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This study investigates the influence of ecological innovations and sustainable financing in promoting the Chinese economy's green total factor productivity (GTFP) from Q1-2004 to Q4-2018. Initially, this study measures GTFP using Data Envelopment Analysis and applies Bootstrap Auto-regressive Distributed Lagged (BARDL) model for dynamic effects. The preliminary results confirm the existence of unit root and a long-term cointegrating relationship among the model variables. The long-run results demonstrate that ecological innovations and sustainable financing have promoted GTFP in China. Moreover, government intervention is imperative to support green productivity growth at the macro level. However, there is a need to control the adverse effect of unemployment in impeding GTFP. Notably, the long-run results reflect the more substantial impact of the stated variables compared to the short run with the convergence towards long-run equilibrium. The policymakers are suggested to prioritise the development of the financial market and technological innovations. [ABSTRACT FROM AUTHOR]

The spatial Durbin model is used to explore the effects of population and industrial agglomeration on production and consumption pollution and spatial spillover differences by using provincial panel data from 2000 to 2018 in China. It is found that industrial agglomeration exacerbates production and consumption pollution within and adjacent to regions, and moderate population agglomeration is conducive to optimizing resource allocation and promoting the sharing of pollution control facilities, which can mitigate production and consumption pollution within and adjacent to regions. Although production pollution is in line with the environmental Kuznets curve, economic growth does not alleviate the consumption pollution brought about by daily life. Consumption pollution is mainly influenced by the consumption level, and everyone is the main subject of pollution. Consumption pollution is much more difficult to manage than production pollution and should be managed from the level of consumption demand. [ABSTRACT FROM AUTHOR]

The farmland loss caused by urban–rural land development has exacerbated China's challenges of using limited farmland to feed more than 1.4 billion people. Earlier studies shed light on the impacts of urban sprawl and rural settlement expansion, separately. However, there is little quantitative understanding of which one has more severe impacts on farmland and its net primary productivity (NPP). Thus, this study used spatially explicit satellite data including land-use maps and estimated NPP data, as well as spatiotemporal analysis methods to conduct a comparative analysis of farmland loss due to urban sprawl and rural settlement expansion at different scales from 2000 to 2020 in China. The results show that during the study period, urban sprawl resulted in a loss of 49,086.6 km2 of farmland area and 8.34 TgC of farmland NPP, while the loss of farmland area and farmland NPP due to rural settlement expansion reached 18,006.8 km2 and 3.88 TgC. The largest gap between the total area of farmland loss due to urban sprawl and the total loss area due to rural settlement expansion was 12,983.3 km2 in Eastern China, while the smallest gap was 1291.1 km2 in Northeastern China. The largest gap between the loss of farmland NPP due to urban sprawl and the total loss due to rural settlement expansion occurred in Eastern China at 1.97 TgC. Spatially, the total loss of farmland and its NPP due to urban sprawl and rural settlement expansion occurred mainly in the eastern and central regions of China; the areas of farmland loss by urban sprawl were more concentrated than that by rural settlement expansion. The negative impacts of urban sprawl on farmland area and its NPP were greater in southern China than that of rural settlement expansion. Noticeably, the loss of NPP per unit of farmland due to rural settlement expansion was higher than that by urban sprawl, especially in the Yangtze River Delta and Beijing–Tianjin–Hebei region. The results highlight the non-negligible impacts of rural settlement expansion on farmland in China. It is necessary to improve farmland protection policies by optimizing the spatial allocation of urban and rural construction land. [ABSTRACT FROM AUTHOR]

Purpose: To develop and validate a risk prediction model for coronary heart disease (CHD) in snorers with hypertension, including traditional and new risk factors. Patients and Methods: Twenty factors were evaluated in the records of 2810 snorers with hypertension. Training (70%) and validation (30%) sets were created by random allocation of data, and a new nomogram model was developed. The model's discrimination and calibration were measured by calculating the area under the receiver operating curve (AUC) and creating calibration charts. The performance of the nomogram model was compared with that of the Prediction for ASCVD Risk in China (China-PAR) and Framingham models by decision curve analysis. An optimal cutoff point for the risk score in the training set was computed to stratify patients. Results: In the nomogram model, the AUCs for predicting CHD at 5, 7 and 9 years in the training set were 0.706 (95% confidence interval [CI] 0.649– 0.763), 0.703 (95% CI 0.655– 0.751) and 0.669 (95% CI 0.593– 0.744), respectively. The respective AUCs were 0.682 (95% CI 0.607– 0.758), 0.689 (95% CI 0.618– 0.760) and 0.664 (95% CI 0.539– 0.789) in the validation set. The calibration chart showed that the predicted events from the nomogram score were close to the observed events. Decision curve analysis indicated that the nomogram score was slightly better than the Prediction for ASCVD Risk in China (China-PAR) and Framingham models for predicting the risk of CHD in snorers with hypertension. A cutoff point was identified for being CHD-free (a nomogram score of ≤ 121), which could be helpful for the early identification of individuals at high-risk of CHD. Conclusion: The nomogram score predicts the risk probability of CHD in snorers with hypertension at 5, 7 and 9 years, and shows good capability in terms of discrimination and calibration. It may be a useful tool for identifying individuals at high risk of CHD. [ABSTRACT FROM AUTHOR]

Digital inclusive finance not only reduces the threshold of rural financial services but also plays an important role in promoting the rural economy. Under the background of the digital economy in China, we studied how digital inclusive finance affects the high-quality development of the rural economy. For this purpose, we assembled the provincial panel data from 2009 to 2018 and constructed an index system of rural high-quality development and then calculated its index using the entropy weight method. FE regression model and RE regression model were employed for empirical analysis, and we constructed a nonlinear regression model to investigate the nonlinear relationship as well. Furthermore, systematic GMM and iterative GMM were used to solve the endogenous problem. We found that digital inclusive finance plays a significant and positive role in promoting rural high-quality development, mainly through the channel of economic efficiency, urban and rural structure, green ecological development, harmony of people's livelihood, and innovative development potential. Each subdimension of digital inclusive finance has a positive impact on rural high-quality development to different degrees. There is also a direct nonlinear relationship between the core variables, which act as a disincentive in the initial stage and boost after reaching a certain inflection point. Therefore, it is recommended to increase the construction of rural digital infrastructure, improve the digitalization of inclusive finance with the help of digital technologies such as cloud computing, and expand the breadth and depth of digital inclusive finance services in rural areas, especially in economically underdeveloped provinces and cities, to effectively promote the comprehensive and high-quality development of rural areas. [ABSTRACT FROM AUTHOR]

Objective: To investigate homocysteine (Hcy) and folate levels, prevalence of hyperhomocysteinaemia (HHcy) and folate deficiency, which are affected by lifestyles in urban, agricultural and stock-raising populations.Design: This is a cross-sectional study.Setting: Urban, agricultural and stock-raising regions in Emin, China.Participants: Totally 1926 subjects - 885 (45·9 %) from urban, 861 (44·7 %) from agricultural and 180 (9·4 %) from stock-raising regions - were obtained using multistage stratified random sampling. Inclusion criteria encompassed inhabitants aged ≥15 years who resided at the current address for ≥6 months and agreed to participate in the study. Surveys on health behaviour questionnaires and physical examinations were conducted and blood samples collected.Results: The folate level of subjects from the stock-raising region was the lowest, followed by those from the agricultural region, and the highest in those from the urban region (3·48 v. 6·50 v. 7·12 ng/ml, P < 0·001), whereas mean Hcy showed no significant difference across regions. The OR for HHcy in stock-raising regions was 1·90 (95 % CI 1·11, 3·27) compared with the urban region after adjusting for all possible covariates. The OR for folate deficiency in stock-raising and agriculture regions was 11·51 (95 % CI 7·09, 18·67) and 1·91 (95 % CI 1·30, 2·82), respectively, compared with the urban region after adjusting for all possible covariates.Conclusions: HHcy and folate deficiency are highly prevalent in stock-raisers, which is of important reference for HHcy control in Xinjiang, with a possibility of extension to others with approximate lifestyles. [ABSTRACT FROM AUTHOR]

Background. Hypertension is a global problem, for which high-altitude residents exhibit higher burden. Hypertension in Tajik nomads from Pamirs with an average altitude above 4000 m remains less studied. We aimed to determine the prevalence, awareness, treatment, control, and risk factors associated with hypertension among Tajik population in Pamirs. Methods. A cross-sectional survey was conducted between August and September 2015 using stratified three-stage random sampling in Taxkorgan county, Pamirs, China. Hypertension is defined as mean systolic and/or diastolic blood pressure (SBP, DBP) ≥140/90 mmHg and/or taking antihypertensive medication within the past two weeks. The prevalence (SBP ≥130 or DBP ≥80 mmHg) was also estimated using the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) High Blood Pressure Guideline. The awareness, treatment, and control of hypertension and associated factors were evaluated. Results. Totally, 797 subjects aged ≥18 years were enrolled with 46.3% men and 88.8% nomads with the mean age of 42.3 ± 15.2 years. The prevalence of hypertension was 24.2% (140/90 mmHg), and the prevalence was as high as 40.3%, based on the 2017 ACC/AHA guideline. Overall awareness, treatment, and control of hypertension were 52.8%, 40.9%, and 9.3%, respectively. In multivariate logistic regression, BMI ≥24.0 kg/m2 (OR: 2.41, 95% CI: 1.44–4.04) was a risk factor for prehypertension, and age ≥60 years (OR: 2.04, 95% CI: 1.15–3.61), BMI ≥24.0 kg/m2 (OR: 2.04, 95% CI: 1.15–3.61), and abdominal obesity (OR: 1.87, 95% CI: 1.09–3.22) were risk factors for hypertension. Angiotensin-converting enzyme inhibitors/angiotensin receptor blockers were the most commonly used antihypertensive medication (45.4%) as monotherapy, and 13.6% of treated hypertensive patients used two drugs. Conclusions. There is a considerable prevalence of hypertension with low awareness, treatment, and control rates among Tajik nomads in Pamirs, where health programs improving the hypertension status are urgently needed, with the excess weight loss as a strategy. [ABSTRACT FROM AUTHOR]

Background. Portal vein tumor thrombosis (PVTT) is one of the major predictive factors for patients with hepatocellular carcinoma (HCC). The objective of this study was to establish a prognostic nomogram for identifying individual survival outcomes in patients with HCC and PVTT on conservative treatment based on specific factors. Methods. Two hundred and ten patients with HCC and PVTT on conservative treatment in Beijing Ditan Hospital between June 2008 and May 2017 were studied retrospectively as a derivation cohort. We built a nomogram based on independent risk factors for survival prediction. The concordance index (c-index) and a calibration curve were used to evaluate the predictive accuracy. During the study, 102 patients were included at the Putuo Hospital and Third People's Hospital of Changzhou as a validation cohort. Results. In the derivation cohort, the independent factors for overall survival were identified by multivariate analysis, namely, aspartate aminotransferase ≥119 IU/L, gamma-glutamyl transferase ≥115 IU/L, Child–Pugh class C liver function, creatinine ≥91 μmoI/L, α-fetoprotein ≥400 ng/ml, and largest tumor diameter ≥5 cm. The nomogram had a c-index of 0.737 (95% confidence interval, 0.692–0.782) and the calibration curves fitted well. The median survival time was 4.2 months in the derivation cohort, with an MST of 5 months for BCLC C stage and 1.8 months for BCLC D stage patients. Kaplan–Meier analysis showed significant statistical differences in the 6-month overall survival rates of the primary and validation cohorts after the total scores were divided into three quartiles (low risk: 0–85; intermediate risk: 86–210; high risk: ≥211; p < 0.0001 in both cohorts). Conclusions. The nomogram can be a more accurate and individualized prediction for 6-month overall survival of patients with HCC and PVTT on conservative treatment, and it is possible to consider further active interventions for patients in the low-risk group (0–85 scores) to achieve the aim of prolonging survival. [ABSTRACT FROM AUTHOR]

We aimed to ascertain the mechanism underlying the effects of acteoside (ACT) from Ligustrum robustum (Roxb.) Blume (Oleaceae) on lipid metabolism and synthesis. ACT, a water-soluble phenylpropanoid glycoside, is the most abundant and major active component of L. robustum ; the leaves of L. robustum , known as kudingcha (bitter tea), have long been used in China as an herbal tea for weight loss. Recently, based on previous studies, our team reached a preliminary conclusion that phenylpropanoid glycosides from L. robustum most likely contribute substantially to reducing lipid levels, but the mechanism remains unclear. Here, we conducted an in silico screen of currently known phenylethanoid glycosides from L. robustum and attempted to explore the hypolipidemic mechanism of ACT, the representative component of phenylethanoid glycosides in L. robustum , using RNA-seq technology, quantitative real-time PCR (qPCR) and Western blotting. First, the screening results for six compounds were docked with 15 human protein targets, and 3 of 15 protein targets were related to cardiovascular diseases. Based on previous experimental data and docking results, we selected ACT, which exerted positive effects, for further study. We generated a lipid accumulation model using HepG2 cells treated with a high concentration of oleic acid and then extracted RNA from cells treated for 24 h with 50 μmol/L ACT. Subsequently, we performed a transcriptomic analysis of the RNA-seq results, which revealed a large number of differentially expressed genes. Finally, we randomly selected some genes and proteins for further validation using qPCR and Western blotting; the results agreed with the RNA-seq data and confirmed their reliability. In conclusion, our experiments proved that ACT from L. robustum alters lipid metabolism and synthesis by regulating the expression of multiple genes, including Scarb1 , Scarb2 , Srebf1 , Dhcr7 , Acat2 , Hmgcr , Fdft1 , and Lss , which are involved several pathways, such as the glycolytic, AMPK, and fatty acid degradation pathways. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to develop an effective nomogram capable of estimating the individual survival outcomes of patients with hepatocellular carcinoma (HCC), and compare the predictive accuracy and discriminative ability with other staging systems.Methods: The nomogram was established based on a retrospective study of 661 patients newly diagnosed with HCC at the Beijing Ditan Hospital (Beijing, China), Capital Medical University, between October 2008 and July 2012. The predictive accuracy and discriminative ability of the previously developed nomogram were assessed by C-index and calibration curves, and were compared to seven current commonly used staging systems. The results were validated, using a bootstrap approach to correct for bias, in a prospective study of 220 patients consecutively enrolled between August 2012 and March 2013.Results: Multivariate analysis of the primary cohort for survival analysis identified the independent factors to be aspartate aminotransferase, ɣ-glutamyl transpeptidase, white blood cell count, neutrophil-to-lymphocyte ratio, prothrombin activity, α-fetoprotein, tumor number and size, lymph node metastasis, and portal vein involvement, which were all included to build the nomogram. The calibration curve for predicting the probability of survival showed consistency between the nomogram and the actual observation. The C-index of the nomogram was 0.81 (95% confidence interval, 0.79-0.82), which was statistically better than that of the Tumor, Node, Metastasis staging (0.71), Barcelona Clinic Liver Cancer staging (0.77), Okuda (0.62), Japan Integrated Staging (0.73), Cancer of the Liver Italian Program score (0.76), Chinese University Prognostic Index (0.68), and the Groupe d' Etude et de Traitement du Carcinome Hepatocellulaire Prognostic classification (0.65) (p < 0.001 for all). The results were validated in the prospective validation cohort.Conclusions: The prognostic nomogram resulted in more accurate individualized risk estimates for overall survival in HCC patients. [ABSTRACT FROM AUTHOR]

Miscanthus has good tolerance to heavy metals (HMs) and has received increasing attention in studies of HM-contaminated soil remediation. In this study, four Miscanthus cultivars (M. lutarioriparius Xiangnadi NO4, M. sinensis Xiangmang NO1, M. lutarioriparius × M. sinensis hybrid Xiangzamang NO1, and M. floridulus Wujiemang NO1) that grow in China were studied. Their tolerance and enrichment abilities in soils containing 50 mg kg−1 cadmium (Cd) and the structure and function of their rhizosphere bacterial communities during the remediation process were analyzed. The results exhibiting a tolerance index (TI) higher than 75 in roots and the aboveground parts (TI > 60, indicating highly tolerant plants) indicated that all four Miscanthus cultivars were tolerant to high Cd concentrations. Moreover, Cd was mainly enriched in roots, the translocation ability from roots to aboveground parts was weak, and the four cultivars exhibited phytostabilization ability in Cd-contaminated soils. High-throughput sequencing (HTS) analysis showed that the Miscanthus rhizosphere bacterial community comprised 33 phyla and 446 genera, including plant growth-promoting rhizobacteria (PGPRs), such as Bacillus , Sphingomonas , and Mesorhizobium. The addition of Cd affected the Miscanthus rhizosphere bacterial community and reduced community diversity. Phylogenetic molecular ecological networks (pMENs) indicated that Cd addition reduced interactions between Miscanthus rhizosphere bacteria and thereby led to a simpler network structure, increased the number of negative-correlation links, enhanced the competition between rhizosphere bacterial species, reduced the number of key bacteria, and changed the composition of those bacteria. PICRUSt functional predictive analysis indicated that Cd stress reduced soil bacterial functions in the Miscanthus rhizosphere. The results of this study provide a basis for the remediation of Cd-contaminated soils by Miscanthus and provide a reference for the subsequent regulation of Miscanthus remediation efficiency by PGPRs or key bacteria. [Display omitted] • Four Miscanthus species had phytostabilization ability. • Miscanthus rhizosphere bacterial communities and functions were analyzed. • Miscanthus rhizospheres were rich in plant growth-promoting rhizobacteria species. • Cd stress simplified bacterial network structure and changed key bacteria. • Cd stress reduced soil bacterial functions in the Miscanthus rhizosphere. [ABSTRACT FROM AUTHOR]

Braided delta is an important reservoir of oil and gas which is enriched in sand with good physical properties. Consequently, study of its sedimentary characteristics and sedimentary sequence has important guiding significance for the oil and gas exploration. In this study, sedimentary model and stratigraphy sequence for Wulabo Formation are established through outcrop measure, analysis of microfacies and sedimentary characteristics in southern margin of Junggar Basin. The results show that the main subfacies of Wulabo Formation is braided delta plain and front, the microfacies is delta plain distributary channel, subaqueous interdistributary channel, subaqueous distributary channel, mouth bar etc. The sandbody in braided delta front is significant reservoir for oil and gas since it has fine particle size, well sorting and rounding. Through lithofacies division, Wulabo Formation can be divided into 8 typical lithofacies and 4 typical litho-facies combination. The grain size probability cumulative of distributary channel is made up of saltation and suspension, moreover, the saltation of subaqueous distributary channel can be divided into two sections and the grain size probability cumulative of mouth bar is composed of multiple sections which is more complicated.Based on the study of sedimentary characteristics, lithofacies and grain size, the braided river delta depositional model of Wulabo Formation is established, which can provide guidance for oil and gas exploration in this area. [ABSTRACT FROM AUTHOR]

Background: Uncertainty remains about the association of potassium (K) intake with depression and anxiety status. We explored their relationship using 24‐h urinary K, reflecting K intake, in general population. Methods: We collected 24‐h urine and performed self‐rating depression and anxiety scales (SDS, SAS) cross‐sectionally in adults selected by random sampling in China. SDS and SAS standard score ≥50 defined depression and anxiety status. Participants were divided into three groups (T1, T2, and T3) by 24‐h urinary K tertile. Odds ratios (OR) and 95% confidence intervals were calculated. Sensitivity analysis was performed by excluding anti‐hypertensive agent takers. Results: 546 participants comprised current analytical sample. First, T1 and T2 groups showed higher SDS scores (40.0 vs 40.0 vs 36.0, p =.001), prevalence (19.8 vs 15.9 vs 7.1%, p =.002), whereas increased adjusted odds for depression status only in T1 group (OR = 2.71, p =.017), compared with T3 group. Second, T1 and T2 groups showed higher SAS scores (38.0 vs 40 vs 35.0, p <.001) and prevalence (14.8 vs 21.4 vs 8.8%, p =.003), whereas increased adjusted odds for anxiety status only in T2 group (OR = 2.07, p =.042), compared with T3 groups. Third, T1 and T2 groups showed higher prevalence (10.4% vs 11.5% vs 2.7%, p =.004) and adjusted odds (OR = 3.71, p =.013; OR = 3.66, p =.014) for co‐existent anxiety and depression status, compared with T3 group. Most results remained consistent in sensitivity analysis. Conclusions: Lower K intake is implicated in presence of anxiety and depression status in general population; this may provide basis for programs to increase K intake and prevent disease. [ABSTRACT FROM AUTHOR]

• Extensive dolomitic rocks are the favorable lithologies for tight oil. • Microscale dissolution pores and fractures are the major reservoir spaces. • We summarize two different types of tight oil accumulation plays. The Permian Fengcheng Formation in the western slope of the Mahu Sag, which is located in the Junggar Basin, NW China, has long been considered to be a high-quality source rock in this area. The lacustrine dolomitic rocks within the Fengcheng Formation has recently been reported to have a good tight oil potential as a special type of tight oil reservoir. However, the characteristics of the tight reservoir and tight oil accumulation, which are key factors for commercial development, are not well documented. We conducted a comprehensive reservoir characterization using petrological (core, thin section, scanning electron microscope, and nanoscale computed tomography) and geophysical (seismic and well logging) data. The Fengcheng Formation contains extensive dolomitic rocks deposited around the evaporite under a saline lacustrine environment accompanied by volcanic activities. The western slope of the Mahu Sag can be divided into two zones: the Wufeng Fault Zone and Fengnan Slope Zone. Dolomitic rock reservoirs and tight oil accumulation exist in both zones. Salt minerals, feldspar, calcite, and dolomite in the dolomitic rocks are susceptible to dissolution, and secondary intergranular or intragranular dissolution pores are the major reservoir spaces. Abundant nanoscale pores exist in the dolomitic rocks, but microscale pores, which dominate in volume, play a more important role. Brittle dolomitic rocks commonly develop fractures, but the Wufeng Fault Zone develops far more fault-related fractures than the Fengnan Slope Zone. The oil properties of the Wufeng Fault Zone and the Fengnan Slope Zone are also different. We propose that these two zones are two different types of tight oil accumulation plays: a fracture controlled accumulation play and a pore controlled accumulation play. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) is revolutionizing the medical industry. This paper first investigates the mechanism of patients' medical AI acceptance after experiencing AI service failure from the perspective of responsibility attribution. Using data from 249 patients in China, findings reveal that patients' self-responsibility attribution is positively related to human–computer trust (HCT) and sequentially enhances the acceptance of medical AI for independent diagnosis and treatment. This paper also investigates the moderating role of personality traits. Specifically, conscientiousness and openness strengthen the association between HCT and acceptance of AI for independent diagnosis and treatment; agreeableness and conscientiousness weaken the association between HCT and acceptance of AI for assistive diagnosis and treatment. • Medical AI diagnosis consisted of independent and assistive diagnosis. • This paper discusses the medical AI acceptance after experiencing AI service failure. • Attribution theory was considered as a theoretical framework. • Personality affects the association between human–computer trust and AI acceptance. [ABSTRACT FROM AUTHOR]

Abstract: Enterovirus 71 (EV71) has led to recent outbreaks of hand, foot and mouth disease (HFMD) in China, resulting in high mortality. In this study, several monoclonal antibodies were generated by immunizing mice with two synthetic peptides, SP55 and SP70, containing amino acids 163–177 and 208–222 of VP1. The specificities of the anti-EV71 peptide monoclonal antibodies were confirmed by Western blot analysis and immunocytochemistry against EV71 virus. Most importantly, we have identified a monoclonal antibody, clone 22A12, which shows strong neutralizing activity against EV71 in an in vitro neutralization assay. Because there is no vaccine available and treatment is very limited, mouse anti-EV71 monoclonal antibody, clone 22A12, could be a promising candidate to be humanized and used for treatment of EV71 infection. [Copyright &y& Elsevier]

Abstract: The effectiveness of a comprehensive schistosomiasis japonica control program implemented in 8 villages along the Yangtze river in Jiangsu province from 2005 to 2008 was studied. Control measures included snail control, chemotherapy of humans and livestock, health education, and transmission cycle interruption using sanitation in dwellings and at anchorage sites for fishermen and sailors. The Schistosoma japonicum prevalence among residents and livestock, the total area of snail habitats, the Oncomelania hupensis snail density, and the percentage of infected snails served as indicators for the effectiveness of the control efforts. After 4 years of program implementation, the seroprevalence in humans had decreased from 9.03% to 3.24% (P <0.001) and the parasitological prevalence among males had decreased from 0.42% to 0.12% (P =0.004). Among females, it remained stable at a low level. The S. japonicum prevalence in livestock had decreased from 2.94% to 0% (P <0.001). Additionally, the area where infected snails could be found had shrunk from 89.99 hectares (ha) to 16.00ha, the snail density had decreased from 0.56 to 0.32 per 0.1m2, and the percentage of infected snails had dropped from 0.38% to 0.12% (all P <0.001). The results demonstrate that an integrated schistosomiasis japonica control strategy focusing on the main transmission cycles and reservoirs and combines chemotherapy, infrastructure interventions and health education combined with robust surveillance is feasible and allows to effectively control S. japonicum. [Copyright &y& Elsevier]

Aims: Patients with heart valvular regurgitation is increasing; early screening of potential patients developing heart failure (HF) is crucial., Methods: From 1 November 2019 to 31 October 2023, a total of 509 patients with heart valvular regurgitation hospitalized in the Department of Cardiovascular Disease of the First Affiliated Hospital of Guangzhou University of Traditional Medicine were enrolled. Three hundred fifty-six cases were selected as the training set for modelling, and 153 cases were selected as the validation set for the internal validation of the model., Results: A predictive model of heart failure with the following nine risk factors was developed: atrial fibrillation (AF), pulmonary infection (PI), coronary artery disease (CAD), creatinine (CREA), low-density lipoprotein cholesterol (LDL-C), d-dimer (DDi), left ventricular end-diastolic diameter (LVEDd), mitral regurgitation (MR) and aortic regurgitation (AR). The model was evaluated by the C-index [the training set: area under curve (AUC) 0.937, 95% confidence interval (CI) 0.911-0.963; the validation set: AUC 0.928, 95% CI 0.890-0.967]. Hosmer-Lemeshow test (the training set: χ 2 10.908, P = 0.207; the validation set: χ 2 4.896, P = 0.769) revealed that both the training and validation sets performed well in terms of model differentiation and calibration. Decision curve analysis showed that both the training and validation sets have higher net benefits, indicating that the model has good utility. Ten-fold cross-validation showed that the training set has high similarities with the validation set, which means that the model has good stability., Conclusions: The occurrence of heart failure in patients with valvular regurgitation has a significant correlation with AF, PI, CAD, CREA, LDL-C, DDi, LVEDd, MR and AR. Based on these risk factors, a prediction model for heart failure was developed and validated, which showed good differentiation and utility, high accuracy and stability, providing a method for predicting heart failure., (© 2024 The Author(s). ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)

Background: This study was conducted to investigate the incidence of deep venous thrombosis (DVT), outcomes and its characteristics in patients with chronic heart failure (CHF) in a retrospective setting., Outcomes: Patients died of cardiac shock or acute exacerbation of heart failure (HF), admitted to intensive care unit (ICU) due to acute exacerbation of HF, patients decided to withdraw treatment and return home due to acute exacerbation of HF., Methods: From January 2015 to June 2022, we admitted 359 patients diagnosed with CHF, and lower limb ultrasonography was performed for the examination of DVT after admission. The incidence of DVT was recorded and patients with known risk factors of VTE were identified and excluded after incidence of DVT was calculated. Patients' clinical data were then collected., Results: The occurrence of DVT was 10.0% (36/359), as calf intramuscular vein thrombosis was the main constitution (n  =  28, 75%). DVT patients with other factors (carcinoma, surgery, stroke, previous history of DVT) constituted a considerable part (33.3%, 12/36). Age, history of Diabetes Mellitus (DM), levels of DDi (D-Dimer), levels of alanine transferase (ALT) and left ventricular end-diastolic diameter (LVEDd) were independent predictors or risk factors of DVT in CHF patients, while chronic kidney disease (CKD) stage 1-4, white blood cell (WBC) and direct oral anticoagulant (DOAC) were protective factors. Incidence of DVT was correlated with a poor outcome of CHF patients (Pearson Chi-Square test, Value 19.612, P  <  0.001)., Conclusions: In this retrospective study, incidence of DVT was found to be relatively high among hospitalized CHF patients, while patients with DVT was associated with a poor prognosis., (© 2024. Springer Nature Japan KK, part of Springer Nature.)

Background: Mothers of children with autism reported higher levels of anxiety than mothers of typical children. This study revealed the relationship between parent-child conflict, children's problem behavior, parenting stress, and maternal anxiety from the perspective of the relationship within the family., Methods: The State-Trait Anxiety Inventory (STAI) and Caregiver Strain Questionnaire (CGSQ) were used to measure maternal anxiety and parenting stress respectively from 102 mothers of children with autism. We also collected information on parent-child relationships and children's problem behaviors by using the Child-Parent Relationship Scale (CPRS) and Conners Parent Symptom Questionnaire (PSQ)., Results: Parent-child conflict positively predicted state and trait anxiety in mothers of children with autism. The severity of children's psychosomatic disorders fully mediated the positive association between parent-child conflict and state-trait anxiety in mothers of children with autism. Parenting stress significantly moderated the impact of parent-child conflict on maternal state anxiety and trait anxiety., Conclusion: In the case of children with autism spectrum disorders, parent-child conflict can directly affect maternal anxiety levels, especially when mothers have low levels of parenting stress. Parent-child conflict can also affect children's problem behaviors and thus indirectly affect maternal anxiety. Therefore, this study is of great significance for the alleviation of anxiety of mothers of autistic children and the family intervention for the early rehabilitation of autistic children., (© 2024. The Author(s).)

Purpose: To explore the predictive value of nutritional risk for all-cause death and functional outcomes among elderly acute stroke patients., Patients and Methods: A total of 479 elderly acute stroke patients were enrolled in this study. The nutritional risk of patients was screened by the GNRI and NRS-2002. The primary outcome was all-cause death, and the secondary outcome was poor prognosis defined as a modified Rankin Scale (mRS) score ≥3., Results: Based on the NRS-2002, patients with nutritional risk had a higher risk of all-cause death at 3 months (adjusted OR: 3.642, 95% CI 1.046~12.689) and at 3 years (adjusted OR: 2.266, 95% CI 1.259~4.076) and a higher risk of adverse functional outcomes at 3 months (adjusted OR: 2.748, 95% CI 1.518~4.972. Based on the GNRI, compared to those without nutritional risk, patients with mild malnutrition also had a higher risk of all-cause death at 3 months (adjusted OR: 7.186, 95% CI 1.550~33.315) and at 3 years (adjusted OR: 2.255, 95% CI 1.211~4.199) and a higher risk of adverse functional outcomes at 3 months (adjusted OR: 1.947, 95% CI 1.030~3.680), so patients with moderate and severe malnutrition had a higher risk of all-cause death at 3 months (adjusted OR: 6.535, 95% CI 1.380~30.945) and at 3 years (adjusted OR: 2.498, 95% CI 1.301~4.799) and a higher risk of adverse functional outcomes at 3 months (adjusted OR: 2.213, 95% CI 1.144~4.279)., Conclusion: Nutritional risk increases the risk of poor short-term and long-term outcomes in elderly patients with acute stroke. For elderly stroke patients, we should pay attention to early nutritional risk screening, and effective intervention should be provided to improve the prognosis of such patients., Competing Interests: The authors report no conflicts of interest in this work., (© 2024 Cong et al.)

This paper attempts to reveal the impact and mechanisms of digital inclusive finance (DIF) on agricultural carbon emission performance (ACEP). Specifically, based on the provincial panel data in China from 2011 to 2020, a super slacks-based measure (Super SBM) model is applied to measure ACEP. The panel regression model and spatial regression model are used to empirically analyze the impact of DIF on ACEP and its mechanism. The results show that: (1) during the study period, China's ACEP exhibited a continuous growth trend, and began to accelerate after 2017. The high-value agglomeration areas of ACEP shifted from the Huang-Huai-Hai plain and the Pearl River Delta to the coastal regions and the Yellow River basin, the provincial differences displayed an increasing trend from 2011 to 2020. (2) DIF was found to have a significant positive impact on ACEP. The main manifestation is that the development of the coverage breadth and depth of use of DIF helps to improve the ACEP. (3) The positive impact of DIF on ACEP had a significant spatial spillover effect, that is, it had a positive effect on the improvement of ACEP in the surrounding provinces. These empirical results can help policymakers better understand the contribution of DIF to low-carbon agriculture, and provide them with valuable information for the formulation of supportive policies.

Background: Stroke is a leading cause of death and functional impairment in older people. To assess the prospective association between fasting blood glucose-to-glycated hemoglobin ratio and all-cause mortality and poor prognosis in stroke patients., Methods: A total of 971 Chinese inpatients with acute stroke (mean age of 65.7) were consecutively enrolled in the prospective clinical study and followed up for 12 months after discharge. Stress hyperglycemia was measured using the ratio of fasting blood glucose (FBG, mmol/L)/glycated hemoglobin (HbA1c, %). The primary outcome was all-cause mortality, and secondary outcomes were poor prognosis defined as infectious complications, a National Institutes of Health Stroke Scale (NIHSS) score ≥ 6, a Barthel Index score ≤ 60, or a modified Rankin Scale (mRS) score of 3-6, presented as multivariate-adjusted odds ratios (ORs) with 95% confidence intervals (CIs) across the quartiles of the FBG/HbA1c ratio., Results: There were 35 (4.1%) all-cause deaths at 3 months and 85 (11.4%) at 12 months. The inpatients with the highest quartile of the FBG/HbA1c ratio had a higher risk of all-cause death at 3 months (adjusted OR: 5.16, 95% CI: 1.03-25.74) and at 12 months (adjusted OR: 2.59, 95% CI: 1.14-5.89)) and a higher risk of infectious complications (adjusted OR 2.37, 95% CI 1.27-4.43) and dysfunction (adjusted OR 1.79, 95% CI 1.06-3.01) during hospitalization than inpatients with the lowest quartile., Conclusions: Stress hyperglycemia, measured by the FBG/HbA1c ratio, was associated with an increased risk of adverse outcomes, including all-cause death, infectious complications, and dysfunction after stroke., (© 2022. The Author(s).)

Purpose: This study was aimed at investigating the association between baseline plasma homocysteine (Hcy) concentrations and the risk of the first ischemic stroke (IS) and at investigating any possible influential modifying factors in hypertensive patients with obstructive sleep apnea (OSA)., Methods: Cox proportional hazards regression was employed to investigate the relationship between plasma Hcy concentration and the first IS. A generalized additive model was applied to determine the nonlinear relationship. In addition, we conducted subgroup analysis., Results: A total of 2350 hypertensive patients with OSA without a history of IS were enrolled in this study. At a median follow-up of 7.15 years, we identified 93 cases of the first IS. After adjusting for potential confounding, the findings revealed that plasma Hcy concentration was strongly and positively associated with the occurrence of the first IS (per SD increment; HR = 1.37, 95% CI: 1.30-1.44). A nonlinear relationship was found between plasma Hcy concentration and the risk of developing the first IS with inflection points for plasma Hcy of 5  μ mol/L. In stratified analysis, a greater positive correlation was found between baseline plasma Hcy concentrations and new-onset IS in patients with DBP ≥ 90 mmHg (per SD increment; HR = 1.48, 95% CI: 1.33-1.65 vs. <90 mmHg: HR = 1.20, 95% CI: 1.02-1.42; P -interaction = 0.04) and BMI ≥ 24 and <28 kg/m 2 (per SD increment; HR = 1.46, 95% CI: 1.26-1.70 vs. <24 kg/m 2 : HR = 1.13, 95% CI: 0.95-1.33 vs. ≥28 kg/m 2 : HR = 1.46, 95% CI: 1.25-1.70; P -interaction = 0.03)., Conclusion: Elevated plasma Hcy concentrations are independently associated with the risk of the first IS in hypertensive patients with OSA. Plasma Hcy concentrations ≥ 5  μ mol/L surely increased the risk of the first IS in hypertensive patients with OSA., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2021 Nanfang Li et al.)

A novel Gram-stain-positive, aerobic, cocci-shaped actinobacterium, designated YIM 75000 T , was isolated from a soil sample collected from a dry-hot river valley in Yunnan Province, P.R. China. Growth was observed at 10-45 °C (optimal 37 °C), 0-8% (w/v) NaCl (optimal at 0-3% NaCl) and pH 6.0-8.0 (optimal at pH 7.3). The peptidoglycan contained LL-diaminopimelic acid, glycine, glutamic acid as well as alanine and its type was A3γ with an LL-Dpm-Gly interpeptide bridge. The major cellular fatty acids (> 10%) were C 16:0 , Summed In Feature 3 (C 16:1 ω6c/C 16:1 ω7c) and C 17:1 ω8c. The predominant menaquinone was MK-9(H 4 ). The major whole-cell sugars contained rhamnose, ribose, arabinose and mannose. The DNA G+C content was 77.0 mol%. The 16S rRNA gene sequence similarities of strain YIM 75000 T with other species were less than 94%. Phylogenetic analyses based on 16S rRNA gene sequences and genome data, revealed that strain YIM 75000 T together with the genus Motilibacter formed a distinct phylogenetic lineage within the phylum Actinobacteria, separating them from members of all orders. Strain YIM 75000 T showed 73.4-73.7% average nucleotide identity and 19.5-19.7% digital DNA-DNA hybridization identity with the closely related genus Motilibacter. Based on the phenotypic, phylogenetic and chemotaxonomic data, it is proposed that the new isolate represents the nomenclature type of the novel species Vallicoccus soli gen. nov., sp. nov. (YIM 75000 T  = DSM 45377 T  = KCTC 49228 T  = CGMCC 1.13844 T ) which is the nomenclature type of the novel genus Vallicoccus gen. nov. within Vallicoccaceae fam. nov and Motilibacterales ord. nov in the phylum Actinobacteria. The family Vallicoccaceae fam. nov. and the order Motilibacterales (contains Vallicoccaceae fam. nov. and Motilibacteraceae Lee 2013) ord. nov. are formally proposed.

BACKGROUND Dendritic cell autophagy plays a pivotal role in asthma. Wuhu decoction can significantly improve respiratory syncytial virus (RSV) bronchiolitis and delay its development into asthma. The aim of the present study was to explore the therapeutic effect and mechanism of Wuhu decoction on RSV -induced asthma in mice. MATERIAL AND METHODS Establishment of asthmatic mice model was induced by RSV. Hematoxylin-eosin staining, periodic acid-Schiff (PAS) staining, and Masson trichrome staining were performed to observe pathological changes in the lungs. The levels of CD4⁺ T, CD8⁺ T, and CD4⁺ CD25⁺ T in blood were analyzed by flow cytometry. The contents of interleukin (IL)-4, interferon-gamma (IFN-γ), IL-10, and IL-13 in serum were measured by enzyme-linked immunosorbent assay (ELISA). The number of autophagosomes in dendritic cells (DCs) of lung tissue was observed by transmission electron microscope. The DCs of lung tissue were isolated by magnetic bead sorting. The levels of LC3-II, Beclin-1, and LC3-I in DCs and MMP-9, TIMP-1, AMPK, p-AMPK, ULK1, and LK1 expression in lung tissues were detected by western blot. Real-time polymerase chain reaction (PCR) detected the expression of AMPK and ULK1 genes. RESULTS Wuhu decoction can effectively alleviate chronic airway inflammation and airway remodeling and reduce airway hyperresponsiveness. Moreover, Wuhu decoction can significantly enhance the level of autophagy in DCs of lung tissue and promote the expression of AMPK and ULK1 in lung tissue. CONCLUSIONS Wuhu decoction may improve the RSV-induced asthmatic symptoms by enhancing autophagy of DCs in lung tissue dependent on the AMPK/ULK1 signaling pathway.

Background: Control of snail intermediate hosts has been proved to be a fast and efficient approach for interrupting the transmission of schistosomiasis. Some plant extracts have shown obvious molluscicidal activity, and a new compound Luo-Wei, also named tea-seed distilled saponin (TDS), was developed based on the saponins extracted from Camellia oleifera seeds. We aimed to test the molluscicidal activity of 4% TDS against the intermediate host snails in China and Egypt, and evaluate its environmental safety to non-target organisms., Methods: In the laboratory, Oncomelania hupensis, Biomphalaria alexandrina and Bulinus truncatus were exposed to 4% TDS, and the median lethal concentration (LC 50 ) was estimated at 24, 48 and 72 h. In the field, snail mortalities were assessed 1, 2, 3 and 7 d post-immersion with 2.5 g/m 3 4% TDS and 1, 3, 7 and 15 d post-spraying with 5 g/m 2 4% TDS. In addition, the acute toxicity of 4% TDS to Japanese quail (Coturnix japonica), zebrafish (Brachydanio rerio) and freshwater shrimp (Macrobrachium nipponense) was assessed by estimations of LC 50 or median lethal dose (LD 50 )., Results: In the laboratory, the LC 50 values of 4% TDS for O. hupensis were 0.701, 0.371 and 0.33 mg/L at 24, 48 and 72 h, respectively, and 4% TDS showed a 1.975 mg/L [corrected] 24 h LC 50 against B. alexandrina, and a 1.396 mg/L 24 h LC 50 against B. truncatus. Across all study regions, the pooled mortalities of O. hupensis were 72, 86, 94 and 98% at 1, 2, 3 and 7 d, following field immersion of 4% TDS at a dose of 2.5 g/m 3 , and were 69, 77, 85 and 88% at 1, 3, 7 and 15 d, following field spraying at 5 g/m 2 , respectively. 4% TDS had moderate toxicity to Japanese quail (7 d LD 50  > 60 mg/kg) and to shrimp (96 h LC 50  = 6.28 mg/L; 95% CI: 3.53-11.2 mg/L), whereas its toxicity to zebrafish was high (96 h LC 50  = 0.15 mg/L; 95% CI: 0.14-0.17 mg/L)., Conclusions: 4% TDS is active against O. hupensis, B. alexandrina and B. truncatus under laboratory and field conditions, and it may be a candidate molluscicide of plant origin.

Human papillomavirus type 16 (HPV16) is considered to be the primary pathogen related to cervical cancer. The HPV16 E2 protein plays an important role in tumourigenicity of cervical carcinoma. In the current study, we enrolled 121 HPV16-positive cervical cancer patients in the case group and 130 HPV16-positive asymptomatic individuals in the control group, and we investigated the association between HPV16 E2 gene variations and cervical cancer. The HPV16 E2 DNA was amplified and sequenced. We identified two HPV variants (EUR and As) in the control group; the As variant was predominant (68.5%), followed by the EUR variant (31.5%). In the case group, three HPV variants (EUR, As and AA) were observed; the As variant was predominant (72.7%), followed by the EUR variant (22.3%) and the AA variant (5.0%). Our results showed a significant difference in the distribution of the HPV16 variants between the case and control groups (P < 0.05). Moreover, in the HPV16 E2 gene variation analysis, the distribution of sixteen variations was significantly different between the case and control groups (P < 0.05), and all of these variations were present in the AA variant. In the subgroup analysis, the frequency of the T3575G (S274A) variation in the EUR variant was significantly different between the case and control groups (P = 0.029); however, there was no significant difference in the frequency of the variations in the As variant between the case and control groups. Our findings in the current study could provide a better understanding of the relationship between HPV16 variants, E2 gene variations and cervical cancer., (Copyright © 2018. Published by Elsevier B.V.)

Background: Chemical peeling is an efficient method for the treatment of pigment disorders. For freckles, medium-depth to deep peeling using a phenol solution is one of the most effective chemical peels, and modifications of facial skin can be observed up to 20 years after peeling. However, applying phenol to the skin may cause serious side effects. Phenol peeling has been rarely used in Asia due to its tendency to cause permanent pigmentary changes and hypertrophic scars., Methods: In total, 896 Chinese inpatients with facial freckles were enrolled in this study. The phenol formula was modified with crystalline phenol, dyclonine, camphor, anhydrous alcohol and glycerin and adjusted to a concentration of 73.6-90.0%. The entire peeling treatment was divided into two procedures performed separately on 2 days., Results: All patients exhibited 26% or greater improvement, and 99.66% of patients exhibited 51% or greater improvement (good and excellent). Scarring and systemic complications were not observed in any patient., Conclusions: The modified phenol formula is very effective and safe for the treatment of facial freckles in Asian patients., Level of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A Gram-stain-negative, aerobic, non-motile, rod-shaped and non-spore-forming bacterium, designated EF23T, was isolated from rhizosphere soil of watermelon. Growth of strain EF23T was observed at 10-37 °C, at pH 5.0-9.0 and in the presence of 0-0.5 % (w/v) NaCl. Strain EF23T contained menaquinone 7 (MK-7) as the major isoprenoid quinone, and summed feature 3 (C16:1ω7c and/or iso-C15 : 0 2-OH), iso-C15 : 0, C16 : 0 and iso-C17 : 0 3-OH as the major fatty acids. Phosphatidylethanolamine was identified as the major polar lipid. The genomic DNA G+C content of strain EF23T was 43.7 mol%. Phylogenetic analyses based on 16S rRNA gene sequences showed that strain EF23T was most closely related to Mucilaginibacter gossypii Gh-67T (98.9 % similarity) and Mucilaginibacter gossypiicola Gh-48T (97.6 %). DNA-DNA relatedness values between strain EF23T and M. gossypii KCTC 22380T and M. gossypiicola KCTC 22379T were 31.6 and 53.7 %. On the basis of the evidence presented in this polyphasic taxonomic study, strain EF23T is considered to represent a novel species of the genus Mucilaginibacter, for which the name Mucilaginibacter rubeus sp. nov. is proposed. The type strain is EF23T (=CGMCC 1.15913T=KCTC 52516T).

Objective: To develop a machine simultaneously integrating mechanized environmental cleaning and automatic mollusciciding and to evaluate its effectiveness of field application, so as to provide a novel Oncomelania hupensis snail control technique in the large-scale marshlands., Methods: The machine simultaneously integrating mechanized environmental cleaning and automatic mollusciciding, which was suitable for use in complex marshland areas, was developed according to the mechanization and automation principles, and was used for O. hupensis snail control in the marshland. The effect of the machine on environmental cleaning and plough was evaluated, and the distribution of living snails was observed at various soil layers following plough. The snail control effects of plough alone and plough followed by mollusciciding were compared., Results: The machine could simultaneously complete the procedures of getting vegetation down and cut vegetation into pieces, plough and snail control by spraying niclosamide. After plough, the constituent ratios of living snails were 36.31%, 25.60%, 22.62% and 15.48% in the soil layers at depths of 0-5, 6-10, 11-15 cm and 16-20 cm respectively, and 61.91% living snails were found in the 0-10 cm soil layers. Seven and fifteen days after the experiment, the mortality rates of snails were 9.38% and 8.29% in the plough alone group, and 63.04% and 80.70% in the plough + mollusciciding group respectively (χ²₇ d = 42.74, χ²₁₅ d = 155.56, both P values < 0.01). Thirty days after the experiment, the densities of snails were 3.02 snails/0.1 m² and 0.53 snails/ 0.1 m² in the soil surface of the plough alone group and the plough + mollusciciding group, which decreased by 64.92% and 93.60%, respectively, and the decrease rate of snail density was approximately 30% higher in the plough + mollusciciding group than that in the plough alone group., Conclusions: The machine simultaneously integrating mechanized environmental cleaning and automatic mollusciciding achieves the integration of mechanical environmental cleaning and automatic niclosamide spraying in the complex marshland areas, which provides a novel technique of field snail control in the large-scale setting in China.

Objective: To evaluate the effectiveness of mid- and long-term schistosomiasis control plan and explore the consolidation strategy in marshland endemic regions, so as to provide an effective approach for interrupting and eliminating schistosomiasis in the regions., Methods: A prospective field study was designed. Dantu District of Zhenjiang City, a marshland schistosomiasis endemic region, was selected, and the "key village, key environment, and key water regions" comprehensive control strategy was implemented according to the endemic level of schistosomiasis. The morbidity due to schistosomiasis in humans and domestic animals, and Oncomelania hupensis snails were surveyed, and the data of the implementation of control measures were collected. The schistosomiasis morbidity and snail status were compared before and after the implementation of the mid- and long-term plan for schistosomiasis prevention and control, and the changing trends of human, domestic animal and snail infections were plotted., Results: During the implementation of the plan from 2005 to 2014, 16.84 km concrete and bank protection and 9 snail sinks were built, 10 culverts re-built, 3.85 hm2 fences were constructed, 29.5 thousand domestic animals were examined and treated, 170 cattle were eliminated, 4930 hm2 fishing farms were built for snail control, 1 560.00 hM2 land were improved, and 376.00 hm2 forests were built for snail control. In addition, 19,364.80 hm2 snail areas were surveyed, 4694.6 hm2 area received molluscicide, 207.9 thousand of people (person-times) received the examination and treatment, 69.1 thousand of harmless toilets were built, 282.2 thousand health education materials and protection materials were allocated, 958 warning signs were established, and 5435 slogans were pasted or hung. After the implementation of the mid- and long-term plan, the percentages of human, bovine and snail infections appeared decline tendencies year by year, and reduced from 0.08%, 1.28% and 0.13% in 2005 to 0 in 2014, respectively, while the areas with snails and infected snails reduced from 284.34 hm2 and 55.10 hm2 in 2005 to 73.60 hm2 and 0 hm2 in 2014, with reduction rates of 74.12% and 100%, respectively. The infection rate of sheep appeared a fluctuation between 2005 and 2014, with the rate of 1.13% in 2005, 0 in 2007 and 2008, rising in 2009 and then between 0.25% and 0.95% from 2009 to 2012, and reducing to 0 in 2013 and 2014. During the 10-year period, the number of cattle reduced year by year from 2005 to 2010, and slightly increased after 2011, showing an overall stable level, while the number of sheep increased year by year after 2006, peaked in 2010, and appeared a decline tendency since 2011, which was almost consistent with the fluctuation of schistosome infection rate in sheep., Conclusions: The sustainable comprehensive control strategy with the "key village, key environments, and key water regions" is an effective approach for schistosomiasis control in marshland endemic regions. However, the endemic situation of schistosomiasis is extremely easy to repeat. The prevention and control of the impact of sheep and wild animals on schistosomiasis transmission should be strengthened in order to consolidate the schistosomiasis control achievements gained.

Objective: To evaluate the field molluscicidal effect of 5% niclosamide ethanolamine granules, so as to provide a novel Oncomelania hupensis snail control approach for emergency treatment of high-risk settings., Methods: Snail control tests with spraying of 5% niclosamide ethanolamine granules were conducted in two settings of 2 counties, and the dose-, time- and setting-specific field molluscicidal effects were tested., Results: In the small-scale setting, spraying of 5% niclosamide ethanolamine granules at doses of 30, 40 and 50 g/m2 resulted in 54.55%, 68.41% and 73.45% 1-day snail mortality, 57.27%, 68.59% and 80.28% 3-day snail mortality, and 63.49%, 77.58% and 85.55% 7-day snail mortality, respectively, and no significant differences were detected in 1- and 3-day snail mortality caused by spraying of 5% niclosamide ethanolamine granules at doses of 30 and 40 g/m2 (all P > 0.05), while significant difference was found in the 7-day snail mortality (χ2 = 4.549, P < 0.05). In addition, spraying of 5% niclosamide ethanolamine granules at doses of 40 and 50 g/m2 resulted in comparable 1-, 3- and 7-day snail mortality (all P > 0.05). In the large-scale setting, spraying of 5% niclosamide ethanolamine granules at a dose of 40 g/m2 resulted in 85.29% and 87.70% 3-day snail mortality, 83.89% and 91.02% 7-day snail mortality, and 83.41% and 91.84% 15-day snail mortality in the environment-cleaning group and non-cleaning group, respectively. The overall snail mortality was 90.02% in the environment-cleaning group 3 to 15 days after spraying, which was significantly higher than that (84.28%) in the non-cleaning group (χ2 = 9.950, P < 0.05). After 15 days of spraying with 5% niclosamide ethanolamine granules at a dose of 40 g/m2, the densities of living snails reduced from 19.90 and 19.83 snails/0.1 m2 to 0.60 and 2.60 snails/0.1 m2 in the environment-cleaning group and non-cleaning group, with 96.98% and 86.89% reductions, respectively., Conclusion: The appropriate dose of 5% niclosamide ethanolamine granules is 40 g/m2 for snail control in the field, and environment cleaning of vegetation with a height of more than 50 cm may improve the molluscicidal efficacy.

Aim: To establish a clinical scoring model to predict risk of acute-on-chronic liver failure (ACLF) in chronic hepatitis B (CHB) patients., Methods: This was a retrospective study of 1457 patients hospitalized for CHB between October 2008 and October 2013 at the Beijing Ditan Hospital, Capital Medical University, China. The patients were divided into two groups: severe acute exacerbation (SAE) group (n = 382) and non-SAE group (n = 1075). The SAE group was classified as the high-risk group based on the higher incidence of ACLF in this group than in the non-SAE group (13.6% vs 0.4%). Two-thirds of SAE patients were randomly assigned to risk-model derivation and the other one-third to model validation. Univariate risk factors associated with the outcome were entered into a multivariate logistic regression model for screening independent risk factors. Each variable was assigned an integer value based on the regression coefficients, and the final score was the sum of these values in the derivation set. Model discrimination and calibration were assessed using area under the receiver operating characteristic curve and the Hosmer-Lemeshow test., Results: The risk prediction scoring model included the following four factors: age ≥ 40 years, total bilirubin ≥ 171 μmol/L, prothrombin activity 40%-60%, and hepatitis B virus DNA > 10(7) copies/mL. The sum risk score ranged from 0 to 7; 0-3 identified patients with lower risk of ACLF, whereas 4-7 identified patients with higher risk. The Kaplan-Meier analysis showed the cumulative risk for ACLF and ACLF-related death in the two risk groups (0-3 and 4-7 scores) of the primary cohort over 56 d, and log-rank test revealed a significant difference (2.0% vs 33.8% and 0.8% vs 9.4%, respectively; both P < 0.0001). In the derivation and validation data sets, the model had good discrimination (C index = 0.857, 95% confidence interval: 0.800-0.913 and C index = 0.889, 95% confidence interval: 0.820-0.957, respectively) and calibration demonstrated by the Hosmer-Lemeshow test (χ (2) = 4.516, P = 0.808 and χ (2) = 1.959, P = 0.923, respectively)., Conclusion: Using the scoring model, clinicians can easily identify patients (total score ≥ 4) at high risk of ACLF and ACLF-related death early during SAE.

Objective: To explore and integrate the key techniques used in the surveillance and forecast of schistosomiasis in the water regions along the Yangtze River, so as to provide technical support for identifying rapidly the risk of schistosomiasis transmission and implementing control measures targeting the risk., Methods: According to the distribution of water systems and water regions along the Yangtze River in Jiangsu Province, the demonstration sites for surveillance and forecast of schistosomiasis were set across the province, where the integration and demonstration of the techniques regarding monitoring of Schistosoma japonicum infection in sentinel mice, human and animal activities, release of forecast information, and emergency treatment of water regions at risk of infection were performed. The pattern of human and animal activities was compared with the S. japonicum infection in sentinel mice in the demonstration sites, and the operability of the release of information and emergency treatment of the risk of S. japonicum infection was evaluated., Results: A total of 50 demonstration sites for surveillance and forecast of schistosomiasis were set in fixed anchor points, opening of the navigation lock to the Yangtze River, freight terminal, agritainment places, ferry, large construction places, and places for guaranteeing the Youth Olympic Games in 23 counties (districts) of 5 cities, Jiangsu Province. During the period between May. and September, 2014, the infectivity of water body was monitored by using 5 batches of sentinel mice, with a 99.06% (4,954/5,001) gross recovery rate of mice. S. japonicum infection was detected in a demonstration site, and an infected mouse was found, with a 0.02% (1/4,933) gross positive rate of sentinel mice. The field survey showed 2 088 person-times contacting water, including 91.95% (1,920/2,088) contacting water due to the production such as capturing fish, harvesting and cultivating crops, and repairing and building boats, and 8.05% (168/2 088) contacting water due to the life activity, such as fishing, washing vegetables and playing with water. The people contacted water predominantly in August and September (49.57%). A total of 859 boats containing 1,877 boatmen were observed, 68.22% (586/859) of which were fishing boats containing 1,306 fishermen (69.58%). There were 32 sheep found in 4 demonstration sites, and 3 sheep were seen in the demonstration site with infected sentinel mouse. Four blue forecasts (emergence of water contact) and one orange forecast (S. japonicum-infected sentinel mouse detected) were released across the province, with one forecast map released which showed 5 sites with fishing and one site with sheep grazing, one emergency response system initiated, mollusciciding implemented in 10 hm2 high-risk regions, 120 sheep grazed in fence, and 35 fishermen given health-education materials, schistosomiasis examination and preventive therapy. In addition, no acute schistosomiasis occurred in the demonstration site with S. japonicum-infected sentinel mice., Conclusions: The integration and demonstration of the techniques regarding monitoring of S. japonicum infection in sentinel mice, human and animal activities, release of forecast information, and emergency treatment of water regions at risk of infection provides an effective approach for the large-scale surveillance and forecast of schistosomiasis.

Objective: To explore the method of Oncomelania hupensis snail surveillance in transmission-interrupted regions of schistosomiasis, so as to provide a new pattern for the surveillance of snail status in the transmission-interrupted areas., Methods: In Dongtai County, north of Jiangsu Province where the transmission of schistosomiasis was interrupted, the surveillance of snail status was performed by means of the village-level general survey, village-level sampling survey, snail survey in key settings of township and county, and snail reporting by residents. In addition, quality-control snail sites were set up for quality control. The effectiveness and cost of the four methods of snail surveillance was compared., Results: A total of 163 079 settings and 22 785.62 hm2 were surveyed in Dongtai County from 2008 to 2013, and 89 residual snail breeding sites were found, with a snail area of 1.48 hm2. The patterns of village-level general survey, village-level sampling survey, and snail survey in key settings of township and county were employed for investigation of 94 550, 45 033 and 23 496 settings, consisting of 57.98%, 27.61% and 14.41% of total settings, and 2, 0 and 6 settings were found with snails, with 0.021/thousand, 0, and 0.255/thousand detection rates of settings with snail breading sites, respectively. The pattern of snail survey in key settings of township and county was more effective than that of village-level survey to detect-snail breeding sites (χ2 = 19.158, P = 0). The recovery rate of quality-control snail breeding sites was 52.56%, 38.27% and 73.62% for the three patterns of snail survey, respectively, and the pattern of snail survey in key settings of township and county showed a higher quality for snail survey than that of village-level survey (χ2 = 111.597 and 85.991, both P = 0). During the period from 2008 to 2013, 289 person-times reported 279 suspected snail habitats and 1 501 living snails, and no Oncomelania snails were found. During the 6-year period, there were 1617.5, 964.7 and 527.7 thousand RMB invested for village-level general survey, village-level sampling survey, and snail survey in key settings of township and county, and the cost of snail survey per hm2 was 129.88, 133.6 and 162.57 RMB/hm2, respectively. The cost of village-level general survey and snail survey in key settings of township and county to detect a snail-breeding site was 808 800 and 88 000 RMB, respectively (t = 12.850, P = 0.000), and the cost of snail survey in key settings of township and county was 10.88% of that of village-level general survey., Conclusion: The snail survey in key settings of township and county is a highly effective and high-quality method for snail surveillance, which miay serve as a prior way for the surveillance of snail status in the transmission-interrupted areas of schistosomiasis.

Objective: To explore the enrichment technique of Schistosoma japonicum cercariae on the water surface, so as to establish a new method combined with the existing technology to detect the cercarial infested water body quickly and sensitively., Methods: Soybean oil, gasoline, kerosene and isophorone were screened as expanding agents. The cercariae were enriched by the thrust of the expanding agents when diffusing on the water surface, and PE adsorption film and C-6 film were applied to seize them so as to determine the infectivity of the water quickly. The relationship between the dose of expanding agents and diffusion radius were explored., Results: Gasoline, kerosene and isophorone were suitable expanding agents, and the diffusion effect of isophorone was the best. After the enrichment by the expanding agents, the detection rate of cercariae of the method seizing cercariae with the film significantly improved in the water., Conclusion: This new method could effectively improve the detection rate of the cercarial infested water and is suitable for the low-degree infested water.

Objective: To establish the surveillance and risk assessment system of schistosomiasis in Jiangsu Province, so as to provide technical support for timely understanding of the risk of schistosomiasis transmission and implementation of targeted control measures., Methods: The surveillance sites of schistosomiasis were assigned according to the epidemic status and endemic type of schistosomiasis as well as the characteristics of the water system, and the prevalence of Schistosoma japonicum in humans and domestic animals, and snail status were investigated. In addition, the quality control of serum detection of S. japonicum infections was performed. The prevalence of human and animal S. japonicum infections, snail status and missing diagnosis of serum detection were analyzed and compared among regions., Results: A total of 27 surveillance sites of schistosomiasis were set up in 26 counties of 10 cities, Jiangsu Province, including 14 sites in transmission-interrupted villages and 13 sites in transmission-controlled villages, and 15 sites in marshland and lake regions, 9 sites in plain regions with water network and 3 sites in mountainous region. In the 27 surveillance sites, a total of 16 617 residents were screened for S. japonicum infection by using dipstick dye immunoassay (DDIA), and 326 were sero-positive, with a sero-prevalence of 1.96% (2.17% for men and 1.8% for women). Of the 326 individuals undergoing parasitological examination, 2 positive cases were detected in the marshland and lake region, with a S. japonicum human prevalence of 0.01%. Of the 762 floating population detected, 10 were positive for blood test, with a sero-prevalence of 1.31%, and no egg-positive individuals were detected. No infection was found in the 476 domestic animals. Of the 746 settings surveyed, a total of 240.7 hm2 snail area was detected, with a mean snail density of 0.06 snails/0.1 m2, and no infected snails were found. There were 780 quality-control sera detected in 26 surveillance sites of schistosomiasis, and the gross coincidence rate was 95.13%, with misdiagnosis rate of 1.28% and missing diagnosis rate of 19.23%., Conclusion: The surveillance sites of schistosomiasis show reasonable distribution in Jiangsu Province, and the endemic situation of schistosomiasis appears a low level in the whole province.

Background: Enterovirus 71 (EV71) is a major cause of hand, foot, and mouth disease in children and may be fatal. A vaccine against EV71 is needed., Methods: We conducted a randomized, double-blind, placebo-controlled phase 3 trial involving healthy children 6 to 71 months of age in Guangxi Zhuang Autonomous Region, China. Two doses of an inactivated EV71 vaccine or placebo were administered intramuscularly, with a 4-week interval between doses, and children were monitored for up to 11 months. The primary end point was protection against hand, foot, and mouth disease caused by EV71., Results: A total of 12,000 children were randomly assigned to receive vaccine or placebo. Serum neutralizing antibodies were assessed in 549 children who received the vaccine. The seroconversion rate was 100% 4 weeks after the two vaccinations, with a geometric mean titer of 170.6. Over the course of two epidemic seasons, the vaccine efficacy was 97.4% (95% confidence interval [CI], 92.9 to 99.0) according to the intention-to-treat analysis and 97.3% (95% CI, 92.6 to 99.0) according to the per-protocol analysis. Adverse events, such as fever (which occurred in 41.6% of the participants who received vaccine vs. 35.2% of those who received placebo), were significantly more common in the week after vaccination among children who received the vaccine than among those who received placebo., Conclusions: The inactivated EV71 vaccine elicited EV71-specific immune responses and protection against EV71-associated hand, foot, and mouth disease. (Funded by the National Basic Research Program and others; ClinicalTrials.gov number, NCT01569581.).

Objective: To evaluate the field effect of the plant molluscicide "Luo-wei" (tea-seed distilled saponins, TDS) against the snail Oncomelania hupensis in the river beach in Anhui Province., Methods: The immersing and spraying experiments were carried out in the river beach in Dongzhi County, Anhui Province, to assess the molluscicidal effect of 4% TDS comparing with 50% wettable powder of niclosamide ethanolamine salt (WPN). The chi(2) test or Fish's exact test was used to examine the differences between or among the molluscicidal effects by different environments, molluscicides, application methods, or days after the intervention. Meanwhile, the cost-effectiveness of the two molluscicides was analyzed., Results: After 1, 2 , 3 d and 7 d of the immersion, the snail death rates in both TDS group and WPN group increased gradually, the snail death rates in the two groups after immersing for 7 d were 94.62% and 99.24%, respectively, and there was no significant difference between them ( chi(2) = 3.30, P > 0.05). After 1 , 3 , 7 d and 15 d of spraying, the snail death rates were 70.82%, 79.75%, 85.11% and 91.65% in the TDS group, and 77.71%, 84.27%, 91.90% and 95.58% in the WPN group, respectively, and the differences among the snail death rates of the two groups at each time point were statistically significant (all P values < 0.05). The costs of spraying were 316.71 yuan per 100 m2 for TDS and 309.71 for WPN., Conclusions: The molluscicidal effect of TDS has reached the requirements of national standard on nature source pesticides in the river beach of the middle and lower reaches of the Yangtze River. It is necessary to further evaluate its cost-effectiveness in large-scale field experiments in the future.

Objective: To monitor water body infestation in schistosomiasis high-risk areas with sentinel mouse technique., Methods: A total of 72 surveillance sites from 47 counties were selected in Hunan, Hubei, Jiangxi, Anhui, Jiangsu, Yunnan, and Sichuan. The water infectivity of Schistosoma japonicum was determined in the surveillance sites by using sentinel mice during June-July and September, 2012., Results: Among the 3,283 sentinel mice which were placed in 72 sites, 3,062 (93.3%) were recovered and dissected. Infected sentinel mice were found in six sites accounting for 8.3% (6/72) of the total surveillance sites, with an occurrence rate of sites with infected mice of 8.3% in June-July and 2.8% in September. 33 infected mice were discovered with a total infection rate of 1.08% (33/3,062). 1,085 adult worms were collected, with a mean worm burden of 32.9 worms per mouse in infected sentinel mice. 4 positive sites were in Hunan and 2 were in Jiangxi. Local acute schistosomiasis or suspected local acute cases which detected elsewhere were reported in 2 positive sites. Some follow-up activities were conducted in the 6 positive sites., Conclusion: Compared with those in 2010, the schistosomiasis risk areas are shrinking in 2012. However, some regions are still the schistosomiasis high-risk areas.

The risk for Schistosoma japonicum infection in Jiangsu province, People's Republic of China, was investigated by a mouse bioassay. Various investigations were conducted in the period 2009-2011 with the presentation here representing the summary of the results from 45-50 sites in the marshlands along the Yangtze River's course through the province. Indices representing three aspects of the infection were collected to assess risk: (i) the proportion of sentinel points where at least one mouse infection was recorded; (ii) the proportion of infected mice at each of these sites; and (iii) the average worm burdens. Directional distribution analysis and scan statistics were used to explore the spatio-temporal risk pattern. The spatial distribution was oriented along the Yangtze River and the directional distributions for the proportion of infected mice and mean worm burdens were similar for the positive sentinel sites. Four statistically significant clusters were detected in 2009, but only one in 2010 and 2011, respectively. Temporal windows for infection risk were seen in June and September. The study illustrates the utility of spatio-temporal analysis in assessing the risk for schistosomiasis. This approach should be useful with respect to surveillance and response that can be expected to be increasingly applied when moving from morbidity control to transmission control.

Objective: To evaluate the ability for serological screening of schistosomiasis among county-level personnel, so as to provide the evidence for establishing the quality control system of field detection of schistosomiasis., Methods: The standard serum panel was prepared for the quality assessment of schistosomiasis diagnostic capability, and detected by county-level personnel in the endemic field simultaneously using single-blind method. The rates of coincidence, misdiagnosis and missed diagnosis were calculated compared with the standard results., Results: Totally 780 samples of standard serum were detected in 26 counties, and showed 134 positive and 646 negative samples. The rates of coincidence, misdiagnosis and missed diagnosis were 95.13%, 1.28% and 19.23%, respectively, and there was a significant difference between the detection results and the standard results (chi2 = 11.6053, P = 0.0007). Among the 26 counties investigated, the misdiagnosis occurred in 5 counties (19.23%) and missed diagnosis occurred in 21 counties (80.77%). The misdiagnosis rate and missed diagnosis rate of serological screening of schistosomiasis were 0-2.08% and 16.67%-33.33% in beach, hilly, water net and marshland endemic areas, respectively, and no significant differences were found in the misdiagnosis rate and the missed diagnosis rate among various types of endemic areas (chi2 = 1.590 and 1.757, P = 0.6671 and 0.6244). The rates of misdiagnosis and the missed diagnosis were 1.14% and 1.39%, and 18.18% and 20.00% in the schistosomiasis transmission-controlled and the schistosomiasis transmission-interrupted areas, respectively, and no significant differences were found in the misdiagnosis rate and missed diagnosis rate between the schistosomiasis transmission-controlled and transmission-interrupted areas (chi2 = 0.008 and 0.001, P = 0.931 and 0.974)., Conclusions: The missed diagnosis is a major cause for the reduction of quality of schistosomiasis detection at the county level in Jiangsu Province, and the coincidental detection of schistosomiasis with standard serum in the field is one of effective approaches for the control of the quality of schistosomiasis detection.

Background: With the successful implementation of integrated measures for schistosomiasis japonica control, Jiangsu province has reached low-endemicity status. However, infected Oncomelania hupensis snails could still be found in certain locations along the Yangtze river until 2009, and there is concern that they might spread again, resulting in the possible re-emergence of infections among people and domestic animals alike. In order to establish a robust surveillance system that is able to detect the spread of infected snails at an early stage, sensitive and reliable methods to identify risk factors for the establishment of infected snails need to be developed., Methods: A total of 107 villages reporting the persistent presence of infected snails were selected. Relevant data on the distribution of infected snails, and human and livestock infection status information for the years 2003 to 2008 were collected. Spatio-temporal pattern analysis including spatial autocorrelation, directional distribution and spatial error models were carried out to explore spatial correlations between infected snails and selected explanatory factors., Results: The area where infected snails were found, as well as their density, decreased significantly between 2003 and 2008. Changes in human and livestock prevalences were less pronounced. Three statistically significant spatial autocorrelations for infected snails were identified. (i) The Moran's I of infected snails increased from 2004 to 2007, with the snail density increasing and the area with infected snails decreasing. (ii) The standard deviations of ellipses around infected snails were decreasing and the central points of the ellipses moved from West to East. (iii) The spatial error models indicated no significant correlation between the density of infected snails and selected risk factors., Conclusions: We conclude that the contribution of local infection sources including humans and livestock to the distribution of infected snails might be relatively small and that snail control may limit infected snails to increasingly small areas ecologically most suitable for transmission. We provide a method to identify these areas and risk factors for persistent infected snail presence through spatio-temporal analysis, and a suggested framework, which could assist in designing evidence based control strategies for schistosomiasis japonica elimination.

Background: The application of chemical molluscicides is still one of the most effective measures for schistosomiasis control in P. R. China. By applying diverse molluscicide treatment scenarios on different snail densities in the field, we attempted to understand the cost-effectiveness of molluscicide application so as to prescribe an optimal management approach to control intermediate host snail Oncomelania hupensis under acceptable thresholds based on the goal of the National Schistosomiasis Control Programme., Methods: The molluscicidal field trial was carried out in the marshland of an island along the Yangtze River, Jiangsu province, P.R. China in October 2010. Three plots in the island representing low-density, medium-density and high-density groups were identified after the baseline survey on snail density. Each snail density plot was divided into four experimental units in which molluscicide (50% niclosamide ethanolamine salt wettable powder) was applied once, twice, trice and four times, respectively. The logistic regression model to correlate snail mortality rate with the covariates of number of molluscicidal treatment and snail density, and a linear regression model to investigate the relationship between cost-effectiveness and number of molluscicidal treatment as well as snail density were established., Results: The study revealed that increase in the number of molluscicide treatments led to increased snail mortality across all three population density groups. The most cost-effective regimen was seen in the high snail density group with a single molluscicide treatment. For both high and low density groups, the more times molluscicide were applied, the less cost-effectiveness was. However, for the median density group, the level of cost-effectiveness for two applications was slightly higher than that in one time., Conclusions: We concluded that different stages of the national schistosomiasis control/elimination programme, namely morbidity control, transmission control and transmission interruption, should utilize different molluscicide treatment strategies to maximize cost-effectiveness.

Objective: To understand the endemic situation of national surveillance sites in Jiangsu Province from 2005 to 2010, so as to provide the evidence for the prevention and control of schistosomiasis., Methods: According to the national surveillance protocol, a longitudinal surveillance on endemic situation of schistosomiasis was carried out in 8 national surveillance sites from 2005 to 2010., Results: In general, the positive rates of blood tests and infection rates of Schistosoma japonicum decreased from 9.04% and 0.22% in 2005 to 4.34% and 0.02% in 2010, and the rates of decline were 51.99% and 90.91%, respectively. The endemic situation of farmers, fishermen and business men were relatively serious, and the infection degree of the low-aged group of students was relatively serious. No local acute schistosomiasis case was detected. A total of 7 466.46 hm2 of environmental sites were investigated, and the areas with living Oncomelania hupensis snails and infected snails were 2 213.98 and 247.91 hm2, respectively, the densities of living snails and infected snails decreased gradually, and no infected snail was found in 2010. However, the total areas with living snails and infected snails still keep a relative high level, and the density of infected snails rebounded in special sites., Conclusion: The endemic situation of the national surveillance sites is under control, and the infection rate of human keeps at a low level in Jiangsu Province. The surveillance and control of snails and infection source should still be strengthened.

A basic framework for the rapid assessment of the risk for schistosomiasis was developed by combining spatial data from Google Earth® with a geographical information system (GIS) package, bundling the modules together with an Internet connection into a WebGIS platform. It operates through functions such as "search", "evaluation", "risk analysis" and "prediction" and is primarily aimed to be a dynamic, early-warning system (EWS) providing user-friendly, evidence-based, near real-time awareness of the status of an important endemic disease. It contributes to rapid information-sharing at all levels of decision-making, facilitating "point-of-care" response, i.e. treatment provided at newly discovered transmission sites. The experience using the platform is encouraging and it has the potential to improve support systems and strengthen schistosomiasis control activities, in particular with regard to surveillance and EWS. It can quickly and intuitively locate early, high-risk areas, retrieve all important data needed as well as provide detailed, up-to-date information on the performance of the control programme. This WebGIS, the first of its kind in the People's Republic of China, is not only applicable for schistosomiasis but can easily be adapted for improving control of any endemic disease in any geographical area.

According to the requirements of the Mid- and Long-term Plan for Prevention and Control of Schistosomiasis in China and based on the actual situation of schistosomiasis control in Jiangsu Province, this paper demonstrates the new technologies achieved by the scientific innovation and the novel control strategies including integrated control in key regions and control of key populations and surveillance and forecast of key water regions since 2004, with the emphasis on the control and elimination of infected Oncomelania snails. Such strategies and technologies implemented the result in continuous decrease in the endemic situation of schistosomiasis in the province, and the whole province achieved the goal of schistosomiasis transmission control in late 2010.

Co-infection with hepatitis delta virus (HDV) and hepatitis B virus (HBV) has been shown to be associated with a more severe form of acute and chronic hepatitis. Cloning and expression of recombinant HDV antigen (rHDAg) in Escherichiacoli are described. Using purified rHDAg, a cost-effective indirect anti-HDV enzyme-linked immunosorbent assay (ELISA) kit was developed. Direct comparison of 15 known HDV-positive sera and 15 HDV-negative sera showed concordance agreement between the new assay kit and the Abbott Murex Anti-Delta (total) kit. In addition, 1,486 hepatitis B surface antigen (HBsAg) positive blood samples collected from various areas of China were tested using this indirect anti-HDV ELISA. It was found that 1.2% (95% CI: 0.7-1.9%) of the samples were anti-HDAg positive. It is suggested that the prevalence of HDV and HBV co-infection in China is relatively low., (Copyright © 2012 Wiley Periodicals, Inc.)

Objective: To assess the control effect of transmission control of schistosomiasis in 14 counties (cities, districts) of Jiangsu Province., Methods: According to the requirement of the national assessment scheme of schistosomiasis, the effect of schistosomiasis control was evaluated. The schistosomiasis morbidity and changes in Oncomelania snail status in recent 2 years were assessed. The field survey was done by using the stratified sampling method. A heavy-endemicity administrative village was randomly sampled from the townships with low, moderate and heavy endemicities in each county, respectively as the assessment villages. The morbidity in resident populations and free-grazing domestic animals and the snail infections in the settings where snails were detected and frequent human and domestic animal activities were observed in recent 3 years., Results: During the period from 2007 through 2010, the transmission control effect of schistosomiasis was assessed in 14 counties (cities, districts) of Jiangsu Province, and field surveys were performed in 42 villages of 39 townships. A total of 264 settings, 1 679.73 hm2 and 39 894 frames were surveyed, and 2 179 snails were collected. Of the 405 living snails dissected, no infected snails were detected, and the snail infection rate was 0. Totally 22 147 residents were investigated. The serum examination of schistosome infection was performed in 22 147 residents, and 300 were sero-positive, with a sero-positive rate of 1.35% (0.30%-4.26%). The stool examination was done in 297 sero-positive cases, and no cases were stool-positive, with a stool-positive rate of 0. A total of 2 931 domestic animals were investigated, including 230 head of cattle, 2 333 pigs and 368 sheep, and no infections were detected. The files regarding the schistosomiasis morbidity and snail status have been established in 14 counties (cities, districts). All infected snails were killed in the 14 counties (districts, cities) 2 years prior to the assessment, and the mean time that no infected snails were detected was 2.71 years (2-4 years). No acute schistosomiasis patients were found in all 14 counties (districts, cities) more than 3 years prior to the assessment., Conclusion: According to the Criteria for Control and Elimination of Schistosomiasis in China (GB 15976-2006), the transmission of schistosomiasis in 14 countries (cities, districts) of Jiangsu Province has been controlled.