Table of Content

02 March 2019, Volume 30 Issue 6

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Interpretation of The Three-year Tough Action Plan for Endemic Diseases Control （2018-2020）: schistosomiasis 

LI Shi-Zhu1， XU Jing1， Lü Shan1， CAO Chun-Li1, WANG Qiang1, Qi Hong-Liang2， YAN Jun2， ZHOU Xiao-Nong1*

2018, 30(6):  601-604. 

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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.

Progress and challenges of schistosomiasis elimination in China

2018, 30(6):  605-609. 

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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 schistosomiasis elimination program in China.

Challenges and countermeasures of schistosomiasis elimination in Jiangxi Province

2018, 30(6):  610-614. 

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Jiangxi Province was once one of schistosomiasis heavy endemic provinces in China. Thanks for more than 60 years’ unremitting effort， great achievements have been obtained in schistosomiasis control in this province. This paper reviews the control history of schistosomiasis， and demonstrates the current epidemic situation of the disease in Jiangxi Province， and its contribution to national schistosomiasis control achievements. The difficulties and challenges of schistosomiasis elimination in this province are analyzed and the countermeasures are also put forward accordingly.

Evaluation of implementation effect of schistosomiasis control program in Jiangsu Province from 2010 to 2015

2018, 30(6):  615-618,624. 

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Objective To evaluate the actual effect of the schistosomiasis control program in Jiangsu Province from 2010 to 2015. Methods A total of 67 schistosomiasis?endemic counties in 10 cities were selected， and a combination of retrospective investigation and on?site investigation was adopted to collect and record the epidemic data of the counties from 2010 to 2015， and a retrospective survey database of epidemic situation was established. The effects of integrated control strategies with both Oncomelania hupensis snail control and infection source control were evaluated. Results From 2010 to 2015， 2 465 911 persons who lived in endemic areas were detected for schistosomiasis， with 16 974 positive cases of blood examinations， and 8 positive cases of fecal examinations. Totally 5 145 people with advanced schistosomiasis were treated and 40 460 people with the history of schistosome cercarial?infested water contact received the expanded chemotherapy. A total of 127 636 cattle raised in the endemic areas were detected， and 51 619 cattle （head?times） with the history of cercarial?infested water contact also received the expanded chemotherapy. The area with snails control by molluscicides was 18 604.84 hm2. By the end of 2015， schistosome?infected snails had not been found and there was no zoological schistosome infection for 5 consecutive years， and in addition， there had been no acute schistosome?infected persons for 6 consecutive years in the whole province. The area with snails dropped to 1 977.18 hm2， with a decreasing rate of 55.24% compared with that in 2010. Conclusion After the implementation of the plan for the prevention and control of schistosomiasis in Jiangsu Province （2010-2015）， the prevention and control of schistosomiasis has achieved remarkable effects and realized the goal of the plan.

Effect and cost-effectiveness of three commonly used molluscicides in large-scale field application

2018, 30(6):  619-624. 

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Objective To evaluate the effect and cost?effectiveness of three commonly used molluscicides， 4% "Luo?wei"（tea?seed distilled saponins， TDS）， 50% niclosamide ethanolamine salt wettable powder （NESWP）， and 26% metaldehyde and niclosamide suspension concentrate （MNSC） in large?scale field application， so as to provide the references for formulating the strategy of snail control. Methods The field test and parallel comparison were implemented. A marshland with Oncomelania hupensis snails of the Yangtze River was divided into 4 parts （10 hm2） for the research， and three of them were experimental areas while the last one was a blank control area. The experimental areas were sprayed with 4% "Luo?wei"， 50% NESWP and 26% MNSC respectively for 3 times and the interval was 1 week. Seven days after each spraying the effect of snail control was investigated， and the costs of molluscicides， labor， transportation， fuel consumption and mechanical loss were recorded. The cost of each molluscicide， snail mortality， snail density， and the cost of increasing 1% of snail mortality per 100 m2 were analyzed and compared. Results After the first， second and third spraying， the corrected snail mortality rates were 67.34%， 76.55% and 84.60% respectively in the 4% "Luo?wei" group； the corrected snail mortality rates were 64.71%， 75.17% and 83.89% respectively in the 50% NESWP group； the corrected snail mortality rates were 66.55%， 76.27% and 86.67% respectively in the 26% MNSC group. There was no significant difference among the 3 groups in the snail mortality at the same spraying time （c2 = 1.590， 0.571， 3.238， all P > 0.05）. In addition， along with the increase of the spraying times， the snail mortality of each group was increased significantly compared to that of the control group （c2 = 79.333， 94.718， 117.020， all P < 0.01）. After the first， second and third spraying， the reduction rates of snail density were 69.82%-86.60% in the 4% "Luo?wei" group， 68.66%-86.55% in the 50% NESWP group， and 71.89%-88.87% in the 26% MNSC group respectively. The decreasing amplitude of the snail density was more than 85% in all the experimental areas after 3 rounds of spraying molluscicide. The snail control costs per 100 hm2 were 19.57 Yuan， 11.97 Yuan and 10.47 Yuan in the 4% "Luo?wei" group， 50% NESWP group， and 26% MNSC group respectively. After the first， second and third spraying， the costs of increasing 1% of snail mortality per 100 m2 were 0.30 Yuan， 2.08 Yuan and 2.38 Yuan in the 4% "Luo?wei" group， 0.20 Yuan， 1.10 Yuan and 1.32 Yuan in the 50% NESWP group， and 0.17 Yuan， 1.04 Yuan and 0.97 Yuan in the 26% MNSC group respectively， and the cost?effectiveness was the highest at the first spraying in all the three groups. Conclusions The effects of the three molluscicides for snail control are similar， but the efficacy of snail control is reduced as the spraying time increases.

Comparative proteomics analysis of Leishmania infantum strains isolated from two epidemiological regions of visceral leishmaniasis in China

2018, 30(6):  625-629. 

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Objective To analyze the protein abundance differences between two Leishmania infantum strains isolated from different epidemiological types of visceral leishmaniasis in China by comparative proteomics method. Methods Tryptic digests of total proteins were analyzed by using liquid chromatography?tandem mass spectrometry （LC?MS/MS）， followed by label?free quantitative differential expression analysis. The MS data were analyzed with MaxQuant software （ver 1.3.0.5） against data base. Results This study resulted in the identification of 4 274 proteins across two strains （JIASHI?5 and SC6）. Of these， 1 219 differentially expressed proteins （ratio ＞ 2.0 or ＜ 0.5， P < 0.05）were identified. Considering the proteins differentially or uniquely expressed in the strains， 550 proteins were only found in the JIASHI?5 strain， and 174 proteins were only found in the SC6 strain. Totally 495 differentially proteins were expressed in the two groups， among which 328 proteins were down?regulated and 167 proteins were up?regulated in SC6 strain. Some of the identified differentially expressed proteins were demonstrated and they involved in energy metabolism， stress response， prolonging the lifetime of the infected host cell and survival and proliferation in virulent strains. Conclusion This study reveals a group of differentially expressed proteins and the related biologic function that may lay the foundation for screening and identification of the key Leishmania molecules relative to pathogenicity.

Results analysis of Jiangsu Provincial Malaria Diagnostic Reference Laboratory in 2017

2018, 30(6):  630-634. 

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Objective To analyze the results of samples testing of Jiangsu Provincial Malaria Diagnostic Reference Laboratory in 2017， so as to provide the evidence for improving the malaria diagnostic performance in this province. Methods The samples of reported malaria cases in Jiangsu were collected by the provincial reference laboratory （PRL） in 2017. The microscopy and nucleic acid test were performed to confirm the infection of Plasmodium species of each case， while Plasmodium antigen tests （rapid diagnostic test， RDT） were performed as well. The detection results were analyzed among different areas and different species. Results Totally 242 malaria cases were reported and the samples were collected by PRL in 2017. A total of 239 cases were confirmed Plasmodium infections， including 163 cases of Plasmodium falciparum infection， 21 cases of P. vivax infection， 11 cases of P. malariae infection， 43 cases of P. ovale infection， and 1 case of P. falciparum and P. ovale mixed?infection. The diagnostic coincidence rate of reported malaria case in 13 prefectures with districts was all > 80%， and the total coincidence rate was 88.8%. The species diagnostic coincidence rates of P. falciparum， P. vivax， P. malariae， and P. ovale were 98.8%， 57.1%， 63.6%， and 81.4% respectively， and the detection rates by RDT to those four species infections were 95.7%， 85.0%， 63.6% and 79.1% respectively. Conclusions In 2017， the malaria diagnostic quality of medical technicians is generally high in Jiangsu Province. However， the diagnostic capacity is slightly different among different regions， and the ability to identify non? P. falciparum parasites remains to be improved. RDT is not ideal for the detection of non?P. falciparum infection. In the current stage of malaria elimination， the malaria diagnostic capacity of technicians in all the sectors should be strengthened and maintained.

Expression of follicular helper T cells in peripheral blood of patients with hepatic echinococcosis

2018, 30(6):  635-639. 

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Objective To detect the expression of follicuLar helper T cells （Tfh） and interleukin?21 （IL?21） in the peripheral blood of patients with hepatic echinococcosis and healthy controls， so as to explore the associations of Tfh and IL?21 expression with the progression of hepatic echinococcosis. Methods Fifty cases of hepatic echinococcosis and healthy controls were collected from Qinghai Provincial People's Hospital， respectively. Flow cytometry was used to detect the expression of Tfh cells in the peripheral blood of hepatic echinococcosis patients and healthy controls， and enzyme?linked immunosorbent assay （ELISA） was used to detect serum IL?21 expression in hepatic echinococcosis patients and healthy controls. The correlation between Tfh cell expression and serum IL?21 level was examined in the patients with hepatic echinococcosis. Results Flow cytometry detected a higher percentage of CD4+CXCR5+ T cells （18.49% ± 5.67% vs. 16.18% ± 4.04%， P < 0.05）， CD4+CXCR5+PD?1+ T cells （4.94% ± 1.91% vs. 2.29% ± 0.79%， P < 0.05） and CD4+CXCR5+ICOS+PD?1+ T cells （30.93% ± 24.10% vs. 21.07% ± 14.25%， P < 0.05） in hepatic echinococcosis patients than in healthy controls， and no significant difference was seen in the percentage of CD4+CRCR5+ICOS+ T cells between the patients and controls （0.29% ± 0.32% vs. 0.25% ± 0.31%， P > 0.05）. The serum IL?21 level was significantly higher in the patients with hepatic echinococcosis than in healthy controls （293.35 ± 203.65 pg/mL vs. 192.72 ± 70.09 pg/mL， P < 0.05）； however， there was no correlation between the Tfh cell expression and serum IL?21 level in patients with hepatic echinococcosis （P > 0.05）. Conclusion The expression of peripheral blood Tfh cells and serum IL?21 is elevated in patients with hepatic echinococcosis， and Tfh cells and IL?21 may contribute to the progression of hepatic echinococcosis.

Analysis of related factors for hepatic alveolar echinococcosis and gallbladder complications of children in Qinghai Province

2018, 30(6):  640-645. 

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Objective To investigate the distribution characteristics of gallbladder diseases in children with hepatic alveolar echinococcosis， and to analyze the related factors for hepatic alveolar echinococcosis and gallbladder diseases. Methods The clinical data of hepatic alveolar echinococcosis patients under 18 years were collected in Qinghai Provincial People's Hospitalfrom January 2012 to December 2017， and the gallbladder?related complications in the surgically treated patients with hepatic alveolar echinococcosis were analyzed. Results The clinical data of 51 child patients with hepatic alveolar echinococcosis were collected and analyzed. According to the PNM classification criteria of WHO， P1， P2 and P3 in the 51 patients accounted for 37.25% （19/51）， 41.18% （21/51） and 19.60% （10/51）， respectively. According to the diagnostic criteria （WS 257-2006） of China for echinococcosis， the patients of infiltration type， calcification type and liquefaction cavitary type accounted for 66.67% （34/51）， 21.57% （11/51） and 11.76% （6/51）， respectively. Among the 51 patients， 78.43% （40/51） of the patients had clinical symptoms of biliary tract disease， and 58.82% （30/51） had gallbladder?related complications. The operations were performed on 40 patients， and 77.50%（31/40） of them had the postoperative complications. The results of binary multivariate logistic regression analysis showed that the clinical image classification， the liver segment distribution， size， location and number of lesions of hepatic alveolar echinococcosis were important correlative factors for the occurrence of gallbladder complications in hepatic alveolar echinococcosispatients. Conclusions The incidence of complications related to gallbladder diseasesis higher in the children with hepatic alveolar echinococcosis in Qinghai Province， and it has great influence on the operation mode and the occurrence and prognosis of postoperative complications. The early diagnosis and treatment of alveolar echinococcosis in children is particularly important.

Value of three-dimensional visualization technology in preoperative evaluation of liver autotransplantation for end-stage hepatic alveolar echinococcosis

2018, 30(6):  646-651. 

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Objective To evaluate the value of the three?dimensional visualization technology for the preoperative assessment of liver autotransplantation for end?stage hepatic alveolar echinococcosis. Methods A total of 8 patients with end?stage hepatic alveolar echinococcosis undergoing liver autotransplantation in Qinghai Provincial People??s Hospital from May 2013 to July 2017 were collected. All cases received preoperative abdominal CT scanning and dynamic three?phase enhanced CT scanning， and the original CT data were transferred to the human 3D visualization virtual surgical planning system. The volumes of Echinococcus multilocularis and pre?resected liver were measured using the 3D visualization reconstruction， and the relationship between the lesion and the neighboring tissues was observed. The value of the 3D visualization technology for the preoperative assessment of liver autotransplantation for end?stage hepatic alveolar echinococcosis was assessed by comparing with the intraoperative findings. Results The 3D visualization reconstruction model clearly displayed the adjacent relationship between the lesions of end?stage hepatic alveolar echinococcosis and the neighboring tissues， and no significant difference was seen between the pre?resected liver volume in 3D visualization reconstruction model and the actually resected liver volume （t = 1.083， P > 0.05）. Conclusions 3D visualization technology is feasible to develop a reasonable scheme for liver resection and vascular anastomosis for end?stage hepatic alveolar echinococcosis prior to liver autotransplantation， which may increase the success of surgery and improve the prognosis.

MicroRNA-155 induces macrophage polarization to M1 in Toxoplasma gondii infection

2018, 30(6):  652-655. 

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Objective To investigate microRNAs differential expression and polarization of human macrophages in Toxoplasma gondii infection. Methods The microRNAs differential expression of human macrophages in T. gondii infection was analyzed by microarray， and further validated by qRT?PCR. pEGFP?miR?155 was transfected into THP?1 cells by Lipofectamine M2000 and the transfection ratio was detected by flow cytometry. Flow cytometry was used to detect CD86 molecular on the macrophages. qRT?PCR was used to detect iNOS and IL12 mRNA expression. NO and IL12 expression were then evaluated by using ELISA. Results The miR?155 up?regulated more than 4?fold in T. gondii infected macrophages and enhanced as well as post?infection prolong. pEGFP?miR?155 transfection ratio was 82.6%. Compared to cells cultured with T. gondii， pEGFP?miR?155 and miR?155?inhibitor， T. gondii and pEGFP?miR?155 inducement enhanced expression of CD86. Additionally， iNOS and IL12 mRNA were enhanced by qRT?PCR （P＜0.05）. NO and IL12 expression were increased by ELISA. Conclusion T. gondii infection up?regulates the host miR?155 expression to modulate macrophages polarization to M1.

A preliminary survey of acaroid mite breeding in farmer home storages

2018, 30(6):  656-659. 

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Objective To investigate the densities and species of acaroid mites in stored products in farmer home storages. Methods The mite samples which were collected from the farmers’ home in Linquan County， Anhui Province included grains， foods， condiments， fruits and vegetables， and the breeding mites were isolated， then identified and classified after using the mites to make slide specimens. Results Twenty?one species of acaroid mites were obtained， belonging to 7 families and 15 genera. The highest breeding density was in the millet （3 888.89 mite/g） and the lowest was in the fennel （2.03 mite/g）， and the frequent breeding species of storages were Tyrophagus putrescentiae and Lepidoglyphus destructor. The average breeding density of acaroid mites in grains was 383.94 mite/g， and the dominant mite species was T. longior. The average breeding density of acaroid mites in condiments was 149.53 mite/g， and the dominant mite species were L. destructor and Chortoglyphus arcuatus. The average breeding density of acaroid mites in foods was 85.15 mite/g， and the dominant mite species were T. putrescentiae， T. longior， T. palmarum， Glycyphagus domesticus and Dermatophagoides farina. The average breeding density of acaroid mites in fruits and vegetables was 49.15 mite/g， and the dominant mite species were Rhizoglyphus robini and T. palmarum. The average breeding density of acaroid mites in other stored products was 25.05 mite/g， and the dominant mite species were T. putrescentiae and L. destructor. Conclusion The species of acaroid mites in home storages are very rich， and it is necessary to take positive measures to reduce the infestation of acaroid mites.

Epidemic status of malaria in Zhenjiang City from 2004 to 2017

2018, 30(6):  660-663,666. 

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Objective To analyze the epidemic situation and epidemiological characteristics of malaria in Zhenjiang City from 2004 to 2017， so as to provide the evidence for formulating the reasonable strategies and measures for malaria prevention and control. Methods The epidemiological data of malaria in Zhenjiang City from 2004 to 2017 were collected and analyzed for the epidemic situation， epidemiological characteristics， species of Plasmodium， blood test status for febrile patients. Results A total of 182 malaria cases were reported in Zhenjiang City between 2004 and 2017， 123 cases（67.58%） were infected with P. vivax， and 55 cases（30.22%） were infected with P. falciparum. Among all the reported cases， 41（22.53%） were local cases， 66（36.26%） were imported cases from other provinces in China， 75（41.21%） were imported cases from abroad. Most of the cases were male（133 cases），and 59.89% of them concentrated in the age groups of 20-50 years. These cases were mainly farmers （24.73%， 45/182） and workers （24.18%， 44/182）， and most of the cases occurred from July to September. From 2004 to 2017， the blood tests were conducted for 258 879 febrile patients， with a positive detection rate of 0.007% in the local population and 0.724% in floating population， and there was a statistically significant difference between them（P ＜ 0.01）. Conclusion Since 2011， no indigenous cases have been reported in Zhenjiang City， and therefore， the control of imported malaria from abroad has become the key of malaria prevention and control in this city.

Epidemic situation of malaria in Qingdao City from 2012 to 2017

2018, 30(6):  664-666. 

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Objective To investigate the epidemic situation and its epidemic characteristics of malaria in Qingdao City from 2012 to 2017， so as to provide the evidence for the prevention and control of malaria in this city. Methods The data of cases and epidemiological characteristics of malaria in Qingdao City， 2012-2017 were collected from the China??s disease prevention and control system infectious disease report information management system and parasitic disease prevention and control information management system， and analyzed. Results A total of 103 cases of malaria were reported in Qingdao City from 2012 to 2017， and all of them were imported. Among them， 98 （95.15%） were imported from Africa and 5 （4.85%） from Asia. There were 92 laboratory confirmed cases （89.32%） and 11 （10.68%） clinically diagnosed cases. The highest incidence occurred in 2016 （0.28/105）. According to the classification of cases， there were 87 falciparum malaria cases （84.47%）， 13 vivax malaria cases （12.62%）， and 3 ovale malaria cases （2.91%）. These patients were mainly young men， and the male to female ratio was 19.6 ∶ 1. There were malaria case reports in each month， and the peak onset season was not obvious. Newly diagnosed and confirmed units were mainly municipal medical institutions； the median of onset?definite diagnosis was 4 days. There was one death case， but there were no recurrence， reburning， and imported secondary cases. Conclusion There were no local malaria cases in Qingdao City from 2012 to 2017. The prevention and control of imported malaria is the focus of the future work.

Changes of inflammatory factors after hepatic cystic echinococcosis surgery and intervention of ulinastatin in Qinghai area

2018, 30(6):  667-670. 

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Objective To observe the changes of inflammatory factors after the hepatic cystic echinococcosis surgery and explore the intervention effect of ulinastatin on postoperative inflammatory factors. Methods Sixty patients with hepatic cystic echinococcosis were selected and randomly divided into a control group and ulinastatin intervention group according to whether or not use ulinastatin. The peripheral venous bloods were extracted in all the patients and the levels of IL?6， IL?8， IL?9， and IL?10 were detected by the ELISA method on the day before operation， 1 day， 3 days， 5 days and 7 days after operation， respectively. The data was statistical analyzed to detect the relationships between/among the inflammatory factors mentioned above and ulinastatin and time. Results The variation of the levels of IL?6， IL?8， IL?9， and IL?10 were changed by the intervention of ulinastatin at different time. The differences of the levels of IL?6， IL?8， IL?9， and IL?10 between the ulinastatin intervention group and the control group were not significant on the day before operation， 1 day and 3 days after operation （t = -1.15 to 1.82， all P > 0.05）， but the levels of IL?6， IL?8， IL?9， and IL?10 of the ulinastatin intervention group were significantly lower than those of the control group and there were statistically significant differences 5 days and 7 days after the operation （t = 3.22 and 23.51， both P < 0.05）. Conclusion Ulinastatin has a good effect in inhibiting the inflammatory factors and can protect and repair the postoperative hepatic injury as well in patients with hepatic cystic echinococcosis.

Value of CT imaging of inferior vena cava and hepatic vein in patients with hepatic cystic echinococcosis

2018, 30(6):  671-673. 

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Objective To evaluate the accuracy of CT imaging of inferior vena cava and hepatic vein in patients with hepatic cystic echinococcosis. Methods A total of 100 patients with hepatic cystic echinococcosis were given triple?phase abdominal CT scan， and the reconstructed images of the inferior vena cava and hepatic vein were obtained and compared to the real situation during the surgical operation. The reliability of the CT evaluation of the echinococcus cyst lesion invading inferior vena cava and hepatic vein was analyzed. Results The compression displacement， half?globular， no clear demarcation between the lesion and blood vessel and narrowing of the vessel detected by CT evaluation were in accordance with the real situation under the surgical sight. However， four cases of clear demarcation between the lesion and blood vessel were affirmed wrong under the surgical sight. There were three cases of over diagnosis of vascular stenosis judgments. Conclusion The CT images of hepatic vein and inferior vena cava can clearly show the relationship between the hepatic echinococcus cyst and hepatic vein and inferior vena cava.

Imaging analysis of 79 cases of hepatic echinococcosis

2018, 30(6):  674-677. 

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Objective To analyze the imaging manifestations of 79 cases of hepatic echinococcosis retrospectively， so as to provide evidences for improving the diagnosis and differential diagnosis of the disease. Methods Seventy?nine patients with hepatic echinococcosis who underwent imaging examinations and pathologic confirmation in Qinghai Provincial People’s Hospital from 2014 to 2017 were chosen as the investigation objects， and the data of their medical records and imaging manifestations were collected and analyzed. Results Among the 79 cases of hepatic echinococcosis， 57 were suffered from cystic echinococcosis （CE） and 22 were suffered from alveolar echinococcosis （AE）. Among the patients with CE， those in single cystic type， multiple cysts type， internal capsule collapse type， solid type， and calcification type were 21， 16， 9， 4 cases and 7 cases respectively. The imaging signs of 62 cases were common. The image of the single cystic type was characterized by intrahepatic cystic water?like lesions， the cystic wall was thin and uniform without any enhancement. The multiple cysts were characterized by "cyst in the cyst"， "rose petals"， and "spoke wheel". The collapse and separation of the internal capsule was manifested as "drift belt sign" and "double ring sign"， the calcification of the cyst wall was curved and eggshell?shaped， the contents of the cyst were cotton?shaped or the whole lesion was calcific. The image of the patients with AE was manifested as a solid mass in the liver， the density and signal were heterogeneous， the edge was irregular and not obviously enhanced ， the "small vesicles" scattered in the lesion were often accompanied by calcification， and the whole lesion showed a map appearance. The other 17 cases of hepatic echinococcosis showed complex and rare imaging features. The capsules of 6 cases of CE contained fat， the images presented single or multiple fat density nodules in the hepatic hydatid cyst， and CT value was -28 to -84 HU； in 4 cases of echinococcosis， the lesions were broken into the bile duct， the density of adjacent bile duct was increased， with bile duct wall thickening and peripheral biliary dilatation. For the 4 cases of echinococcosis combined with primary liver cancer， the imaging manifestations of the hepatic cysts presented solid?mass enhancement， with "fast forward and fast out" performance. For the image of the 3 cases of CE with infection， the cystic wall was thickening and enhanced obviously， of these， 2 cases had gaseous shadows in the cyst， 1 patient’s cyst was complicated with infection and it invaded the abdominal wall. Conclusion The imaging manifestations of hepatic echinococcosis are varied and complicated， which need careful analysis for differential diagnosis.

Revolution CT hepatic perfusion imaging assessment of peripheral infiltration zone of hepatic alveolar echinococcosis

2018, 30(6):  678-681. 

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Objective To analyze the blood supply and metabolism in the marginal area of foci of hepatic alveolar echinococcosis by quantitative perfusion parameters. Methods Thirty patients with hepatic alveolar echinococcosis were scanned with the Revolution CT and the images were analyzed. The perfusion parameters， such as the bloodflow （BF）， time to peak （TTP）， blood volume （BV）， mean transit time （MTT） and hepatic arterial fraction （HAF） were compared among different groups. Results The BF， TTP， BV and MTT values of the peripheral infiltration zone and the values of the surrounding normal liver tissues were significantly different （[F=24.579]， 8.343， 20.535 and 21.843， all P < 0.05）， but the HAF values of the peripheral infiltration zone and the values of the surrounding normal liver tissues were not significantly different in the hepatic alveolar echinococcosis patients （[F=2.621]，P＞0.05）. Conclusion The whole hepatic perfusion Revolution CT can accurately and quantitatively analyze the alveolar echinococcosis foci， especially the peripheral infiltration zone， which has important guiding significance for the formulation of surgical plan.

Seroepidemiological survey of Toxoplasma gondii infection in patients with gynecological malignant tumors

2018, 30(6):  682-684,708. 

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Objective To investigate the seroprevalence of Toxoplasma gondii infection in patients with gynecological malignant tumors， so as to provide the evidence for the control of T. gondii infections in the patients with gynecological malignant tumors. Methods A total of 327 patients with gynecological malignant tumors were recruited， and 200 women with normal healthy examinations were served as controls. The serum anti?T. gondii IgG and IgM antibodies were detected by using ELISA， and the seroprevalence was compared between the patients and controls， and among various types of cancers. Results The overall seroprevalence of T. gondii was 26.91% （88/327） in the patients with gynecological malignant tumors， which was significantly higher than that （5.00%） in the healthy volunteers （[χ2] = 39.36， [P< 0.01]）. The prevalence of anti?T. gondii IgG antibody in the cancer patients was significantly higher than that in the controls （26.30% vs. 5.00%； [χ2] = 37.79， [P< 0.01]）， while the prevalence of anti?T. gondii IgM antibody in the cancer patients was not significantly different from that in the controls （0.92% vs. 0； corrected [χ2] = 0.58， [P> 0.01]）. The positive rates of anti?T. gondii IgG antibody were 27.68%， 25.47% and 25.69% in ovarian cancer， cervical cancer， and breast cancer patients respectively， which were all significantly higher than those in the controls （[χ2] = 32.35， 27.32 and 28.00； all P values < 0.01）； however， there was no significant difference among the various types of cancer patients in the positive rates of anti?T. gondii IgG antibody （[χ2] = 0.17， [P> 0.05]）. In addition， the positive rates of anti?T. gondii IgM antibody were 1.79%， 0 and 0.92% in ovarian cancer， cervical cancer and breast cancer patients respectively， which was not significantly different from those in the controls （all P values > 0.05）. Conclusion The seroprevalence of T. gondii infection is high in the patients with gynecological malignant tumors. It is suggested that the prevention and control of T. gondii infection should be strengthened in these patients.

Major challenges of schistosomiasis elimination in Hubei Province

2018, 30(6):  685-687. 

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This paper summarizes the major experiences from schistosomiasis control， analyzes the challenges of schistosomiasis elimination， and proposes suggestions for further control programs in Hubei Province， with aims to provide insights into the acceleration of the progress towards schistosomiasis elimination and the achievement of the goal designed in the 13th Five?Year Plan of National Schistosomiasis Control in China.

Role of WeChat publicity in control of imported malaria from abroad in timber industry

2018, 30(6):  688-690. 

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Objective To evaluate the effects of WeChat publicity in imported malaria control in timber industry in Zhangjiagang City， so as to provide new ideas for the control of malaria imported from abroad. Methods The data of malaria epidemic in Zhangjiagang City was collected， and the contact way of the overseas personnel in timber industry in Zhangjiagang City were obtained. The knowledge of the prevention and control of malaria was propagandized by WeChat among these personnel， and the awareness situation of malaria control knowledge of this population was investigated by questionnaires before and after the WeChat publicity. In addition， the number of new malaria cases among returnees from abroad in timber industry before and after WeChat publicity was calculated. Results All the links in timber industry in Zhangjiagang City adopted WeChat as the contact way. Before and after the WeChat publicity， 128 and 150 questionnaires were collected， respectively， the awareness rates of malaria control knowledge of the investigated objects were in the range of 7.81%-62.50% and 33.33%-90.00%， respectively， and the differences between the awareness rates on all the questions before and after the WeChat publicity were statistically significant （all P < 0.05）. Before the WeChat publicity， there were 6 new malaria cases in the population going aboard in timber industry， whereas no new cases were found after the publicity in this population. Conclusion WeChat publicity plays a good role in the prevention and control of malaria imported from overseas in timber industry in Zhangjiagang City， and this publicity method can be promoted in other industries.

Endemic situation of schistosomiasis in surveillance sites of Jingzhou City， 2017

2018, 30(6):  691-693. 

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Objective To grasp the endemic situation of schistosomiasis in Jingzhou City in 2017， so as to provide the evidence for formulating prevention strategies. Methods According to the requirements of National Schistosomiasis Surveillance Program （2014）， Hubei Schistosomiasis Surveillance Program （2015） and Jingzhou Schistosomiasis Surveillance Program， the local population infection monitoring， mobile population infection monitoring， livestock disease monitoring， snail monitoring， and wild manure monitoring were carried out at 71 monitoring sites throughout the city. Results Among the 71 surveillance sites， 44 118 local residents received the indirect hemagglutination test （IHA） for schistosomiasis and 1 925 persons were positive， with the positive rate of 4.36%， However， no stool examination positive cases were found. Totally 2 175 mobile people received the IHA for schistosomiasis and 93 persons were positive， with the positive rate of 4.28%， but no stool examination positive cases were found. A total of 1 937 head of cattle received the stool examination for schistosome infection， but no positives were found. Totally 1 302 Oncomelania hupensis habitats were found in 69 surveillance sites， with 1 923.64 hm2 area with snails. Totally 348 756 frames were surveyed， and the occurrence rate of snails was 17.19%. A total of 142 494 living snails were captured， with the average density of 0.41 snail/0.1 m2. No schistosome?infected snails were found. Totally 596 cases of wild manure were picked up in 41 environments with snails among 23 surveillance sites， but schistosome infested wild manure was not found. Conclusions In 2017， the level of schistosomiasis epidemic was very low in Jingzhou City. However， the risk of epidemic rebound still exists， and therefore， it is necessary to strengthen the monitoring work to further consolidate the achievements of schistosomiasis control.

Seroepidemiological survey of Toxoplasma gondii infection among employees in a pork food processing enterprise

2018, 30(6):  694-695. 

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Objective To understand the situation of seroepidemiology of Toxoplasma gondii infection among employees in a pork food processing enterprise in Dongtai City. Methods Totally 200 employees from a pork food processing enterprise in Dongtai City were selected as the research objects. The venous blood of the selected population was extracted and the IgG antibody against T. gondii in serum was detected by ELISA， and the results were analyzed. Results Among the 200 employees， 36 cases were positive in IgG antibody detection， the positive rate was 18.0%. The positive rate of IgG antibody among workers with different length of service was significantly different （[χ2] = 9.813， P ＜ 0.05）. With the increase of working age， the positive rate of IgG antibody gradually increased. The positive rate of IgG antibody to T. gondii was significantly higher in the population who had frequent contact with animals. Conclusions The positive rate of IgG antibody against T. gondii in employees in pork food processing enterprises is high. Therefore， the detection of antibodies against T. gondii and health education should be strengthened in this population.

Investigation of Toxoplasma gondii infection among special populations in Nanjing City, Jiangsu Province

2018, 30(6):  696-697,701. 

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Objective To understand the prevalence of Toxoplasma gondii infection among special populations in Nanjing City， so as to provide the reference for formulating the interventions for the prevention and control of T. gondii infections in this population. Methods The HIV/AIDS patients， tumor patients， pregnant women， and people with livestock and poultry breeding or processing works were selected as the study subjects from September to November 2015. The venous blood samples were collected from each participant for detecting IgG and IgM antibodies against T. gondii by ELISA. Results The overall prevalence of T. gondii infection was 10.2% in the study subjects in Nanjing City. The T. gondii infection rates were 12.2%， 11.3%， 4.0%， and 13.0% among the HIV/AIDS patients， tumor patients， pregnant women， and people with livestock and poultry breeding or processing works， respectively， and there was no statistically significant difference among the four groups （[χ2] = 5.668， P = 0.130）. The prevalence of T. gondii infection was higher in men than in women （15.3% vs. 5.8%； [χ2] = 10.213， P = 0.001）， and there were significant differences in the prevalence of T. gondii infection in terms of gender （[χ2] = 9.501， P = 0.023）， education levels （[χ2] = 9.850， P = 0.043） or occupations （[χ2] = 8.983， P = 0.062）. Conclusions The infection rate of T. gondii among the special population in Nanjing City is high. Therefore， the health education intervention should be strengthened in the follow?up work for the special population.

Analysis of assessment results of malaria elimination in Suzhou City

2018, 30(6):  698-701. 

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Objective To analyze the assessment results of malaria elimination in Suzhou City， so as to provide references for consolidating the results of malaria elimination in the city. Methods According to "Jiangsu Province Malaria Evaluation and Assessment Implementation Plan （2014 Edition）" and "Jiangsu City Malaria Evaluation Implementation Regulations （2015 Edition）"， the assessment of the county?level cities and districts under the jurisdiction of Suzhou City was conducted. After the assessment， the municipal level assessment and evaluation were carried out， and one district was randomly selected for the assessment of malaria elimination review. Results The assessment score of malaria elimination in Suzhou City was 98.6 points. Wujiang District was randomly selected for review assessment， and the review score was 95.8 points. According to the 85 points attainment criteria specified by the national assessment， Suzhou City met the requirement of malaria elimination. Conclusions Suzhou City has passed the inspection certification of malaria elimination in Jiangsu Province. However， the post?elimination malaria monitoring should be continued to consolidate the achievements.

Progress of research on association between schistosomiasis and single nucleotide polymorphisms

2018, 30(6):  702-704. 

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Single nucleotide polymorphisms （SNP） has been regarded as a new genetic marker due to its rich dynamics and relatively stable heredity. SNP can express the relationship between genes and diseases to seek disease?linked genes particularly. A number of domestic and international studies have demonstrated that the formation of schistosomiasis egg granuloma is closely linked to HLA?Ⅱ related antigen. By detecting alleles loci of HLA?Ⅱ gene， researchers can identify the gene or haplotype that is associated with the susceptibility and progression of schistosomiasis. The detected candidate genes can serve useful therapeutic and preventative purposes by providing new technical methods to defeat schistosomiasis. In?depth study on SNP is beneficial to evaluate schistosomiasis inclination clinically， as well as to promote early diagnosis and preventive treatment.

Surgical treatment strategy for complex hepatic echinococcosis: a review

2018, 30(6):  705-708. 

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The hepatic echinococcosis is an anthropozoonosis and caused by the larva of Echinococcus. The main pathogenic type of Echinococcus in China is E. granulosus and E. multilocularis， which cause cystic echinococcosis and alveolar echinococcosis respectively. At present， the treatment of hepatic echinococcosis has made great progress， but there are still some difficulties in the treatment of complex echinococcosis， especially of the cases existing one or more complications， and the focus of infection encroaching the hepatic portal， important vessels and bile vessel. This paper based on the literature reports and clinical experiences in recent years， puts forward the surgical treatment strategy for complex hepatic echinococcosis.

Echinococcosis of infratemporal fossa with intraorbital and basicranial involvement: a case report

2018, 30(6):  709-710. 

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This paper presents a patient with echinococcosis of infratemporal fossa invading intraorbital and basicranial sites. With the excellent collaboration between doctors and nurses， the patient received total resection of hydatid asci and internal capsules and anti?echinococcosis therapy. Then， the patient significantly improved and was discharged from hospital successfully.

Misdiagnosis of cerebral alveolar echinococcosis: a case report

2018, 30(6):  711-712. 

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This paper reports a case of cerebral alveolar echinococcosis misdiagnosed.