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Multiple evanescent white dot syndrome (MEWDS) is a rare fundus disease, characterized by acute vision loss and visual field defects. Many previous studies have explained the possible pathogenesis and clinical features of primary MEWDS. However, as the number of reported cases increases, secondary MEWDS occurs in other related retinal diseases and injuries, exhibiting some special characteristics. The associated retinal diseases include multifocal choroiditis/punctate inner choroidopathy (MFC/PIC), acute zonal occult outer retinopathy, best vitelliform macular dystrophy, pseudoxanthoma elasticum, and ocular toxoplasmosis. The related retinal injury is laser photocoagulation, surgery, and trauma. Although primary MEWDS often have a self-limiting course, secondary MEWDS may require treatment in some cases, according to the severity of concomitant diseases and complications. Notably, MEWDS secondary to MFC/PIC that is prone to forming choroidal neovascularization and focal choroidal excavation, needs positive treatment with corticosteroids. The possible underlying pathogenesis of secondary MEWDS is the exposure of choroidal antigen after the disruption of Bruch's membrane. The MEWDS-related features in secondary MEWDS are still evanescent under most circumstances. Its prognosis and treatment depend on the severity of complications. Current studies propose that the etiology is associated with immune factors, including viral infection, inflammation in choroid and Bruch's membrane, and antigen exposure caused by retinal and/or choroidal insults. More pathogenic studies should be conducted in the future. Accurate diagnosis for secondary MEWDS could benefit patients in aspects of management and prognosis.

An innovative complex lidar system deployed on an airborne rotorcraft platform for remote sensing of atmospheric pollution is proposed and demonstrated. The system incorporates integrated-path differential absorption lidar (DIAL) and coherent-doppler lidar (CDL) techniques using a dual tunable TEA CO2 laser in the 9–11 μm band and a 1.55 μm fiber laser. By combining the principles of differential absorption detection and pulsed coherent detection, the system enables agile and remote sensing of atmospheric pollution. Extensive static tests validate the system’s real-time detection capabilities, including the measurement of concentration-path-length product (CL), front distance, and path wind speed of air pollution plumes over long distances exceeding 4 km. Flight experiments is conducted with the helicopter. Scanning of the pollutant concentration and the wind field is carried out in an approximately 1 km slant range over scanning angle ranges from 45° to 65°, with a radial resolution of 30 m and 10 s. The test results demonstrate the system’s ability to spatially map atmospheric pollution plumes and predict their motion and dispersion patterns, thereby ensuring the protection of public safety.

Abstract Background Data-driven research is a very important component of One Health. As the core part of the global One Health index (GOHI), the global One Health Intrinsic Drivers index (IDI) is a framework for evaluating the baseline conditions of human-animal-environment health. This study aims to assess the global performance in terms of GOH-IDI, compare it across different World Bank regions, and analyze the relationships between GOH-IDI and national economic levels. Methods The raw data among 146 countries were collected from authoritative databases and official reports in November 2021. Descriptive statistical analysis, data visualization and manipulation, Shapiro normality test and ridge maps were used to evaluate and identify the spatial and classificatory distribution of GOH-IDI. This paper uses the World Bank regional classification and the World Bank income groups to analyse the relationship between GOH-IDI and regional economic levels, and completes the case studies of representative countries. Results The performance of One Health Intrinsic Driver in 146 countries was evaluated. The mean (standard deviation, SD) score of GOH-IDI is 54.05 (4.95). The values (mean SD) of different regions are North America (60.44, 2.36), Europe and Central Asia (57.73, 3.29), Middle East and North Africa (57.02, 2.56), East Asia and Pacific (53.87, 5.22), Latin America and the Caribbean (53.75, 2.20), South Asia (52.45, 2.61) and sub-Saharan Africa (48.27, 2.48). Gross national income per capita was moderately correlated with GOH-IDI (R 2 = 0.651, Deviance explained = 66.6%, P

Artificial intelligence (AI), particularly deep learning (DL) algorithms, has demonstrated remarkable progress in image-recognition tasks, enabling the automatic quantitative assessment of complex medical images with increased accuracy and efficiency. AI is widely used and is becoming increasingly popular in the field of ultrasound. The rising incidence of thyroid cancer and the workload of physicians have driven the need to utilize AI to efficiently process thyroid ultrasound images. Therefore, leveraging AI in thyroid cancer ultrasound screening and diagnosis cannot only help radiologists achieve more accurate and efficient imaging diagnosis but also reduce their workload. In this paper, we aim to present a comprehensive overview of the technical knowledge of AI with a focus on traditional machine learning (ML) algorithms and DL algorithms. We will also discuss their clinical applications in the ultrasound imaging of thyroid diseases, particularly in differentiating between benign and malignant nodules and predicting cervical lymph node metastasis in thyroid cancer. Finally, we will conclude that AI technology holds great promise for improving the accuracy of thyroid disease ultrasound diagnosis and discuss the potential prospects of AI in this field.

ObjectiveThis study compared the diagnostic value of various diagnostic methods for lymph node metastasis (LNM) of papillary thyroid carcinoma (PTC) through network meta-analysis.MethodsIn this experiment, databases such as CNKI, Wanfang, PubMed, and Web of Science were retrieved according to the Cochrane database, Prisma, and NMAP command manual. A meta-analysis was performed using STATA 15.0, and the value of the surface under the cumulative ranking curve (SUCRA) was used to determine the most effective diagnostic method. Quality assessments were performed using the Cochrane Collaboration’s risk of bias tool, and publication bias was assessed using Deeks’ funnel plot.ResultsA total of 38 articles with a total of 6285 patients were included. A total of 12 diagnostic methods were used to study patients with LNM of PTC. The results showed that 12 studies were direct comparisons and 8 studies were indirect comparisons. According to the comprehensive analysis of the area of SUCRA, US+CT(86.8) had the highest sensitivity, FNAC had the highest specificity (92.4) and true positive predictive value (89.4), and FNAC+FNA-Tg had higher negative predictive value (99.4) and accuracy (86.8). In the non-invasive method, US+CT had the highest sensitivity, and the sensitivity (SEN) was [OR=0.59, 95% confidence interval (CI): (0.30, 0.89]. Among the invasive methods, the combined application of FNAC+FNA-Tg had higher diagnostic performance. The sensitivity was [OR=0.62, 95% CI: (0.26, 0.98)], the specificity (SPE) was [OR=1.12, 95% CI: (0.59, 1.64)], the positive predictive value was [OR=0.98, 95% CI: (0.59, 1.37)], the negative predictive value was [OR=0.64, 95% CI (0.38, 0.90)], and the accuracy was [OR=0.71, 95% CI: (0.31, 1.12)].ConclusionIn the non-invasive method, the combined application of US+CT had good diagnostic performance, and in the invasive method, the combined application of FNAC+FNA-Tg had high diagnostic performance, and the above two methods were recommended.

AIM: To determine the etiologies, treatment modalities and visual outcomes of vitreous hemorrhage (VH; range from birth to 18y). METHODS: A total of 262 eyes from 210 patients between January 2010 and September 2016 were included. All children underwent an appropriate ocular and systemic examination. Data collected included demographics, clinical manifestations, details of the ocular and systemic examination, management details, final fundus anatomy and visual acuity (VA). RESULTS: The most common etiologies were non-traumatic VH (64.89%), most of which were due to retinopathy of prematurity (ROP; 37.10%); while traffic accidents, including 16 (21.00%) eyes, was the most common ocular traumas. Surgery, performed in 143 (54.58%) eyes, was the most common management modality. The initial mean baseline visual acuity was 2.77±0.21 logarithm of the minimal angle of resolution (logMAR) in children and adolescent with traumatic VH, which was significantly improved to 2.15±1.31 logMAR (P

AIM: To describe and compare pathologic findings in eyes enucleated after superselective ophthalmic arterial chemotherapy (SOAC) or SOAC with intravenous chemotherapy (IVC) for retinoblastoma. METHODS: Medical records between January 1st, 2014 and June 30th, 2017 were retrospectively analyzed, and pathologic findings were recorded. This study included 36 eyes from 22 (61.1%) male and 14 (38.9%) female patients. Nineteen of 36 (52.8%) eyes received SOAC (mean=3, range=1-7) as primary treatment, and 17 of 36 (47.2%) eyes received SOAC (mean=3.7, range=1-10) after IVC (mean=6.1, range=2-11). Tumor extension including choroidal invasion (n=9, 25%), optic nerve invasion (n=5, 13.9%) and anterior segment invasion (n=5, 13.9%) were recorded. RESULTS: Histopathologic evidence of ischemic damage in the retina and choroid was found in 28 (77.8%) eyes. Thrombosed blood vessels were identified in 9 (25%) eyes, including orbital artery in the retrobulbar orbit (n=1), intrascleral vessels (n=4), and chorioretinal vessels (n=6). Fibrotic changes were found in extraocular muscles (n=5, 13.9%) and optic nerve (n=5, 13.9%). Varying degrees of scleral degeneration were found in all eyes. In statistical analysis, there was no significant difference in clinical and pathologic changes between SOAC group and SOAC with IVC group except for optic nerve invasion (P=0.047). CONCLUSION: SOAC for retinoblastoma can result in ocular toxicity, and SOAC with IVC do not increase the toxicity but reduced the incidence of optic nerve invasion.

Abstract Background The People’s Republic of China (P. R. China) has made significant progress on schistosomiasis control. Among the 12 provincial-level administrative divisions (PLADs) with schistosomiasis endemic in P. R. China, Guangdong, Shanghai, Fujian, Guangxi and Zhejiang PLADs (following as five PLADs) had successively eliminated schistosomiasis during 1985–1995. However, consolidation of the schistosomiasis elimination in these five PLADs remains challenging. In the current study, we sought to understand the epidemic situation in these post-elimination areas and their surveillance capabilities on schistosomiasis. Methods Annual data reflecting the interventions and surveillance on human beings, cattle and snails based on county level from 2005 to 2016 were collected through the national schistosomiasis reporting system and the data were analyzed to understand the epidemic status of schistosomiasis in the five PLADs. A standardized score sheet was designed to assess the surveillance capacity for schistosomiasis of selected disease control agencies in five PLADs and ten counties. Assessment on surveillance capacity including schistosomiasis diagnostic skills, identification of snails’ living and infection status and knowledge about schistosomiasis and its control were made. Descriptive analysis was used to analyze the epidemic status and evaluation results on surveillance capacities. Results The assessments showed that no local cases in humans and cattle or infected snail were found in these five PLADs since 2005. However, from 2005 to 2016, a total of 221 imported cases were detected in Zhejiang, Shanghai and Fujian, and 11.98 hm2 of new snail habitats were found in Zhejiang, Shanghai and Guangxi. In addition, snail infestation reoccurred in 247.55 hm2 of former snail habitats since 2011. For the surveillance capacity assessment, the accuracy rate of IHA and MHT were 100 and 89.3%, respectively. All participants could judge the living status of snails accurately and 98.1% on the infection status of snails. The accuracy rate of the questionnaire survey was 98.0%. Conclusions Elimination of schistosomiasis was consolidated successfully in five PLADs of P. R. China due to effective and strong post-elimination surveillance. Comprehensive consolidation strategies should be focused on the elimination of residual snails and the prevention of imported infection sources to consolidate the achievements of schistosomiasis control.

Abstract Models using 3D cell culture techniques are increasingly accepted as the most biofidelic in vitro representations of tissues for research. These models are generated using biomatrices and bulk populations of cells derived from tissues or cell lines. We present an alternate method to culture individually selected cells in relative isolation from the rest of the population under physiologically relevant matrix conditions. Matrix gel islands are spotted on a cell culture dish to act as support for receiving and culturing individual single cells; a glass capillary-based microfluidic setup is used to extract each desired single cell from a population and seed it on top of an island. Using examples of breast and colorectal cancers, we show that individual cells evolve into tumors or aspects of tumors displaying different characteristics of the initial cancer type and aggressiveness. By implementing a morphometry assay with luminal A breast cancer, we demonstrate the potential of the proposed approach to study phenotypic heterogeneity. Results reveal that intertumor heterogeneity increases with time in culture and that varying degrees of intratumor heterogeneity may originate from individually seeded cells. Moreover, we observe that a positive relationship exists between fast growing tumors and the size and heterogeneity of their nuclei.

AIM: To introduce a modified technique of internal limiting membrane (ILM) centripetal dragging and peeling to treat idiopathic macular hole (IMH) and to observe the ILM-retina adhesive forces. METHODS: Twenty-six consecutive patients with stage 3 to 4 IMH and followed up at least six months were enrolled. All patients underwent complete par plana vitrectomy, ILM dragging and peeling, fluid and gas exchange, 15% C3F8 tamponade and 2-week prone position. The best corrected visual acuity, macular hole evaluation by optical coherence tomography, and complications were evaluated. RESULTS: The mean diameter of IMH was 524±148 μm (range: 201-683 μm), with 21 cases (80.8%) greater than 400 μm. ILM dragging and peeling were successfully performed in all cases. Most of the ILM-retina adhesive forces are severe (42.3%, 11/26), followed by mild (38.5%, 10/26), and moderate (19.2%, 5/26). The mean follow-up duration was 21.2±6.1mo. The IMH was closed in 25 (96.3%) eyes. Visual acuity (logMAR) improved significantly from 1.2±0.6 preoperatively to 0.7±0.5 postoperatively (P

Abstract Background To report a case of non-prescription cold and flu medication-induced transient myopia with uveal effusion. Case presentation Bilateral high intraocular pressure, shallow anterior chambers, uveal effusion, and a myopic shift were encountered in a 39-year-old Chinese male 1 night after taking a non-prescription flu medicine three times than the recommended dose. Ultrasound biomicroscopy (UBM) showed bilateral ciliochoroidal effusions, disappearance of the ciliary sulcus, closure of the angle of the anterior chamber, and anterior displacement of the lens-iris diaphragm. Treatment with aqueous suppressants was given. Within a week, the uncorrected vision restored, and the myopia had disappeared. UBM revealed major resolution of the ciliochoroidal effusions in both eyes, deepening of the anterior chamber, return of the lens-iris diaphragm to a more posterior position. Conclusions Overdose of non-prescription cold and flu medication may cause bilateral uveal effusions inducing acute angle-closure glaucoma and acute myopia.

Abstract Background To report a case of multiple evanescent white dot syndrome (MEWDS) following simultaneous rabies vaccination. Case presentation Review of the clinical, laboratory, photographic, optical coherence tomographic (OCT), fundus autofluorescent, angiographic, electrophysiologic, and perimetric records of a patient suffering from MEWDS. Results: A healthy 33-year-old Chinese female suffering from rapidly progressive visual loss of her left eye associated with photopsia and a para-central scotoma, seven days after receiving simultaneous rabies vaccination. Both anterior segments and fundus examination were unremarkable. The findings on OCT, electrophysiology, and perimetry were pathognomonic for MEWDS. Conclusions The clinical presentation and the benign course were consistent with the diagnosis of MEWDS. No other events could be identified as a cause, other than the rabies vaccination. This case may suggest an autoimmune basis for MEWDS in predisposed patients.

We present a two-tiered microchip system to capture and retrieve rare cells from blood samples with high purity. The first module of the system is a high throughput microfluidic interface that is used to immunomagnetically isolate targeted rare cells from whole blood, and discard > 99.999% of the unwanted leukocytes. The second module is a microwell array that furthers the purification by magnetically guiding each cell into a separate well concurrently, and allows individual retrieval of each cell. We demonstrate the design of the system as well as its characterization by experiments using model cell lines that represent circulating fetal trophoblasts. Our results show that single cells can be retrieved with efficiencies and purities as high as 100% within 145 mins.

Abstract Background To report a case of Werner’s syndrome with bilateral juvenile cataracts. Case presentation Review of the clinical, laboratory, photographic, genetic testing of the patient. A 26-year-old Chinese man presented with impaired vision in both eyes for more than a year. Anterior segment examination of both eyes revealed cataract. According to the ocular symptoms and systemic signs, including low body weight, a short stature, a bird-like face, atrophic and scleroderma-like skin, in addition to the juvenile cataracts, the clinical diagnosis of Werner’s syndrome was made. Next-generation sequencing identified a homozygous WRN mutation in this patient. Conclusions The ocular and systemic findings in this patient in combination with the homozygous WRN mutation indicated the definitive Werner’s syndrome diagnosis.

Abstract Background Pulmonary tuberculosis (PTB,both smear positive and smear negative) is an airborne infectious disease of major public health concern in China and other parts of the world where PTB endemicity is reported. This study aims at identifying PTB spatio-temporal clusters and associated risk factors in Zhaotong prefecture-level city, located in southwest China, where the PTB notification rate was higher than the average rate in the entire country. Methods Space-time scan statistics were carried out using PTB registered data in the nationwide TB online registration system from 2011 to 2015, to identify spatial clusters. PTB patients diagnosed between October 2015 and February 2016 were selected and a structured questionnaire was administered to collect a set of variables that includes socio-economic status, behavioural characteristics, local environmental and biological characteristics. Based on the discovery of detailed town-level spatio-temporal PTB clusters, we divided selected subjects into two groups including the cases that resides within and outside identified clusters. Then, logistic regression analysis was applied comparing the results of variables between the two groups. Results A total of 1508 subjects consented and participated in the survey. Clusters for PTB cases were identified in 38 towns distributed over south-western Zhaotong. Logistic regression analysis showed that history of chronic bronchitis (OR = 3.683, 95% CI: 2.180–6.223), living in an urban area (OR = 5.876, 95% CI: 2.381–14.502) and using coal as the main fuel (OR = 9.356, 95% CI: 5.620–15.576) were independently associated with clustering. While, not smoking (OR = 0.340, 95% CI: 0.137–0.843) is the protection factor of spatial clustering. Conclusions We found PTB specially clustered in south-western Zhaotong. The strong associated factors influencing the PTB spatial cluster including: the history of chronic bronchitis, living in the urban area, smoking and the use of coal as the main fuel for cooking and heating. Therefore, efforts should be made to curtail these associated factors.

Abstract Background Anti-angiogenesis treatments are the most commonly used treatments for the vision loss caused by exudative age-related macular degeneration (AMD), in which the anti-vascular endothelial growth factor (VEGF) drugs with ranibizumab and bevacizumab are current standard treatments. However, the outcome of anti-VEGF therapeutics is not uniform in all patients. Methods We performed a literature-based meta-analysis including, five published studies relevant to HTRA1 and response to anti-VEGF treatment (bevacizumab or ranibizumab). Summary odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using fixed- and random-effects models. Sensitivity analysis and meta-regression were also performed. Q-statistic test and Egger’s test was used to evaluate heterogeneity and publication bias respectively. Results Overall, no association between the rs11200638 polymorphism in HTRA1 gene and the anti-VEGF treatment response was found in the genotype GG versus AA (OR = 1.06; 95% CI: 0.77 to 1.48; P = 0.98), genotype GA versus AA (OR = 1.11; 95% CI: 0.83 to 1.47; P = 0.93), genotype GG + GA versus AA (OR = 1.22; 95% CI: 0.94 to 1.57; P = 0.09), and allele G versus A (OR = 0.92; 95% CI: 0.78 to 1.08; P = 0.14). In the subgroup analysis by ethnicity Caucasian population, and a significant association was still not observed in all genetic models. Sensitivity analysis indicated the robustness of our findings, and no publication bias was observed in our meta-analysis. Conclusions This study shows that there was no association between the polymorphism rs11200638 in HTRA1 gene and response to anti-VEGF treatment of exudative AMD. However, more studies are needed to further prove the conclusion of present study, especially well-designed and high quality randomised controlled trials or intervention studies.

China has made remarkable progress in reducing schistosomiasis caused by Schistosoma japonicum over the past 7 decades but now faces a severe threat from imported schistosomiasis. Results from national surveillance during 2010–2018 indicate integrating active surveillance into current surveillance models for imported cases is urgently needed to achieve schistosomiasis elimination in China.

Letter to the editor

AIM:To determine the effects of epidermal growth factor (EGF) on the proliferation and migration of Müller cell line Moorfields/Institute of Ophthalmology-Müller 1 (MIO-M1), and its related molecular mechanisms under normal and oxidative stress conditions.METHODS: Müller cells were cultured with different concentrations of EGF in the presence or absence of varied amounts of H2O2 and glucose oxidase (GO) which induced oxidative stress. The proliferation and migration of Müller cells were examined by 5-Bromo-2-deoxyUridine (BrdU), MTT assay, Transwell assay and scratch wound healing assays. The cell viability was determined with the MTT assay. The secretion of EGF by Müller cells was evaluated by ELISA. Western blot was performed to detect the activation of extracellular regulated protein kinases (ERK)1/2 and Akt signal pathways.RESULTS:EGF stimulated the proliferation and migration of Müller cells in a concentration-dependent manner in vitro. Underoxidative damage condition,2h of pretreatment with 10-100 ng/mL EGF can mostly inhibit 50% lethal dose of 0.08 mmol/L H2O2-induced cell damage. The Western blot results showed that after Müller cells were exposed to varying EGF for 24h, Akt and ERK1/2 were phosphorylated in a dose-dependent manner. In the presence of the LY294002, the potent PI3K inhibitor, the p-Akt was significantly attenuated.CONCLUSION:EGF may induce the proliferation and migration of human Müller cells through the Akt and the ERK1/2 signal pathways, and induce PI3K-mediated glioprotective effect under oxidative stress.

Citrus sinensis chromosomes present a morphological differentiation of bands after staining by the fluorochromes CMA and DAPI, but there is still little information on its chromosomal characteristics. In this study, the chromosomes in 'Valencia' C. sinensis were analyzed by fluorescence in situ hybridization (FISH) using telomere DNA and the 45S rDNA gene as probes combining CMA/DAPI staining, which showed that there were two fragile sites in sweet orange chromosomes co-localizing at distended 45S rDNA regions, one proximally locating on B-type chromosome and the other subterminally locating on D-type chromosome. While the chromosomal CMA banding and 45S rDNA FISH mapping in the doubled haploid line of 'Valencia' C. sinensis indicated six 45S rDNA regions, four were identified as fragile sites as doubled comparing its parental line, which confirmed the cytological heterozygosity and chromosomal heteromorphisms in sweet orange. Furthermore, Ag-NOR identified two distended 45S rDNA regions to be active nucleolar organizing regions (NORs) in diploid 'Valencia' C. sinensis. The occurrence of quadrivalent in meiosis of pollen mother cells (PMCs) in 'Valencia' sweet orange further confirmed it was a chromosomal reciprocal translocation line. We speculated this chromosome translocation was probably related to fragile sites. Our data provide insights into the chromosomal characteristics of the fragile sites in 'Valencia' sweet orange and are expected to facilitate the further investigation of the possible functions of fragile sites.

Formation of yellow-red color cocoons in the silkworm, Bombyx mori, occurs as the result of the selective delivery of carotenoids from the midgut to the silk gland via the hemolymph. This process of pigment transport is thought to be mediated by specific cellular carotenoids carrier proteins. Previous studies indicated that two proteins, Cameo2 and CBP, are associated with the selective transport of lutein from the midgut into the silk gland in Bombyx mori. However, the exact roles of Cameo2 and CBP during the uptake and transport of carotenoids are still unknown. In this study, we investigated the respective contributions of these two proteins to lutein and β-carotene transport in Bombyx mori as well as commercial cell-line. We found that tissues, expressed both Cameo2 and CBP, accumulate lutein. Cells, co-expressed Cameo2 and CBP, absorb 2 fold more lutein (P

In China, the mountainous and hilly schistosomiasis-endemic areas are mainly distributed in 2 provinces of Sichuan and Yunnan. Although great success has been achieved in schistosomiasis control in mountainous and hilly areas, there is a risk of re-emerging schistosomiasis in local areas. Hereby, we described the emergency treatment of two schistosomiasis outbreaks that occurred in transmission-interrupted areas of Yunnan Province in 2011 and 2013, pointed out the risk of schistosomiasis rebounding in mountainous and hilly areas and proposed some suggestions.

China is one of the schistosomiasis-endemic countries with the highest burden of disease across the world. Following the control efforts for over 60 years, great successes have been achieved in schistosomiasis control in the country, and the control program is moving towards transmission interruption and elimination. To commemorate the 60th anniversary of publishing Chairman Mao Zedong's two poems entitled " Farewell to the God of Plague ", a series of activities that disseminate schistosomiasis control achievements have been conducted in China throughout 2018, including the development of Chinese spirit on schistosomiasis control in the new era. After extensive discussion, collection and screening, and "Integration of all efforts, scientific control, willingness to dedication and swearing to wipe out the 'God of Plague' " was proposed as Chinese spirit on schistosomiasis control in the new era. Integration of all efforts is a summary of administrative policy-making and population participation in Chinese schistosomiasis control programs; scientific control is the refinement of the Chinese national schistosmiasis control strategy that is developed and implemented tailoring to time and circumstances; willingness to dedication is a valuable spiritual wealth and inexhaustible source of power for Chinese schistosomiasis control professionals in the new era; and swearing to wipe out the "God of Plague" is a sacred mission assigned to Chinese professionals participating in the national schistosomiasis control program in the new era. Chinese spirit on schistosomiasis control in the new era will further strengthen our belief in achieving the goal of schistosomiasis elimination in China eventually.

The Three-year Tough Action Plan for Endemic Diseases Control (2018 - 2020), which was formulated by 10 ministries of China, was issued on November 29, 2018. Schistosomiasis control is an important part of this plan, and the implementation of the plan provides an important basis for the health poverty alleviation and the fight against schistosomiasis in China. This paper describes the objective and principle of the plan and proposes "six actions" and supporting measures to implement the three-year tough action targeting schistosomiasis, with aims to guide the scientific implementation of the three-year tough action against schistosomiasis and facilitate the progress towards schistosomiasis elimination in China.

Objective: To understand the professional theory, prevention and control practice, experimental diagnosis and other technical skills of parasitic diseases among technicians of all levels of disease control and prevention institutions, so as to provide the evidence for strengthening the capacity building of Chinese professional personnel., Methods: According to the method of recommendation at all levels, the subjects from disease control and prevention institutions at province, prefecture or county levels were chosen to assess the theory of parasitic diseases and test operation skills by using the method of answering the questions together with on-site operations in China. A database was built consisting of subjects' basic information and assessment scores. By using the method of hierarchical classification, the scores by gender, age, professional title, institutions and places of participants were analyzed., Results: A total of 124 professions in prevention and treatment of parasitic diseases in 31 provinces (cities and regions) were evaluated in China. The average total score of all the subjects was 125.0 ± 35.2, with a passing rate of 54.8%. The average scores of male subjects and female subjects were 120.8 ± 34.2 and 126.6 ± 35.4 respectively; the average scores of the subjects aged under 30 years, between 30 and 40 years, and above 40 years were 125.6 ± 33.6, 124.9 ± 35.8, and 119.3 ± 45.9 respectively; the average scores of persons with junior, intermediate and senior professional titles were 119.8 ± 35.8, 136.0 ± 32.5 and 127.1 ± 40.9 respectively. The average theoretical assessment score of all the subjects was 67.4 ± 15.6, with a passing rate of 68.5%. The average practical skill assessment score of all the subjects was 57.6 ± 21.8, with a passing rate of 46.0%. The average detection rates of Plasmodium falciparum , P. vivax , P. ovale and P. malariae in endemic and non-endemic areas were 64.1%, 72.8%, 57.0%, 58.3% and 35.9%, 46.9%, 33.3%, 43.8%, respectively. The detection ability of professionals in endemic areas was significantly higher than that in non-endemic areas ( χ 2 = 767.10, 462.12, 134.97 and 360.80, respectively, all P < 0.01). The total detection rate of schistosome eggs was 48.7%, and the detection rates of schistosome eggs were 67.4% and 36.8% in endemic and non-endemic areas, respectively. The detection ability of professionals in endemic areas was significantly higher than that in non-endemic areas ( χ 2 = 817.74, P < 0.01). The detection rates of Ascaris lumbricoides , Trichuris trichiura , and Enterobius vermicularis were 85.7%, 78.6%, 91.7%, and 61.8%, 23.5% and 74.4% in the technicians in southern region and northern region of China, showing significant differences ( χ 2 = 622.58, 301.70 and 588.71, respectively, all P < 0.01)., Conclusions: The overall results of the subjects are good, but the technical operation capability of them is relatively low. Therefore, the specific training based on daily work needs should be enhanced. In addition, we should attach importance to talent cultivation and technical reserve, and strengthen the construction of the team, so as to meet the needs of the prevention and control of parasitic diseases.

Schistosomiasis is an old and geographically widespread parasitic disease that severely damages human health and affects socioeconomic development in China. The implementation of the integrated strategy with emphasis on controlling the source of Schistosoma japonicum infection and the National Mid- and Long-Term Plan for Schistosomiasis Prevention and Control (2004 - 2015) in China greatly facilitated the progress towards the elimination of schistosomiasis in China. Since transmission control of schistosomiasis was achieved in 2015, the goal of the national schistosomiasis control program has moved to transmission interruption and elimination in China. Because of the impacts of natural and social factors, and the new situation, new task and new demands following the continuous decline in the endemic situation of schistosomiasis, several challenges exist to achieve the goal of schistosomiasis elimination nationwide. This paper analyzed the current endemic status of schistosomiasis, progress and challenges of schistosomiasis elimination, and proposed some suggestions for the national chistosomiasis elimination program in China.

Objective: To assess the risk of imported leishmaniasis in China, offering scientific evidences for leishmaniasis prevention and control., Methods: The expert consultation method was used to establish a risk index system, and the risk matrix was used to evaluate the risk scales of leishmaniasis., Results: This risk assessment indicator system included 3 first-grade indexes and 13 second-grade indexes to the aspect of risk probability. Five indexes were also included on the aspect of the risk hazard severity in this system. The transmission risk matrix assessment showed that the risk of imported leishmaniasis transmission in China was in low risk level., Conclusions: This risk matrix assessment is applied for the transmission of imported leishmaniasis in China in the first time, indicating the potential risk of imported leishmaniasis in China.

Objective: To understand the epidemiological characteristics of death cases of echinococcosis in China from 2008 to 2016, so as to provide an important reference for the prevention and control of echinococcosis., Methods: The death information registration and management system data were selected to analyze the epidemiological characteristics of the death cases of echinococcosis. The data were analyzed by SPSS 21.0 and the map was drawn by ArcGIS 10.1 software., Results: From 2008 to 2016, a total of 367 death cases of echinococcosis were reported in China, and the number of deaths in turn was 33, 30, 21, 32, 35, 54, 55, and 81 in each year, with an annual average crude mortality of 129.29 /10 5 . The average age of death was (56 ± 18) years; the sex ratio of male to female was 100∶94. There was no statistical difference between the male and female death cases ( χ 2 = 0.33, P > 0.05).The death cases of echinococcosis were mainly distributed in endemic areas of Qinghai, Sichuan, Ningxia, Xinjiang, Gansu, Inner Mongolia, Yunnan and non-endemic areas of Heilongjiang, Jiangsu, Henan and Shandong. The death cases in the first eleven provinces accounted for 87.5% (321/367) of the total death cases, among which the highest proportions of the nationality, occupation, educational level, highest diagnostic units, and the place of death were Han (52.0%, 191/367), farmer (46.6%, 171/367), junior high school or below (57.2%, 210/367), provincial or three-level hospitals (46.6%, 171/367), and at home (59.9%, 220/367)., Conclusions: Since 2014, the death cases of echinococcosis in China have been increasing year by year, indicating that the prevention and treatment of echinococcosis is still very serious. The causes for the rise of the fatality rate remain to be further studied.

Health education and health promotion are important measures for comprehensive control of schistosomiasis in China, which can improve the compliance rate of residents involved in schistosomiasis control activities, reduce the water contact behavior of the target population, thus avoiding or decreasing the infection of schistosome in endemic areas. In recent years, the comprehensive control of schistosomiasis in China has achieved remarkable results. China has reached the goal of transmission control and is moving toward the transmission interruption or even elimination of schistosomiasis. This article analyzes the role of health education and health promotion in schistosomiasis control programme and the current challenges. Meanwhile, suggestions are also put forward on how to conduct health education and health promotionin the stage of schistosomiasis elimination.

Objective: To understand the unhealthy related behaviors of echinococcosis patients in Tibetan region in Sichuan Province, so as to provide the references for the health education of echinococcosis., Methods: The echinococcosis patients who were registered in the Tibetan region in Sichuan Province were selected as target population. The basic situation and unhealthy related behaviors of them were surveyed by individual interviews., Results: Totally 368 echinococcosis patients were investigated. The proportion of patients who lived with dogs was 53.3%, who did not wash hands before meals was 23.4%, who ate raw food was 15.5%, who fed dogs with diseased livestock visceral organs was 9.8%, who drank unboiled water was 8.7%, and who played with dogs was 5.4%. The proportion of nomads' unhygienic behaviors was higher than that of sedentary residents' unhygienic behaviors. The proportion of playing with dogs and feeding dogs with diseased livestock visceral organsin students was higher than that in nomads., Conclusions: There are some unhealthy related behaviors in echinococcosis patients in Garzê Prefecture, and the different health education modes for echinococcosis patients with different characteristics should be applied.

China was once a country with the heaviest burden of parasitic diseases. Under the leadership of the Communist Party and national authority, after more than 60 years' efforts of prevention and control, the remarkable results have been achieved in China. However, affected by the social and economic development and environmental changes, the prevention and control of parasitic diseases, especially imported parasitic diseases, are facing new challenges, and the parasitic diseases, such as malaria, schistosomiasis, leishmaniasis, filariasis and trypanosomiasis, appear increasingly. With the development of the Belt and Road Initiative, the transmission risks of these diseases are more increased. The purpose of this paper is to describe the experience and results of parasitic disease prevention and control in China, understand the present parasitic disease epidemic situation of the Belt and Road Initiative related countries, analyze the transmission risks of important parasitic diseases, and present some relevant suggestions, so as to provide the evidence for the health administrative department formulating the prevention and control strategies of such parasitic diseases timely and effectively.

Cysticercosis refers to a parasitic infection caused by the larvae of pork tapeworm Taenia solium . It is a parasitic zoonosis and listed by the World Health Organization (WHO) as one of the neglected tropical diseases. Cysticercosis is spreading all over the world through globalization and it mainly epidemic in developing countries. In the southwest and minority nationality areas of China, as a result of the low level of medical and health care, and the unchangeable diet custom, there are still many cases of cysticercosis, which is manifested as a local high prevalence. Neuroimaging is the preferred method for cysticercosis diagnosis, and by using CT and MRI scans it is possible to visualise the infecting cysticerci and assess their number and location within the central nervous system (CNS) . The immunological assay is also required in the diagnosis. At present, the prevention and control of cysticercosis is still relatively weak. In this paper, the current status and research progress of cysticercosis are reviewed, and further suggestions on the prevention and control of cysticercosis are put forward.

Objective: To set up and apply the evaluation standards for photography of schistosomiasis control theme, so as to offer the scientific advice for enriching the health information carrier of schistosomiasis control., Methods: Through the literature review and expert consultation, the evaluation standard for photography of schistosomiasis control theme was formulated. The themes were divided into 4 projects, such as new construction, natural scenery, working scene, and control achievements., Results: The evaluation criteria of the theme photography were divided into the theme (60%), photographic composition (15%), focus exposure (15%), and color saturation (10%) . A total of 495 pictures (sets) from 59 units with 77 authors were collected from schistosomiasis epidemic areas national wide. After the first-step screening and second-step evaluation, the prizes of 3 themes of control achievements and new construction, working scene, and natural scenery were selected, such as 6 pictures of first prize, 12 pictures of second prize, 18 pictures of third prize, and 20 pictures of honorable prize., Conclusions: The evaluation standards of theme photography should be taken into the consideration of the technical elements of photography and the work specification of schistosomiasis prevention and control. In order to improve the ability of records for propaganda purpose of schistosomiasis control and better play a role of guiding correct propaganda, the training and guidance of photography of professionals should be carried out.

Objective: To investigate the changes of serum anti-schistosome antibody titers in schistosomiasis japonica patients after treatment, in order to provide the evidence for formulating the schistosomiasis surveillance program in marshland and lake regions., Methods: Upon prospective cohort study, the stool examination positive schistosomiasis patients and blood examination positive suspected patients (the titer was more than 1:80, including 1:80) were selected as the research objects in Jiangling County in 2014, and they received the 2-day praziquantel therapy. Half year, one year and two years after the treatment, their blood samples and fecal samples were collected for IHA anti-schistosome antibody detections and schistosome egg and miracidium detections., Results: In 2014, the stool examination positives were 251, and the majority of them were over 41 years old, accounting for 93.23% (234/251) ; 581 cases of high antibody titers were detected by the IHA method, and the majority of them were over 41 years old, accounting for 89.16% (518/581) . Half year, one year and two years after the treatment, among the stool examination positives, the negative conversion rates of stool positives were 99.60% (250/251), 100% (239/239) and 100% (234/234) respectively and the negative conversion rates of antibody positives were 21.91% (55/251), 64.11% (156/239) and 76.89% (193/234) respectively. In the high antibody titer positives, the negative conversion rates were 38.04% (221/581), 64.11% (359/560), and 77.86% (429/551) respectively, Half year, one year and two years after the treatment. There were statistically significant differences among the antibody negative conversion rates by χ 2 test ( χ 2 = 77.538, 183.412, 25.469 respectively, all P < 0.001) . The geometric mean values of antibody titers of different durations between 2 groups were analyzed by 2-independent-samples T test, and the geometric mean values of antibody titers between the 2 groups were different before the treatment ( t = 23.576, P < 0.01), but the geometric mean values of antibody titers between the 2 groups were not different 6 months, 1 year and 2 years after the treatment ( t = -0.046, 1.165, -0.132, P = 0.964, 0.245, 0.895 respectively)., Conclusions: The levels of serum anti-schistosome antibody degrade slowly in schistosomiasis japonica patients after the treatment, and the results of IHA tests cannot distinguish the current schistosome infection from previous schistosome infection. Therefore, it is necessary to develop the specific diagnostic technology for schistosome infection in order to meet the need of monitoring.

China's prevention and control of parasitic diseases has made remarkable achievements. However, the prevalence and transmission of parasitic diseases is impacted by the complicated natural and social factors of environment, natural disasters, population movements, and so on. Therefore, there are still the risks of the outbreak of emergency parasitic diseases affairs, which may affect the control effectiveness of parasitic diseases and endanger the social stability seriously. In this article, we aim at the analysis of typical cases of emergency parasitic disease affairs and their impacts on public health security in China in recently years, and we also elaborate the disposal characteristics of emergency parasitic disease affairs, and propose the establishment of response system to emergency parasitic disease affairs in China, including the organizational structure and response flow path, and in addition, point out that, in the future, we should strengthen the system construction and measures of the response system to emergency parasitic disease affairs, so as to control the risk and harm of parasitic disease spread as much as possible and to realize the early intervention and proper disposal of emergency parasitic disease affairs.

Objective: To evaluate the human resource in a national institute of parasitic diseases from 2007 to 2016, so as to provide a reference for the construction of a well-crafted human resource of national parasitic diseases control and prevention., Methods: The basic information of the staff in the national institute of parasitic diseases was investigated and a related database was established to analyze the quantity and structure of the human resource allocation in 10 years through the annual statistics each year., Results: The number of staff in the institute increased by 6.25% in 2016 compared with that in 2007, and 43.32% of the staff were under 35 years old. In 2016, 59.36% of the staff had a master degree or a higher level degree, and 37.97% of the staff had senior technical titles. The difference value of the inflows and outflows was 3.21%., Conclusions: The change of the structure and quality of human resource in this institute has a good tendency in the past ten years. The organization should optimize the human resource allocation and improve its capacity in disease control and prevention to broaden the methods of talent introduction and control the brain drain problem.

Objective: To understand the spatial distribution characteristics of wild feces in schistosomiasis endemic areas of Jiangling County, Hubei Province and further explore the source of infection efficiently, so as to provide the evidence for the development of corresponding monitoring and response technology., Methods: In 2011, the fresh wild feces were investigated every two months in the selected 15 villages by the severity of historical endemic in Jiangling County. The schistosome miracidium hatching method was used to test the schistosome infection of the wild feces. The descriptive analysis and spatial analysis were used for the description of the spatial distribution of the wild feces., Results: Totally 701 wild feces samples were collected with the average density of 0.055 6/100 m 2 , and the positive rate of the wild feces was 11.70% (82/701). The results of the regression analysis showed a positive spatial correlation between the positive rate of wild feces and the rate of human infection, the area with infected Oncomelania hupensis and the number of fenced cattle, and the corrected R 2 of the model was 0.58., Conclusions: The infection rate of wild feces is positively correlated with the rate of human infection, area with infected O. hupensis and number of fenced cattle in space in Jiangling County, so the prevention and control measures could be conducted according to the spatial distribution of the positive wild feces.

Objective: To assess the theoretical knowledge and practical skills of parasitic diseases among technicians from disease control and prevention institutions., Methods: The Assessment on National Parasitic Disease Control and Prevention Techniques was organized in September, 2015. Together, 124 subjects from disease control and prevention institutions at province, prefecture or county levels in 31 provinces joined the assessment. A database was built consisting of subjects' basic information and assessment scores. Statistical analysis was used to analyze the scores by gender, age, professional title, institutions and places of participants., Results: The average total score of all the subjects was 123.3, with a passing rate of 57.3%. The average scores of male subjects (48 subjects) and female subjects (76 subjects) were 125.9 and 121.7 respectively; the average scores of the subjects aged under 30 years (57 subjects), between 30 and 40 years (61 subjects) and above 40 years (6 subjects) were 119.6, 128.1 and 111.2 respectively; the average scores of persons with junior (94 subjects), intermediate (28 subjects) and senior (2 subjects) professional titles were 119.2, 135.9 and 140.5 respectively. The average theoretical assessment score of all the subjects was 61.9, with a passing rate of 62.9%. The average practical skill assessment score of all the subjects was 61.4, with a passing rate of 58.1%., Conclusions: The theoretical assessment results range widely. The theoretical knowledge results of technicians from disease control and prevention institutions are low in general. Therefore, the specific training based on daily work needs to be enhanced.

Flood damage is one of the ordinary natural calamities. The areas of middle and down of the Yangtze River and its south are the endemic area of schistosomiasis. As the flood damage, it causes property loss, and harm public and people health severely even. This paper aims at the status of catastrophic flood damage again in the Yangtze River basin, analyzes the impact of schistosomiasis transmission by it, and indicates that at present, the process of schistosomiasis control in China is marching from transmission control to transmission interruption and elimination, but the frequent flooding exacerbates Oncomelania hupensis snail breeding area and schistosomiasis source spreading, which may influence, in a certain extent, the realization of the goal of schistosomiasis control in China. We should timely assess and monitor the impact and risk of schistosomiasis transmission by flood damage, and give the early warning and adopt emergency handling measures in time. This paper also proposes the disaster prevention measures according to flood damage stages (the early, middle, later, and post-flood) and the occurrence and development of damage and endemic situation, so as to control the risk and damage of the disease transmission in a high limit, to consolidate the current achievements of schistosomiasis prevention and control and guarantee the realization of the goal of schistosomiasis interruption and elimination in China on the schedule.

Objective: To implement a two-level community-based health education pattern of schistosomiasis in residents of endemic areas in marshland and lake regions, so as to explore the suitable pattern of health education under hypo-endemic situation., Methods: Two schistosomiasis endemic villages in Jiangling County, Hubei Province were collected as study areas, and among which, one village was treated as an intervention group, where the two-level community-based health education pattern as well as regular control measures was implemented; the other village was a control group, where only regular control measures were implemented. The awareness rates on schistosomiasis control, the rates of correct behavior and the compliance rates of examination, treatment and chemotherapy of the two groups before and after the intervention were compared., Results: According to the results of the baseline survey in 2014, the awareness rates of schistosomiasis control of the intervention and control groups were 84.00% and 77.45%, respectively, the correct rates of behavior of the two groups were 72.00% and 63.73%, respectively, and the compliance rates of the treatment were 80.36% and 82.28%, respectively, there were no statistically significant differences between all the above rates of the two groups (all P > 0.05). After the intervention of the two-level community-based health education, the correct rates of behavior, and the compliance rates of examination and chemotherapy of the two groups were 92.31% and 80.37%, 95.11% and 82.55%, 84.13% and 63.64%, respectively, and the differences between all the rates above of the two groups were statistically significant (all P < 0.05). When compared to those before intervention, the growing rates of the compliance rates of examination, treatment and chemotherapy of the intervention group were 20.97%, 15.33% and 23.29%, respectively, while those of control group were 14.27%, 4.17%, -3.77%, respectively, the growing rates of the intervention groups were higher than those of the control groups., Conclusions: Through the two-level community-based pattern of health education, the compliance rates of examination and treatment of the residents have improved, and therefore, the pattern is suitable for popularization and application in marshland and lake regions.

Introduction: Primary hyperparathyroidism (PHPT) results in increased bone turnover, resulting in bone mineral density (BMD) reduction and a predisposition towards fractures. Parathyroidectomy (PTX) is the only definitive cure., Objective: The primary goals of this study were to investigate the impact of PTX on BMD in patients with PHPT and to identify factors associated with post-operative BMD improvement using a multivariate model., Methods: Between 1999 and 2010, a total of 757 patients underwent PTX for treatment of PHPT; 123 patients had both a pre- and a post-operative dual-energy X-ray absorptiometry (DEXA) scan. A prospective database was queried to obtain information about patient demographics, medications, comorbidities, and pre- and post-operative laboratory values. A Cox regression model was used to stratify patients and to identify factors that independently predict BMD response following PTX in this patient population., Results: Overall, mean percent change in BMD was +12.31 % at the spine, +8.9 % at the femoral neck (FN), and +8.5 % at the hip, with a mean follow-up of 2.3 ± 1.5 years. A total of 101 (82.1 %) patients had BMD improvement at their worst pre-operative site. In patients who improved, 69.9 % (n = 86) had >5 % increase. Factors associated with BMD improvement at the worst pre-operative site were as follows: male gender (hazard ratio [HR] 2.29; 95 % confidence interval [CI] 1.54-4.21); pre-operative BMD with T-score less than -2.0 (HR 1.89; 95 % CI 1.11-2.39); age <55 years (HR 1.74; 95 % CI 1.14-2.25); BMD DEXA scan at >2.5 years post-operatively (HR 1.71; 95 % CI 1.09-2.17); history of previous fracture (HR 1.24; 95 % CI 1.05-1.92); and private insurance (HR 1.18; 95 % CI 1.06-2.1). The use of bisphosphonates, estrogens, vitamin D supplementation, or tobacco; obesity; history of previous PTX, serum calcium or parathyroid hormone levels were not independently associated with post-operative BMD improvement., Conclusion: Osteoporosis is one of the established National Institutes of Health criteria for PTX in asymptomatic patients with PHPT, but BMD improvement is not consistently seen during the post-operative period. Gender, age, more severe pre-operative bone disease, and insurance status were all predictors for greater BMD improvement following PTX. Further studies with a rigorous post-operative BMD regimen are needed in order to validate these results.