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    09 January 2023, Volume 34 Issue 6
    Schistosomiasis control in China from 2012 to 2021: progress and challenges 
    XU Jing, CAO Chun⁃li, LÜ Shan, LI Shi⁃zhu, ZHOU Xiao⁃nong
    2022, 34(6):  559. 
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    Schistosomiasis has been endemic in China for more than 2 000 years, which causes huge morbidity, social and economic burdens. Guided by the national specific strategic programs and criteria for schistosomiasis, tremendous achievements have been gained for schistosomiasis elimination in China. This paper reviews the progress of schistosomiasis control and endemic status of schistosomiasis in China during the period from 2012 to 2021, analyzes the challenges to achieve the goal of schistosomiasis elimination in China by 2030, and proposes suggestions for future schistosomiasis control programs.
    Recombinant Schistosoma japonicum egg ribonuclease SjCP1412 inhibits the activation of LX⁃2 hepatic stellate cells in vitro
    LI Qi-feng, SONG Li-jun, YANG Ying-ying, DONG Pan-pan, MEI Cong-jin, LI Yi-xin, ZHANG Jian-feng, XIONG Chun-rong, YU Chuan-xin, YANG Kun
    2022, 34(6):  566. 
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    Objective To investigate the effect of recombinant Schistosoma japonicum egg ribonuclease SjCP1412 (rSjCP1412) on proliferation, cell cycle, apoptosis and activation of human hepatic stellate cells LX-2 in vitro, and explore the underlying mechanisms. Methods The rSjCP1412 protein was expressed in Escherichia coli BL21 by prokaryotic expression, and the highly purified soluble rSjCP1412 protein was prepared by Ni NTA affinity chromatography and urea gradient refolding dialysis. Yeast RNA was digested using 12.5, 25.0, 50.0 µg rSjCP1412 proteins at 37 ℃ for 2, 3, 4 h, and the enzymatic products were electrophoresed on 1.5% agarose gel to observe the RNAase activity of rSjCP1412 protein. The proliferation of LX-2 cells stimulated by different doses of rSjCP1412 protein for 48 hours was measured using CCK-8 assay, and the apoptosis of LX-2 cells stimulated by different doses of rSjCP1412 protein for 48 hours was detected using the Annexin V-FITC/PI double staining, while the percentage of LX-2 cells at G0/G1, S and G2/M phases of cell cycle following stimulation with different doses of rSjCP1412 protein for 48 h was detected by DAPI staining. The typeⅠcollagen, type Ⅲ collagen and α-smooth muscle actin (α-SMA) mRNA expression was quantified using quantitative florescent real-time PCR (qPCR) assay and Western blotting at transcriptional and translational levels in LX-2 cells following stimulation with different doses of rSjCP1412 protein for 48 h, while soluble egg antigen (SEA) served a positive control and PBS without rSjCP1412 protein as a normal control in the above experiments. The expression of collagenⅠ, α-SMA and Smad4 protein was determined using Western blotting in LX-2 cells following stimulation with rSjCP1412 protein, transforming growth factor- β1 (TGF-β1) alone or in combination, to examine the signaling for the effect of rSjCP1412 protein on LX-2 cells. Results The rSjCP1412 protein was successfully expressed and the highly purified soluble rSjCP1412 protein was prepared, which had a RNase activity. Compared with the normal group, the survival rates of LX-2 cells significantly decreased post-treatment with 12.5, 25.0, 50.0 µg/mL rSjCP1412 protein and SEA for 48 h (F = 22.417 and 20.448, both P values < 0.05). The apoptotic rates of LX-2 cells significantly increased post-treatment with 12.5, 25.0, 50.0 µg/mL rSjCP1412 protein for 48 h (F = 11.350, P < 0.05), and treatment with 12.5, 25.0, 50.0 µg/mL rSjCP1412 protein for 48 h resulted in arrest of LX-2 cells in G0/G1 phase (F = 20.710, P < 0.05). Treatment with 12.5, 25.0, 50.0 µg/mL rSjCP1412 protein for 48 h caused a significant reduction in relative expression levels of collagen Ⅰ (F = 11.340, P < 0.05), collagen Ⅲ (F = 456.600, P < 0.05) and α-SMA mRNA (F = 23.100, P < 0.05) in LX-2 cells, and both rSjCP1412 protein and SEA treatment caused a significant reduction in collagen Ⅰ (F = 1 302.000, P < 0.05), α-SMA (F = 49.750, P < 0.05) and Smad4 protein expression (F = 52.420, P < 0.05) in LX-2 cells. In addition, rSjCP1412 protein treatment inhibited collagen Ⅰ (F = 66.290, P < 0.05), α-SMA (F = 31.300, P < 0.05) and Smad4 protein expression (F = 27.010, P < 0.05) in LX-2 cells activated by TGF-β1. Conclusion rSjCP1412 protein may induce apoptosis of LX-2 cells and inhibit proliferation, cell cycle and activation of LX-2 cells through down-regulating Smad4 signaling molecules.
    Comparison of pathogenicity and gene expression profiles between adult Schistosoma japonicum isolated from hilly and marshland and lake regions of Anhui Province
    WU Jia⁃ling, HU Ming⁃chuang, WANG Qi, LIU Dao⁃hua, ZHANG Le⁃sheng, ZHU Lei, SUN Cheng⁃song, CAO Zhi⁃guo, WANG Tian⁃ping
    2022, 34(6):  580. 
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    Objective To compare the differences in pathogenicity and gene expression profiles between adult Schistosoma japonicum isolated from hilly and marshland and lake regions of Anhui Province, so as to provide the scientific evidence for formulating the precise schistosomiasis control strategy in different endemic foci. Methods C57BL/6 mice were infected with cercariae of S. japonicum isolates from Shitai County (hilly regions) and Susong County (marshland and lake regions) of Anhui Province in 2021, and all mice were sacrificed 44 days post⁃infection and dissected. The worm burdens, number of S. japonicum eggs deposited in the liver, and the area of egg granulomas in the liver were measured to compare the difference in the pathogenicity between the two isolates. In addition, female and male adult S. japonicum worms were collected and subjected to transcriptome sequencing, and the gene expression profiles were compared between Shitai and Susong isolates of S. japonicum. The differentially expressed genes (DEGs) were subjected to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Results The total worm burdens [(14.50 ± 3.96) worms/mouse vs. (16.10 ± 3.78) worms/mouse; t = 0.877, P = 0.392], number of female and male paired worms [(4.50 ± 0.67) worms/mouse vs. (5.10 ± 1.45) worms/mouse; t = 1.129, P = 0.280], number of unpaired male worms [(5.50 ± 4.01) worms/mouse vs. (5.60 ± 1.69) worms/mouse; t = 0.069, P = 0.946], number of eggs deposited in per gram liver [(12 116.70 ± 6 508.83) eggs vs. (16 696.70 ± 4 571.56) eggs; t = 1.821, P = 0.085], and area of a single egg granuloma in the liver [(74 359.40 ± 11 766.34) μm2 vs. (74 836.90 ± 13 086.12) μm2; t = 0.081, P = 0.936] were comparable between Shitai and Susong isolates of S. japonicum. Transcriptome sequencing identified 584 DEGs between adult female worms and 1 598 DEGs between adult male worms of Shitai and Susong isolates of S. japonicum. GO enrichment analysis showed that the DEGs between female adults were predominantly enriched in biological processes of stimulus response, cytotoxicity, multiple cell biological processes, metabolic processes, cellular processes and signaling pathways, cellular components of cell, organelles and cell membranes and molecular functions of binding and catalytic ability, and KEGG enrichment analysis showed that these DEGs were significantly enriched in pathways of vascular endothelial growth factor signaling, glutathione metabolism, arginine and proline metabolism. In addition, the DEGs between male adults were predominantly enriched in biological processes of signaling transduction, multiple cell biological processes, regulation of biological processes, metabolic processes, development processes and stimulus responses, cellular components of extracellular matrix and cell junction and molecular functions of binding and catalytic ability, and these DEGs were significantly enriched in pathways of Wnt signaling, Ras signaling, natural killer cells⁃mediated cytotoxicity, extracellular matrix⁃receptor interactions and arginine biosynthesis. Conclusions  There is no significant difference in the pathogenicity between S. japonicum isolates from hilly and marshland and lake regions of Anhui Province; however, the gene expression profiles vary significantly between S. japonicum isolates.
    Screening of traditional Chinese medicine⁃derived snail control drug targets based on network pharmacology
    XIONG Tao, GUO Jin⁃lu, LU Fang⁃guo, LIU Jia⁃hao, ZHENG Tao, LI Jia⁃shan
    2022, 34(6):  588. 
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    Objective To screen the targets of traditional Chinese medicine⁃derived potential plant molluscicides based on network pharmacology and explore the mechanisms of molluscicidal actions. Methods The traditional Chinese medicines with molluscicidal actions were screened based on retrospective literature reviews, and their molluscicidal efficiency was summarized. The active ingredients and potential targets of traditional Chinese medicines were captured from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform, Unified Protein Database and literature mining using network pharmacology. The drug⁃active ingredient⁃target network was created using the software Cytoscape 3.7.2, and the key targets were subjected to Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis using the Metascape software. Results A total of 27 types of snail control drugs derived from traditional Chinese medicines were screened from publications and classified into 14 categories. Network pharmacology identified 190 active ingredients, and the active ingredients with a high degree in the drug⁃active ingredient⁃target network included quercetin, linoleyl acetate, luteolin, beta⁃carotene, (24S)⁃ethylcholesta⁃5,22,25⁃trans⁃3beta⁃ol, fumarine and arctiin, with 181 corresponding potential targets screened. KEGG pathway enrichment analysis revealed that these targets were mainly located in 16 pathways, including the neuroactive ligand⁃receptor interactions, regulation of adipocyte lipolysis and adrenergic signal in myocardial cells. Conclusions This study preliminarily demonstrates the multi⁃ingredient, multi⁃target and multi⁃pathway mechanisms of action of 27 molluscicides. The screened key ingredient may provide the basis for isolation, purification and pharmacological studies of molluscicides, and the screened key targets and key pathways may facilitate the illustration of mechanisms of actions of traditional Chinese medicine⁃derived molluscicides and development of novel green molluscicides.
    Epidemiological characteristics and influencing factors of Blastocystis hominis infection among children with diarrhea under five years of age in Guangzhou City
    XU Wei⁃rong, WANG Guo⁃shu, LI Qin, ZHENG Jin⁃xin, GUO Zhao⁃yu, CHEN Jia⁃xu, CHEN Mu⁃xin, TIAN Li⁃guang
    2022, 34(6):  598. 
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    Objective To investigate the prevalence and influencing factors of Blastocystis hominis infection among children with diarrhea under five years of age in Guangzhou City. Methods Children with diarrhea under 5 years of age admitted to Guangzhou Children’s hospital, Guangzhou Maternity and Child Healthcare Hospital and Guangzhou Women and Children’s Medical Center during the period between January 1 and December 31, 2020, were enrolled. Participants’ demographics, living environments and health status were collected using questionnaire surveys. Stool samples were collected from participants and nucleic acid was extracted. B. hominis infection was identified using PCR assay and sequence alignment, and the factors affecting B. hominis infection among children with diarrhea under 5 years of age were identified using univariate analysis and multivariate logistic regression analysis. Results A total of 684 children with diarrhea under 5 years of age were enrolled, including 468 male children and 216 female children, with a mean age of (1.79 ± 1.12) years. The overall prevalence of B. hominis infection was 4.97% [34/684, 95% confidential interval (CI): (3.59%, 6.86%)] among participants, and there was no significant difference in the prevalence of B. hominis infection between children with chronic [7.52% (20/266), 95% CI: (4.92%, 11.33%)] and acute diarrhea [3.35% (14/418), 95% CI: (2.01%, 5.54%)] ([χ2] = 5.983, P = 0.014). Multivariate logistic regression analysis identified keeping pet [odds ratio (OR) = 6.298, 95% CI: (2.711, 14.633)], drinking non⁃tap water [OR = 4.522, 95% CI: (1.769, 11.561)], lactose intolerance [OR = 4.221, 95% CI: (1.043, 17.087)], antibiotic use [OR = 0.125, 95% CI: (0.017, 0.944)] and chronic diarrhea [OR = 2.172, 95% CI: (1.018, 4.637)] as factors affecting B. hominis infection among children with diarrhea under 5 years of age in Guangzhou City. Conclusions B. hominis infections is detected in children with diarrhea under five years of age in Guangzhou City. Improving home environments and pet⁃keeping hygiene is recommended to reduce the likelihood of B. hominis infection among children.
    mmunoprotective effect of recombinant peptidyl⁃prolyl cis⁃trans isomerase from Babesia microti against B. microti infection in mice
    CAI Yu⁃chun, SONG Peng, CHEN Mu⁃xin, SUN Jia⁃hui, ZHOU Yan, LIN Lin, CHEN Jia⁃xu
    2022, 34(6):  604. 
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    Objective To evaluate the immunoprotective effect of active immunization with recombinant peptidyl⁃prolyl cis⁃trans isomerase from Babesia microti against B. microti infection in mice. Methods Female BALB/c mice at 6 weeks of age, each weighing approximately 20 g, were divided into the recombinant protein immunization group, the infection control group and the normal control group, of 25, 18, 15 mice in each group, respectively. Mice in the recombinant protein immunization group were given active immunization with recombinant BmPPIase protein, and 18 mice with the highest antibody titers were intraperitoneally injected with 100 μL of B. microti⁃infected whole blood 2 weeks after the last immunization. Mice in the infection control group were intraperitoneally injected with 100 μL of B. microti⁃infected whole blood, while 15 mice in the normal control group received no treatment. Blood samples were collected from mice in the recombinant protein immunization group and the infection control group on days 0 to 30 post⁃immunization for detection of B. microti infection, and blood samples were collected on days 0, 7, 14, 21, and 28 post⁃immunization for routine blood tests with a blood cell analyzer and for detection of serum cytokines using cytometric bead array. Results Anti⁃BmPPIase antibodies were detected in 25 mice in the recombinant protein immunization group 2 weeks after the last immunization, with titers of 5 × 103 to 8 × 104. B. microti infection rate peaked in mice in both the recombinant protein immunization and the infection control group on day 7 post⁃immunization, with positive infection rates of 13.3% and 50.0%, and there were significant differences between the two groups in terms of B. microti infection rate on days 3 ([χ2] = 113.18, P < 0.01), 5 ([χ2] = 475.22, P < 0.01), 7 ([χ2] = 465.98, P < 0.01) and 9 post⁃infection ([χ2] = 18.71, P < 0.01), while the B. microti infection rate tended to be 0 in both groups on day 11 post⁃immunization. Routine blood tests showed higher red blood cell counts [(5.30 ± 0.50) × 1012 to (9.87 ± 0.24) × 1012 counts/L)] and hemoglobin levels [(89.67 ± 22.80) to (148.60 ± 3.05) g/L)] in the recombinant protein immunization group than in the infection control group on days 0 to 28 post⁃immunization. Cytometric bead array detected higher serum interferon⁃γ [(748.59 ± 17.56) to (3 858.28 ± 1 049.10) fg/mL], tumor necrosis factor⁃α [(6 687.34 ± 1 016.64) to (12 708.13 ± 1 629.79) fg/mL], interleukin (IL)⁃6 [(611.05 ± 75.60) to (6 852.68 ± 1 554.00) fg/mL] and IL⁃17a [(167.68 ± 185.00) to (10 849.27 ± 355.40) fg/mL] and lower IL⁃10 levels [(247.65 ± 138.00) to (18 787.20 ± 2 830.22) fg/mL] in the recombinant protein immunization group than in the infection control group during the study period. Conclusions Recombinant BmPPIase protein induces up⁃regulation of interferon⁃γ, tumor necrosis factor⁃α and presents a high immunoprotective activity against B. microti infection in mice, which is a potential vaccine candidate protein.
    revalence of Echinococcus infection in small mammals captured from Shiqu County, Sichuan Province from 2015 to 2020
    HE Wei, YANG Liu, WANG Qi, YU Wen⁃jie, LIAO Sha, LIU Yang, ZHONG Bo, LUO Zhao⁃hui, WANG Qian
    2022, 34(6):  611. 
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    Objective To investigate the prevalence of Echinococcus infection in small mammals in Shiqu County, Sichuan Province from 2015 to 2020, so as to provide insights into echinococcosis control in Shiqu County. Methods One setting with frequent activity of small mammals was sampled as the survey site from each of 9 townships where human alveolar echinococcosis was hyperendemic, in Shiqu County, Sichuan Province from 2015 to 2020. Two quadrats measuring 50 m × 50 m were assigned in each survey site during the period between July and August from 2015 to 2020 to capture all small mammals in quadrats, and the species of small mammals were identified by morphological characteristics. All captured small mammals were dissected in the field and Echinococcus infection was identified by visual examinations. The affected organs of Echinococcus⁃infected small mammals were collected, and Echinococcus infection was detected using PCR assay, with Echinococcus species characterized. The prevalence of Echinococcus infection was calculated in small mammals, and the trends in the prevalence of Echinococcus infection were analyzed during the period from 2015 to 2020. In addition, the prevalence of Echinococcus infection was compared in small mammals using visual examinations and PCR assay. Results A total of 2 692 small mammals were captured in the survey sites of Shiqu County from 2015 to 2020, and morphology characterized 1 360 Microtus fuscus (50.52%) and 1 332 Plateau pika (49.48%). The prevalence rates of Echinococcus infection were 35.63%, 19.16%, 21.41%, 8.40%, 7.68% and 4.44% by visual examinations and 18.96%, 5.36%, 5.61%, 4.58%, 3.30% and 0.37% by PCR assay in small mammals in Shiqu County from 2015 to 2020, both showing a tendency towards a decline year by year ([χ2] = 215.024 and 117.045, both P values < 0.001). The prevalence of Echinococcus infection was significantly higher in small mammals by visual examinations than by PCR assay during the period from 2015 to 2020 except in 2018 ([χ2] = 33.597, 21.815, 51.373, 17.268 and 9.537, all P values < 0.01). PCR assay detected a reduction in the prevalence of E. multilocularis infection from 10.21% to 0.37% and a reduction in the prevalence of E. shiquicus infection from 8.75% to 0 in small mammals in Shiqu County from 2015 to 2020, both appearing a tendency towards a decline year by year ([χ2] = 117.045 and 43.436, both P values < 0.001). In addition, the prevalence of E. multilocularis and E. shiquicus infections reduced from 15.19% to 0.45% and from 8.23% to 0 in M. fuscus, and the prevalence of E. multilocularis and E. shiquicus infections reduced from 7.76% to 0 and from 9.01% to 0 in P. pika in Shiqu County from 2015 to 2020. Conclusions M. fuscus and P. pika were dominant species of small mammals in Shiqu County, Sichuan Province from 2015 to 2020, and E. multilocularis infection was mainly found in M. fuscus and E. shiquicus infection mainly found in P. pika. The prevalence of Echinococcus infection appeared a tendency towards a decline in both M. fuscus and P. pika year by year during the period from 2015 to 2020.
    Construction of a human health literacy indicator system for prevention of parasitic diseases based on Delphi method
    WANG Yi, LI Cheng⁃yuan, ZHANG Jia⁃yao, HUANG Yi⁃xin, YANG Kun, LIU Yao⁃bao
    2022, 34(6):  616. 
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    Objective To construct a human health literacy indicator system for prevention of parasitic diseases based on Delphi method. Methods Based on literature reviews and expert interviews, a questionnaire was designed and a two⁃round Delphi consultation was performed. A human health literacy indicator system for prevention of parasitic diseases was constructed according to the deletion criteria and experts’ advice. Results A total of 14 experts completed the two⁃round consultation. The second⁃round authority coefficients were 0.91 to 0.96 for the first⁃level indicators, 0.87 to 0.97 for the second⁃level indicators and 0.86 to 0.97 for the third⁃level indicators. A human health literacy indicator system for prevention of parasitic diseases was constructed with the main framework of basic knowledge and awareness, healthy behaviors, and healthy skills, which contained 3 first⁃level indicators, 12 second⁃level indicators and 48 third⁃level indicators. Among the three first⁃level indicators, basic knowledge and awareness had the highest weighting coefficient (0.336 5), followed by healthy behaviors (0.334 9), and healthy skills had the lowest weighting coefficient (0.328 6). The three secondary⁃level indicators with the highest combined weights included awareness of the epidemic status (0.088 2), awareness of the resource of infection (0.085 8) and basic awareness of parasitic diseases (0.085 5). Conclusion A human health literacy indicator system for prevention of parasitic diseases is preliminarily constructed, which provides insights into the development of health literacy evaluation tools for prevention of parasitic diseases in the new era.
    Investigation on prevalence of Schistosoma japonicum infections in wild mice in Shitai County, Anhui Province, 2018
    HE Jia⁃chang, CHEN Xue⁃feng, WANG Tian⁃ping, GAO Feng⁃hua, TAO Wei, DAI Bo, DING Song⁃jun, LIU Ting, LI Yi, WANG Hao, MAO Wei⁃fei, ZHANG Le⁃sheng, XU Xiao⁃juan, ZHANG Shi⁃qing
    2022, 34(6):  622. 
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    Objective To investigate the prevalence of Schistosoma japonicum infection in wild mice in Shitai County, Anhui Province, so as to provide insights into precise control of the source of S. japonicum infections. Methods Wild mice were captured using the trapping method for three successive nights at snail⁃infested settings from Jitan Village of Jitan Township, and Shiquan Village and Xibai Village of Dingxiang Township, Shitai County, Anhui Province in June and October, 2018. All trapped wild mice were sacrificed and liver and mesenteric vein specimens were collected for detection of S. japonicum eggs using microscopy, while the fecal samples in mouse intestines were collected for identification of S. japonicum infections using Kato⁃Katz technique. In addition, the population density of trapped wild mice was estimated and the prevalence of S. japonicum infection was calculated in trapped wild mice. Results A total of 376 wild mice were trapped from three villages in Shitai County. The population density of trapped wild mice was 9.1% (376/4 124), and the prevalence of S. japonicum infection was 24.2% (91/376) in trapped wild mice. The highest prevalence of S. japonicum infection was detected in Shiquan Village of Dingxiang Township (30.1%), and the lowest prevalence was seen in Xibai Village of Dingxiang Township; however, there was no significant difference in the prevalence of S. japonicum infection in trapped wild mice among three villages ([χ2] = 4.111, P > 0.05). In addition, there was no significant difference in the prevalence of S. japonicum infection in wild mice captured between on June (26.8%, 34/127) and October (22.9%, 57/249) ([χ2] = 0.690, P = 0.406). The trapped wild mice included 6 species, including Rattus norvegicus, Niviventer niviventer, R. losea, Apodemus agrarius, Mus musculus and N. coning, and the two highest prevalence of S. japonicum infection was detected in R. losea (34.9%, 22/63) and R. norvegicus (31.2%, 44/141). Conclusions The prevalence of S. japonicum infections is high in wild mice in Shitai County, and there is a natural focus of schistosomiasis transmission in Shitai County.
    Effectiveness of a whole⁃process health education model among inpatients with ascites type of advanced schistosomiasis
    ZHOU Rui⁃hong, HOU Xun⁃ya, CHENG Xiang⁃hui, PAN Jie, LAI Ru⁃yi, CHEN Gui⁃mei, ZHANG Hui, WEI Lan⁃jun, ZHANG Lu, LIU Jia⁃xin
    2022, 34(6):  626. 
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    Objective To evaluate the effectiveness of a whole⁃process health education model among inpatients with ascites type of advanced schistosomiasis. Methods A “admission⁃hospitalization⁃discharge” whole⁃process health education model was created, 101 inpatients with ascites type of advanced schistosomiasis were given the whole⁃process health education. The scores of schistosomiasis control knowledge, attitudes towards schistosomiasis control and healthy behaviors, and awareness of schistosomiasis control knowledge, correct rate of attitudes towards schistosomiasis control and correct rate of healthy behaviors were compared among inpatients with ascites type of advanced schistosomiasis before and after implementation of the whole⁃process health education. Results The scores of schistosomiasis control knowledge, schistosomiasis control attitudes and healthy behaviors were all significantly higher among inpatients with ascites type of advanced schistosomiasis after implementation of the whole⁃process health education than before implementation (Z = -7.688, -3.576 and -4.328, all P values < 0.01). In addition, the awareness of schistosomiasis control knowledge increased from 54.3% to 82.7% ([χ2] = 188.886, P < 0.01), and the correct rate of attitudes towards schistosomiasis control increased from 88.4% to 98.0% ([χ2] = 22.001, P < 0.01), while the correct rate of healthy behaviors increased from 48.2% to 59.7% ([χ2] = 11.767, P < 0.01). Conclusions The whole⁃process health education model may remarkably improve the awareness of schistosomiasis control knowledge and promote the formation of positive attitudes towards schistosomiasis control and correct behaviors among inpatients with ascites type of advanced schistosomiasis, which is of great significance to facilitate patients’ cure.
    Bacterial community diversity in Dermatophagoides farinae using high⁃throughput sequencing
    ZHOU Xiao⁃qian, MA Jie, WANG Rui⁃yi, WANG Ruo⁃hang, WU Yi⁃qiang, YANG Xin⁃yan, CHEN Yu⁃juan, TANG Xiao⁃niu, SUN En⁃tao
    2022, 34(6):  630. 
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    Objective To investigate the bacterial community diversity in Dermatophagoides farinae. Methods Laboratory⁃cultured D. farinae was collected, and the composition of microbial communities was determined by sequence analyses of the V4 region in the bacterial 16S ribosomal RNA (16S rRNA) gene on an Illumina PE250 high⁃throughput sequencing platform. Following quality control and filtering of the raw sequence files, valid reads were obtained and subjected to operational taxonomic units (OTU) clustering and analysis of the composition of microbial communities and alpha diversity index using the Usearch software, Silva database, and Mothur software. Results A total of 187 616 valid reads were obtained, and 469 OTUs were clustered based on a sequence similarity of more than 97%. OTU annotation showed that the bacteria in D. farinae belonged to 26 phyla, 43 classes, 100 orders, 167 families and 284 genera. The bacteria in D. farinae were mainly annotated to five phyla of Proteobacteria, Firmicutes, Bacteroidota, Actinobacteriota, and Acidobacteriota, with Proteobacteria as the dominant phylum, and mainly annotated to five dominant genera of Ralstonia, norank⁃f⁃Mitochondria, Staphylococcus and Sphingomonas, with Wolbachia identified in the non⁃dominant genus. Conclusions A high diversity is identified in the composition of the bacterial community in D. farinae, and there are differences in bacterial community diversity and abundance among D. farinae.
    Epidemiological investigation on a visceral leishmaniasis case in Zhengzhou City of Henan Province
    YANG Cheng⁃yun, ZHAO Xiao⁃ming, LU De⁃ling, ZHANG Yue⁃quan, QIAN Jian⁃hua, WANG Xiao, LI Su⁃hua, HE Zhi⁃quan, QIAN Dan, LIU Ying, JI Peng⁃hui, ZHOU Rui⁃min, ZHANG Hong⁃wei
    2022, 34(6):  635. 
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    Objective To perform an epidemiological investigation on a case with visceral leishmaniasis in Zhengzhou City, Henan Province, and to identify the source of infection, so as to illustrate the transmission chain and assess the risk of local leishmaniasis transmission. Methods The medical data were collected from a case with visceral leishmaniasis in Zhengzhou City, and the patient’s bone marrow smears were detected by microscopy. Serum anti⁃Leishmania antibody test and PCR assay were performed among high⁃risk residents and all dogs in the village where the patient lived. Sandflies were captured using light traps and artificial traps, and the captured female Phlebotomus chinensis was subjected to PCR assay. The internal transcribed spacer 1 (ITS1) gene was amplified with a nested PCR assay using the genomic DNA extracted from visceral leishmaniasis patients, positive dogs and sandflies, and the sequences were aligned with those download from NCBI. In addition, a phylogenetic tree was created based on the ITS1 gene. Results The visceral leishmaniasis patient had recurrent irregular fever, reduced complete blood counts, low hemoglobin, and a large number of Leishmania amastigotes in bone marrow smears, and was therefore diagnosed as visceral leishmaniasis. Both rk39 rapid diagnostic test and PCR assay tested negative among 324 residents living neighboring the patient’s residence, while 21.39% (43/201) dogs were positive for rk39 rapid diagnostic test and 13.93% (28/201) positive for PCR assay. There were 17 female Ph. chinensis tested positive for Leishmania (0.82%) by PCR assay, and the ITS gene sequences from visceral leishmaniasis patients, positive dogs and sandflies shared a 100% homology with L. infantum. The Leishmania species was therefore characterized as L. infantum. Conclusions L. infantum infection occurs in visceral leishmaniasis patients, dogs and sandflies in Zhengzhou City, indicating a complete transmission chain and a high transmission risk of visceral leishmaniasis by L. infantum. Intensified control measures are required to prevent local transmission of leishmaniasis in Zhengzhou City.
    Bibliometric analysis of publications pertaining to artemisinin resistance in Plasmodium falciparum based on Web of Science
    DONG Li, LI Jian, WANG Li⁃lei, MO Jin⁃yu
    2022, 34(6):  639. 
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    Objective To analyze the global literature output and citation of publications pertaining to artemisinin (ART) resistance in Plasmodium falciparum from 2011 to 2021, so as to provide insights into researches on resistance of P. falciparum to ART. Methods The publications pertaining to ART resistance in P. falciparum were retrieved from the Science Citation Index Expanded (SCIE) database in Web of Science during the period from January 2011 through May 2022. The subject, journal, country, affiliation and author distributions and citations of publications were descriptively analyzed. Results A total of 1 640 publications pertaining to ART resistance in P. falciparum were retrieved in the SCIE database during the period from January 2011 through May 2022, and the number of publications appeared an overall tendency towards a rise during the study period. These articles were published in 343 journals, and the three most productive journals included Malaria Journal (341 publications, 20.79%), Antimicrobial Agents and Chemotherapy (141 publications, 8.60%), American Journal of Tropical Medicine and Hygiene (68 publications, 4.15%), with infectious diseases (565 publications, 34.45%), parasitology (531 publications, 32.38%), and tropical medicine (517 publications, 31.54%) as the predominant subject. The three most productive countries included the United States of America (627 publications, 38.23%), United Kingdom (395 publications, 24.08%), and Thailand (294 publications, 17.94%), with total citations of 25 280, 18 622 and 15 474, respectively, and the most productive countries included Mahidol University (Thailand), Oxford University (England) and London University (England), with 234, 220 publications and 142 publications and 15 058, 15 421 citations and 6 191 citations, respectively. The three most productive authors were all from Mahidol University, with 85, 77 and 63 publications, respectively; and among the three most cited authors, two were from Mahidol University, Thailand, with 8 623 and 7 961 total citations , and one from National Institutes of Health, the United States of America, with 6 267 total citations. A total of 138 articles were published by Chinese scientists, with 3 434 total citations , and National Institute of Parasitic Diseases of Chinese Center for the Diseases Control and Prevention was the most productive Chinese institution, with 35 publications, 1 165 total citations and 33.29 citations per publication. Conclusions The literature output of ART resistance in P. falciparum was relatively high in the United States of America, Europe, and Southeast Asian countries during the period from 2011 to 2021, with a relatively high academic impact. Publications in Malaria Journal and Antimicrobial Agents and Chemotherapy are recommended to be paid much attention by Chinese scientists to understand the latest advances and extend the research interests.
    Mechanism of hepatic fibrosis associated with Echinococcus: a review
    ZHANG Ren⁃jie, PANG Hua⁃sheng, LI Jing⁃zhong, LUO Zhao⁃hui, AI Lin, SONG Peng, CAI Yu⁃chun, LU Yan, MO Xiao⁃jin, CHEN Mu⁃xin , CHEN Jia⁃xu
    2022, 34(6):  646. 
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    Echinococcosis is a zoonotic parasitic disease caused by Echinococcus infections, and this disorder may cause fibrosis of multiple vital organs, which may further progress into cirrhosis. Early⁃stage hepatic fibrosis is reversible, and unraveling the mechanisms underlying hepatic fibrosis induced by Echinococcus infections is of great significance for the prevention and treatment of early⁃stage hepatic fibrosis. Recently, the studies pertaining to hepatic fibrosis associated with Echinococcus infections focus on cytokines and immune cells. This review summarizes the advances in the mechanisms underlying host immune cells⁃ and cytokines⁃mediated hepatic fibrosis in humans or mice following Echinococcus infections.
    Global distribution and transmission of Fasciola
    YAO Jia⁃wen, JIA Tie⁃wu
    2022, 34(6):  654. 
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    As a global zoonotic disease, fascioliasis is a serious threat to human and animal health and animal husbandry development. The complexity of the classification and identification of Lymnaeidae, the intermediate host of Fasciola, notably the emergence of its sibling species, leads to misunderstanding of geographical distribution and transmission potential of Fasciola. This review introduces the classification of flukes of the family Fasciolidae, describes the geographical distribution of F. hepatica and F. gigantic, and discusses the co⁃evolution of Fasciola and Lymnaeidae host snails, and the effects of human activities and ruminant migration on global spread and transmission of Fasciola. In addition, we revisit the intermediate host snails of Fasciola in Africa based on the latest molecular biological evidence.
    Application of integrated species distribution models in parasitic diseases prevention and control: a review
    LI Lu, WANG Qiang, XU Jing
    2022, 34(6):  659. 
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    Species distribution model, a mathematical model theoretically based on the temporal and spatial locations of species in the ecosystem and their associations with other species, is useful to display the current species distribution and predict the future species distribution, which has been widely applied in ecology, biogeography and spatial transmission of infectious diseases. Integrated species distribution model is a comprehensive, summative and reliable combination model that simultaneously uses multiple species distribution models or integrates multiple data sources for modeling. This review describes the theory and classification of species distribution models, and summarizes the creation and verification of integrated species distribution models and their applications in parasitic disease prevention and control. During the practical applications of integrated species distribution models, the study scale, niche matching, big data utilization, combination of multidisciplinary methods and knowledge background and ecological implications should be emphasized.  
    Proteinuria associated with hookworm infection: a case report
    WU Ling, TANG An⁃qi, CHEN Tong, YE Xue⁃feng, LI Ming⁃quan, MA Tao, ZHAO Liang⁃bin
    2022, 34(6):  665. 
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    As a common soil⁃borne nematode, hookworm is mainly parasitized in the intestine, and the clinical manifestations of hookworm infections mainly include gastrointestinal symptoms and iron⁃deficiency anemia. In addition, hookworm may be also parasitized in other organs in addition to gastrointestinal system, resulting in development of disorders in other systems. Proteinuria caused by hookworm infections is rare and easy to be misdiagnosed in clinical practices. Hereby, the diagnosis and treatment of a case of proteinuria associated with hookworm infections was reported, in order to increase the understanding of hookworm infection⁃associated proteinuria among clinicians.
    Hepatic cystic echinococcosis complicated with tuberculous empyema misdiagnosed as hepatic and pulmonary cystic echinococcosis: one case report
    LI Wen⁃deng, PANG Ming⁃quan, LI Chao⁃qun, XU Kai, DONG Yun, ZHAO Wen⁃qian, WANG Yan, FAN Hai⁃ning
    2022, 34(6):  669. 
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    Hepatic cystic echinococcosis is a chronic parasitic disease caused by the infection with the larvae of Echinococcus granulosus in human or animal liver tissues. As a chronic active infectious disease, tuberculous empyema mainly invades the pleural space and then causes visceral and parietal pleura thickening. It is rare to present comorbidity for hepatic cystic echinococcosis and tuberculous empyema. This case report presents a case of hepatic cystic echinococcosis complicated with tuberculous empyema misdiagnosed as hepatic and pulmonary cystic echinococcosis, aiming to improve clinicians’ ability to distinguish this disorder.