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    30 August 2022, Volume 40 Issue 4
    GUIDELINE
    Guidelines for malaria diagnosis and treatment
    Expert Group of National Center for Infectious Diseases
    2022, 40(4):  419-427.  doi:10.12140/j.issn.1000-7423.2022.04.001
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    Malaria is an endemic infectious disease caused by Plasmodium and is mainly prevalent in tropical and subtropical areas. Despite the World Health Organization’s announcement of the country’s malaria elimination certification in 2021, the threat of imported malaria will persist as international travel increases. In order to facilitate clinicians’ understanding and rational treatment of malaria and to improve the diagnosis and treatment of malaria, we have invited experts in the relevant field of infectious diseases and parasitic diseases in China to prepare the guidelines for malaria diagnosis and treatment. The guidelines introduce the etiology, epidemiology, pathogenesis, clinical manifestations, diagnosis and differential diagnosis, treatment, care, and prevention of malaria, emphasising on treatment options for different clinical conditions, so that the clinician can use them properly.

    EXPERT VIEWPOINTS
    Scientific basis of strategies for schistosomiasis control and prospect of the 14th Five-Year Plan in China
    FENG Jia-xin, GONG Yan-feng, LUO Zhuo-wei, WANG Wei, CAO Chun-li, XU Jing, LI Shi-zhu
    2022, 40(4):  428-435.  doi:10.12140/j.issn.1000-7423.2022.04.002
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    Schistosomiasis has been endemic in China for more than 2 000 years, seriously endangering the population’s health and affecting economic development. According to the epidemic characteristics of schistosomiasis, different strategies have been implemented in different historical periods in China to control schistosomiasis. Under the guidance of different strategies, China has achieved remarkable results in schistosomiasis control. The target of schistosomiasis transmission control was achieved nationwide in 2015. The strategies of schistosomiasis control in different periods of China all follow certain scientific basis and rules. This paper reviews the scientific basis of different strategies for schistosomiasis control and puts forward some thoughts and suggestions for schistosomiasis intervention strategies during the 14th Five-Year Plan period to be helpful for the elimination of schistosomiasis.

    Research progress of stem cells in driving schistosome growth and development
    WANG Ji-peng
    2022, 40(4):  436-440.  doi:10.12140/j.issn.1000-7423.2022.04.003
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    Stem cells are unspecialized cells that have the ability of self-renewal and differentiation into multiple cell types, which commit the tissue turnover and repair of the body. In recent years, the function of stem cells in schistosomes and other parasitic flatworms has attracted attention and a series of discoveries have been made. This review summarized the advances and tools in schistosome stem cell research to provide valuable information for understanding the basic biology of schistosome growth and development as well as the establishment of intermediate and definitive hosts.

    ORIGINAL ARTICLES
    Cyclic guanosine monophosphate-adenosine monophosphate promotes liver egg granuloma formation and fibrosis in mice infected with Schistosoma japonicum
    LIANG Le, ZHANG Jing, SHEN Yu-juan, HU Yuan, CAO Jian-ping
    2022, 40(4):  441-445.  doi:10.12140/j.issn.1000-7423.2022.04.004
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    Objective To investigate the effects of cyclic guanosine monophosphate-adenosine monophosphate (cGAMP), a second messenger molecule, on liver egg granulomas and fibrosis in Schistosoma japonicum-infected mice and to preliminarily clarify its regulatory mechanism. Methods C57BL/6 mice were randomly divided into cGAMP-treated group (8 mice), infected control group (28 mice), and infected cGAMP-treated group (28 mice). For the cGAMP-treated group, cGAMP (2 μg, 100 μl) was injected via the tail vein, while the infected control group and the infected cGAMP-treated group were injected with PBS (100 μl) and cGAMP (2 μg, 100 μl) via the tail vein once a week, respectively, after being infected with S. japonicum cercariae [(20 ± 2)/mouse] via abdominal skin patch. From each group, 8 mice received 10 ingections to observe survivl state after each injection. After 7 weeks, mice orbital blood samples from infected control group and infected cGAMP-treated group (each 5) were collected to detect the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) by ELISA. The liver tissues sections were prepared and stained with hematoxylin eosin (HE) and Masson to estimate the area of individual egg granuloma and fibrosis, and count the number of eggs in the liver tissues. Mice liver tissues were collected from infected control group and infected cGAMP-treated group (15 each), on 0, 4, and 7 weeks post-infection, for extraction of total RNA, which was used for performing real time fluorescent quantitative PCR (qRT-PCR) to examine the expression level of IFN-β-encoding gene Ifnb1; the mice orbital blood was collected to detect the serum β-interferon (IFN-β) level by ELISA. GraphPad Prism 8.0.2 software was used for statistical analysis, and t-test was used for comparison between the two groups. Results There were no deaths in the cGAMP-treated group, and 10 weeks after infection, 2 mice died in the infected control group and 5 mice died in the infected cGAMP-treated group, with statistically significant differences between the two groups (χ2 = 7.55, P < 0.01). The number of eggs in the liver of mice from the infected control group and the infected cGAMP-treated group was 50 600 ± 15 473 and 53 400 ± 16 273, respectively, with no statistically significant difference (t = 0.28, P > 0.05). HE staining showed significant liver histopathological damage in both the infected control and infected cGAMP-treated groups, with proportions of (35.32 ± (15.09)% and (64.98 ± 13.91)% (t = 3.23, P < 0.05), respectively. The area of liver egg granulomas was (0.57 ± 0.45) mm2 and (1.17 ± 0.74) mm2 in the infected control and infected cGAMP-treated groups, respectively (t = 2.95, P < 0.01). Masson staining showed that liver fibrosis occurred in both the infected control and infected cGAMP-treated mice, with proportions of (24.50 ± 6.39)% and (39.02 ± 6.79)%, respectively (t = 3.48, P < 0.01). At 4 and 7 weeks post-infection, the expression levels of Ifnb1 mRNA in liver tissues of mice from infected cGAMP-treated group were 16.58 ± 6.71 and 10.52 ± 2.88, respectively, which were upregulated compared with 9.280 ± 4.50 and 6.62 ± 1.58 in the infected control group (t = 2.95, 2.18, P < 0.05). The serum IFN-β levels in the infected cGAMP-treated group were (1 206.45 ± 211.87) pg/ml and (960.62 ± 151.33) pg/ml, respectively, which were upregulated compared to (845.12 ± 284.11) pg/ml and (685.20 ± 143.88) pg/ml in the infected control group (t = 2.28, 2.95, P < 0.05). ALT was (394.80 ± 72.82) U/L and (627.20 ± 93.58) U/L (t = 4.38, P < 0.01) and AST was (605.00 ± 148.90) U/L and (871.80 ± 138.10) U/L (t = 2.94, P < 0.05) in the mice of infected control and infected cGAMP-treated groups, respectively. Conclusion cGAMP promots liver egg granuloma formation and fibrosis in mice infected with S. japonicum, indicative of exerting the promotive effect through inducing type Ⅰ interferon immune response.

    Immunoprotective effect of dexamethasone on experimental cerebral malaria in mice
    HUANG Yuan-yuan, YAO Shi-jie, BIAN Zhi-fang, WEN Yi-xin, ZHENG Li, CAO Ya-ming
    2022, 40(4):  446-453.  doi:10.12140/j.issn.1000-7423.2022.04.005
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    Objective To explore the immunoprotective effect of dexamethasone (DEX) on experimental cerebral malaria (ECM) in mice. Methods C57BL/6 mice were randomly assigned into infection group, DEX treatment group and control group with 20 mice in each group. The mice in the infection group and DEX treatment group were injected intraperitoneally with 1 × 106 Plasmodium berghei ANKA-infected red blood cells, while mice in the control group did not receive any treatment. The mice in the DEX treatment group were treated with intraperitoneal dexamethasone sodium phosphate (80 mg/kg) on the 1st and 2nd days post-infection, while the control and infection groups were injected with an equal volume of normal saline. From the 3rd day on post-infection, the tail vein blood of infected mice was collected to prepare blood smears, and the infected erythrocytes were counted after Giemsa staining to observe the changes of parasitemia. The survival rate and ECM-related neurological symptoms of the mice were recorded daily. On the 3rd and 5th days post-infection, mice spleen cell suspensions were prepared, and flow cytometry was used to detect spleen Th1 cells, regulatory T cells (Tregs), the expression level of programmed death receptor-1 (PD-1), toxic T lymphocyte-associated antigen-4 (CTLA-4) on CD4+ T cells, M1 and M2 macrophages. The spleen cell suspensions were cultured for 48 hours, and the culture supernatant was tested by ELISA for secretion pro-inflammatory/anti-inflammatory cytokines, including tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and IL-10. On the 6th day post-infection, Evans blue (EB) staining was used to evaluate the effect of DEX treatment on the blood-brain barrier in mice. One-way ANOVA test was used to compare the results from flow cytometry and cytokine detection, independent sample t-test was used to compare the mice parasitemia, and Log-Rank test was used to compare survival rate. Results Plasmodium-infected red blood cells began to appear in the peripheral blood of mice in the infection group and DEX treatment group from the 3rd day post-infection, and the parasitemia was (25.89 ± 1.97)% and (22.91 ± 3.21)% on the 9th day post-infection, respectively. The difference was not statistically significant (t = 1.12, P > 0.05). Mice in the infection group began to die on the 6th day post-infection, accompanied by ECM neurological symptoms, and all died by the 9th day post-infection. Mice in the DEX treatment group began to die on the 8th day post-infection, accompanied by ECM neurological symptoms, and all died by the 10th day post-infection. Compared to the infection group, DEX treatment delayed the onset of cerebral malaria (χ2 = 4.31, P < 0.05). On the 3rd and 5th days post-infection, the proportion of spleen CD4+ T cells expressing PD-1 in the DEX treatment group was (18.10 ± 0.52)% and (39.13 ± 0.91)%, respectively, higher than the control group [(11.53 ± 1.00)% and (13.72 ± 1.78)%] and the infection group [(14.87 ± 1.02)% and (35.87 ± 0.74)%]. The differences were statistically significant (F = 41.41, 378.00; P < 0.05, 0.01). The proportion of spleen CD4+ T cells expressing CTLA-4 were (3.05 ± 0.12)% and (8.70 ± 1.01)%, respectively, higher than the control group [(0.28 ± 0.02)% and (0.45 ± 0.10)%] and the infection group [(0.44 ± 0.13)% and (0.68 ± 0.13)%]. The differences were statistically significant (F = 730.20, 191.80; P < 0.01). On the 3rd and 5th days post-infection, the proportion of Th1 in the spleen cells of the mice in the DEX treatment group was (0.14 ± 0.04)% and (0.63 ± 0.06)%, respectively, which were lower than the infection group [(0.30 ± 0.06)% and (0.80 ± 0.04)%]. The differences were statistically significant (F = 10.93, 56.58; P < 0.05, 0.01). On the 5th day post-infection, the proportion of Tregs cells in the spleen cells of the DEX treatment mice was (1.30 ± 0.08)%, which was higher than the control group (1.12 ± 0.08)% and the infection group(0.86 ± 0.03)% (F = 36.51, P < 0.01). On the 3rd day post-infection, the proportion of M1 macrophages in the spleen cells of the mice in the DEX treatment group was (0.43 ± 0.12)%, which was lower than the infection group (1.03 ± 0.14)% (F = 29.81, P < 0.01). On the 5th day post-infection, the proportion of M2 macrophages in the spleen cells of the DEX treatment mice was (1.56 ± 0.20)%, which was higher than the control group (0.49 ± 0.04)% and the infection group (0.87 ± 0.06)% (F = 60.21, P < 0.01). On the 3rd and 5th days post-infection, the levels of TNF-α in the culture supernatant of spleen cells in the DEX treatment group were (140.18 ± 27.38) pg/ml and (328.23 ± 75.70) pg/ml, which were lower than those in the infection group [(247.34 ± 35.34) pg/ml and (650.88 ± 43.56) pg/ml] (F = 11.70, 32.09; P < 0.01). IL-6 levels were (40.03 ± 9.09) pg/ml and (1 270.52 ± 83.75) pg/ml, which were lower than the infection group (511.97 ± 41.70) pg/ml and the control group (4 131.31 ± 645.16) pg/ml. The difference was statistically significant (F = 299.40, 93.11; P < 0.01). The level of IL-10 was (283.06 ± 44.83) pg/ml and (592.63 ± 51.69) pg/ml, higher than (118.82 ± 8.47) pg/ml and (424.49 ± 51.44) pg/ml in the infection group (F = 36.04, 73.95; P < 0.01). On the 6th day post-infection, the blood-brain barrier of the mice in the infection group was dramatically damaged, and EB penetrated into the brain tissue, showing a dark blue stain. The blood-brain barrier of the mice in the control group was intact, and there was no obvious infiltration of EB. The mice in the DEX treatment group only had a small amount of EB infiltrated into the brain tissue. Conclusion In ECM mice, DEX regulates the activation and response intensity of Th1 and Tregs cells through enhancing the expression levels of immunosuppressive molecules PD-1 and CTLA-4 on the surface of CD4+ T cells, promotes the polarization of M1 to M2 macrophages, and inhibits the secretion levels of pro-inflammatory factors, alleviates blood-brain barrier damage in ECM mice, thereby reducing the pathogenicity of ECM.

    Epidemiological characteristics of malaria in Shaanxi Province from 2011 to 2020
    CAO Lei, MA Lin, ZHU Ni, ZHANG Yi, WANG An-li, WANG Shu, LI Xin-xin
    2022, 40(4):  454-459.  doi:10.12140/j.issn.1000-7423.2022.04.006
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    Objective To analyze the malaria epidemiological characteristics and malaria case information in Shaanxi province from 2011 to 2020 to provide basis for the surveillance and prevention of re-transmission after malaria elimination. Methods Malaria surveillance data and individual case epidemiological survey data in 2011—2020 in Shaanxi Province were collected from the national infectious disease reporting information management system and parasitic disease prevention and control information management system, analyzing the infected species, source of infection, regional distribution, monthly distribution and diagnosis timeliness. The distribution of monthly case report was analyzed using the circular distribution method, and the onset-diagnosis time interval was determined using the Kruskal-Wallis test. Results From 2011 to 2020, a total of 609 malaria cases were reported in Shaanxi Province, including 604 imported from abroad, four imported from other provinces in China (reported from 2011 to 2013, all from Yunnan Province), and one recurrent case (reported in Shangzhou District, Shangluo City in 2010, which recurred in 2011). The main sources of reported cases were Africa (559 cases, accounting for 91.79%) and Asia (45 cases, accounting for 7.39%). There were 447 cases of P. falciparum infection (accounting for 73.40%), 79 cases of P. vivax infection (accounting for 12.97%), 56 cases of P. ovale infection (accounting for 9.19%), 11 cases of P. malariae infection (accounting for 1.81%), and 16 cases of uncharacterized Plasmodium (accounting for 2.63%). The P. falciparum cases were mainly from Guinea (71 cases), Angola (70 cases) and Cameroon (43 cases). The P. vivax cases were mainly from Ethiopia (17 cases), Pakistan (9 cases) and Angola (7 cases). The P. ovale cases were mainly from Guinea (19 cases), Nigeria (8 cases) and Angola (7 cases). The P. malariae cases were mainly from Guinea (3 cases) and Angola (3 cases). From 2011 to 2020, malaria cases were reported every month, with more cases reported in January and July, accounting for 10.84% (66/609) and 9.69% (59/609) of the total cases, respectively. There was no central trend in the distribution of malaria reporting months in Shaanxi Province from 2011 to 2020 (Z = 0.754, P > 0.05). The Yanta District of Xi’an City had the most cases reported (230 cases), accounting for 37.77% of the total number of cases; the current address of the cases is the most in Hanbin District of Ankang City (72 cases), accounting for 11.82% of the total number of cases. From 2011 to 2020, the age of reported malaria cases was concentrated in 20-50 years old, accounting for 86.70% (529/609) of the total reported cases. The occupations are mainly farmers, workers and cadres, accounting for 38.92% (237/609), 19.21% (117/609) and 11.82% (72/609) of the total cases, respectively. The median time interval between onset of symptoms and diagnosis of malaria cases from 2011 to 2017 was 5 to 7 days, and then decreased to 3 days in 2020. There was a statistically significant difference in the time interval between onset of symptoms and diagnosis of malaria cases each year (χ2 = 25.457, P < 0.05). Conclusion The malaria cases reported in Shaanxi Province from 2011 to 2020 were mainly imported from overseas, mostly from Africa, with the predominant infection species P. falciparum.

    Diversity analysis of intestinal bacterial flora of Culex pipiens pallens at different developmental stages
    LV Wen-xiang, CHENG Peng, PENG Hui, WANG Hai-yang, LIU Hong-mei, WANG Hai-fang, GUO Xiu-xia, GONG Mao-qing, LIU Li-juan
    2022, 40(4):  460-467.  doi:10.12140/j.issn.1000-7423.2022.04.007
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    Objective To determine the composition and diversity of intestinal microflora of Culex pipiens pallens at different developmental stages. Methods The intestinal tracts of 20 Cx. pipiens pallens Ⅳ-instar larvae, pupae and female mosquitoes were dissected to collect intestinal samples for extraction of genomic DNA of intestinal bacteria, with triplicate for each developmental stage. The 16S rRNA highly variable regions of intestinal bacteria was amplified by PCR and sequenced using the Illumina NovaSeq6000 sequencing platform. The number of sequences and operational taxonomic units (OTU) were compiled and statistically analyzed using structural histogram and Veen diagram to reveal the flora composition and abundance of intestinal bacteria at different developmental stages of Cx. pipiens pallens. The abundance and diversity of microbial flora were analyzed by the Alpha diversity index. Principal coordinate analysis (PCoA) was used to examine the variance in the flora structure at different developmental stages. Linear discriminant analysis (LEFSe) was used to differentiate the species with significant differences in abundance between groups. SPSS 22.0 statistical software was used to conduct one-way ANOVA for genus-based analysis of the core bacterial abundance of Cx. pipiens pallens at different stages. Results The intestinal microbiota of Cx. pipiens pallens larvae, pupae and female mosquitoes were 1 972 OTUs, belonging to 22 phyla, 45 classes, 112 orders, 178 families and 329 genera. At the genus level, the fourth instar larvae, pupae and female mosquitoes were composed of 230, 233 and 228 genera, respectively. The dominant genera were Bacteroides with the abundance of (16.83 ± 3.5) %, (26.98 ± 0.94) % and (20.82 ± 2.63) %, respectively; Muribaculaceae, the abundance was (12.36 ± 1.94) %, (19.98 ± 1.24) %, (14.90 ± 1.52) %, respectively; the abundance of Alistipes was (4.13 ± 0.62)%, (7.29 ± 1.28)%, (5.36 ± 1.00)%, respectively; Lachnospiraceae_NK4A136_group were (3.39 ± 0.39)%, (5.77 ± 0.21) % and (3.93 ± 0.40)%, respectively. At the level of OTU, Veen diagram analysis showed that the number of OTU shared by the fourth instar larvae, pupae and female adult was 687, and the unique OTU was 250, 284 and 309, respectively. Alpha diversity showed that the composition and diversity of Cx. pipiens pallens were different at different developmental stages (F = 36.83, P < 0.01; F = 28.91, P < 0.01), the species abundance and diversity of pupae were the highest (6.58 ± 0.04). The results of PCoA showed that the microflora was presented in three groups, with each stage falling into one group, respectively. There were statistically significant differences in the composition of bacteria among different stages (Df = 2, R2 = 0.707 44, P < 0.01). The results of LEFSe showed that 17 taxa were different at developmental stages. There were statistically significant differences in the abundance of Leifsonia, Bacteroides, Muribaculaceae and Wolbachia in different developmental stages of Cx. pipiens pallens (F = 48.331, 10.826, 17.759, 95.139, P < 0.01). Leifsonia mainly existed in the fourth instar larval stage (0.887 ± 0.022), Bacteroidetes (0.270 ± 0.009) and Muribaculaceae (0.200 ± 0.012) mainly existed in the pupa stage. Wolbachia mainly existed in the female mosquito stage (0.172 ± 0.025). Conclusion The dominant intestinal flora of Cx. pipiens pallens at different developmental stages are Bacteroides and Muribaculaceae, and the pupa shows the highest species abundance and species diversity.

    Resistance to deltamethrin and knockdown resistance mutation in Aedes albopictus from Jiangsu Province
    WANG Guan-xi, LI Ya-shu, LI Yue-yue, CAO Yuan-yuan, YANG Meng-meng, ZHANG Mei-hua, WU Jing-yao, LIANG Cheng, LI Ju-lin, ZHOU Hua-yun, TANG Jian-xia, ZHU Guo-ding
    2022, 40(4):  468-474.  doi:10.12140/j.issn.1000-7423.2022.04.008
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    Objective To investigate the resistance of deltamethrin in Aedes albopictus in Jiangsu Province, and explore the association with knockdown resistance (kdr) mutation, to provide a theoretical basis for scientific control of Ae. albopictus. Methods The diagnostic doses were determined by preparing test bottles containing deltamethrin of 1, 2, 4, 6 or 8 μg/bottle and control bottles without deltamethrin using the CDC bottle bioassay with 10-25 susceptible laboratory-cultured Ae. albopictus in each bottle. Ae. albopictus larvae and pupae were collected from Suining County in Xuzhou City, Huaiyin District in Huai’an City, and Yixing City in Wuxi City, in Jiangsu Province during August and September 2020 and reared to the first filial generation (F1 generation). The mortality rate of Ae. albopictus was calculated by using 10-25 F1 generation female mosquitoes for exposure to a diagnostic dose of deltamethrin in the test bottle and the blank in the control bottle for 30 min to evaluate the resistance level. The DNA was extracted from the mosquitoes after bioassay, and the gene coding region of voltage-gated sodium channel (VGSC) transmembrane structural domains Ⅱ, Ⅲ and Ⅳwere amplified by PCR and sequenced. Bioedit and Seqman software were used for statistical analysis of the kdr mutations, genotypes and mutation frequency. A Chi-square test was used to compare the kdr mutation frequency in the resistant and susceptible phenotype mosquitoes. Results The diagnostic doses of deltamethrin to Ae. albopictus was 4 μg/bottle. A total of 149 Ae. albopictus were collected from Suining County, Huaiyin District and Yixing City. The corrected mean mortality rate of Suining County was (28.2 ± 1.4)%, and the mean mortality rates in Huaiyin District and Yixing City were (64.4 ± 5.5)% and (56.3 ± 17.7)%, respectively. Ae. albopictus collected from all three counties’ (cities and districts) were resistant to deltamethrin. There were 447 DNA sequences obtained, and the sequencing results showed that the kdr mutations existed in the gene coding region at codons 1532 and 1534 of the VGSC structural domain Ⅳ of Ae. albopictus in three counties (cities and districts). Two alleles at codon 1532 were wild-type ATC/I (279/298, 93.6%) and mutant ACC/T (19/298, 6.4%); three genotypes were the wild-type homozygote I/I (133/149, 89.3%), wild/mutant heterozygote I/T (13/149, 8.7%), and mutant homozygote T/T (3/149, 2.0%). Four alleles at codon 1534 were wildtype TTC/F (275/298, 92.3%), mutant TCC/S (5/298, 1.7%), mutant TTA/L (14/298, 4.7%), and mutant TTG/L (4/298, 1.3%); four genotypes were the wild-type homozygote F/F (128/149, 85.9%), wild/mutant heterozygote F/S (5/149, 3.4%), wild/mutant heterozygote F/L (14/149, 9.4%), and mutant homozygote I/I (2/149, 1.3%). Among the 72 resistant mosquitoes phenotyped, 87.5% (63/72) and 86.1% (62/72) were wild-type at codon 1532 and 1534, respectively, and 12.5% (9/72) and 13.9% (10/72) were kdr mutant, respectively. Among the 77 sensitive adults, 90.9% (70/77) and 85.7% (66/77) were wild type at codon 1532 and 1534, respectively, and 9.2% (7/77) and 14.3% (11/77) were kdr mutant, respectively. Chi-square test revealed no significant difference between kdr mutant genotypes at codon 1532 and 1534 with resistant and susceptible phenotypes Ae. albopictus( χ2 = 0.168, 4.111, P > 0.05). Conclusion In Suining County, Huaiyin District and Yixing City of Jiangsu Province, Ae. albopictus mosquitoes were found resistant to deltamethrin. The frequencies of kdr mutations at codon 1532 and 1534 in Ae. albopictus was low. No significant correlation was found between the resistance phenotype and kdr mutations at codon 1532 and 1534.

    The endemic status of echinococcosis in China from 2004 to 2020
    HAN Shuai, KUI Yan, XUE Cui-zhao, ZHANG Ya-lan, ZHANG Ben-guang, LI Qi-yang, WANG Ting, DAI Yang, YUAN Yi, TAO Wei, ZHU Ai-ya, LI Zheng-xiang, WANG Zi-jiang, TANG Lei, WU Wen-ting, XIE Han-guo, YAO Li-nong, YANG Yi-chao, WU Wei-ping
    2022, 40(4):  475-480.  doi:10.12140/j.issn.1000-7423.2022.04.009
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    Objective To analyze the endemic situation and epidemiological characteristics of echinococcosis in China, and provide a scientific basis for optimizing control strategy. Methods From the Infectious Diseases Report System of the Chinese Center for Disease Control and Prevention, information of nationwide echinococcosis cases reported in 2004 to 2020 were collected, and descriptively analyzed on time distribution, the regional distribution, and demographic distribution, using Microsoft Office 2016 software. Results From 2004 to 2020, a total of 66 040 cases of echinococcosis were reported in 31 provinces (municipalities and autonomous regions), among which 65 340 cases were reported in nine endemic provinces (Xinjiang, Sichuan, Qinghai, Gansu, Ningxia, Tibet, Inner Mongolia, Shaanxi and Yunnan) and 700 cases were reported in 22 non-endemic provinces, accounting for 98.9% and 1.1% of the total, respectively. Among the nationwide total, 31 494 male cases and 34 546 female cases were recorded. The toal number of reported cases of echinococcosis was on the increase from 991 in 2004 to 3 650 on 2020, showing an increasing trend (z = 2.27, P < 0.05). The number of reported cases of echinococcosis from non-endemic provinces in 2004 was 17 cases, which increased to 56 in 2020, showing an increasing trend (z = 4.1675, P < 0.05). The age distribution indicated that majority (91.3%) of cases were at the age goup of ≥ 20, whereas 11 cases were at the age group of under one year old, and 200 cases were at 85 years old or older. The occupation distribution demonstrated that herdsmen and farmers accounted for 72.8% (48 074/66 040) of the total, housework and unemployed 5.5% for (3 606/66 040); and students for 4.6% (3 034/66 040). A total of 56 cases were reported in non-epidemic areas in 2020, including 38 imported cases. Henan reported the most cases with 16, Xinjiang imported 24 cases, and 10 provinces had suspected local cases. Conclusion The endemicity of echinococcosis in nine west provinces remains high. The number of reported cases showed increasing trend. Herdsmen, farmerd, youth and middle age are the population with high prevalence.

    Epidemiological investigation on cases of visceral leishmaniasis in Henan Province in 2020
    YANG Cheng-yun, HE Zhi-quan, LU De-ling, QIAN Dan, LIU Ying, LI Su-hua, ZHOU Rui-min, DENG Yan, ZHANG Hong-wei, WANG Hao, ZHAO Dong-yang, GUO Wan-shen
    2022, 40(4):  481-486.  doi:10.12140/j.issn.1000-7423.2022.04.010
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    Objective To investigate the current endemic status of visceral leishmaniasis in Henan Province and to provide basis for surveillance and scientific control. Methods The visceral leishmaniasis endemicity data and the information from individual cases tracking in Henan Province in 2020 were collected. Based on the reported cases, epidemiological investigations and interventions were carried out in the villages where the local cases were reported. Blood samples were collected from the patients’ family members and neighbours within an area of 100 m radius centered on the patient’s residence, meantime, blood samples were also collected from all domestic and stray dogs in the natural villages where the patients reside. The rk39 immunochromatographic test strip was used to detect serum anti-Leishmania antibody in the samples of villagers and dogs. DNA was extracted from the blood samples of patients (provided by the reporting hospital within 1 week of the case report), villagers and a number of dogs to detect Leishmania kinetoplast target gene by PCR. Then internal transcribed spacer 1 (ITS-1) was amplified and sequenced for those samples with kinetoplast gene positive to identify the species of Leishmania. From May to September, methods of manual capture and light traps were used to collect sandflies in four villages (Yinjiagou, Xiaoguan, Sanzongmiao and Huzhanggou villages) for morphological identificatiobn by dissestion. DNA was extracted from female Phlebotomus chinensis. PCR was performed to detect Leishmania kinetoplast target gene for determining Leishmania infection in the andflies. Results A total of 16 cases of visceral leishmaniasis were reported in Henan Province in 2020. The 16 cases covered the age ranging from 8 months to 68 years old. Thirteen cases had typical clinical symptoms, including fever, pancytopenia, and splenomegaly. The average time and the median time from onset to definitive diagnosis were 45.3 d and 30 d, respectively. Among the 16 cases, 13 were local infections, and 3 were imported cases from other provinces. Among the 13 local cases, 6 cases were children including 4 children less than two years old, who reside in seven countries of Zhengzhou, Luoyang and Anyang. Most infections occurred from October to May of the following year (11/13). A total of 376 blood samples were collected from the residents, the positive rate of rk39 antibody was 0.5% (2/376) and all of the 376 blood samples were negative for PCR test. A total of 721 blood samples were collected from dogs. The positive rate of rk39 antibody was 17.5% (126/721). The positive rates of dogs in Zhengzhou, Luoyang and Anyang were 21.8% (59/271), 15.0% (50/333) and 14.5% (17/117), respectively, with no significant difference among the three cities (χ2 = 5.5693, P > 0.05). PCR was performed on 99 dog samples. The positive rate was 36.4% (36/99). Among the 66 seropositive dogs, 36 were positive by PCR with a positive rate of 54.5% (36/66), while 33 seronegative dogs were all negative in the PCR test. The ITS-1 sequences amplified from the patients had 100% homology with the L. infantum sequence (GenBank accession number MG041377). The ITS-1 sequences amplified from the positive dogs had 100% homology with the L. infantum sequence (GenBank accession number MN648767). A total of 1 115 sandflies were captured and identified as P. chinensis, Sergentomyia khawi and S. squamirostris. Among them, 39 female P. chinensis were negative in PCR detection. Conclusion There exists local transmission of visceral leishmaniasis caused by L. infantum in Henan Province, and the positive rate of canine Leishmania infection in dogs is relatively high. It is necessary to strengthen the management of dogs to prevent further spread of visceral leishmaniasis in Henan Province.

    Long non-coding RNA NEAT1 involves in intestinal epithelial cell response against Cryptosporidium parvum infection via regulating IL-8 expression
    LI Teng, SHEN Yu-juan, CUI Li-jun, LIU Hua, HU Yuan, JIANG Yan-yan, CAO Jian-ping
    2022, 40(4):  487-492.  doi:10.12140/j.issn.1000-7423.2022.04.011
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    Objective To investigate the role and mechanism of long non-coding RNA NEAT1 (lncRNA NEAT1) in regulating host immune response against Cryptosporidium parvum infection. Methods The human colon adenocarcinoma cell line (HCT-8, oocysts/cell = 2 ∶ 1) was used to the establish C. parvum-infection model. The cell growth was evaluated for the infected group and the uninfected group at 4 h and 36 h post-infection of C. parvum oocysts. The total RNA was extracted from the cells at 4 h and 36 h, respectively. qRT-PCR was used to detect the gene expression level of IL-8, the dynamic expression of lncRNA NEAT1 and its long isoform lncRNA NEAT1_2. The knockdown model of lncRNA NEAT1 (lncRNA NEAT1KD group) was established by the Smart Silencer system, and the IL-8 mRNA expression in the lncRNA NEAT1KD group was compared with the control group (without knockdown). Results After 4 h incubation with C. parvum, the sporozoites adhered and invaded the cells. The relative expression levels of lncRNA NEAT1 and lncRNA NEAT1_2 in the infection group were 0.467 ± 0.364 and 0.282 ± 0.230, respectively, which were decreased compared with the control group (0.960 ± 0.152 and 0.865 ± 0.219) (t = 2.780, 3.672; P < 0.05). The relative mRNA level of inflammatory cytokine IL-8 in HCT-8 cells was 1.273 ± 0.647, which was not significantly increased compared with 1.017 ± 0.231 of the control group (t = 0.828, P > 0.05). After 36 h of incubation, C. parvum successfully invades host cells and reproduces. The relative expression levels of IL-8, lncRNA NEAT1 and lncRNA NEAT1_2 were 1.046 ± 0.293, 1.029 ± 0.237 and 1.000 ± 0.449 in control group, while in the infected group the relative expression levels of IL-8, lncRNA NEAT1 and lncRNA NEAT1_2 were 6.835 ± 2.065, 2.728 ± 0.897 and 3.303 ± 2.643, which were significantly up-regulated compared with the control group (t = 5.652, P < 0.01; t = 4.854, P < 0.01; t = 2.577, P < 0.05). In negative control group, the relative transcription levels of lncRNA NEAT1 and lncRNA NEAT1_2 were 1.040 ± 0.446 and 1.005 ± 0.410. After the knockdown, the relative transcription levels of lncRNA NEAT1 and lncRNA NEAT1_2 in the lncRNA NEAT1KD group were 0.382 ± 0.126 and 0.312 ± 0.068, respectively. The difference was statistically significant compared with negative control group (t = 4.481, P < 0.01; t = 5.301, P < 0.01). Moreover, the relative transcription level of IL-8 mRNA in the lncRNA NEAT1KD group (0.525 ± 0.230) was significantly lower than that of the control group (0.959 ± 0.229) (t = 4.688, P < 0.01) after inhibiting the expression of lncRNA NEAT1. Conclusion During C. parvum infection, lncRNA NEAT1 was dynamically expressed and was up-regulated during the infection. Moreover, lncRNA NEAT1 can modulate the host immune defence against C. parvum by regulating the transcription of IL-8 in infected host cells.

    Establishment of mouse infection model of Babesia microti Lishui isolate and consequent pathological changes
    SONG Peng, CAI Yu-chun, LU Yan, AI Lin, CHEN Mu-xin, CHEN Shao-hong, CHEN Jia-xu
    2022, 40(4):  493-499.  doi:10.12140/j.issn.1000-7423.2022.04.012
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    Objective To establish the mouse infection model of Babesia microti Lishui isolate (isolated from one patient in Lishui, Zhejiang Province) and evaluate the change of parasitemia and pathological features during infection in the mice. Methods NOD-SCID mice were intraperitoneally inoculated with whole blood sample from a patient infected B. microti Lishui for species preservation and isolation. Fifty BALB/c mice were randomly assigned to infection group and control group, 25 mice in each group. The BALB/c mice in the infection group were intraperitoneally inoculated with 1.0 × 107 infected erythrocytes from NOD-SCID mice and the BALB/c mice in the control group were inoculated with an equal volume of normal saline. The tail vein blood was collected daily to prepare the thin blood smear. The morphology of B. microti was observed under microscope after Giemsa staining, and the parasitemia was calculated. DNA was extracted from the infected mice samples. The 18S rRNA gene was amplified by Nest-PCR for sequencing, geneotyping, and phylogenetic tree analysis. At 0, 5, 10, 15, and 20 days post-infection, 5 mice in each group were selected to measure their body weight, spleen weight, and spleen length. The spleen tissue sections were prepared, and the pathological characteristics were observed under a microscope after HE staining. The routine blood test for samples from the infected mice was detected by an animal automatic blood analyzer. T-test was used for comparison between the two groups. Results At 5 days post-infection, the ring forms of the B. microti Lishui isolate were observed in the blood smear in the infection group. At 10 days post-infection, two or four parasites, in the shape of a double pear-shaped or Maltese cross, could be identified in the same erythrocyte, and hemolysis occurred. The parasitemia in mice in the infection group peaked (39.1 ± 4.6)% at 10 days post-infection and decreased to less than 1% after 20 days post-infection. The 18S rRNAs of the B. microti Lishui isolate and B. microti (GenBank accession number MT423326) share 98% sequence identity at the nucleotide level, and they also clustered in the same branch on the phylogenetic tree. At 10, 15 and 20 days post-infection, the body weight of mice in the infection group was (20.60 ± 1.02), (22.04 ± 0.77) and (22.78 ± 0.64) g, which was lower than that of the control group [(23.94 ± 0.84), (24.50 ± 0.26) and (24.64 ± 0.54) g] (t = 5.64, 6.78 and 4.99, P < 0.01). At 5, 10, 15 and 20 days post-infection, the spleen weight of mice in the infection group was (0.33 ± 0.02), (0.98 ± 0.11), (0.93 ± 0.04) and (0.67 ± 0.05) g, which was higher than that of the control group [(0.11 ± 0.01), (0.12 ± 0.01), (0.10 ± 0.02) and (0.11 ± 0.01) g] (t = 21.82, 22.25, 35.62 and 10.47, P < 0.01); the spleen length of the infected mice was (2.40 ± 0.12), (3.16 ± 0.06), (3.22 ± 0.05) and (2.98 ± 0.08) cm, which was higher than that of the control group [(1.76 ± 0.09), (1.74 ± 0.09), (1.74 ± 0.15) and (1.80 ± 0.07) cm] (t = 9.44, 30.27, 20.93 and 24.09, P < 0.01). At 10 days post-infection, splenomegaly, architectural distortion, blurring of the white pulp/red pulp border, massive lymphoproliferation, and congestion of splenic sinus were recognized in the spleen of mice in the infection group. The microanatomical structure of the spleen and the border region between the red and white pulp were recovered at 20 days post-infection. The rountin blood test results showed, at 10 days post-infection, the erythrocyte count, hematocrit, hemoglobin concentration, mean corpuscular volume, erythrocyte distribution width-standard deviation, erythrocyte distribution width-coefficient of variation, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration of mice in the infection group were (4.45 ± 0.32) × 1012/L, (27.72 ± 2.03)%, (86.2 ± 6.0) g/L, (60.7 ± 1.4) fL, (80.1 ± 4.0) fL, (31.9 ± 1.3)%, (19.4 ± 0.4) pg and (320.4 ± 3.8) g/L, respectively, which was higher than that of the control group [(9.55 ± 0.16) × 1012/L, (47.94 ± 1.64)%, (163.0 ± 4.8) g/L, (48.2 ± 1.1) fL, (27.7 ± 1.3) fL, (13.5 ± 0.5)%, (16.7 ± 0.7) pg and (339.0 ± 3.9) g/L] (t = 32.24, 17.34, 22.23, 15.71, 30.33, 28.41, 7.43 and 7.61, P < 0.01). At 10 days post-infection, the white blood cell count, monocyte count, monocyte percent, neutrophil count, and neutrophil percent of the mice in the infection group were (6.76 ± 0.87) × 109/L, (0.78 ± 0.20) × 109/L, (9.90 ± 0.87)%, (1.92 ± 0.42) × 109/L and (27.74 ± 2.67)%, which was higher than that of the control group [(3.85 ± 0.26) × 109/L, (0.17 ± 0.05) × 109/L, (3.28 ± 0.40)%, (0.78 ± 0.15) × 109/L and (21.20 ± 1.18)%] (t = 7.12, 6.54, 15.54, 5.71 and 5.00, P < 0.01). Conclusion A mouse infection model with B. microti isolated from patient in Zhejiang Lishui was established. After infection, the mice body weight was significantly reduced, accompanying with splenomegaly, spleen structural disorder and anemia.

    Development of a system for long-term in vitro cultivation of Cysticercus pisiformis and isolation and identification of its secretory products
    ZHANG Shao-hua, LIU Ting-li, LUO Xue-nong, WANG Shuai, GUO Ai-jiang, BAI Xue, CHEN Guo-liang, CAI Xue-peng
    2022, 40(4):  500-506.  doi:10.12140/j.issn.1000-7423.2022.04.013
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    Objective To develop a long-term in vitro cultivation method for Cysticercus pisiformis and identify its secretory products in the culture. Methods New Zealand white rabbits were infected with Taenia pisiformis eggs by gavage at a dose of 2 000 eggs per rabbit. Three months after infection, C. pisiformis were collected from the abdominal cavities and randomly assigned to four groups (10 larvae/group), including PBS group, RPMI 1640 group, bile group (RPMI 1640 + 10% rabbit bile) and serum group (RPMI 1640 + 10% exosome-free fetal bovine serum). The cysticerci were cultured at 37 ℃ in a 5% CO2 incubator and were observed continuously at 5 min, 1 h, 2 h, 12 h, 24 h, 36 h, 48 h and daily for subsequent days to record the scolex evagination, activity, survival status and morphological changes of cysticerci in each group, for screening optimal culture condition. Under the optimized conditions, the cysticerci were cultured in cell culture bottle (25 cm2), 50 larvae each, and the culture medium was collected every 48 h for centrifugal concentration, from which the supernatants were used to detect the expression of enolase (Tpeno) and 14-3-3 (Tp14-3-3) proteins by Western blotting. The exosomes were also extracted from the culture supernatants and incubated with negative rabbit serum, anti-CD63, monoclonal anti-Tpeno 1D7 and polyclonal anti-Tp14-3-3 antibodies for 45 min, followed by adding colloidal gold labelled IgG to observe the exosome morphology by transmission electron microscopy (TEM), and examine the expression of labeled proteins of CD63, Tpeno and Tp14-3-3 by immunoelectron microscopy (IEM). The data analysis was using SPSS 20.0 software, and one-way ANOVA was applied for comparison of group data. Results Before cultivation, the larvae were oval in shape, containing concaved dot-like white scolices. The larvae in the PBS group could survive for 7 days, while in RPMI 1640 group lasted for 2 months. However, the survival time of cysticerci in the bile group was the shortest of 48 h only, while that was longest in the serum group, which was over 3 months, and there was a significant difference between the groups (P < 0.05). While the parasites were viable, the length of cysticerci vesicle in the PBS group, RPMI 1640 group, bile group and serum group was (1.38 ± 0.39), (1.30 ± 0.12), (1.18 ± 0.59) and (1.83 ± 0.10) cm, respectively. Meanwhile the vesicle width for cysticerci was (0.45 ± 0.10), (0.68 ± 0.05), (0.25 ± 0.06) and (0.85 ± 0.05) cm, respectively. Among these, the vesicle length and width of cysticerci in the serum group were significantly different from those in the other three groups (Flength = 7.58, 65.93, 7.11; Fwidth = 73.85, 29.41, 308.57, P < 0.05 or P < 0.01). In addition, at 12 h, the scolex evagination rates of cysticerci in PBS group, RPMI 1640 group, bile group and serum group were (33.3 ± 5.8) %, (20.0 ± 0.0) %, (100.0 ± 0.0) % and (13.3 ± 5.8) %, respectively, The differences among the serum group, the PBS group and the bile group were statistically significant (F = 18.00, 676.00; P < 0.01). No statistically significant difference was found between the serum group and the RPMI 1640 group (F = 4.00, P > 0.05). Compared with the culture results of the other three groups, RPMI 1640 + 10% exosome-free fetal bovine serum was used as the optimal culture solution. SDS-PAGE analysis showed that the larvae-released products and exosome proteins could be successfully extracted from the culture supernatants with RPMI 1640 + 10% exosome-free fetal bovine serum. Using specific antibodies, two cysticerci-derived proteins, Tpeno and Tp14-3-3, were detected with the expected molecular weight (Mr) of 47 000 and 28 000, respectively. TEM showed cysticerci-derived exosomes are circular or elliptical, nano-sized vesicles (50-150 nm diameter) with disc-shaped morphology. IEM analysis demonstrated that the exosome proteins were not recognized by negative rabbit serum and did not show colloidal gold particle label. In contrast, the biomarker protein (CD63) and two parasite-specific proteins (Tpeno and Tp14-3-3) were positively expressed in exosomes with significant colloidal gold particle label. Conclusion This study established an in vitro culture system for C. pisiformis, being able to consecutively cultivate for at least 3 months. With this system, C. pisiformis-derived exosomes could be extracted from the culture supernatant.

    TEACHING RESEARCH
    Blended teaching of medical parasitology in China during COVID-19 pandemic
    ZOU Wei-hao, ZHOU Li-juan, PENG Hong-juan, TONG Kuang
    2022, 40(4):  507-510.  doi:10.12140/j.issn.1000-7423.2022.04.014
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    The COVID-19 pandemic has promoted the development of online teaching in various educational institutions. Different online teaching practice has shown advantages and potential problems. The combination of online and offline teaching (mixed teaching) is a new teaching practice that can exert its advantages simultaneously, and has been wildly used during the COVID-19 pandemic, even being extended to the post-pandemic era. Medical parasitology is a foundation course for medicine and a bridging course towards clinical medicine and preventive medicine. The traditional teaching of medical parasitology has presented many limitations, including outdated teaching concepts and practices, and the disconnection between theory teaching and practice teaching. In response to these difficulties, many innovative ideas and measures have been taken o reform the teaching practice of the foundation medical courses, including updating teaching program, adopting innovative teaching practice (such as blended teaching), and promoting the teaching evaluation method. In this paper, we concluded the blended teaching tools, platforms, manners, effects and evaluation methods in medical parasitology in China during the COVID-19 pandemic to provide information for the teaching reform in the post-pandemic era.

    REVIEWS
    Research progress on clinical trials of schistosomiasis vaccine candidates
    CHEN Bing, ZHANG Guo-li, ZHANG Gao-hong
    2022, 40(4):  511-515.  doi:10.12140/j.issn.1000-7423.2022.04.015
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    Schistosomiasis is a wide-spread parasitic zoonosis caused by Schistosoma, which seriously harms human health and affects socioeconomic development worldwide. Schistosomiasis vaccines have attracted much attention as they will contribute not only to reducing the over-reliance on praziquantel for the treatment of this disease but also to achieving the goal of disease control and elimination. There have been no schistosomiasis vaccines available until now; however, four schistosomiasis vaccine candidates, glutathione S-transferase, fatty acid binding protein, tetraspanin-2 and calpain, have entered human clinical trials. This paper reviewed the clinical research progress and challenges of the four schistosomiasis vaccine candidates to provide insights into developing vaccines for schistosomiasis and other helminthiases in China.

    Research progress on vascular invasion of hepatic alveolar echinococcosis
    ZHANG Ting-ting, DU Qiu-pei, GUO Xin-jian, ZHANG Ling-qiang, WANG Zhi-xin, CHANG Zheng-song, ZHAO Qian, WANG Hai-jiu, HOU Li-zhao
    2022, 40(4):  516-523.  doi:10.12140/j.issn.1000-7423.2022.04.016
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    The surgical treatment for multilocular hepatic echinococcosis is determined by the severity of the lesion invasion to the important vascular system (blood vessels, bile ducts and lymph nodes). Currently, the clinical relationships among the pathological changes, examination indications and treatments of vascular invasion, bile duct invasion and lymph node metastasis are not clear. Here we have summarized recent advances worldwide in multilocular hepatic echinococcosis. The mechanisms of multilocular hepatic echinococcosis progression and metastasis, the pathological distribution of the lesions and the clinical imaging, the morphology and microscopic characteristics of the vascular invasion were reviewed. This review will shed light on the development and research of the diagnosis and treatment of vascular invasion caused by multilocular hepatic echinococcosis.

    The transimission ecology of the echinococcosis on the Tibetan Plateau
    ZUO Qing-qiu, ZHENG Jia-xin, WANG Gang, WANG Xu, WANG Xiao-ming, WANG Zheng-huan
    2022, 40(4):  524-535.  doi:10.12140/j.issn.1000-7423.2022.04.017
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    Zoonotic diseases are not only significant risks to humans, but also seriously affect global biodiversity conservation. The eastern Tibetan plateau has the highest echinococcosis prevalence in the world. The complex and stable echinococcosis transmission networks is based on several wild and domestic animal species. In this study, we summarized the epidemiological research advances of echinococcosis in the rural area of the Tibetan plateau. We also discussed the ecological factors and their functional mechanisms for the transmission of echinococcosis including host species community composition and dynamics, host species behaviour ecology, and human disturbance. Based on these discussions, we put forward suggestions for a better integrative strategy for echinococcosis control and the sustainable development of the plateau ecosystem.

    SHORT COMMUNICATIONS
    Polymorphism analysis of candidate genes for ivermectin resistance in Haemonchus contortus
    LUO Xiao-ping, LI Jun-yan, GAO Wa, GEN Wan-heng, WANG Rui, HU Wei, QIAO Lei, SHAO Guo-yu, YANG Xiao-ye
    2022, 40(4):  536-539.  doi:10.12140/j.issn.1000-7423.2022.04.018
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    The whole genomic DNA of susceptible strains (Hc-S) and resistance strains (Hc-R) of Haemonchus contortus was extracted and the target fragments of candidate genes were amplified by synthesised primers and sequenced directly by PCR. Then DNA sequencing results were analysed using Lasergene7.0 software. EditSeq program was used to intercept DNA fragments containing the coding sequence (CDS) region where specific single nucleotide polymorphism (SNP) sites were located, and MegAlign program was used for sequence alignment and single nucleotide and amino acid polymorphism analysis. The results showed no difference in all nucleotide sites of the HCOI00378500 gene in 25 Hc-S samples, while among 35 Hc-R samples, 8 samples showed a total of 32 SNP sites with 17 amino acid mutations, of which SNPs with the highest mutation rate accounted for 8.6%. The CDS region of the HCOI00506600 gene sequence was mutated at the 75th base of all samples in 40 Hc-R (T > C), and 7 samples of the 21 Hc-S had mutations (T > C), in which the amino acid was changed from isoleucine (Ile, I) to threonine (Thr, T). Among the 38 susceptible strains successfully sequenced, there are 4 SNPs at sites 38, 101, 125 and 134 of the HCOI01200700 gene; among the 13 successfully sequenced resistant strains, there are 6 SNPs at sites 32, 48, 71, 86, 101 and 131. The 38th, 125th and 134th positions of the HCOI01200700 gene showed G/A polymorphism (52.6%, 20/38), T/C polymorphism (57.9%, 22/38) and C/A polymorphism (57.9%, 22/38), respectively. There was at least one 38G, 125T or 134C in the Hc-S, while 38A, 125C or 134A in the Hc-R. Two candidate positive molecules were analysed and identified, including a candidate functional gene HCOI00506600 and a candidate marker HCOI01200700 for the diagnosis of IVM resistance.

    Analysis of the expressed lncRNA related to albendazole resistance of Haemonchus contortus
    CHEN Xin-di, WANG Teng-yu, SHI Ya-qin, MAO Xiao-wei, YAN Xu, SU Ya, WEN Hai-feng, WANG Wen-long
    2022, 40(4):  540-544.  doi:10.12140/j.issn.1000-7423.2022.04.019
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    To understand the expression profile of long non-coding RNAs (lncRNAs) associated with albendazole resistance in Haemonchus contortus, screen differentially expressed lncRNAs and analyze lncRNAs that may be involved in drug resistance. The total RNA of sensitive and drug-resistant strains was extracted by the TRIzol method, and the cDNA library was constructed. Double-terminal sequencing was carried out on the Illumina HiSeqTM4000 platform. The filtered data of fastp software were compared to the reference genome of H. contortus (GenBank accession number GCA_000469685.2) by HISAT2 software. The differentially expressed lncRNA was screened. The cis-regulation mode of significant differential lncRNA target genes was predicted and the differential genes were classified by gene ontology (GO) and enriched by Kyoto encyclopedia of gene and genomes (KEGG). Real-time fluorescence quantitative PCR (qRT-PCR) was used to verify the differentially expressed lncRNA. The results of sequence alignment analysis showed that the reads of the exon region, the intron region and the intergenic region of sensitive strains were 41 344 932 (80.2%), 5 641 886 (10.9%) and 4 550 203 (8.8%), respectively. The reads of exon region, intron region and intergenic region of drug-resistant strains were 36 894 046 (79.4%), 5 644 097 (12.1%) and 3 886 628 (8.3%), respectively. There were 640 differentially expressed lncRNAs detected between the sensitive and the drug-resistant strains. The differential expressions of 246 lncRNA were 32 up-regulated and 214 down-regulated, respectively. The prediction results of the cis-regulation location showed that 76 significant differential lncRNA were screened from 547 differential mRNA, and 81 significant differential mRNA with cis-regulation function were predicted, forming 91 groups of targeted cis-regulatory relationships. The result of GO function analysis showed that these genes were mainly involved in single tissue process, cell process, metabolism, cell composition, binding and catalytic activity. KEGG analysis showed that the dominant enriched signal pathways were fluid shear stress and atherosclerosis, pentose and glucuronate interconversions, drug metabolism-cytochrome P450, neomycin, kanamycin and gentamicin biosynthesis, glycolysis/gluconeogenesis, C-type lectin receptor signal pathway. The results of qRT-PCR showed the relative expression levels of three down-regulated expressions of lncRNA MSTRG.3773.1, MSTRG.7803.1 and MSTRG.6845.2 were 0.74 ± 0.1, 0.33 ± 0.05 and 0.24 ± 0.07, respectively. The relative expression levels of the two up-regulated expressions of MSTRG.3773.2 and MSTRG.7878.1 were 1.33 ± 0.27 and 3.00 ± 0.55, respectively, which was consistent with the sequencing results. There were significant differences in lncRNA expression profiles between albendazole-sensitive and drug-resistant strains of H. contortus. lncRNA such as MSTRG.3151.1, MSTRG.8532.1, MSTRG.7561.2 and MSTRG.4538.1 may be involved in the production of drug resistance.

    Prevalence of the soil-transmitted nematode infections in the national surveillance site in Zhangzhou City from 2016 to 2020
    XIE Xian-liang, CHEN Yun-hong, JIANG Dian-wei, GAO Lan-lin, ZHENG Dan, ZHANG Zhi-kui, WEI Mei-xian, XIE Han-guo
    2022, 40(4):  545-548.  doi:10.12140/j.issn.1000-7423.2022.04.020
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    To analyze the prevalence and epidemic trend of soil-transmitted nematode infection at a national surveillance site of Xiangcheng District in Zhangzhou City from 2016 to 2020. Tianbao Village and Dazhai Village in Tianbao Town, Punan Village and Pulin Village in Punan Town, and Gaokeng Village in Shiting Town were selected as the survey sites in Xiangcheng District. No less than 200 permanent residents aged 3-years or above were selected from each administrative village. Fecal samples were collected from the residents recruited in the study and were examined for soil-transmitted nematode eggs (two slide-reading per sample) using the modified Kato-Katz thick smear method. The cellophane tape method was used to detect the eggs of Enterobius vermicularis in children aged 3-9 years. For individuals with hookworm infection, the test-tube filter paper incubation method was used to culture hookworms and identify the species of hookworms. Five households were randomly selected from each village, and one soil sample from the field or vegetable garden was collected for each household to check for Ascaris eggs and hookworms. From 2016 to 2020, a total of 5 309 local residents were tested, and the total infection rate was 3.0% (159/5 309). The infection rates of hookworm and Trichuris trichiura were 2.9% (154/5 309) and 0.1% (5/5 309), respectively. No A. lumbricoides infection was found. Six hundred twenty-five children aged 3-9 were examined, and the E. vermicularis infection rate was 27.8% (174/625). The infection rates for males and females were 3.7% (96/2 608) and 2.3% (63/2 701), respectively. The difference was statistically significant (χ2 = 8.31, P < 0.01). The highest infection rate was 7.3% (79/1 077) in ≥ 65 years age group with a statistically significant difference between the age groups (χ2 = 123.51, P < 0.01). The infection rate was higher among farmers, with 3.6% (157/4 325) than in other occupations. The difference was statistically significant (χ2 = 32.95, P < 0.01). The highest infection rate was in illiterate and semi-literate residents 10.1% (79/781) with statistically significant difference between the educational levels (χ2 = 171.18, P < 0.01). The total infection rates of soil-derived nematodes between 2016 and 2020 were 3.9% (44/1 126), 1.0% (11/1 104), 7.6% (78/1 029), 0.9% (9/1 013) and 1.6% (17/1 037), respectively. The infection rates of E. vermicularis in children were 34.0% (33/97), 28.4% (27/95), 30.9% (30/97), 30.9% (46/149) and 20.3% (38/187), respectively. The infection rates of hookworm were 3.6% (41/1 126), 1.0% (11/1 104), 7.4% (76/1 029), 0.9% (9/1 013) and 1.6% (17/1 037), respectively. There were significant differences in the total infection rate and hookworm infection rate among different years (χ2 = 114.90, 110.32; P < 0.01). T. trichiura infections were only found in 2016 and 2018. The infection rates were 0.3% (3/1 126) and 0.2% (2/1 029), respectively. The majority of the hookworm infected cases had a mild infection, accounting for 98.1% (151/154). All T. trichiura infected cases were mild infections (5/5). From 2016 to 2020, a total of 115 soil samples were collected. The positive rate of hookworm larvae was 8.7% (10/115), and all were identified to be Necator americanus. No human Ascaris eggs were detected. The positive soils were all from vegetable gardens. From 2016 to 2019, the infection rate of soil-transmitted nematodes in the rural population in Xiangcheng District showed a significant decrease. The E. vermicularis infection in children still remains at high level, and monitoring and prevention should continue to be strengthened.

    Ultrasound and pathological manifestations of lesions in SD rats with hepatic Echinococcus multilocularis infection established by different methods
    WU Liang-liang, YANG Ling-fei, SONG Tao
    2022, 40(4):  549-552.  doi:10.12140/j.issn.1000-7423.2022.04.021
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    100 male SD rats were randomly divided into the liver puncture group and the portal vein injection group, with 50 rats in each group. The SD rat hepatic Echinococcus multilocular infection models were established by open liver puncture and portal vein injection. The survival rates of the two groups were compared after infection. The infection rate in the two groups was calculated by ultrasonic examination and open examination 4 months after infection. The ultrasonic manifestations of lesions in the two groups were compared. Hematoxylin-eosin (HE) staining was used to observe the liver lesions of the two groups. The results showed that the postoperative survival rate of rats in the liver puncture group was 96.0% (48/50), which was higher than 84.0% (42/50) in the portal vein group (χ2 = 4.000, P < 0.05). The infection rate in the liver puncture group was 56.3% (27/48), and there was no significant difference compared to that of the portal vein group (61.9%, 26/42) (χ2 = 0.296, P > 0.05). Ultrasound results showed that of the 27 rats successfully inoculated in the liver puncture group, 4 had multiple lesions, and the remaining 21 rats showed single intrahepatic lesions. The 26 rats successfully inoculated in the portal vein group showed single E. multilocular infection (P < 0.05). The lesions in the liver puncture group were all located in the left lobe of the liver. The lesions in the portal vein group were all located in the right lobe of the liver (P < 0.05). The liver lesions of the 12 rats in the liver puncture group were solid lesions with uniform internal echoes, 7 were solid lesions with uneven echoes and calcifications, and 8 were non-uniform echoes with internal echoes of different sizes, and mixed lesions of echogenic vesicles. The liver lesions of 6 rats in the portal vein group showed solid lesions with uniform internal echo, 16 rats showed mixed lesions with uneven echo and internal vesicles of different sizes, and 4 showed mixed lesions with heterogeneous internal echoes accompanied by calcification and vesicles. The difference between the two groups was statistically significant (P < 0.01). The average maximum diameter of liver lesions in the liver puncture group was (5.86 ± 2.69) mm, which was smaller than that in the portal vein group (11.69 ± 5.94) mm (t = -4.578, P < 0.01). The results of HE staining showed that all the lesions were infected by E. multilocularis. There were obvious germinal structures in the liver of rats in the liver puncture group and portal vein group, and there were varying degrees of inflammatory cell infiltration and proliferative fibrous connective tissue around the lesions. It is suggested that both methods can establish the rat model of hepatic E. multilocularis infection, and there are differences in ultrasonic manifestations. The portal vein puncture injection method is more suitable for establishing the animal model of E. multilocular infection.

    CASE REPORTS
    A case of advanced lung cancer complicated with Rhabditis axei infection
    CUI Yu-xui, WANG Xue-zhi, JIANG Zhi-fang, ZHANG Ling, SONG Ting-ge, SONG Mei-mei, SUN Hong, MA Shao-lin, SUN Lu, ZHAO Juan, YANG Peng
    2022, 40(4):  553-555.  doi:10.12140/j.issn.1000-7423.2022.04.022
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    A 48-year-old female patient with late stage lung cancer was admitted at Baoding Second Central Hospital on October 16, 2020. The patient reported numbness in both hands, persistent back pain, abdominal pain and diarrhea, long-term constipation, anemia, and progressive weight loss. Physical examination after admission showed no palpable enlargement of superficial lymph nodes, and clear breath sounds in both lungs, and positive percussion pain on 7-8 thoracic vertebrae in the back. Laboratory tests, hemoglobin 88 g/L. A large number of active parasites were found under the low magnification by microscope on the routine smear, and the eggs were found under the high magnification by microscope. Combined with the patient’s medical history, clinical manifestations and related auxiliary examinations, the diagnosis of Ehrlichen worm disease was made. The patient received oral albendazole (400 mg each time, twice a day) for 5 days. The patient was reviewed for the routine smear microscope on October 21 and November 16, respectively. No parasites were found under the routine smear microscope, the symptoms improved, the anemia improved, and the weight increased significantly.

    A case of Anisakis infection in Fujian Province
    HUANG Shu-ling, LIN Shi-han, QIU Xi-bin, CEHN Yong-xuan, LIN Chen-xin
    2022, 40(4):  556-558.  doi:10.12140/j.issn.1000-7423.2022.04.023
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    An 42-year-old male patient who was found to have a parasite in his ileocecal region during a colonoscopy examination in December 2021. The worm was reported motile and was removed with biopsy forceps. During the colonoscopy, no abnormality was found in the intestinal mucosa where the parasite was found and no abnormality was found in the intestinal lumen. The extracted parasite was identified as Anisakis simplex preliminarily by morphological identification. DNA was extracted from parasites and tested by PCR. The amplified fragment was about 1 000 bp. After sequencing, BLAST analysis showed that it was consistent with Anisakis simplex up to 99%. By phylogenetic tree analysis, it was clustered with Anisakis simplex. The parasite was confirmed to be Anisakis simplex. The patient reported that he had lived in southeast coastal cities for a long time and had a history of eating raw seafood products for many years. No discomfort was reported after the parsite was removed, so no other examination and treatments were performed.

    Detection of Trichomonas tenax in pleural effusion: a case report
    ZHENG Yun-wei, GUO Jiang-mei
    2022, 40(4):  559-561.  doi:10.12140/j.issn.1000-7423.2022.04.024
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    A 69-year-old male patient with pleural effusion and pulmonary infection was treated in Jiangxi Provincial people’s Hospital on October 17th, 2021. The patient complained of pain in the right costal arch for 7 days, with a history of periodontal disease and a personal history of cerebral infarction. Physical examination upon admission showed dullness on percussion at the right chest, the right lung breath sound was not heard, and dry rales could be heard in the left lung. Chest Color Doppler Ultrasound revealed bilateral pleural effusion; chest X-ray and CT showed right pleural effusion and right lung infection. Trichomonas could be seen in hydrothorax smear and Wright-Gibbs smear. High-throughput sequencing of pleural effusion showed Trichomonas oralis. Combined with the patient’s history and auxiliary examination results, the diagnosis was oral Trichomonas infection and pulmonary infection. During hospitalization, patients were given closed thoracic drainage, intravenous infusion of metronidazole and ornidazole (0.5 g/once, twice a day) and intrapleural injection of metronidazole and ornidazole (0.5 g/once, once a day) for 14 days combined with piperacillin tazobactam (4.5 g/once, 3 times a day) for 23 days, and urokinase (200 000 units/time) on October 30th and October 31st, respectively. After three times of intrapleural injections to eliminate pleural separation on November 2nd, the patient’s symptoms improved and no trichomonas was found in pleural effusion. Chest CT indicated that the pleural effusion was significantly improved, and the patient was discharged without additional abnormality. One month after discharge, the patient had no discomfort, no pleural effusion and no obvious abnormality were found by chest CT examination.