Epidemiological survey of cystic echinococcosis in southwest China:From the Qinghai-Tibet plateau to the area of Yunnan

BACKGROUND Echinococcosis is prevalent in 9 provinces in Western and Northern China.An epidemiological survey of echinococcosis in 2012 and 2016 showed cases of echinococcosis in Yunnan Province.AIM To understand the spatial distribution and epidemiological characteristics of echinococcosis in Yunnan for the prevention and control of echinococcosis and to reduce the risk of infection in Yunnan Province.METHODS Based on the China Information System for Disease Control and Prevention(CISDCP),echinococcosis cases reported from 36 hospitals and 34 Centers for Disease Control were investigated and epidemiologically analyzed from 2021 to 2022.The exclusion criteria included suspected cases,same case only counted once and cases not from Yunnan.A total of 705 cases were investigated,of which 397 cases were suitable for statistical analysis.In these 397 cases,epidemiological investigation was tracked in 187 cases.All data were inputted using double entry in the Excel database,with error correction by double-entry comparison.The data on echinococcosis cases in Yunnan Province were analyzed by ArcGIS 10.1 software to generate a density map of echinococcosis distribution.All statistical analyses were conducted using SPSS 17.0,including the chi-square test,linear regression test and logistic univariate and multivariate regression analyses.RESULTS A total of 397 cases were found in 89 counties in Yunnan Province.The number of cases in the top three prefectures were Dali(38.1%),Diqing(10.1%),and Kunming(8.3%),and the top five counties were Jianchuan(9.1%),Shangri La(8.3%),Eryuan(7.6%),Heqing(6.9%),and Dali Districts(5.0%).There were significant differences between the different areas.The case reporting rate by CISDCP(33.8%)was low;the first case was reported by CISDCP in 2002,and the highest number of cases was 50(2017).Confirmed and clinical cases accounted for 62.5%and 37.5%,respectively.However,90.9%of the cases of hydatid disease were reported by the hospital system,and only 9.1%of the cases of hydatid disease were found in the community through active screening.The difference between the two methods of case detection was statistically significant.Most of the cases of echinococcosis were found in farmers/herdsmen(75.1%)and students(9.1%).In addition,Han(43.6%)and Bai(26.2%)had a higher incidence of infection than other nationalities,and the liver(87.7%)and lung(6.8%)were the most common sites of cyst formation.Among the analyzed cases,187 were epidemiologically analyzed and the clinical symptoms were not obvious in the early stage in 47.1%of cases.The results of logistic regression analysis showed that the age group,education level,presence of dogs in the family(either previously or currently),and handwashing(occasionally or not)were factors related to echinococcosis infection.55.6%of cases were in endemic areas,and 44.4%of cases were in non-endemic areas.Among 83 cases in non-endemic areas,only 4 cases had been to endemic areas and had a history of living,working,travelling,or hunting in echinococcosis epidemic areas.CONCLUSION Cases of echinococcosis were reported throughout the entire Yunnan province,with the majority distributed in Western Yunnan,suggesting that echinococcosis control should be strengthened in this area.We suggest that an epidemiological investigation should be carried out in the future,based on the clues from newly discovered cases in hospitals or from the CISDCP.The newly discovered cases in the hospital provided clues to comprehensively determine the location of cases and where epidemic spot investigation should be conducted.

Leptin receptor polymorphism in patients with asthma and its correlation with the disease progression

Objective:To study the leptin receptor Gln223Arg locus polymorphism in patients with asthma and its correlation with the disease progression.Methods: The patients who were diagnosed with bronchial asthma in our hospital between July 2014 and April 2017 were selected as the asthma group for the study, and the healthy volunteers who received physical examination in our hospital during the same period were selected as the control group. The leptin receptor gene Gln223Arg locus polymorphism was determined, and the contents of inflammatory mediators and airway remodeling indexes in serum as well as the contents of immune cells in peripheral blood were determined.Results: Eotaxin, Galectin-3, YKL-40, SAA, IL-33, ADAM33, NE and MMP9 contents in serum as well as Th17, Th9 and Tfh contents in peripheral blood of asthma group of patients with AA+AG genotype and GG genotype were significantly higher than those of control group whereas TIMP1 and TIMP2 contents in serum as well as Treg contents in peripheral blood were significantly lower than those of control group;Eotaxin, Galectin-3, YKL-40, SAA, IL-33, ADAM33, NE and MMP9 contents in serum as well as Th17, Th9 and Tfh contents in peripheral blood of asthma group of patients with AA+AG genotype were significantly higher than those of patients with GG genotype whereas TIMP1 and TIMP2 contents in serum as well as Treg content in peripheral blood were significantly lower than those of patients with GG genotype.Conclusion: The substitution from leptin receptor Gln223Arg locus polymorphism A G replacement in patients with asthma can aggravate the inflammatory response and immune response disorder as well as airway remodeling.

Clinical effect and antiviral mechanism of T-705 in treating severe fever with thrombocytopenia syndrome

Severe fever with thrombocytopenia syndrome(SFTS)virus(SFTSV)is an emerging tick-borne virus with high fatality and an expanding endemic.Currently,effective anti-SFTSV intervention remains unavailable.Favipiravir(T-705)was recently reported to show in vitro and in animal model antiviral efficacy against SFTSV.Here,we conducted a single-blind,randomized controlled trial to assess the efficacy and safety of T-705 in treating SFTS(Chinese Clinical Trial Registry website,number ChiCTR1900023350).From May to August 2018,laboratory-confirmed SFTS patients were recruited from a designated hospital and randomly assigned to receive oral T-705 in combination with supportive care or supportive care only.Fatal outcome occurred in 9.5%(7/74)of T-705 treated patients and 18.3%(13/71)of controls(odds ratio,0.466,95%Cl,0.174-1.247).Cox regression showed a significant reduction in case fatality rate(CFR)with an adjusted hazard ratio of 0.366(95%Cl,0.142-0.944).Among the low-viral load subgroup(RT-PCR cycle threshold>26),T-705 treatment significantly reduced CFR from 11.5 to 1.6%(P=0.029),while no between-arm difference was observed in the high-viral load subgroup(RT-PCR cycle threshold<26).The T-705-treated group showed shorter viral clearance,lower incidence of hemorrhagic signs,and faster recovery of laboratory abnormities compared with the controls.The in vitro and animal experiments demonstrated that the antiviral efficacies of T-705 were proportionally induced by SFTSV mutation rates,particularly from two transition mutation types.The mutation analyses on T-705-treated serum samples disclosed a partially consistent mutagenesis pattern as those of the in vitro or animal experiments in reducing the SFTSV viral loads,further supporting the anti-SFTSV effect of T-705,especially for the low-viral loads.

Assessment of malaria control consultation and service posts in Yunnan, P. R. China

Background:This paper seeks to assess the function of malaria control consultation and service posts(MCCSPs)that are located on the border areas of Yunnan province,P.R.China,as a strategy for eliminating malaria among the mobile and migrant population in these areas.Methods:A retrospective descriptive analytical study was conducted.Blood smear examinations conducted at all MCCSPs in Yunnan from 2008 to 2014 were analysed.A cross-sectional survey was conducted in 2014 to understand how the MCCSPs function and to elucidate the quality of the blood smear examinations that they conduct.Results:Out of the surveyed MCCSPs,66%(39/59),22%(13/59),and 12%(7/59)were attached to local township hospitals,village health clinics,and the county centre for disease control and prevention or private clinics,respectively.More than 64%(38/59)of the posts’staff were part-time workers from township hospitals and village health facilities.Less than 31%(18/59)of the posts’staff were full-time workers.A total of 35 positive malaria cases were reported from seven MCCSPs in 2014.Four MCCSPs were unable to perform their functions due to under staffing in 2014.There was a small fluctuation in blood smear examinations from January 2008 to June 2009,with two peaks during the period from July 2009 to October 2010.The number of blood smear examinations has been increasing since 2011.The yearly mean number of blood smear examinations in each post increased from 44 per month in 2011 to 109 per month in 2014,and the number of positive malaria cases detected by blood smear examinations has declined(χ^(2)=90.67,P=0.000).The percentage of people from Yingjiang county getting blood smear examinations increased between 2008 and 2014,while percentages of the mobile population including Myanmar people,people from other provinces,and people from other Yunnan counties getting blood smear examinations decreased.Conclusion:MCCSPs face challenges in the phase of malaria elimination in Yunnan,China.New case detection strategies should be designed for MCCSPs taking into account the current trends of migration.