Objective : To analyze the prevalence and influencing factors of leprosy reactions in Zhejiang Province from 2010 to 2019, so as to provide reference for the control of leprosy. Methods: Through the national leprosy management system, the new leprosy cases in Zhejiang Province from 2010 to 2019 were recruited to analyze the incidence of leprosy reactions in different demographic characteristics and leprosy clinical features. The multivariate logistic regression analysis was conducted to explore the influencing factors for leprosy reactions. Results : Totally 191 leprosy cases were investigated. The incidence rate of leprosy reactions was 29.32%; the the incidence rate of typeⅠand type Ⅱreaction was 16.75% and 9.42%, respectively. There were 33 leprosy reaction cases (58.93%) before multidrug therapy (MDT) , 13 cases (23.21%) during 0-6 months of MDT, 5 cases (8.93%) during 7-12 months of MDT, 3 cases (5.36%) during over 12 months of MDT, and 2 cases (3.57%) after MDT. The results of the multivariate logistic analysis showed that the cases who were 35 years old or below (OR=2.245, 95%CI: 1.006-5.008) , were not floating population (OR=3.442, 95%CI: 1.394-8.494) , were infected outside family (OR=3.878, 95%CI: 1.075-13.993) and were smear positive (>0+,OR=4.514, 95%CI: 1.365-14.926; >3+,OR=4.727, 95%CI: 1.443-15.485) were risk factors for leprosy reactions. Conclusions The prevalence of leprosy reactions is high in Zhejiang Province from 2010 to 2019, and is associated with age, floating population, source of infection and BI.

Objective: To assess the implementation of National Leprosy Control Plan (2011-2020) in Zhejiang Province, so as to provide insights into leprosy control. Methods: Leprosy control data were collected from the National Leprosy Management Information System of China, and health administrative sectors, centers for disease control and prevention and professional leprosy control institutions at each level in Zhejiang Province. According to the scheme for the final evaluation of National Leprosy Control Plan (2011-2020), the implementation of 12 indicators in Zhejiang Province in 2020 was investigated, including the current number of leprosy patients, prevalence of leprosy, proportion of training on leprosy control skills, proportion of regular leprosy treatment, proportion of treatment of adverse reactions, annual examination rate of close contacts, proportion of early case identification and awareness of leprosy control knowledge. Results: There were 50 registered leprosy cases in Zhejiang Province by the end of 2020, with a decrease of 50.98% relative to in 2010. The prevalence of leprosy was less than 1/105 in 93 counties (districts) of Zhejiang Province, and the rate of training on leprosy control skills, rate of regular leprosy treatment, rate of treatment of adverse reactions, annual examination rate of close contacts, rate of early case identification were all 100% in Zhejiang Province. There were no new confirmed cases with diagnosis of leprosy having grade 2 deformity or disability, or no new cases with deformity or disability within 2 years following anti-leprosy therapy. In addition, the awareness of leprosy control knowledge was 91.67% among the public and 98.12% among the close contacts. All of the 12 indicators reached the requirements of the National Leprosy Control Plan (2011-2020). Conclusions The implementation of the National Leprosy Control Plan (2011-2020) in Zhejiang Province had achieved the targets defined in the final evaluation of the plan. Intensifying multi-sectoral joint leprosy prevention and control and improving early identification and standardized therapy of leprosy cases are recommended for future leprosy control in Zhejiang Province.

Objective: To investigate the epidemiological characteristics of sexually transmitted diseases (STDs) in Zhejiang Province from 2018 to 2022, so as to provide insights into improving STDs prevention and control strategies. Methods: Data of syphilis, gonorrhea, condyloma acuminatum, genital herpes and genital Chlamydia trachomatis infections reported in Zhejiang Province from 2018 to 2022 were collected from the Infectious Disease Surveillance System of Chinese Disease Prevention and Control Information System. The temporal, spatial and population distribution of STDs were analyzed, and the trends in incidence of STDs were evaluated using annual percent change (APC). Results: A total of 386 770 STDs cases were reported in Zhejiang Province from 2018 to 2022, with mean annual reported incidence of 127.80/105. The mean annual reported incidence from high to low was syphilis (44.11/105), genital Chlamydia trachomatis infections (40.20/105), gonorrhea (24.92/105), condyloma acuminatum (13.32/105), and genital herpes (5.34/105). The incidence of STDs appeared a tendency towards a decline from 2018 to 2022 (APC=-9.332%, P<0.05), with an average annual growth rate of -9.41%. Syphilis (APC=-11.536%, P<0.05), condyloma acuminatum (APC=-7.509%, P<0.05), and genital Chlamydia trachomatis infections (APC=-9.009%, P<0.05) showed a appeared a tendency towards a decline. The top three highest reported incidence were reported in Hangzhou City (185.98/105), Taizhou City (133.85/105) and Lishui City (122.73/105), respectively. The mean annual reported incidence of females was higher than that of males (140.60/105 vs. 117.83/105; P<0.05). Most STDs cases were at ages of 20 to 49 years (265 314 cases, 68.60%). Farmers (118 096 cases, 30.53%), household and unemployed personnel (85 924 cases, 22.22%) were the predominant occupation. Conclusions The incidence of STDs appeared a tendency towards a decline in Zhejiang Province from 2018 to 2022, with regional differences in incidence. People at ages of 20 to 49 years, farmers, household and unemployed personnel are high-risk populations for STDs.

Objective:To analyze spatiotemporal distribution characteristics of syphilis in Zhejiang province from 2016 to 2020, to explore cluster areas of syphilis cases, and to provide a theoretical basis for accurate prevention and control of syphilis.Methods:Data on reported syphilis cases in Zhejiang province from 2016 to 2020 were collected from the notifiable infectious disease surveillance system in China Disease Control and Prevention Information System. The ArcGIS10.2 software was used as a data management and presentation platform to establish a database for spatial analysis of syphilis in Zhejiang province from 2016 to 2020, and spatial autocorrelation analysis of reported syphilis incidence was conducted. The SaTScan 9.6 software was used for spatiotemporal scanning analysis.Results:A total of 158 420 cases of syphilis were reported in Zhejiang province from 2016 to 2020, and the average annual reported incidence rate was 49.07 per 100 000 in all counties and districts (range: 20.52 per 100 000-124.29 per 100 000) . The overall spatial distribution pattern of syphilis cases in Zhejiang province was characterized by higher reported syphilis incidence in the West area and lower incidence in the middle area. Global autocorrelation analysis showed that all the global Moran′s I indices from 2016 to 2020 were over 0, Z values were over 1.96, and P values were below 0.001, suggesting the spatial clustering of reported syphilis cases. Local autocorrelation analysis showed that there were 2 high-high clustering areas (Tonglu and Chun′an counties in Hangzhou city, Jingning county in Lishui city) , and 1 low-low clustering area (Jindong district, Dongyang and Yongkang county-level cities in Jinhua city) . Local hot-spot analysis with G statistic showed that there were 6 positive hot-spot areas and 8 negative hot-spot areas of syphilis cases in Zhejiang province. SaTScan spatiotemporal scanning analysis revealed 3 clustering areas, mainly distributed in Taizhou and Zhoushan cities along the eastern coast, and some counties and districts in the southwestern mountainous areas. Conclusions:The reported incidence rate of syphilis in Zhejiang province is characterized by spatial clustering. In the future, prevention and control of syphilis should be strengthened in southwestern mountainous areas, eastern islands, and other remote areas as well as areas with poor transportation.

Medical ethics has a long history and rich connotations.It has developed from the simple "medical morality" of ancient times to the modem medical ethics.The basic principles of medical ethics include autonomy,non-maleficence,beneficence,justice,and so on.Researchers often conduct clinical researches in the balance between achievements and ethical norms.Clinical researchers of surgery should have a deep understanding of medical ethical principles and strictly abide by medical ethics.Ethics committee should strictly perform their duties and play the role of inspection and supervision.Modem medical knowledges should be popularized throughout the society to make clinical research correctly understood.Adhering principles of ethics first,people orientation and cooperation practice,with patients' benefit as evaluation criteria,balance of surgical "Dao" and "Shu" can be achieved.