OBJECTIVE To study the sites of nosocomial infection in the Traditional Chinese Medical Hospital and the pathogen distribution and drug resistance;to provide basis against nosocomial infection. METHODS Retrospective analysis was performed for 851 strains of bacteria isolated from those tested specimens sent by the inpatient department from 2005 to 2007. RESULTS The main sites of nosocomial infection was respiratory tract,followed urinary tract and wounds,the main responsible bacteria was Gram-negative bacilli,their rate was 52%.While the rate of Gram-positive cocci was 36%,the rate of fungi was 12%.The common bacteria in nosocomial infection our hospital were Klebsiella pneumoniae,Escherichia coli,Pseudomonas aeruginosa,Staphylococcus and Candadi albicans,whose rate of drug resistance was similar to that in the comprehensive hospital. CONCLUSIONS In nosocomial infection the proportion of Gram-positive cocci and fungi is increasing,so is their rate of drug resistance.It mustn′t be neglected in clinic.

Objective To study epidemiological and clinical patterns of leprosy in children in China. Methods The data of leprosy in children from 1989 to 1998 in China were analyzed in terms of gender, infection source, detection mode, skin lesion, nerve damage, leprosy reaction, clinical type and skin smear. Results A total of 22 437 leprosy cases were detected during 1989～ 1998, of which 912 (4.1％ ) were child cases (560 males and 352 females). Average delay in detection was 1.13 years (n=909). The main source of infection was close contact within families, accounting for 69.2％ , and majority of cases were detected through active modes. Among children with leprosy, 96.8％ were with skin lesions, 76.0％ with nerve damage, 4.7％ with leprosy reactions, 12.4％ with grade II disability and 41.2％ with positive skin smears. The average proportion of child cases was 4.2％ in Yunnan, Guizhou and Sichuan Provinces, and 1.3％ in Shandong, Jiangsu and Zhejiang Provinces. The proportion of child cases was stable in Guizhou and Sichuan Provinces during this period, whereas in 1998 it significantly increased to 11.6％ in Yunnan. Conclusion The present study suggests that proportion of children with leprosy is one of the sensitive indicators of leprosy endemicity. The sources of leprosy infection in children is predominately due to the contact with active cases within families.

ObjectiveTo study the epidemiological characteristics of leprosy in China,2001-2010.MethodsData were collected from the database of the national system of leprosy surveillance.A descriptive and comparative analysis was performed.ResultsTotally,15 507 new leprosy cases were detected from 2001 to 2010 with an average case detection rate of 0.118 per 100 000 population.Among these cases,2.7％ were children under 15 years,86.5％ multibacillary,and 22.5％ suffered from grade 2 disability.From 2001 to 2010,a total of 1506 relapse cases were detected,and relapse occurred after multi-drug therapy(MDT) in 464 of these cases.There were significant differences between low and high endemic areas in the proportion of children under 15 years,females,immigrant patients among newly detected patients as well as the proportion of cases of relapse after MDT among all the relapse cases.By the end of 2010,the registered leprosy cases were 6032 with a prevalence rate of 0.450 per 100 000 population,among whom 2886 were under MDT.ConclusionsThe leprosy case detection rate continued to decrease in China from 2001 to 2010 with an unequal distribution.The pocket areas were in Yunnan province,Guizhou province,Sichuan province,Guangdong province,Hunan province and Tibet Autonomous Region.It is warranted to enhance the control of leprosy and reduce the prevalence of disability due to leprosy.

Objective To study the high risk factors of anastomotic leakage after colon cancer surgery ,so as to provide evidence for the prevention of anastomotic leakage. Methods Fifty-three patients with anastomotic leakage after colon cancer surgery of 916 cases were selected as research objects,then the correlation between systemic factors,local factors and occurrence of anastomotic leakage was analyzed and studied. Results The correlation between age, ASA grade, serum hemoglobin, red blood cell, total protein, fasting blood glucose of systemic factors except for sex and occurrence of anastomotic leakage was obvious (P< 0.05). There was correlation between the methods of anastomosis, anastomotic tension, setting position of drainage tube, intestinal obstruction, abdominal infection and degree of tumor differentiation except for with or without chemotherapy and radiotherapy and occurrence of anastomotic leakage(P < 0.05). Conclusion The high risk factors of anastomotic leakage after colon cancer surgery are multiple,and well various work should be done during perioperative period.

Objective To investigate the prevalence of urticaria among children aged 2-6 years in Nanjing city.Methods A questionnaire survey was carried out in children aged 2-6 years in 5 main districts of Nanjing City.Results The number of valid questionnaires was 13 610,accounting for 92.8％ of total respondents.Among the 13 610 respondents,1 116 were diagnosed as urticaria,including 565 boys and 551 girls,with the total prevalence rate being 8.54％.No significant difference was observed in the prevalence rate of urticaria between boys and girls (8.49％ vs.8.60％,x2 =0.04,P =0.832) or among children of different age groups (x2 =1.84,P =0.17).The prevalence of urticaria increased with age,and positively correlated with parents' educational level (rs =0.96,P =0.000).Children born in urban areas showed higher prevalence of urticaria than those in rural areas (8.79％ vs.5.56％,x2 =13.98,P =0.000).Conclusions The prevalence of urticaria has increased among children aged 2-6 years in recent years.More studies should be carried out to investigate into the pathogenesis and relevant factors of urticaria,so as to facilitate its prevention and treatment.

Objective To investigate the prevalence of atopic dermatitis (AD) among children aged 2-6 years in Nanjing city.Methods A questionnaire survey was carried out in children aged 2-6 years in 7 main districts of Nanjing City.Results A total of 13 061 children were investigated,among which,768 were diagnosed as AD,including 410 boys and 358 girls.The prevalence rate of AD was 5.88％ (95％ CI,5.48％-6.28％) in total,6.16％ (95％ CI,5.59％-6.74％) in boys and 5.59％ (95％ CI,5.02％-6.15％) in girls.Higher prevalence rate of AD was observed in boys compared with girls,and in children whose place of birth was in urban areas compared with those in rural areas.In addition,the prevalence rate of AD increased with age and with the rise in parental educational level.Conclusions Rapid economic development has dramatically changed life habits,dietary structure and residential environment of people,which can influence the prevalence of AD.

Objective To analyze the epidemiological features of leprosy in China from 2011 to 2015,and to provide scientific evidences for prevention and treatment strategies.Methods An epidemiological analysis and a trend analysis were conducted based on the national leprosy surveillance data from 2011 to 2015.Results The leprosy detection rate in China decreased from 0.085 per 100 000 in 2011 to 0.049 per 100 000 in 2015,with an average annual decline rate being 12.9％.A total of 4 775 leprosy cases were newly detected during 2011-2015,including 106 (2.2％) children,1 499 (31.4％) females,518 (10.8％) floating people,4 041 (84.6％) multibacillary cases and 1 134 (23.7％) cases with grade 2 disabilities.From 2011 to 2015,328 relapsed cases were reported,including 153 (46.6％) cases recurring after combined chemotherapy.The prevalence rate of leprosy in China decreased from 0.407 per 100 000 in 2011 to 0.235 per 100 000 in 2015,with an average annual decline rate being 12.9％.By the end of 2015,there had been 3 230 registered leprosy cases and 124 counties with a prevalence rate above 1 per 100 000.Conclusions The detection rate and prevalence rate of leprosy in China were both decreasing continuously from 2011 to 2015.The high-epidemic provinces were Yunnan,Guizhou,Sichuan and Guangdong.However,leprosy control in middle-and low-epidemic provinces can not be ignored.

Objective To compare the efficacy of uniform multi-drug therapy (UMDT) versus routine multi-drug therapy (RMDT) for the treatment of multi-bacillary (MB) leprosy patients based on bacterial index changes and frequencies of leprosy reaction.Methods This study recruited newly diagnosed leprosy patients after taking informed consent in three districts of Guizhou province as well as in one district of Yunnan province from November 2003 to June 2005.The patients received 6-month UMDT or 2-year RMDT.Clinical follow up and bacterial reexamination were carried out once a year.Changes of bacterial index (BI) and frequencies of leprosy reaction were compared between the patients receiving RMDT and UMDT.Results A total of 166 patients received UMDT and 170 received RMDT in this study.Among the UMDT-treated patients,114 were skin smear positive,and 83 had been followed up for 42 months; of the RMDT-treated patients,149 underwent all the bacterial examinations during a 48-month follow up.The mean bacterial index decreased from 2.84 before treatment to 0.33 at the end of the 42-month follow up in the 83 patients,and from 2.55 to 0.26 at the end of the 48-month follow up in the 149 patients,with no significant difference in the changes of bacterial index between the two groups (t =0.77,P ＞ 0.05).Bacterial index became negative in 73.5％ (61/83) of the UMDT-treated patients and in 77.2％ (115/149) of the RMDT-treated patients (x2 =0.40,P＞ 0.05)at the end of follow up.During the follow up peroid,the incidence of type Ⅰ leprosy reaction was 14.6％ (13/89) in the UMDT group,significantly higher than that in the RMDT group (3.4％ (5/149),x2 =10.08,P＜ 0.01 ).Conclusions There is no significant difference in mean bacterial index changes and bacterial clearance rate during the follow up peroid between UMDT- and RMDT-treated patients.The incidence of type Ⅰ leprosy reaction is higher in the UMDT group than in the RMDT group,and further investigation is needed to clarify the mechanisms underlying the phenomenon.

Objective To detect gene mutations associated with dapsone-,rifampicin-and ofloxacinresistance in lesions of patients with recurring or treatment-resistant leprosy collected from 2010 to 2011.Methods Clinical data and lesional specimens were collected during 2010-2011 from patients with recurring or treatment-resistant leprosy who were diagnosed and reported by provincial centers for leprosy control.Mycobacterium leprae DNA was extracted from the specimens and subjected to PCR for the amplification of folP1,rpoB and gyrA genes.The PCR products were directly sequenced and BLAST program was used to compare the sequence of isolated strains with the reference sequence in GenBank.Results Twenty-four patients were enrolled in this study,including 13 with recurring leprosy and 11 with treatment-resistant leprosy.Twenty-one patients showed positive PCR results in all the three regions.Of these PCR-positive specimens,3 from 1 patient with recurring and 2 patients with resistant leprosy harbored a point mutation,acc (threonine)→gcc (alanine),at codon 53 in the floP1 gene,1 from a patient with recurring leprosy harbored a missense mutation,gat (aspartic acid) → aac (asparagine),at codon 441 in the rpoB gene.Conclusions Mutations are detected in the folP1 and rpoB genes,which are associated with the resistance to dapsone and rifampicin respectively,but not in the ofloxacin resistance-associated gyrA gene,in Mycobacterium leprae isolates from patients with recurring or treatment-resistant leprosy.

ObjectiveTo approach the status of leprosy disabilities in newly detected cases in recent 11 years in China.MethodsBased upon the records from the National Leprosy Recording and Reporting System in National Center for STD and Leprosy Control, 24128 leprosy cases detected during 1989-1999 in China were analyzed in terms of leprosy disbility.ResultsThe proportion of disabilies in newly detected leprosy cases in 1989 in whole country was 46.49% and decreased to 32.7% in 1999, and the proportions of cases with grade Ⅱ disabilities were 25.55% (1989) and 22.06% (1999). There were 19 provinces where disability rate was more than 40%. Out of patients with disabilities, those with grades Ⅰ and Ⅱ disabilities and with deformities (loss of eyebrow, facial paralysis or saddle nose) accounted for 37.54%, 61.04% and 1.42%, respectively. There were 20 provinces where grade Ⅱ disabilities accounted for more than 50% of all patients with disabilities. The disability rates in patients aged under 15 years, 15-65 years and over 65 years were 24.74%, 39.3% and 53.33%. The patients with a delay in detection of 2 years had a disability rate of 28.95%, and those with a delay of more than 2 years and 5 years had the rates of 48.06% and 60.95%, respectively. The disability rate was 53.76% in patients with leprosy reactions. The grade Ⅱ disability rate in paucibacillary patients (28.53%) was significantly higher than that in multibacillary ones (22.03%). Conclusions Disability rate of leprosy in newly detected cases is still high although it has decreased in the recent 11 years. The rate is associated with delay in detection, leprosy reaction and leprosy type. It suggests that early detection of leprosy patients, regular treatment with multidrug therapy, and management of leprosy reactions will be the effective measures to prevent disabilities of leprosy.