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 To investigate a method to detect the sentinel lymph nodes(SN) of thyroid papillary carcinoma and its predictive value for cervical metastasis of carcinoma. Methods Intraoperative methylene blue dye mapping was performed in 24 cases of thyroid papillary carcinoma. The coincidence rate of frozen section pathology and routine section pathology of SN was observed,and the predictive value of SN for (metastasis) of the cervical lymph nodes was noted. Results SN was successfully detected in 21(87.5%) of 24 cases. The average number of SN was 3 nodes. There was one false negative case, the false negative rate was 4.8%(1/24), and no false positive cases were found. The predictive value of sentinel lymph nodes to (cervical) lymph node metastasis was 83.3%.Conclusions Methylene blue staining to identify sentinel lymph nodes could accurately predict the status of cervical lymph node metastasis of thyroid papillary carcinoma.

Objective To determine the efficacy of computed radiogram (CR) of chest in the diagnosis of pulmonary carcinoma.Methods There were 56 cases of pulmonary carcinoma confirmed by pathology including 34 cases of central pulmonary carcinoma and 22 cases of periphral pulmonary carcinoma in this paper.Four kinds of chest CR images (plain CR,wide CR,HE-CR and LE-CR) and two kinds of chest CR tomogmphic images (plain CR tomogram and HE-CR) were compared with conventional X-ray (CXR) and conventional tomogram (CTomo)respectively in showing normal structures and abnormal shadowes tomogram.Results The normal structure were displayed more clearly by CR than by CXR,except wide CR and HE-CR in showing right inferior pulmonary artery.The central pulmonary carcinoma was displayed more clearly by CR and LE-CR than by CRX in all aspects.The airways were involved displayed much more clearly by wide CR than by CXR.The display of peripheral vessels and inside densiy of neoplasm was similar on wide CR and CXR films,but the mass margins were abscure on wide CR.HE-CR displayed less clearly than CRX in all aspects.In the peripheral lung carcinoma,plain CR and LE-CR played the better in display of neoplasma margin and cavity in tumor than CXR did, but CXR displayed the margin clearly than wide CR did.HE-CR displayed all of the signs less clearly than CXR did. The indexes displayed by CR tomo were all bettre than that done by CXR tomo.Conclusion All kinds of CR (including CR tomo) images of chest have advantages in displaying normal strcture and neoplasma signs, versus CXR and CXR tomo images. Synthesizing the adventages of various CR(including CR tomo) images,the observator can find more signs to improve the accuracy of diagnosis of pulmonary carcinoma.

Objective To estimate the prevalence of hepatitis C virus (HCV) infection among sexually transmitted disease (STD) clinic attendees infected with human immunodeficiency virus type 1 (HIV-1) in Guangxi Zhuang Autonomous Region.Methods Totally,11 553 blood plasma samples were collected from STD clinic attendees in Guangxi Zhuang Autonomous Region,and subjected to HIV-1 antibody screening and confirmatory testing.Enzyme linked immunosorbent assay (ELISA) was performed to detect anti-HCV antibodies in 140 anti-HIV-1 antibody-positive samples and 282 anti-HIV-1 antibody-negative samples from age-and marital status-matched attendees.Chi-square test was performed to assess the differences in the prevalence rate of HCV infection between anti-HIV-1-negative and-positive samples,and Logistic regression analysis to evaluate the risk factors for HCV and HIV co-infection.Results The positivity rate of anti-HCV antibodies was 33.57％ (47/140)among anti-HIV-1-positive samples,significantly higher than that in anti-HIV-1-negative samples (1.06％ (3/282),x2 =94.66,P ＜ 0.05).Logistic regression analysis showed a statistical increase in the prevalence of HCV/HIV co-infection in individuals reporting more than one sexual partners compared with those reporting only one sexual partner (OR =2.4,95％ CI (1.0-5.6),P =0.05),and in intravenous drug users compared with non-intravenous drug users (OR =20.8,95％ CI(5.7-76.5),P ＜ 0.05).Conclusions HCV infection appears to be associated with HIV-1 infection,and comprehensive intervention on HIV-1-infected patients may slow down HCV transmission.

ObjectiveTo investigate the prevalence of syphilis among outpatients in sexually transmitted disease (STD) clinics in Guangxi Zhnang Autonomous Region,and to assess the socioeconomic and behavioral factors associated with the infection.MethodsThe outpatients to 14 STD clinics in 8 cities of Guangxi Zhnang Autonomous Region were investigated with questionnaires by their doctors at the first visit.Venous blood samples were obtained from these outpatients and subjected to toludine red unheated serum test (TRUST) to screen for syphilis.Treponema pollidum particle agglutination (TPPA) was performed for TRUSTpositive samples.The epidemiological data were collected by using EpiData software,statistically analyzed by using SPSS13.0 software package.ResultsA total of 10 930 STD outpatients were recruited in the study,and 1297 samples were confirmed to be both TRUST and TPPA positive.The prevalence of syphilis was 11.9％ in all of the outpatients,14.3％ in female outpatients and 10.3％ in male outpatients,13.3％ in the outpatients of Zhuang nationality,and 11.4％ in those of Han nationalily.Multivariate analysis showed that syphilis was independently related to female sex[odds ratio(OR) 2.23,95％ confidence interval(CI) 1.69 - 3.00,P＜0.01 ],low educaiion level (middle school:OR 1.70,95％ CI 1.11 - 2.62,P ＜ 0.05; primary school or illiteracy,OR 1.98,95％ CI 1.13 - 3.46,P＜0.05),annual income of more than 30000 Yuan (OR 1.91,95％ CI 1.18 -3.10,P ＜ 0.01 ),commercial sex workers or having multiple sexual partners(OR 1.54,95％ CI 1.16 - 2.06,P ＜0.01 ).ConclusionsSyphilis serology should be the routine test in STD clinical settings in Guangxi region,and the intervention should be enhanced to control the prevalence of syphilis in high-risk populations.

Objective To correlate dynamic parameters at contrast enhanced CT and interstitial fibrosis grade of non-small cell lung cancer (NSCLC). Methods Twenty-nine patients with NSCLC were evaluated by multi-slice CT. Images were obtained before and at 20,30,45,60,75,90,120,180,300,540,720,900 and 1200 s after the injection of contrast media, which was administered at a rate of 4 ml/s for a total of 420 mg I/kg body weight. Washout parameters were calculated. Lung cancer specimens were stained with hematoxylin-eosin stain and collagen and elastica double stain. Spearman test was made to analyze correlation between dynamic parameters and interstitial fibrosis grade of tumor. Results Twentynine NSCLC demonstrated washout at 20 min 12. 1 (0. 32-58.0 ) HU, washout ratio at 20 minutes 15.3% (0. 3%-39.2% ), slope of washout at 20 minutes 0. 0152 %/s ( 0. 0007%/s-0. 0561%/s ).Interstitial fibrosis of 29 lesions was graded as grade Ⅰ (10), grade Ⅱ (14) and grade Ⅲ (5). There were significant correlation between washout at 20 min ( r = - 0. 402, P ＜ 0. 05 ), washout ratio at 20 min ( r =-0.372,P＜0.05), slope of washout ratio (r = -0.459,P ＜0.05) and interstitial fibrosis grade in tumors. Conclusion NSCLC washout features at dynamic multi-detector CT correlates with interstitial fibrosis in the tumor.

Objective: To investigate the mediating effect of insomnia among mobile phone addiction, aggressive behaviors and self-perceived identity among university students. Methods: A total of 740 university students were sampled from five universities in Binjiang District, Hangzhou City using a cluster random sampling method. The mobile phone addiction, aggressive behaviors and self-perceived identity were assessed using the Mobile Phone Addiction Index Scale, the Athens Insomnia Scale, the Chinese college students' version of the Buss-Perry Aggression Questionnaire, and the Self-Perceived Identity Scale, and the mediating effect of insomnia among mobile phone addiction, aggressive behaviors and self-perceived identity was examined using Process macro program and Bootstrap method. Results: A total of 740 questionnaires were allocated, and 700 valid questionnaires were recovered, with an effective recovery rate of 94.59%. The respondents included 221 men (31.57%) and 479 women (68.43%), and there were 607 respondents with a specialty of medicine (86.71%). There were 331 participants detected with mobile phone addiction (47.29%), 90 with aggressive behaviors (12.86%) and 289 with low-level self-perceived identity (41.29%), and the prevalence rates of mild, moderate, severe and extremely severe insomnia were 28.00%, 26.14%, 26.43% and 19.43% among respondents, respectively. Mobile phone addiction had a direct predictive effect on aggressive behaviors (β=0.301, P<0.001) and self-perceived identity (β=-0.129, P<0.001), and presented an indirect predictive effect on aggressive behaviors (effect of mobile phone addiction on insomnia: β=0.083, P<0.001; effect of insomnia on aggressive behaviors: β=0.999, P<0.001; effect of insomnia on self-perceived identity: β=-0.698, P<0.001). The contributions of mediating effects caused by insomnia were 21.61% and 31.02% to total effects. Conclusions Insomnia presents partial mediating effects among mobile phone addiction, aggressive behaviors and self-perceived identity among university students. Mobile phone addiction may directly affect aggressive behaviors and self-perceived identity, and indirectly affect aggressive behaviors and self-perceived identity via insomnia.

Objective To compare the value of diffusion kurtosis imaging (DKI) mode and mono-exponential mode in predicting the response to neoadjuvant chemotherapy (NAC) for locally advanced breast carcinoma using DWI.Methods From January 1,2013 to December 31,2016,eighty patients with locally advanced breast carcinoma were enrolled into this prospective clinical study.The diagnosis was confirmed on the basis of histopathological results.The clinical stage stayed at Ⅱ or Ⅲ.The patients would receive breast-conserving surgery after NAC.All the patients underwent DWI examination by using both mono-exponential mode and DKI mode before chemotherapy was initiated.The parameters included ADC,mean diffusivity (MD) and mean kurtosis (MK).Within 1 to 3 days before or after MRI examination,the patients underwent aspiration biopsy,received 4 to 8 cycles of NAC and followed by surgery.According to histologic grading before NAC,the patients were classified into well-differentiated and poor-differentiated group.According to the comparison between pathological results acquired from biopsy before NAC and specimen acquired after surgery,the patients were classified into pathologic complete response (pCR) and pathologic non-complete response (non-pCR) according to treatment effect.The imaging parameters were compared between the pCR and the non-pCR group using t test.The predicting ability of two imaging modes was compared and analyzed with ROC analysis.The relationships between multiple imaging parameters,pathologic,clinical characteristics of tumor and treatment effect were analyzed using logistic multi-variate regression analysis,and further analyzed using Wald test.Results There were 30 cases of pCR and 50 cases of non-pCR.The ADC and MD values were lower in the pCR group than in the non-pCR group (P＜0.05).MK value was higher in the pCR group than in the non-pCR group (P＜0.05).ROC analysis showed that the area under ROC curve of ADC,MD and MK in predicting treatment effect were 0.732,0.866 and 0.683 respectively.Logistic regression analysis showed that,according to predicting ability,MD,ADC and MK successively were the independent predictors for the early response to chemotherapy.Conclusion Compared with mono-exponential mode,DKI mode can reflect the real micro-environment and water diffusion restriction within the tumor area more reliably and accurately,and is more suitable to serve as an imaging technique for predicting the response to NAC for locally advanced breast carcinoma.

Objective To determine the prevalence of penicillinase-producing Neisseria gonorrhoeae(PPNG) and the distribution of blaTEM-135 gene variants in PPNG at several gonococcal antimicrobial surveillance sites in China, to compare N. gonorrhoeae multi-antigen sequence typing(NG-MAST)types of PPNG and its blaTEM-135 gene variants, and to assess the difference and association in NG-MAST types of blaTEM-135 gene variants among different regions. Methods A total of 572 N. gonorrhoeae isolates were collected at 6 gonococcal antimicrobial surveillance sites from Jiangsu, Shanghai, Zhejiang, Tianjin, Guangdong and Guangxi in 2012. After isolation, purification, and identification, cefalotin paper discs were used for detection of PPNG. DNA was extracted by QIAxtractor DX kits after cultivation of the PPNG strains. Then, mismatch amplification mutation assay (MAMA) PCR was performed to identify blaTEM-135 variants, and NG-MAST analysis to determine N. gonorrhoeae genotypes. Results Among the 572 N. gonorrhoeae strains, 38.1%(218/572) were identified as PPNG, and of the PPNG strains, 52.3% (114/218) were blaTEM-135 variants. The detection rate of PPNG at these surveillance sites from high to low was as follows: 51.7% (45/87, Zhejiang), 45.6%(36/79, Shanghai), 38.0% (78/205, Guangdong), 37.5% (12/32, Guangxi), 31.2% (24/77, Jiangsu) and 25.0%(23/92, Tianjin), and that of blaTEM-135 variants was as follows: 68.9%(31/45, Zhejiang), 58.3%(14/24, Jiangsu), 50.0%(39/78, Guangdong), 47.2%(17/36, Shanghai), 39.1%(9/23, Tianjin)and 33.3%(4/12, Guangxi). NG-MAST analysis showed that the ST2318, ST1768, ST1866, ST1053 and ST8726 types predominated among these bla TEM-135 variants, and a strong correlation was found between blaTEM-135 variants and some NG-MAST types, such as ST1768, ST1053 and ST8726 types. The distribution of NG-MAST types was significantly different between the surveillance site in Tianjin (in the Northern part of China) and the other sites (in the Southern part of China), but highly similar among the surveillance sites in Jiangsu, Zhejiang and Shanghai regions. Conclusions There is a high prevalence of PPNG and its blaTEM-135 variants at several gonococcal antimicrobial surveillance sites in China, with significant differences in NG-MAST genotype distribution of PPNG and its blaTEM-135 variants among different regions.