Objective To have insight into the epidemiological situation and to predict the possibilities for achieving the national goal of basic eradication or the WHO target of elimination of leprosy as a public health in the leprosy high－ endemic areas in China. Methods Based upon the data during 1983－ 1996 from the National Leprosy Recording and Reporting Surveillance System and using the appropriate mathematical models, the expected calendar year of reaching the national goal in terms of detection and prevalence rates and the WHO target of elimination under different conditions was predicted. Results Of 337 counties where the national goal of basic eradication of leprosy had not reached and 40 counties where the WHO goal of leprosy elimination had not achieved in 1996, the detection rates in calendar years followed the negatively exponential models with a significant goodness－ of－ fit in 67 and 11 counties, respectively. In the former, the national goal can be met in 6％ of counties before the year 2000 or 34.4％ before 2010 in terms of detection rate, or 31.3％ before the year 2010 in terms of prevalence rate. In the latter, the WHO target can be met in 8－ 10 counties within this century when the duration of disease was determined with the WHO definition. While the MB proportion among new cases increased by 10％ , the target would be met one year later. However, at the same MB proportion, the change of the duration of completing the fixed treatment from PB 0.5 year and MB 2 years to PB 0.75 year and MB 3 years will result in the achievement of the goal 2－ 10 years later. Conclusion The results imply that WHO goal of leprosy elimination can be reached in more than 95％ of counties by the end of this century, but the national goal of achieving basic eradication of leprosy in more than 95％ of counties by this century will not be met, indicating that leprosy control will go beyond the century in China.

Objective This study was designed to evaluate the change in coagulation and platelet function during cardiac surgery using SONOCLOT(SCT), a new coagulation and platelet function analyser which can analyse the whole process of coagulation including platelet function , fibrin formation and fibrinolysis with only 0 4ml of whole blood Methods Thirty ASA Ⅱ Ⅲpatients scheduled for cardiac surgery were studied 15 patients underwent valve replacement (group V) and another 15 patients coronary artery bypass graft (CABG, groupC) under combined intravenous and inhalation anesthesia Anesthesia was induced with midazolam 0 05mg?kg -1 ,fentanyl 5 10?g kg -1 or propofol 1 1 5mg?kg -1 and vecuronium 0 1 0 2mg?kg -1 and maintained with isoflurane(0 8 1 5MAC) supplemented with intermittent boluses of propofol and fentanyl ECG,SpO 2, P ET CO 2, BP, CVP, PAP, HCT and T were monitored during operation And dopamine, adrenaline, nitroglycerin, milrinone and other vasoactive drugs were used to maintain hemodynamic stability Blood samples were taken before anesthesia (T 1), after induction (T 2), after heparinization 3mg? kg -1 ( T 3) and 5min after protamine administration (T 4) for determination of ACT, clot rate and platelet function using SONOCLOT analysis Platelet counts were checked at T 1 and T 4 Results CPB time was less than 2h in all 30 patients Clot rate was significantly faster at T 2 than at T 1(P

Objective The normothermic isolated contracting rat heart model was used to investigate the mechanism of protective effect of propofol on left ventricular function and myocardial metabolism against ischemia-reperfusion injury by determination of the catecholamme concentration in the coronary outflow. Methods forty healthy male SD rats weighing 310-450 g were randomly divided into 4 groups of each 10 animals: control group, propofol 10?mol/L (P10), 50?mol/L (P50) and 100?mol/L (P100). The animal were sacrificed by knock-out and the heart was immediately removed. The aorta was connected to a Larigendorff apparatus and retrogradely perfused with oxygenated (95% O, and 5% CO2) Krebs-Henseleit buffer (KHB) for 5 min. Then the left ventricle was perfused through a cannula inserted in pulmonary vein at a constant pressure of 12.5 cm H2O (preload). The pressure at aorta outflow was 90 cm H2O (afterload). Different concentrations of propofol in KHB were prepared. Global ischemia of the heart was induced by suspension of perfusion for 25 min followed by 30 min reperfusion. Coronary flow (CF), aortic flow (AF), cardiac output (CO = AF + CF), HR, left ventricular peak systolic pressure (LVPSP), left ventricular end-diastolic pressure (LVEDP), left ventricular developed pressure (LVDP = LVPSP-LVEDP) and the product of LVDP and HR were measured and recorded 5 min and immediately before ischemia and 5, 10, 15, 20, 25 and 30 min following reperfusion. Coronary outflow was collected for determination of creatine kinase (CK) and catecholamine ( epinephrine, norepinephrine and dopamine) concentrations.Results Before ischemia CF was significantly higher and CO, HR, LVPSP and LVDP ? HR were significantly lower in the 3 propofol groups in comparison with the controls. During reperfusion CF, CO, HR, LVPSP and LVEDP recovered much better in the propofol groups than those in control group. In group P50 LVDP ? HR reached 88.7% of the pre-ischemic value while in control group only 56.3% . The CK and catecholamine concentrations were not significantly different among the 4 groups before ischemia. During reperfusion CK, epinephrine and noeepinepherine concentrations were significantly lower in propofol groups than in control group (P

Objective To investigate the effect of midazolam on expression of adhesion molecules on the platelet membrane surface in patients with coronary heart disease (CHD) .Methods Blood samples were taken from 10 healthy volunteers and 40 patients with CHD and anticoagulated with 3.8% sodium citrate. Platelet rich plasma (PRP) was obtained by centrifugation at 800 r/min for 8 min at room temperature. Ten volunteers served as control group (group E). The 40 patients with CHD were randomly divided into 4 groups ( n = 10 each) : group A, B, C and D. In group E and group A PRP was incubated without midazolam while in group B, C and D PRP was incubated with midazolam 100 (B) , 200 (C) and 400 ng?ml-1 (D) for 3 min. The inhibitory effect of midazolam on expression of CD154, CD41/61 and CD26p on the platelet membrane surface was determined by flow cytometry. Results The five groups were comparable with respect to age, sex (M/F ratio) , body weight, platelet count, bleeding and coagulation time. The expression of CD154, CD41/61 and CD62p on the platelet surface was significantly increased in patients with CHD. Midazolam 200 and 400 ng?ml-1 inhibited the expression of CD154, CD41/61 and CD62p on the platelet membrane surface in patients with CHD, whereas midazolam 100 ?g?ml-1 had no significant effect on CD154, CD41/61 and CD62p. Conclusion The expression of adhesion molecules on the platelet membrane surface is greater in patients with CHD than in healthy adults. Midazolam 200 and 400 ng?ml-1 can inhibit the expression of CD154, CD41/61 and CD62p on the platelet membrane surface.

Objective To investigate the relationship between type D personality and post-traumatic stress disorder symptoms in survivors after the Zhouqu debris flow disaster.Methods In tatal,213 residents randomly sampled from the Zhouqu debris flow area were assessed one year after disaster.Questionnaires included the posttraumatic stress disorder check list-specific version(PCL-S) and type D personality scale(DS14).Results The prevalence of Type D in the post-disaster sample was 51.17％ accessed by the DS14,compared with 31.1％ prevalence in chinese college students.PTSD symptoms in survivors with type D were significantly severer than those without type D.Initial traumatic feeling,economic loss and negative affectivity were significant predictors of PTSD symptoms in survivors with type D.Conclusion Type D personality is positivel correlated with PTSD and may be a vulnerability factor for PTSD symptoms.

OBJECTIVE To study the methods of surgical and prostheses repair of the defects after resection of the malignant maxillary sinus tumors.METHODS In 60 cases with malignant maxillary sinus tumors,surgical defects of 18 cases were repaired by pedicle forehead flaps,sternocleidomastoid myocutaneous flap,temporalis myofascial flap,pectoralis major myocutaneous flaps or palate flaps,and the surgical defects of 50 cases were repaired with maxillary obturator prostheses.RESULTS The postoperative speaking,swallowing,respiratory function and facial appearance recovered well in 68.3% cases,not well in 20% cases,poorly in 11.7% cases.There were 3 cases with wound split,1 case with necrosis of the margin of pectoralis major myocutaneous flaps and 3 cases with cutaneous fistula in inner canthus,and 8 cases with difficulty of opening mouth after operation.CONCLUSION Surgical reconstruction and obturator prostheses are the simple and economic methods for repair the defects after resection of the malignant maxillary sinus tumors.The proper fixation of prostheses and close the defects completely are the keys to recover the functions and facial appearance.

Objective To determine the distribution of Helicobacter pylori (H.pylori) iceA, babA2 in patients in Shanghai and explore the association of H. pylori strain genotype with its clinical outcome after infection. Methods A total of 141 H. pylori strains was isolated from gastric biopsy samples of 43 patients with chronic gastritis, 47 patients with duodenal ulcer (DU), 30 patients with gastric ulcer(GU) and 21 patients with non cardia gastric carcinoma. The iceA, vacA, cagA, and babA2 genotypes were determined by polymerase chain reaction (PCR). Results iceA1, iceA2 and babA2 were detected in 74.5% (105/141) , 15.6% (22/141) and 63.8% (90/141) of the 141 H.pylori strains, respectively, while 2 of isolated H. pylori strain (1.4%) were positive for both iceA alleles and 16(11.3%) were negative for both iceA alleles. The prevalence of babA2 and the combined genotype of babA2 and cagA in H. pylori isolated from DU patients were significantly higher than that in GU patients (74.5% vs. 50.0% for babA2, P =0.028; 70.2% vs. 46.7% for babA2 and cagA, P =0.039). There was no significant difference in prevalence of babA2 among other disease groups. No association of different clinical diseases with iceA genotype was detected. Conclusions The most common genotype of H.pylori strains isolated from patients in Shanghai is iceA1 +/babA2 +. babA2 may play different role in the pathogenesis of duodenal ulcer and gastric ulcer. No association between iceA status and clinical outcome of H.pylori infection was confirmed in our study.

AIM: To investigate the clinic effect of the femoral neck fracture (FNF) with percutaneous internal fixation of hollow screw Ti-nails. METHODS: A total of 57 patients with closed FNF were recruited from Department of Orthopaedics in the First Mine Hospital of Pingdingshan Coal Group from February 2001 to December 2005. They were treated with 3 hollow screw Ti-nails (produce by Shanghai Qunli Medical Devices Co., Ltd) in 5-mm diameter under C-arm X-ray monitoring after close reduction by hand, punctured with 4-6 bone round nails in 2.5-mm diameter through skin for prefixation. The patients were encouraged to stretch and flex muscles early and perform articular physiological movement. The criteria of outcomes: Excellent: the patients were completely cured in six months after surgery, no pain was found in diseased coxa, the articular movement was normal, and they could walk freely half one year after surgey. Good: The fracture was cured in 9 months lately or no healing, there was a little ache in diseased coxa, the articular movement was limited, and they could walk normally in 10-12 months after surgery and recover slight work. Bad: The fractures were not cured, there were absorption, shifting, and aching in fracture joint early, and they need walk with walking stick. RESULTS: There were 55 cases followed up for 9 months, 51 cases for 18 months, and 57 cases for 42 months.①The curative effect of FNF by internal fixation was excellent in 27 cases, good in 20 cases and bad in 10 cases. ②Host response: 6 patients suffered from fracture shift due to screw-nail displacement, 4 patients got bone un-union, 6 patients experienced femoral head necrosis, and 2 patients got ache at bone fracture and were limited for articulation movement. No infection and rejection happened among 57 patients. CONCLUSION: The treatment of AO cannula Ti-screws internal fixation under closed reduction is effective for FNF, and no abnormal biocompatibility between materials and host appears in the clinical follow-up.

Objective:To investigate changes of platelets and coagulation function in patients undergoing cardiac valvular replacement surgery during cardiopulmonary bypass(CPB).Methods: Thirty patients scheduled for elective cardiac valvular replacement were equally randomlized to 2 groups: control group and propofol group. In control group anesthesia was induced with midazolam 0.05 mg?kg -1,fentanyl 0.01 mg?kg -1 and vecuronium 0.1-0.2 mg?kg -1, and maintained with isoflurane,fentanyl and vecuronium. In propofol group anesthesia was induced with midazolam 0.05 mg?kg -1,fentanyl 0.005-0.01 mg?kg -1,propofol 1.5 mg?kg -1 and vecuronium 0.1-0.2 mg?kg -1, and propofol 4-5 mg?kg -1?h -1 was administered during operation with isoflurane,fentanyl and vecuronium. Blood samples were taken from jugular vein to assay SonACT, clot rate and platelet function with Sonoclot ananlysis, and to measure platelet count, PT and APTT before anesthesia, 5 min after induction,before CPB,10 min after CPB and at the end of operation.Results: Compared with those before anesthesia, PF, clot rate, platelet count, PT and APTT in both groups significantly decreased 10 min after CPB and at the end of operation(P

ObjectiveTo explore the influences of perceived social support and social evaluations( including trust in others,government and social organizations,satisfaction of the government and social organizations,and satisfaction with the disaster relief and reconstruction work)on disaster area adults'life satisfaction after the Yushu earthquake.MethodsWith perceived social support scale (PSSS),satisfaction with life scale (SWLS) and self made survey,370 Tibetan adults were investigated,and the average age was 32.99 ± 12.66.Results ①Perceived fricnds' support( r =0.24,P ＜ 0.01 ),perceived others＇ support ( r =0.15,P ＜ 0.01 ),trust in others,government and social organizations ( r =0.19,P ＜ 0.01 ),satisfaction with the government and social organizations ( r =0.14,P ＜ 0.05) and satisfaction with the disaster relief and reconstruction work ( r=0.17,P ＜ 0.01 )had significant positive correlations with Yushu adults'life satisfaction.②Perceived friends' support ( β =0.21,P ＜ 0.01 )and trust in others,government and social organizations(β =0.27,P＜0.05) were significant predictors of Yushu adults'life satisfaction.ConclusionPerceived friends'support and trust in others,government and social organizations can play an important role in Yushu adults'life satisfaction after the earthquake.