Post-COVID-19 cholangiopathy:A systematic review

BACKGROUND The recent and still ongoing pandemic caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)entailed various long-term complications,including post-infectious cholangiopathy.AIM To identify the available studies concerning post-coronavirus disease 2019(COVID-19)cholangiopathy.METHODS An extensive bibliographical search was carried out in PubMed and in Cochrane Library to identify the articles(retrospective and prospective studies,cohort studies,case series and case reports)published between January 1,2020 and August 22,2022,using both MeSH terms and free-language keywords:cholangiopathy;COVID-19;post-COVID-19 cholangiopathy;SARS-CoV-2.RESULTS Thirteen studies fulfilled the inclusion criteria,which included 64 patients suffering from this condition.The patients were male in 82.8%of cases.Liver transplant was executed in 6 patients and scheduled in 7 patients,while 2 patients refused the surgical approach.Therefore in 23.4%of the cases,performing this procedure appeared to be necessary.CONCLUSION This review has revealed that generally the involvement of the liver in the course of SARS-CoV-2 infection is mild and transient,inducing cholestasis of cholangiocytes but can also be severe enough to cause organ failure in some cases.

Life Is Quantum Biology Effects Explained from the Schrödinger Equation, Serious or Life-Threatening Conditions or Diseases, and COVID-19 Results

Background: A plant based approach was undertaken to ascertain the efficacy of the Technology/Innovation of a new medical Technology based on similar activity to the circulatory system of plants. Basic Technology formulations were introduced into plant structures to evaluate the responses for cell division and plant growth which ultimately lead to the final product. This Technology/Innovation transforms and enhances common botanical/herb products such that they can be used to treat COVID-19 infection and Serious or Life-threatening conditions or diseases. They can restore the diseased cell’s abnormal metabolism to homeostasis and return it to normal function by slowing or reversing the cell’s malfunctioning metabolism, or in other words, slowing or reversing the disease process. Methods: A systematic treatment for COVID-19 infection and Serious or Life-threatening illness in patients is based on theories of traditional Chinese medicine. The Technology/Innovation is developed as dietary supplement products for treatment of Serious or Life-threatening conditions or diseases. Results: The results consist of over one hundred Serious or Life-threatening patient medical records. The U.S. Food and Drug Administration (FDA) reviewed/evaluated/accepted the Technology/Innovation patient medical record results, which included fifty-four COVID-19 patients with Prioritized Review Expedited No.: 2020-2867 CR2020-2596 information on September 16, 2020 and twenty-seven cancer patients Cancer Survival Rate Results in (Table 1) with FDA Establishment Identification No.: 3012327979 information on March 25, 2019 as FDA-Regulated medical products and meet the requirement under FDA Significant Scientific Agreement standards.

Post-COVID-19 cholangiopathy:Current understanding and management options

Post-coronavirus disease 2019(COVID-19)cholangiopathy(PCC)is a rare but lifethreatening complication of COVID-19 infection.PCC typically presents when patients recovering from the contagion and manifests as cholestasis in patients with no history of pre-existing liver disease.The pathogenesis of PCC is little understood.Hepatic injury in PCC could be mediated by the predilection of severe acute respiratory syndrome coronavirus 2 for cholangiocytes.Though PCC shows some resemblance to secondary sclerosing cholangitis in critically ill patients,it is considered as a separate and unique entity in the literature.Various treatment options like ursodeoxycholic acid,steroids,plasmapheresis,and endoscopic retrograde cholangiopancreatography guided interventions have been tried but with limited success.We have noticed significant improvement in liver function with antiplatelet therapy in a couple of patients.PCC can progress to end-stage liver disease necessitating liver transplantation.In this article,we discuss the current knowledge of PCC focusing on its pathophysiology,clinical manifestations,and management strategies.

Evaluation of children and adults with post-COVID-19 persistent smell,taste and trigeminal chemosensory disorders:A hospital based study

BACKGROUND Smell disorders are the most frequent persistent coronavirus disease 2019(COVID-19)complications.AIM To describe the patterns and characteristics of persistent smell and taste disorders in Egyptian patients.METHODS Assessment was done to 185 patients(adults=150,age:31.41±8.63 years;children=35;age:15.66±1.63 years).Otolaryngology and neuropsychiatric evaluations were done.Measurements included:A clinical questionnaire(for smell and taste);sniffin'odor,taste and flavor identification tests and the Questionnaire of Olfactory Disorders-Negative Statements(sQOD-NS).RESULTS Duration of disorders was 11.53±3.97 ms(6-24 ms).Parosmia(n=119;64.32%)was developed months after anosmia(3.05±1.87 ms).Objective testing showed anosmia in all,ageusia and flavor loss in 20%(n=37)and loss of nasal and oral trigeminal sensations in 18%(n=33)and 20%(n=37),respectively.Patients had low scoring of sQOD-NS(11.41±3.66).There were no specific differences in other demographics and clinical variables which could distinguish post-COVID-19 smell and taste disorders in children from adults.CONCLUSION The course of small and taste disorders are supportive of the nasal and oral neuronal compromises.Post-COVID-19 taste and trigeminal disorders were less frequent compared to smell disorders.Post-COVID-19 flavor disorders were solely dependent on taste and not smell disorders.There were no demographics,clinical variables at onset or specific profile of these disorders in children compared to adults.

Work Ability Index and Work Ability Score: A Comparation between both Scores in a Persistent COVID-19 Cohort

Aims: The present study aims to compare the assessment of work ability based on the use of the Work Ability Index (WAI) with another questionnaire base only on the use of WAI’s first item, termed as the “Work Ability Score” (WAS). Study design: A cohort of 384 Spanish workers included in a Post COVID-19 condition or persistent COVID-19 multicenter research was utilized. Place and Duration of Study: This cohort was enlisted in four hospitals (Hospital Universitario 12 de Octubre, Madrid;Hospital Universitario Virgen Macarena, Sevilla, Andalucía;Hospital Universitario Gregorio Marañón, Madrid and Complejo Asistencial Universitario de Salamanca, Castilla y León), since 2021 until 2022. Methodology: 384 Spanish workers (176 men and 208 women;aged 20 to 70 years) with Post COVID-19 condition or persistent COVID-19 were included. Descriptive analysis of primary scores was conducted. Given the non-normal distribution of data, the Mann-Whitney and Kruskal-Wallis tests were employed. Spearman and Kendall correlations were employed to assess the relationship between WAI and WAS, also used weighted Kappa to estimate the degree agreement between WAI and WAS. Logistic regression models were utilized to study determinants influencing WAI and WAS, categorized as poor or moderate. Results: WAI had an average score of 32.98 (SD = 10.28), whereas WAS had an average of 5.95 (SD = 2.77). Significant differences were observed in both WAI and WAS across the same variables. Strong and statistically significant correlations were evident between WAI and WAS (rs = 0.83, p < 0.001). All the variables used in the logistic regression model (gender, the sector employment, and previous chronic diseases) were statistically significant in both questionnaires. Conclusion: WAS questionnaire could be used as a tool for reliable assessment of work ability among Spanish workers with Post COVID-19 condition or Persistent CO-VID-19.

血清细胞角蛋白19片段、α-烯醇化酶检测在子宫内膜癌诊断及病情严重程度评估中的价值

目的:探讨血清细胞角蛋白19片段(CYFRA21-1)、α-烯醇化酶(ENO1)检测对子宫内膜癌的诊断价值以及对患者病情严重程度的评估作用。方法:选择83例子宫内膜癌患者、95例良性子宫内膜疾病患者和100例健康女性作为研究对象。采用酶联免疫吸附法检测血清CYFRA21-1、ENO1水平,比较各组血清CYFRA21-1、ENO1水平差异。分析血清CYFRA21-1、ENO1水平与子宫内膜癌患者病理特征的关系。采用受试者工作特征(ROC)曲线分析血清CYFRA21-1、ENO1水平诊断子宫内膜癌的效能。结果:子宫内膜癌组血清CYFRA21-1、ENO1水平高于良性子宫内膜疾病组和对照组,良性子宫内膜疾病组血清CYFRA21-1、ENO1水平高于对照组(均P<0.05)。透明细胞癌患者血清CYFRA21-1、ENO1水平高于其他三种类型,鳞癌患者血清CYFRA21-1、ENO1水平高于腺癌和混合性癌(均P<0.05)。Ⅲ期和Ⅳ期患者血清CYFRA21-1、ENO1水平均高于Ⅰ期和Ⅱ期患者(均P<0.05);Ⅱ期患者血清CYFRA21-1、ENO1水平高于Ⅰ期患者(均P<0.05)。不同分化程度患者血清CYFRA21-1、ENO1水平两两比较均有统计学差异(均P<0.05),高分化患者血清CYFRA21-1、ENO1水平最高。肌层浸润≥1/2、发生淋巴结转移的患者血清CYFRA21-1、ENO1水平高于肌层浸润<1/2、未发生淋巴结转移的患者(P<0.05)。复发组和术后1年内死亡的子宫内膜癌患者血清CYFRA21-1、ENO1水平均高于未复发组和未死亡患者(均P<0.05)。血清CYFRA21-1诊断子宫内膜癌的AUC为0.939,以≥4.8 ng/ml作为诊断阈值,其敏感度、特异度和约登指数分别为95.18%、75.90%和71.08%;血清ENO1诊断子宫内膜癌的AUC为0.879,以≥482.5 pg/ml作为诊断阈值,其敏感度、特异度和约登指数分别为85.54%、76.92%和62.47%。结论:血清CYFRA21-1、ENO1水平提高与子宫内膜癌多种病理特征相关,术后复发和1年内死亡患者血清CYFRA21-1、ENO1水平增加尤为明显,通过检测这两个指标可辅助诊断子宫内膜癌并对病情进行评估。

Issues related to post-COVID-19 syndrome

The pandemic caused by severe acute respiratory syndrome coronavirus-2(SARSCoV-2)in 2019-2022 leads to a multisystem illness that results in damage to numerous organ systems.In this review,our goal was to assess current research on long-term respiratory,cardiac,neurological,digestive,rheumatological,urogenital,and dermatological system complications of coronavirus disease 2019(COVID-19).Bibliographic searches were conducted in December 2021 using PubMed and Google Scholar,retrospectively,covering all COVID-19 literature to determine the consequences of the disease.This review may help to determine the prospects for new studies and predict the upcoming aspects requiring assessment in post-COVID-19 syndrome.

基于MPNet与BiLSTM的COVID-19临床文本命名实体识别方法

随着生物医学研究与信息化技术的迅速发展,临床医学文献数量呈指数级增长,利用文本挖掘技术自动提取医学知识逐渐成为当前研究热点。针对目前新型冠状病毒肺炎(Corona Virus Disease 2019,COVID-19)临床文本研究匮乏、语料不足与标注质量不高等问题,本文结合UMLS医学语义网络和专家定义方式,制定医学实体标注规则,建立命名实体识别语料库,明确实体识别任务。其次,提出了一种基于MPNet与BiLSTM的COVID-19临床文本命名实体识别模型。通过预训练语言模型获得文本的向量化表示,解决了一词多义问题;采用双向长短期记忆网络,捕捉文本的长距离依赖;最后引入条件随机场,实现句子级序列注释,输出完整的最优标签序列。实验结果表明,MPNet-BiLSTM-CRF模型在COVID-19临床命名实体识别数据集上取得了较好的表现。

Ophthalmologic implications to consider when using hydroxychloroquine to treat COVID-19 and induced arthritis

As the world continues to grapple with the novel coronavirus[coronavirus disease 2019(COVID-19)],many treatments have been proposed to help alleviate the symptoms and reduce the mortality rate.Hydroxychloroquine(HCQ)is an antimalarial drug that is typically used for several autoimmune,rheumatic,and dermatological conditions.It has also been considered to treat and prevent COVID-19 and subsequent arthritis associated with the infection.This drug is known to cause retinal toxicity,which can lead to vision impairment or loss.While the exact mechanism is not yet fully understood,it is thought to be due to the accumulation of the drug in the retinal pigment epithelium.The risk of toxicity increases with long-term use or with high doses of the drug and is more likely to occur in patients with pre-existing retinal diseases or those who are predisposed to retinal diseases.In this context,several steps can be taken to monitor and minimize the risk of ophthalmological adverse events when using HCQ to treat patients with COVID-19.

Challenges to associate early onset epilepsy with COVID-19 autoimmune encephalitis:A case

BACKGROUND Diagnosis of coronavirus disease 2019(COVID-19)-related neurological events in the pediatric population is challenging.Overlapping clinical picture of children with altered neurological state and inborn errors of metabolism,in addition to the frequency of asymptomatic COVID-19 cases,pose the main challenges for diagnosis.Diagnostic approaches to the onset post-COVID 19 subacute encephalopathy are still troublesome as seronegative autoimmune encephalitis(AIE)is reported.CASE SUMMARY A 27-mo-old boy was admitted for stormy refractory seizure of polymorphic semiology and altered mental status followed by various neuropsychiatric features that were suggestive of AIE.Brain magnetic resonance imaging and cerebrospinal fluid analysis were normal.Neither the immunological assessment,including viral serologies,antinuclear antibodies,autoimmune antibodies(NMDA,AMPA,CASPR2,LG11,GABARB,Hu,Yo,Ri,CV2,PNMA2,SOX1,Titin,amphiphysin,Recoverin),nor the metabolic assessment for lactate and pyruvate showed significant anomaly.Both positive history of COVID-19 infection and the findings of characteristic repetitive extreme delta brush played a key role in the diagnosis of COVID-19-related AIE.A remarkable improvement in the state of the child was noted after two pulse doses of intravenous Veinoglobulin and high dose of intravenous Corticosteroid.CONCLUSION Diagnostic biomarkers for AIE might aid effective treatment.

新冠病症统一命名的建议

新冠疫情暴发三年多来,国内外出现多种有关新冠病症的名称,如国内有新型冠状病毒肺炎、新型冠状病毒感染等,国外有世卫组织命名的2019冠状病毒病以及倡用的新冠后症状,此外还有长新冠、新冠后综合征、新冠后遗症等较为常见的名称。目前已出现一定的混乱,需要正视。通过辨析,提出取舍意见,认为目前应与世卫组织一致,统一使用2019冠状病毒病、新冠后症状。根据术语学有关要求,同时提出规范名词的建议,为进一步审定新冠病症名称提供参考。

抗烟草黑胫病菌的菌株ZY-19-2的鉴定及发酵条件研究

烟草黑胫病是烟草上重要毁灭性病害之一,生产上主要采取综合防治措施,包括种植抗病品种、农业防治、病害发生期的药剂防治,以及生物防治和植物诱导抗性的利用等,后两者已成为当前综合防治的研究重点。生物防治是烟草黑胫病防治最主要的手段之一。从烟草根际土样中分离、筛选得到一株对烟草黑胫病菌有抑制作用的菌株ZY-19-2,为了评价该菌株利用价值,对菌株ZY-19-2进行了鉴定及不同培养条件下该菌株产几丁质酶的活力。结果表明:该菌株为淡紫拟青霉(Paecilomyces lilacinus);该菌株的最佳发酵条件以1.2%胶体几丁质为碳源,发酵液初始pH为6.0,以1%蛋白胨为氮源,0.1%吐温80作为表面活性剂,发酵时间为60h,接种量为1%,摇床转速为120r/min,最高酶活达到0.216U/mL。通过对菌株ZY-19-2发酵条件的优化,为应用该菌株规模化生产高效廉价的几丁质酶、几丁质寡糖及对烟草黑胫病防治奠定基础。

基层新型冠状病毒感染后病症诊治及照护广东专家推荐意见

新型冠状病毒感染后病症(PCC)定义为在有可能或确诊严重急性呼吸综合征冠状病毒2型(SARSCoV-2)感染的3个月后,出现无法用其他诊断来解释的、至少持续2个月的症状。PCC是生物学因素、心理学因素及社会文化因素综合作用的结果,具有患病数较多、发病机制复杂、症状多样、长期照护需求大的特点。PCC的诊断被视为排除性诊断,可划分为“非重度COVID-19多器官后遗症”“肺纤维化后遗症”“肌痛性脑脊髓炎或慢性疲劳综合征”“体位性直立性心动过速综合征”“重症监护后综合征”和“医学或临床后遗症”6种亚型,在整体性评估的基础上,可在多学科协作的模式下,通过药物、膳食、运动、心理干预、患者教育等方法进行治疗和照护。

Effects of SARS-CoV-2 infection on incidence and treatment strategies of hepatocellular carcinoma in people with chronic liver disease

BACKGROUND Chronic liver disease(CLD)was associated with adverse clinical outcomes among people with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.AIM To determine the effects of SARS-CoV-2 infection on the incidence and treatment strategy of hepatocellular carcinoma(HCC)among patients with CLD.METHODS A retrospective,territory-wide cohort of CLD patients was identified from an electronic health database in Hong Kong.Patients with confirmed SARS-CoV-2 infection[coronavirus disease 2019(COVID-19)+CLD]between January 1,2020 and October 25,2022 were identified and matched 1:1 by propensity-score with those without(COVID-19-CLD).Each patient was followed up until death,outcome event,or November 15,2022.Primary outcome was incidence of HCC.Secondary outcomes included all-cause mortality,adverse hepatic outcomes,and different treatment strategies to HCC(curative,non-curative treatment,and palliative care).Analyses were further stratified by acute(within 20 d)and post-acute(21 d or beyond)phases of SARS-CoV-2 infection.Incidence rate ratios(IRRs)were estimated by Poisson regression models.RESULTS Of 193589 CLD patients(>95%non-cirrhotic)in the cohort,55163 patients with COVID-19+CLD and 55163 patients with COVID-19-CLD were included after 1:1 propensity-score matching.Upon 249-d median follow-up,COVID-19+CLD was not associated with increased risk of incident HCC(IRR:1.19,95%CI:0.99-1.42,P=0.06),but higher risks of receiving palliative care for HCC(IRR:1.60,95%CI:1.46-1.75,P<0.001),compared to COVID-19-CLD.In both acute and post-acute phases of infection,COVID-19+CLD were associated with increased risks of allcause mortality(acute:IRR:7.06,95%CI:5.78-8.63,P<0.001;post-acute:IRR:1.24,95%CI:1.14-1.36,P<0.001)and adverse hepatic outcomes(acute:IRR:1.98,95%CI:1.79-2.18,P<0.001;post-acute:IRR:1.24,95%CI:1.13-1.35,P<0.001),compared to COVID-19-CLD.CONCLUSION Although CLD patients with SARS-CoV-2 infection were not associated with increased risk of HCC,they were more likely to receive palliative treatment than those without.The detrimental effects of SARS-CoV-2 infection persisted in post-acute phase.

抗烟草黑胫病菌菌株ZY-19-2的鉴定及发酵条件研究(英文)

[目的]鉴定抗烟草黑胫病菌的菌株ZY-19-2,并研究该菌株的发酵条件。[方法]从烟草根际土样中分离、筛选得到一株对烟草黑胫病菌有抑制作用的菌株ZY-19-2,根据形态特征对其进行了鉴定,并研究了不同培养条件下该菌株产几丁质酶的活力。[结果]该菌株为淡紫拟青霉(Paecilomyceslilacinus);该菌株的最佳发酵条件以1.2%胶体几丁质为碳源,发酵液初始pH值为6.0,以1%蛋白胨为氮源,0.1%吐温80作为表面活性剂,发酵时间为60h,接种量为1%,摇床转速为120r/min,最高酶活达到0.216U/ml。[结论]通过对菌株ZY-19-2发酵条件的优化,为应用该菌株规模化生产高效廉价的几丁质酶、几丁质寡糖及对烟草黑胫病防治奠定基础。

疫情防控形势下博物馆空调通风系统运行和管理方法探讨

博物馆空调通风系统既为文物提供适宜的展出、存储环境,也为参观人员提供舒适的热环境。面对疫情,博物馆空调通风系统如何有效避免成为病毒传播的媒介,是值得暖通专业运行管理人员分析、探讨的问题。本文结合文物保护需求和防疫工作需要,探讨了博物馆空调通风系统在新形势下的运行管理办法,为减少、控制病毒传播提供参考。

“平疫结合”型中庭式酒店建筑公共空间设计方法研究——以西安为例

“平疫结合”型中庭式酒店建筑空间组织模式的更新是改善城市公共空间环境、满足城市公共卫生防疫体系需求的重要组成部分。当前,“平疫结合”理念的研究多集中在医疗建筑领域,对于酒店建筑平转疫的研究则相对较少。研究基于新冠肺炎疫情对于中庭式酒店设计的反思,选择中庭式酒店建筑为研究对象,通过实地考察与问卷调查分析酒店人流行为及隔离行为,探讨“平疫结合”型中庭式酒店公共空间的功能布局与空间流线优化,归纳梳理了中庭式酒店公共空间组织设计方法及酒店“疫时”分区与流线模式,并将其在唐隆酒店平面布局改造中进行了具体实施。

数据驱动下的传染病大流行期间大城市交通运行状况研究

新型冠状病毒肺炎是近百年来人类遭遇的影响范围最广的全球性大流行病,探究新冠疫情期间不同城市交通运行状况的演变规律,对当前传染病大流行情境下的交通运行至关重要,并对未来类似情形下的城市交通治理具有借鉴作用。城市交通运行状况可由交通健康指数、拥堵延时指数等数据来表征,因此本文收集疫情放开后十个大城市近一个月的拥堵延时指数、平均车速和交通健康指数等数据,通过相关性分析、线性回归、k-means聚类分析等方法,从多个角度探究城市交通健康指数与拥堵延时指数或平均车速之间的关系,据此采用拥堵延时指数来研究各城市交通运行状况。进而基于拥堵延时指数将研究时段划分为疫情影响期、疫情稳定期、复工复产期、春节影响期这四个阶段。并在早晚高峰、疫情、春节以及跨年夜等多种情境下,从工作日和节假日多方面挖掘各城市在疫情放开影响下交通状况变化的异同点。结果表明,在疫情放开和春节假期等多种复杂因素的影响下,交通健康指数仍能由拥堵延时指数或平均车速线性表征,交通健康指数存在一定程度的冗余,用拥堵延时指数等更易获取的数据就能够描述城市的交通运行状况。此外,疫情消退过程中,工作日早晚高峰出行的不均衡性较小,而节假日早晚高峰出行的不均衡性较大,达到40%。

Expanding telemedicine to reduce the burden on the healthcare systems and poverty in Africa for a post-coronavirus disease 2019 (COVID-19) pandemic reformation

The coronavirus disease 2019(COVID-19)global public health emergency,has exposed the fragility of health systems.Access to healthcare became a scarce commodity as healthcare providers and resource-poor popula­tions became victims of the novel corona virus.Therefore,this study focuses on Africa’s readiness to integrate telemedicine into the weak health systems and its adoption may help alleviate poor healthcare and poverty after COVID-19.We conducted a narrative review through different search strategies in Scopus on January 20,2021,to identify available literature reporting implementation of various telemedicine modes in Africa from January 1,2011 to December 31,2020.We summarized 54 studies according to geographies,field,and implementation methods.The results show a willingness to adopt telemedicine in the resource-poor settings and hard-to-reach populations,which will bring relief to the inadequate healthcare systems and alleviate poverty of those who feel the burden of healthcare cost the most.With adequate government financing,telemedicine promises to enhance the treating of communicable and non-communicable diseases as well as support health infrastructure.It can also alleviate poverty among vulnerable groups and hard-to-reach communities in Africa with adequate government financing.However,given the lack of funding in Africa,the challenges in implementing telemedicine require global and national strategies before it can yield promising results.This is especially true in regards to alleviating the multidimensionality of poverty in post-COVID-19 Africa.

由“COVID-19本该是中国的切尔诺贝利,却成了西方的滑铁卢”所引起的思考

有鉴于美国《纽约时报》网站“新型冠状病毒肺炎(COVID-19)本该是中国的切尔诺贝利,却成了西方的滑铁卢”的观点与分析,在对COVID-19防治的有关事件,如特朗普对COVID-19防治的“独到解读”(宁可无药也反对用中医药,尽管有疫苗美国每年仍有数万人死于流感等)进行综述与探讨的基础之上笔者认为:①由于感染性疾病的新发与病原变异,无疫苗与无特效抗病原药物的防治也许将愈来愈多见;②由于感染性疾病的发生并非仅是由病原微生物感染所致,对其防治既要重视疫苗或特效抗病原药物的开发与应用,但也不能唯其是用或唯其是等而错失良机;③特朗普“独到解读”并非空穴来风,西方国家“滑铁卢”也并非仅仅全是由政治与社会方面的原因所致, 还与学术界简单化的认识错觉与片面经验不无关系;④转变科学观念,以复杂性科学为指导,以辨证与辨病相结合为方法,来完善感染性疾病的临床认识与防治,也许才是应对愈来愈复杂的临床实际病情,提高与改善其防控效果的必由之路。