: After runs of the Three Gorges Project, regularized changes hydrologic conditions has taken place in Poyang Lake which is characterized by lower water level and thus might lead to lower density of Oncomelania snails on marshlands and reducing of prevalence of schistosomiasis. Significant strengthening of schistosomiasis control efforts might also contributed to the stable and low level of prevalence of schistosomiasis in the region.

Objective: To investigate the changing rules of schistosomiasis endemic situation before and after reaching the criteria of schistosomiasis transmission controlled or interrupted in hilly endemic areas of Jiangxi Province, so as to provide the evidence for reformulating the criteria of schistosomiasis control and eradication in the future., Methods: In the hilly areas of schistosomiasis endemic in Jiangxi Province, 2 counties where the transmission has been interrupted and 1 county where the transmission has been controlled were selected and investigated with the retrospective research method. The endemic detailed data were collected and recorded 10 years before reaching the criteria of transmission interrupted/controlled, and several years after reaching the criteria (ending in 2008), and then a database was established. The changing rules of endemic situation before and after reaching the criteria of transmission interrupted/controlled were analyzed and compared., Results: After reaching the criteria of transmission controlled, in the 3 counties, Guangfen, Shangrao and Dean, the declined rates of areas with Oncomelania hupensis snails were 96.79%, 98.99%, and 99.77% respectively. The snail density maintained a lower level, and 95% of infected persons and cattle were cured. The average time from transmission controlled to the transmission interrupted was 17 years in Guangfen County and 26 years in Dean County. However, in Shangrao County, the snail situation rebounded due to the snail re-found and spread although the schistosomiasis morbidity of population/animals maintained stably., Conclusions: After reaching the criteria of transmission interrupted/controlled, the remained snails were easy to re-find and spread under some certain condition, which is one of main obstacles for reaching the criteria of transmission interrupted. In an isolated snail unit, if the snail area and snail density are controlled in a very low level, it is still difficult to transmit and spread schistosomiasis even if there exist infectious sources.

Objective: To investigate the impact of the Water Conservancy Project of Poyang Lake after operation on Oncomelania hupensis snail habitats in 10 counties (cities or districts) around Poyang Lake., Methods: The data of the distribution, numbers, areas, elevation and slope, etc. of snail infested marshlands on upstream of the project site in Poyang Lake were investigated and collected. Accordingly, the status of the submerged and flooding areas of the marshlands were analyzed and calculated respectively in the case that the project ran by different water regulation schemes at 14, 13, 12 m and 11 m levels., Results: In accordance with the regulation and storage preset programs at 14, 13, 12 and 11 m water levels, the number and its areas of submerged marshlands, from downstream to upstream in Poyang Lake, in turn decreased. Under the condition of the regulation at the 14 m water level, the numbers of completely submerged and partially submerged marshlands as well as the submerged areas were accounted for 32.9%, 51.4% and 60.3% of the whole marshlands, respectively. At the 13 m water level regulation, they were 9.8%, 46.8% and 1.9% respectively. At the 11 m level, only part of 4 marshlands were flooded, which were accounted for only 0.5% of the total number of marshlands and 0.2% of whole areas of the marshlands., Conclusions: The Water Conservancy Project of Poyang Lake may create a condition for eliminating snails through water flooding. If implementing regulation at the 14 m level for two or three consecutive years, 60.3% of snail habits could realize the snail-free objective. However, if implementing the 11 m or 10 m water level regulation, there will be little impact on areas of snail habitats and the snail distribution in the Poyang Lake region from the point of view of "marshlands flooding". The impacts on marshlands in different counties might differ due to the location and elevation.

Objective: To evaluate the situation of realizing schistosomiasis transmission control in Jiangxi Province., Methods: The situation of reaching the criteria of schistosomiasis transmission control was evaluated by using the method of field surveys combined with retrospective investigations., Results: The schistosome infection in human was kept at a stable low level, and the infection rate in residents was below 1% in 90.24% (536/594) of whole epidemic controlled villages. There were 45 spots with schistosome infected Oncomelania hupensis snails in 38 pieces of marshland. The epidemic situation in livestock showed less optimistic than that in human, and the infection rate in bovine was higher than 1% in 19.87% (118/594) of the whole epidemic controlled villages., Conclusions: Currently, the prevalence of schistosomiasis is at a low level in 9 infection-controlled counties of Jiangxi Province. More favorable situation has emerged to the realization of schistosomiasis transmission control. However, it is necessary to strengthen the infectious sources control with emphasis on bovine so as to achieve the goal of transmission control in whole province in 2015.

Objective: To elucidate the necessity of No.14v lymph node dissection in D2 lymphadenectomy for advanced gastric cancer., Methods: Clinicopathological data of 131 cases of advanced gastric cancer receiving D2 or D2+ plus No.14v lymph node dissection were reviewed retrospectively. Clinicopathological factors associated with No.14v lymph node metastasis were analyzed and prognostic value of No.14v lymph node metastasis was evaluated., Results: Of the 131 patients, 24 (18.3%) had positive No.14v lymph node. The incidence of 14v metastasis was associated with tumor location, tumor size, depth of invasion, N staging, TNM staging, No.1, No.6, and No.8a lymph nodes metastasis. Tumor location and N staging were independent risk factors for No.14v metastasis (all P<0.05). The 5-year survival rate was 8.3% and 37.8% in patients with and without No.14v metastasis respectively. The difference was statistically significant (P<0.01). Multivariate analysis revealed that metastasis of No.14v was an independent prognostic factor for advanced gastric cancer after D2 lymphadenectomy (P=0.029, RR=1.807, 95%CI:1.064-3.070)., Conclusions: For advanced middle and lower gastric cancers, especially those with larger size, serosa invasion and possibility of No.6 lymph node metastasis, it is necessary and feasible to remove the No.14v lymph node.

Objective: To investigate the impact of tumor size in the prognosis of T4a stage gastric cancer., Methods: The best cut-off point depending on tumor size was selected by Kaplan-Meier. Compare cliniclópathological characteristics between small size gastric cancer (SSG) and large size gastric cancer (LSG). Univariate analysis was done by Log-rank test and multivariate analysis was performed using the Cox proportional hazard regression model. The independent prognostic factors of patients were performed subgroup analysis., Results: Eight centimetre was the optimal cut-off of tumor size for T4a stage gastric cancer. There were significantly differences between SSG and LSG in tumor location (χ² = 15.695), histological grade (χ² = 4.393), macroscopic type (χ² = 5.629) and early recurrence (χ² = 4.292). Univariate analysis showed age (χ² = 4.463), tumor size (χ² = 9.057), macroscopic type (χ² = 6.679), histological grade (χ² = 5.122), location of tumor (χ² = 8.707) and N stage (χ² = 132.954) are related to survival (P < 0.05). Among them, tumor size (HR = 1.339), histological grade (HR = 1.169) and N stage (HR = 1.876) were independent risk factor for survival (P = 0.05). For SSG, N stage (HR = 2.014) and histological grade (HR = 1.192) were independent risk factor for survival (P = 0.05), and for LSG, N stage (HR = 1.876) was independent risk factor for survival (P = 0.000). Further stratified analysis indicated that the 5-year survival rate of LSG is significantly lower than that of SSG in T4a stage patients of gastric cancer without lymph nodes metastasis or poorly differentiated (HR = 0.182 and 0.653, P < 0.01)., Conclusions: Tumor size is an independent prognostic factor in patients of T4a stage gastric cancer. Tumor size cut-off point of 8 cm can exert significant impact on the prognosis of T4a stage gastric cancer without lymph nodes metastasis or poorly differentiated.

Objective: To evaluate the feasibility and necessity of No.13 lymph node dissection in D2 radical gastrectomy for lower-third advanced gastric cancer (AGC)., Methods: Data of 379 cases who were diagnosed as TNM II-III stage AGC were collected from January 2001 to June 2007. One hundred cases who undergone No.13 lymph node dissection during D2 gastrectomy for lower-third AGC were selected as study group. Other 279 cases (control group) received only D2 gastrectomy. The differences in clinicopathologic and intraoperative and postoperative parameters and 5-years survival rate were compared using the SPSS 17.0 software., Results: There were no significant differences between the two groups in patients' gender, age, tumor size, histologic type, Borrmann type, duodenum invasion, tumor depth, lymph node metastasis, TNM classification, operative time, blood loss and the incidence of postoperative complications (P > 0.05). In the study group, there were 9 patients with positive No. 13 lymph node, and its 5-year survival rate (46.0%) was higher than the control group (36.5%, χ² = 4.452, P < 0.05). The Univariate analysis showed that age (χ² = 7.539), No.13 lymph node dissection (χ² = 4.452), tumor size (χ² = 7.100), duodenum invasion (χ² = 9.106), tumor depth (χ² = 7.428), lymph node metastasis (χ² = 45.046), TNM classification (χ² = 57.008) are associated with prognosis of lower-third AGC (P < 0.05). Multivariate analysis identified age (HR = 0.500, 95% CI: 0.343 - 0.730), tumor size (HR = 0.545, 95%CI: 0.339 - 0.876), duodenum invasion (HR = 5.821, 95%CI: 2.326 - 14.572), and tumor depth (T4: HR = 2.087, 95% CI: 1.283 - 3.394) as independent prognostic factors (P < 0.05)., Conclusion: No. 13 lymph node dissection for TNM II-III stage lower-third advanced gastric cancer is feasible and necessary.

Objective: To evaluate the clinicopathologic characteristics and prognosis of mixed histological type (MHT) gastric cancer., Methods: Clinical and follow-up data of 1108 gastric cancer patients undergoing radical operation in Tianjin Cancer Hospital between 2003 and 2006 were analyzed retrospectively. Clinicopathologic characteristics of MHT gastric cancer were summarized and the prognosis was analyzed by Kaplan-Meier analysis and COX regression., Results: Among the 1108 patients, 144 (13.0%) had mixed histology type of gastric cancer. Compared to the unitary histological type (UHT), MHT gastric cancer had bigger tumor size, higher proportion of T4 tumor, and was easier for lymph node and distant metastasis (all P<0.05). The 3- and 5-year survival rates of patients with MHT were 26.5% and 10.8% respectively, which were lower than those with UHT (58.8% and 35.0%, P<0.01). Univariate and multivariate analyses showed TNM classification was an independent prognostic factor (P<0.01)., Conclusions: MHT gastric cancer shows worse prognosis than UHT gastric cancer. There is no difference in prognosis among various combination of MHT gastric cancer. TNM classification is an independent prognostic factor of MHT gastric cancer.

Objective: To evaluate the prognostic value of metastatic lymph node ratio (MLR) for gastric cancer patients with less than 15 lymph nodes dissected., Methods: Clinical data of 610 gastric cancer patients undergoing operation in Tianjin Cancer Hospictal from January 2003 to July 2007 were analyzed retrospectively. Patients were divided into two groups: <15 lymph nodes dissected group (n=320) and ≥ 15 lymph nodes dissected group (n=290). MLR was classified based on the following intervals: rN1 ≤ 10%, rN2 10%-30%, rN3 30%-60% and rN4 >60%. Survival was determined by Kaplan-Meier method and difference was assessed by Log-rank test. Multivariate analysis was performed using Cox proportional hazard regression model. Survival rates were compared between two groups in pN and rN stages respectively., Results: In <15 nodes group, all the survival differences among various rN stages were not significant (all P>0.05), while in same rN stage, all the survival differences among various pN stages were not significant (all P>0.05). Significant differences of 5-year cumulative survival rates were found between the two groups in pN2 and pN3a stage patients (both P<0.05) while no significant differences were found among different rN stages (all P>0.05). Multivariate analysis demonstrated rN stage was an independent prognostic factor for gastric cancer patients with <15 lymph nodes dissected (P=0.012, RR=1.617, 95%CI:1.111-2.354)., Conclusion: The rN staging system based on MLR can predict the prognosis of gastric cancer patients with less than 15 lymph nodes dissected.

Objective: To investigate the status of lymph node metastasis (LNM) and to discuss reasonable lymphadenectomy in early gastric cancer (EGC)., Methods: Between January 1991 and December 2010, 242 EGC patients underwent surgery in the Tianjin Cancer Hospital. Their clinical characteristics, pathologic features, and lymph node metastasis were analyzed retrospectively., Results: LNM was observed in 22 of 242 patients (9.1%), and 10 (5.5%) in 182 mucosal lesions and 12 (20.0%) in 60 submueosal lesions. There were 14 patients had LNM in the first tier alone, 4 patients had skipped metastasis, and 4 patients had LNM in the first, second, and third ties. The LNM was identified in 18 patients at the first tier with groups 7 and 3 being the most common (8 patients in each group), 7 patients at the second tier (4 patients in group 8a and 3 in group 9), and 2 patients at the third tier (one 16b, and one 4sa). Multivariable analysis showed that the depth of invasion (P=0.003, OR=4.386, 95%CI:1.656-11.617), and lymphatic vessel involvement(P=0.002, OR=13.621, 95%CI:2.711-68.447) were independent risk factors for LNM., Conclusions: LNM in EGC is mainly correlated with depth of invasion, and lymphatic vessel involvement. Precise evaluation of LNM pre- and intra-operatively is very important for the reasonable surgery.

Objective: To evaluate the value of negative lymph node count (NLNC) in prediction of prognosis of advanced gastric cancer after radical resection., Methods: The 544 cases of radical gastrectomy patients with complete clinical and follow-up data between January 2011 and July 2007 were collected. Survival was determined by the Kaplan-Merier method and univariate analysis was done by Log-rank test, Multivariate analysis was performed using the Cox proportional hazard regression model., Results: Univariate analysis showed age (χ(2) = 4.449), T stage (χ(2) = 30.482), N stage (χ(2) = 205.452), location of tumor (χ(2) = 16.649), tumor size (χ(2) = 35.117), macroscopic type (χ(2) = 4.750), histological grade (χ(2) = 6.130), NLNC stage (χ(2) = 150.369) and type of gastrectomy (χ(2) = 25.605) were related to survival. Among them, T stage, N stage, tumor size and NLNC stage were independent risk factors for survival (P < 0.05). The prognostic factors of patients were performed subgroup analysis, NLNC > 15 group can prolong the survival than NLNC ≤ 15 group in the T2 stage (HR = 0.315), T4 stage (HR = 0.401), the same classification of location of tumor (HR = 0.286-0.493), tumor size (HR = 0.336, 0.465), macroscopic type (HR = 0.306, 0.418), histological grade (HR = 0.411, 0.365) and type of gastrectomy (HR = 0.444, 0.358 and 0.356, all P < 0.05). More NLNC can prolong Disease-Free Survival for patient of early recurrence (χ(2) = 8.648, P = 0.003)., Conclusions: Sufficient negative lymph node count can prolong the survival and decrease the risk of early recurrence.

Objective: To observe the characterization of cellular immune of schistosomiasis japonica patients in low endemic area of Poyang Lake region., Methods: The schistosomiasis patients who were positive by stool detections were selected as study subjects, and the individuals who were negative by stool detections in three consecutive years were selected as negative controls. The CD4+T cell, CD8+T cell and CD4+CD25+Treg in venous blood of the study subjects were detected by using flow cytometry. In vitro, cytokine (IFN-gamma and IL-10) production of PBMC in response to soluble egg antigen (SEA) and soluble worm antigen preparation (SWA) were measured by ELISA., Results: The levels of CD4+CD25+Treg in individuals who were positive by stool detections (5.99 +/- 1.60)% were higher than those of the negative (5.04 +/- 1.64)%, and the difference was significant (t = 3.261, P < 0.01). One year after the treatment, the levels of IFN-gamma were significantly higher (Stimulated by SEA before and after the treatment, the mean levels were 121.97 and 2 564.03 pg/ml, respectively; stimulated by SWA before and after treatment, the mean levels were 102.89 and 646.26 pg/ml, respectively) and IL-10 were significant lower in patients who were positive by stool detections (Stimulated by SEA before and after treatment, the mean level were 294.75 and 122.43 pg/ml, respectively; stimulated by SWAP before and after treatment, the mean cytokine levels were 110.10 and 31.85 pg/ml, respectively)., Conclusion: The increase of induced CD4+CD25+Treg is one of causes that down-regulate cellular immune of human body after infection with Schistosoma japonicum.

Objective: To discuss the reasonable surgery for gastric body cancer., Methods: From January 2001 to December 2006, the clinicopathological data of 145 patients with a tumor in the middle third of the stomach underwent radical gastric resection were analyzed retrospectively. We conducted comparative analysis for the differences in clinicopathological characteristics and prognosis between total gastrectomy (TG) and subtotal gastrectomy (STG)., Results: The 98 patients underwent TG, 47 received STG. There were significant differences in aspects of tumor size, depth of tumor, nodal status and TNM stage between the 2 groups. Patients with more advanced cancer were more likely to receive TG. The 5-year survival rate for TG was lower (25.5%) than STG (63.8%) (χ(2) = 11.707, P = 0.000). However, if tumor stages were stratified, there was no significant difference in the 5-year survival rate. TNM stage (P = 0.044) and histologic type (HR = 1.834, 95%CI: 1.073 - 3.135, P = 0.027) were independent prognostic factors., Conclusions: The overall survival rate of STG for gastric cancer in the middle third of the stomach is better than that of TG. If the radical resection margin can be obtained for gastric body carcinoma, STG is considered instead of TG.

Objective: To understand the characterization and levels of antibody isotype responses to soluble egg antigen (SEA) and adult worm antigen (AWA) of Schistosoma japonicum in schistosomiasis patients in Poyang Lake region., Methods: Antibody isotype IgG, IgG1, IgG2, IgG3, IgG4, IgE, IgM and IgA responses to SEA and AWA in the sera of individuals from endemic and non-endemic areas were determined by indirect ELISA., Results: The levels of antigen-specific antibody isotypes in the sera of patients with egg positive were significantly higher than those of people with egg negative and normal control population from non-endemic area (P < 0.001), and except for anti-SEA IgG2 and anti-AWA IgG4 and IgE antibodies, the levels of antibody isotypes in the sera of people with egg negative in endemic area were significantly higher than those of normal control population from non-endemic area (P < 0.05). In the population with egg positive, children had higher levels of anti-SEA IgM and IgG1 and anti-AWA IgM antibody, and lower AWA specific IgG than adults. There was no significant difference between the male and female except for the male had higher levels of IgG (F = 4.677, P = 0.032) and IgG1 (F = 5.55, P = 0.020)against AWA. Three months post-treatment, the levels of IgG1, IgG3, IgG4 antibody responses to SEA deceased significantly (P < 0.001, P = 0.029, P = 0.044), and almost all the antibody levels decreased significantly (P < 0.05) twelve months post-treatment, except for SEA specific IgE and IgM and AWA specific IgG4 and IgM antibodies., Conclusions: The levels of antigen-specific antibody isotypes in the sera of patients with egg positive are significantly higher than those of people with egg negative and normal control population from non-endemic area. Almost all of antibody levels decrease significantly twelve months post-treatment. The levels of antibody isotypes in the sera of people with egg negative in endemic area are significantly higher than those of population from non-endemic area, giving a clue that the selection of negative control of schistosomiasis diagnostic kit should be noticed.

Objective: To evaluate the medium-term effect and stability of the schistosomiasis comprehensive control strategy based on infectious source control after its popularization and application in marshland endemic areas., Methods: The schistosomiasis comprehensive control strategy based on infectious source control including "replacing buffalo with machine", "marshlands isolation and grazing forbidden", etc. was implemented in all villages of Sanli Township, a heavy endemic area with schistosomiasis in Jianxian County. The infection situation of schistosomiasis in population and Oncomelania snails in 4 villages around the lake were monitored regularly for 6 consecutive years., Results: The infection rate of schistosomiasis in population significantly decreased after the comprehensive control measures were carried out. Two years later, the infection rate in Huangjia Village was 0, and was sustained at zero for 5 consecutive years; the infection rate in Fengfu Village decreased by 77.24% and stabilized to zero for the next three years; the population infection rates in Fanrong Village and Caomen Village decreased by 82.33% and 82.53%, respectively, then the infection rates of the two villages kept under 1% and were 0 for 2 years and 1 year, respectively. The number of spots with infected snails in two marshlands in pilot areas decreased yearly from 10 before the intervention to 0, in which, the infection rate of snails and the number of spots with infected snails in Huangjiaoniu Marshland and Goulian Marshland decreased to zero 1 year and 3 years after the strategy was implemented, respectively, and the infected snails were not found in these marshlands in following years., Conclusion: Strengthening the management of buffaloes in surrounding areas and utilizing marshland resources is the main measure that can consolidate and expand the medium-term and long-term effect of the schistosomiasis 2.2 comprehensive strategy based on infectious source control.

Objective: To investigate the possibility of applying multiplex ligation-dependent probe amplification (MLPA) to the detection of azoospermia factor (AZF) microdeletion on the Y chromosome in infertile men with azoospermia or severe oligozoospermia., Methods: DNA samples were obtained from 147 azoospermia or severe oligozoospermia patients and 154 normal controls. After denatured at 95 degrees C, the samples were hybridized to the specific probes designed for the AZF region. With the ligase, the hybrid products were amplified by a pair of universal primers labeled with FAM fluorescence, and then separated by capillary electrophoresis for data analysis. Meanwhile all the samples were subjected to multiplex-PCR (mPCR) analysis for sequence-tagged sites (STS) in the AZF region., Results: STS deletion was detected in 22 (15.0%) of the 147 patients but not in the normal controls. By MLPA, 40 (27.2%) of the patients were found with specific probe omission in the AZF region, as compared with 20 cases in the control group., Conclusion: Compared with mPCR, MLPA has a better sensitivity in detecting AZF microdeletions, and it provides more precise genetic information on the AZF regions, which may contribute to in-depth exploration into the etiological mechanism of impaired spermatogenesis.

Objective: To evaluate the clinical diagnostic efficiency of Indirect Hemagglutination Assay Kit (IHA kit) for antibody detection of schistosomiasis japonica., Methods: Schistosomiasis examinations by parasitological method were conducted in the schistosomiasis endemic areas in Jiangxi, Anhui and Hubei provinces, respectively. A total of 371 serum samples of schistosomiasis patients and 761 serum samples of non-patients without history of schistosome infection and infested water contact were collected. All the sera were detected by using IHA Kit. The diagnostic efficiency indicators of the kit, including sensitivity, specificity, positive predicted value, negative predicted value etc. were calculated., Results: The sensitivity and specificity of the kit were 95.1% (95% confidence interval was between 92.9% and 97.3%) and 97.8% (95% confidence interval was between 96.8% and 98.8%), respectively; the positive and negative predicted values were 95.4% and 97.6%, respectively. No statistically significant difference was found in the prevalence of IHA positive detecting by the kit among the groups with different EPG levels (< or = 40, 41-100, > 100). Also, no significant difference was observed in sensitivity and specificity among the different age groups., Conclusions: The IHA kit shows a relative high efficiency for diagnosis and can be used for mass screening of schistosomiasis in field sites.

Objective: To perform the bioinformatics analysis of nicotinamide phosphoribosyl transferase of Schistosoma japonicum so as to provide the evidence for the development and application of it., Methods: Internet online procedures and the related software were exploited to analyze the open reading frame (ORF) of SjNAMPT gene, physical and chemical properties of SjNAMPT protein and the domains of the protein, and predict the space structure and functions of the protein., Results: The SjNAMPT protein sequence was composed of 179 amino acids with 19.63 kDa of the molecular weight. The protein was stable and had no structures of transmembrane and helical coils. The protein belonged to the family of nicotinate phosphoribosyl transferase with multiple phosphorylation sites. The protein probably located in cytoplasm and dominated by random coils in second structure. The similarity of the SjNAMPT protein sequence was lower than that of other species of NAMPT., Conclusions: SjNAMPT is a specific protein of Schistosoma japonicum with a certain activity, and probably related to purine metabolism and glucose metabolism. It is worth for further study.

Based on the objective of long- and mid-term development program for schistosomiasis control in China, the paper presents an analysis of strategy for schistosomiasis control and its function in the 12th Five-Year Plan. Meanwhile, the strategy and key elements of schistosomiasis control for recent years are put forward for different endemic areas.

Objective: To evaluate the efficacy of five diagnostic test kits for the detection of antibodies to Schistosoma japonicum in endemic areas of Poyang Lake., Methods: Residents over 5 years old in three schistosomiasis-endemic administrative villages in the lake region were simultaneously examined by modified Kato-Katz thick smears and nylon bag sedimentation/hatching method. At the same time, five sero-diagnostic test kits for detection of IgG antibody against soluble egg antigen of S. japonicum were carried out., Results: The distribution of seropositive rates of S. japonicum IgG antibodies determined by sero-diagnostic tests showed similar trends with that of egg positive rates in different age groups, but the seropositive rate (33.1%-57.1%) was significantly higher than that of egg positive rate (5.0%-8.2%), both reached a peak in 40-49-year-old group. The antibody positive rates determined by each test increased with the infection intensity. The sensitivity of the evaluated test kits ranged from 81.2%-94.5%. 26.9% to 46.1% among those egg negatives were antibody positive by the kits. Furthermore, 5.5%-18.8% of the egg positives were antibody negative by the kits., Conclusion: The five sero-diagnostic kits can be used for epidemiological survey in schistosomiasis endemic areas at community level. Among them, enzyme-linked immunosorbent assay shows higher sensitivity.

Objective: To synthesize and express the gene of egg protein IPSE (IL-4-inducing principle of Schistosoma mansoni eggs) and evaluate its immunologic characteristics., Methods: The IPSE gene of S. mansoni was synthesized by overlapping PCR, and confirmed by DNA sequencing, The recombinant plasmid IPSE-pET32a(+) was constructed by inserting the gene of IPSE into expression vector pET32a(+) at the downstream of thioredoxin (Trx) coding sequence. The recombinant plasmid IPSE-pET32a(+) was transformed into E. coli BL21(DE3) and followed by expression of the protein induced by IPTG. Large-scale fusion protein was prepared and purified with Ni affinity chromatography gel under denaturing conditions. A small amount of soluble Trx-IPSE was obtained by dialyzing the fusion protein in a large volume of PBS. Western blotting was used to detect if the recombinant IPSE was recognized by the IgG antibody in the pooled patient sera of schistosomiasis japonica and its binding capacity to the non-specific IgE antibody in the sera of healthy persons., Results: DNA sequencing confirmed that the nucleotide sequence of synthesized IPSE gene was completely identical to the native one. SDS-PAGE showed that the recombinant plasmid IPSE/pET32a(+) expressed a fusion protein with an Mr 35700 after being induced by IPTG. The pure fusion protein Trx-IPSE reacted positively with the pooled sera of schistosomiasis patients under either denaturing or renaturing conditions. The protein Trx-IPSE also reacted with the nonspecific IgE in the sera of healthy persons., Conclusion: The IPSE gene of Schistosoma mansoni has been synthesized, and the recombinant can react with natural antibody IgG against S. japonicum and non-specifically bind to IgE antibody.

Objective: To investigate a non-syndromic deafness family in which potential interaction between the GJB2 gene and a mitochondrial gene appeared to be the cause of hearing impairment., Methods: Audiological examination was performed by pure-tone audiometry (PTA). Blood samples from 8 members of the pedigree were obtained. DNA was extracted from the leukocytes. The coding region of the GJB2 gene and mitochondrial DNA target fragments were amplified by polymerase chain reaction (PCR). The PCR products were analyzed by sequencing., Results: Direct sequencing showed that the proband had both a heterozygous mutation of 235delC in the GJB2 gene and a mitochondrial 1555 A to G mutation. The proband had profound hearing loss. The maternal relatives had sensorineural hearing loss in the higher frequencies or no hearing loss., Conclusion: The GJB2 mutations may be an aggravating factor in the phenotypic expression of the non-syndromic hearing loss associated with the A1555G mitochondrial mutation.

Objective: To explore the effects of manipulation and traction combined with Nimodipine on the blood flow velocity of vertebrobasilar artery (VBA) in cervical vertigo of high flow velocity,and to evaluate clinical therapeutic effects between two methods., Methods: From March 2008 to Feburary 2009,70 patients who were diagnosed as high flow velocity of cervical vertigo were randomly divided into treatment group (35 cases) and control group (35 cases). Among 70 patients, 32 were male and 38 were female. The age ranged from 21 to 45 years with an average of 37.6 years. The disease course ranged from one day to two years with an average of 12.6 days. Patients of the treatment group were treated with manipulation for total three weeks, three times once week. The patients in the control group were treated with traction (weight ranged from 5 to 6 kg, 20 minutes each time, once every other day) and Nimodipine for total three weeks (three times each day, and with a dose of 40 mg each time). After three weeks, the changes of flow velacity of VBI and score before and after treatment were observed using transcranil Doppler (TCD) and Evaluation Scale for Cervical Vertigo. After six weeks, the therapeutic effects were assessed., Results: The mean velocity in left vertebral artery (LVA), right vertebral artery (RVA) and basilar artery (BA) were obviously lower than those before treatment in two groups (P < 0.01). The LVA, RVA and BA of the treatment group was lower than those of control group after 3 weeks (P < 0.01). There was significant difference in vertigo score after treatment between the two groups. The improvement rate of double-sides sign in X-ray image and the therapeutic effects of treatment group was superior to that of control group (P < 0.01)., Conclusion: The effect of manipulation on flow velocity of VBA is superior to that of traction combined with Nimodipine, and there are better therapeutic effects in treating cervical vertigo of high flow velocity in comparison with traction combined with Nimodipine. But there are more higher demands for manipulation's application.

Objective: To evaluate the cost-effectiveness and cost-benefit on the integrated schistosomiasis control strategies with emphasis on infection source, and provide scientific basis for the improvement of schistosomiasis control strategy., Methods: Aiguo and Xinhe villages in Jinxian County were selected as intervention group where the new comprehensive strategy was implemented, while Ximiao and Zuxi villages in Xinzi County served as control where routine control program was implemented. New strategy of interventions included removing cattle from snail-infested grasslands and providing farmers with farm machinery, improving sanitation by supplying tap water and building lavatories and methane gas tanks, and implementing an intensive health education program. Routine interventions were carried out in the control villages including diagnosis and treatment for human and cattle, health education, and focal mollusciciding. Data were collected from retrospective investigation and field survey for the analysis and comparison of cost-effectiveness and cost-benefit between intervention and control groups., Results: The control effect of the intervention group was better than that of the control. The cost for 1% decrease of infection rate per 100 people, 100 cattle, and 100 snails in intervention group was 480.01, 6 851.24, and 683.63 Yuan, respectively, which were about 2.70, 4.37 and 20.25 times as those in the control respectively. The total cost/benefit ratio (BCR) was lower than 1 (0.94 in intervention group and 0.08 in the control). But the total benefit of intervention group was higher than that of the control from 2005 to 2008. The forecasting analysis indicated that the total BCR in intervention group would be 1.13 at the 4th year and all cost could be recalled. Sensitivity analysis revealed that the BCR in intervention group changed in the range around 1.0 and that of the control ranged blow 0.5. The cost-benefit of intervention group was evidently higher than that of the control., Conclusions: The integrated control strategy focusing on infection source control brings about triplex benefits in schistosomiasis control, social development (and ecological protection) and economic efficacy, and shows better effects and benefits than the conventional control strategy.