Abstract：Objective To investigate the detection methods of newly discovered leprosy cases in Hunan Province in 2013-2022, and analyze the trend of changes, and provide scientific basis for the prevention and treatment of leprosy. Methods The detailed information of newly diagnosed leprosy cases in Hunan Province from 2013 to 2022 was collected through the Leprosy Management Information System (LEPMIS), and the descriptive epidemiological method was used to analyze the detection methods of newly discovered leprosy cases. Results From 2013 to 2022, a total of 250 newly diagnosed leprosy cases were detected in Hunan Province, including 143 cases (57.20%) were found in outpatient clinics, 33 cases (13.20%) were found in clue investigations, 27 cases (10.80%) were notifiable-reported, 23 cases (9.20%) were self-reported, 11 cases (4.40%) were found in other ways (e.g., group survey), 9 cases (3.60%) were found in contact examinations, 2 cases (0.80%) were found in census, and 2 cases (0.80%) were found in epidemic point inspection. From 2013 to 2022, the number of cases detected in outpatient clinics showed an upward trend (rs=0.515), while the cases detected in clue investigation (rs=-0.873), notifiable-reported (rs=-0.127), self-reported (rs=-0.301), contact examination (rs=-0.363), census (rs=-0.701) and epidemic point inspection (rs=-0.701) showed a downward trend. The majority of leprosy cases with different demography characteristics and clinical characteristics were found through outpatient clinics, except that the majority of leprosy cases in children were found by contact examination (66.76%). Of 165 male cases, 92 cases (55.76%) were found in outpatient clinics and 51 out of 85 female cases (60.00%) were found in outpatient clinics. Among age groups, 113 out of 187 cases aged 15 to 60 (60.43%) and 30 out of 60 cases aged over 60 (50.00%) were found in outpatient clinics. Among patients with differentoccupations, 112 out of 208 cases of farmers (53.85%) and 31 out of 42 cases of other occupations (73.81%) were found inoutpatient clinics. Among cases with different types of leprosy, 111 out of 185 cases of multibacillary leprosy (60.00%) and 32 out of 65 cases of paucibacillary leprosy (49.23%) were found in outpatient clinics. Among cases with different numbers of skin lesions, 4 out of 8 cases of skin lesion-free leprosy (50.00%), 3 out of 9 cases of single skin lesion leprosy (33.33%), and 136 out of 233 cases of multiple skin lesions leprosy (58.37%) were found in outpatient clinics. Of 72 cases without nerve damage, 48 cases (66.67%) were found in outpatient clinics. Of 27 cases with single nerve damage, 17 cases (62.96%) were found in outpatient clinics. Of 151 cases with multiple nerve damage, 78 cases (51.66%) were found in outpatient clinics. Among patients with different levels of malformation, 58 out of 102 cases with no malformation (56.86%), 28 out of 45 cases with Grade malformation (62.22%), 35 out of 68 cases with Grade Ⅱmalformation (51.47%), and 22 out of 35 cases with other types of malformation (62.86%) were found in outpatient clinics. Conclusions Outpatient clinics is the main way to detect newlydiagnosed leprosy cases under the low prevalence of leprosy in Hunan Province, and it is an important strategy to move the early detection of leprosy cases to comprehensive medical institutions in the future.

Objective To research and develop an index system for training evaluation of national health emergency response.Methods A combinative approach was applied,including core expert group discussion,on-site investigation into parameters applied in Delphi assessment by field experts,national reviews by provincial health departments.Results Firstly,a framework of index system was constructed by core expert group based on literature;Secondly,the index was screened by mean score from field experts' investigation and suggestion of core experts,then an index system was formulated with 5 first level indexes,19 second level indexes and 46 third level indexes;Thirdly,index weight was determined according to the mean weight by field experts investigation and adjusted suggestion of core experts;Finally,the index system for training evaluation of national health emergency response was approved by Ministry of Health and applied to the whole nation.Conclusions The combinative approach is practical in research and developing index system.The index system covers a full range of related factors,and is applicable at provincial level.However,attention should be paid to improving training after evaluation.

Objective To investigate the MRI features of spinal epidural angiolipomas.Methods Clinical and MRI data of 18 patients with spinal epidural angiolipomas confirmed pathologically were retrospective analyzed.The MRI features of lesion site,size,shape,signal,bone destruction,enhancement and typing were observed and analyzed.Results One case of 18 cases were located in cervical vertebra,15 cases were thoracic vertebra,and 2 cases were lumbar vertebra.Ten cases formed paravertebral lump through foramen intervertebrale and damaged adjacent bones.MRI showed that T1W1 signal intensity was either isointense (n 11),mixed intense (n=5) or hyperintense (n =2).T2WI showed signal intensity was hyperintense (n=13) or mixed intense (n=5).The fat signal was seen in 5 cases,both T1W1 and T2W1 showed hyperintense.All the 18 cases showed remarkable enhancement.Ⅰ type (lesions confined to the spinal canal) was 8 cases (8/18,44.44％),Ⅱ type (lesions were dumbbell-shaped to the spinal canal) was 10 cases (10/18,55.56％).Conclusion The location of occurrence and the manifestations of MRI in spinal epidural angiolipomas have certain characteristics,which provides important clues to the preoperative diagnosis.

Objective To discuss the value of hypotonic-MRCP combined with LAVA dynamic contrast-enhanced scan in diagnosis of duodenal tumor.Methods Five patients with duodenal adenocarcinomas confirmed by pathology were involved in this study.All cases underwent plain MRI and hypotonic-MRCP and LAVA dynamic contrast-enhanced scans.Results 4 of 5 cases were correctly diagnosed with MR imaging.Imaging signs included:the cavum of descending duodenum appeared as asymmetrical stenosis,masses with soft tissue signal intensity connecting the intestinal wall with wide base,the intestinal wall stiff,the intestinal mucosa destruction.The lesions would be slightly-moderately enhanced at LAVA dynamic enhancement scanning.Conclusion Hypotonic-MRCP combined with LAVA dynamic contrast-enhanced scan can display the direct and indirect sign of duodenal tumors,which was effective in identifying the circumscription of the tumor and its extension.

Objective: To learn the influencing factors for self-violent thoughts and behaviors among the ninth-grade students in Jiangbei District of Ningbo, so as to provide the basis for carrying out psychological intervention. Methods: The ninth-grade students in a junior high school each of the six streets ( towns ) in Jiangbei District were recruited by multi-stage cluster sampling method from October to November 2018. A self-designed questionnaire was used to investigate the general information, life style, psychological condition, self-violent thoughts and behaviors in the latest year. Multivariate logistic regression model was used to analyze the influencing factors for self-violent thoughts and behaviors. Results: A total of 1 300 questionnaires were issued and 1 238 valid ones were recovered, with an effective rate of 95.23%. The prevalence rates of self-violent thoughts and behaviors among the ninth-grade students were 16.88% and 8.48%. TheResults of the multivariate logistic regression analysis showed that abnormal marital status of parents ( OR=2.074, 95%CI: 1.139-3.775 ) , no moderate physical activity ( OR=1.764, 95%CI: 1.101-2.826 ) , sleeping less than 8 hours ( OR=1.858, 95%CI: 1.273-2.712 ) , alcohol consumption ( OR=2.108, 95%CI: 1.448-3.070 ) , sense of despair ( OR=6.397, 95%CI: 4.195-9.757 ) , sense of anxiety ( OR=4.094, 95%CI: 2.725-6.151 ) , sense of loneliness ( OR=1.879, 95%CI: 1.241-2.854 ) , and cyber-bullying ( OR=5.155, 95%CI: 2.780-9.556 ) were risk factors for self-violent thoughts; not living with parents ( OR=2.057, 95%CI: 1.021-4.145 ) , alcohol consumption ( OR=1.756, 95%CI: 1.074-2.872 ) , sense of despair ( OR=7.197, 95%CI: 4.365-11.864 ) , sense of anxiety ( OR=5.832, 95%CI: 3.276-10.382 ) , fighting ( OR=2.272, 95%CI: 1.219-4.232 ) and physical bullying ( OR=3.462, 95%CI: 1.135-10.558 ) were risk factors for self-violent behaviors. Conclusion Drinking, family relationship, bullying, and mental health problems such as sense of despair and anxiety were associated with the self-violent thoughts and behaviors of ninth-grade students.

Objective:To investigate the relationship between the expression of inhibin subunit Beta A (INHBA) and the clinicopathological data and its effect on proliferation, invasion and metastasis of gastric cancer cells and its possible mechanisms.Methods:Using Gene Expression Profiling Interactive Analysis (GEPIA) public database to verify the expression of INHBA mRNA in gastric cancer and adjacent tissues and its relationship with pathological stage and prognosis; the relationship between INHBA and clinical prognosis was analyzed using the Kaplan-Meier Plotter online database. Immunohistochemistry was used to confirm the correlation between protein expression level of INHBA in gastric cancer and adjacent tissues and clinical pathological staging. In vitro, the cell proliferation was detected by tetrazolium salt (MTT) method; the cell migration ability was detected by scratch test, and cell invasion and metastasis ability was detected by transwell chamber assay. The expression of INHBA and epithelial-mesenchymal transition (EMT) related proteins was detected by Western blot. Results:The GEPIA database and Kaplan-Meier Plotter online database analysis showed that INHBA mRNA was highly expressed in various cancer tissues and significantly higher in gastric cancer tissues than normal tissues ( P<0.05). The high expression of INHBA mRNA was associated with clinical stage and poor prognosis of gastric cancer ( P<0.05). The results of immunohistochemistry showed that the staining score of INHBA in gastric cancer tissues was significantly higher than that in adjacent tissues ( P<0.05), and its expression level was correlated with clinical tumor node metastasis (TNM) stage ( P<0.05). The results of MTT, scratch test and transwell chamber showed that INHBA overexpression could promote the proliferation, migration, invasion and metastasis of gastric cancer cells, while interference with INHBA expression could inhibit the proliferation, migration, invasion and metastasis of gastric cancer cells; Western blot results showed that the expression of CDH1 was down regulated and the expression of CDH2 was up-regulated after INHBA overexpression. The expression of CDH1 was up-regulated and the expression of CDH2 was down-regulated after INHBA overexpression was inhibited. Conclusions:INHBA is highly expressed in gastric cancer tissues compared with adjacent tissues. The expression level of INHBA is related to tumor progression and poor prognosis. INHBA can promote the proliferation, migration and invasion of gastric cancer MGC-803 cell line and its mechanism may be related to INHBA promoting cell EMT.

Objective:To evaluate the clinical features and follow-up effect of treatment for retinal capillary hemangioma (RCH) of myopic disc.Methods:Retrospective case series studies. A total of 14 patients (15 eyes) diagnosed with juxtapapillary RCH (JRCH) at Peking Union Medical College Hospital and followed up for more than 12 months from January 2007 to December 2019 were included. Among these patients, there were 7 males (7 eyes) and 7 females (8 eyes) with the average age of 29.8±12.7 years. There were 6 isolated JRCH cases, all of which were monocular patients, including 1 case with a single peripheral RCH; 8 cases with von Hippel-Lindau disease, including 5 cases of binocular RCH. Out of 15 eyes, 6 eyes were merged with peripheral RCH. Three eyes were simply observed, and 12 eyes were treated with photodynamic therapy (PDT) alone or PDT combined with other treatments. The average follow-up time was 55.2 months. Its clinical characteristics and long-term treatment effects were analyzed.Results:At the first visit, among the 15 eyes, 3 eyes had visual acuity <0.1, 5 eyes were 0.1-0.4, and 7 eyes were> 0.5. The endogenous and fixed exogenous JRCH were 12 (80%, 12/15) and 3 (20%, 3/15) eyes, respectively. The size of the tumor was 1/4 to 4 optic disc diameters (DD); the combined macular edema, epiretinal membrane, and macular hole were 11, 5, and 1 eyes, respectively. There were 3 eyes with tumor diameter less than 1 DD. The visual acuity at the first diagnosis was 0.6-1.0, and no treatment was given. The follow-up time was 12 months in 2 eyes and 120 months in 1 eye. At the last follow-up, his vision remained stable and the tumor did not enlarge. Six eyes with tumor diameter ranging from 1.0 to 2.5 DD, visual acuity was 0.06 to 0.6 at first diagnosis, accompanied by retinal exudation. 5 eyes were treated with PDT alone, and 1 eye was treated with PDT combined with anti-vascular endothelial growth factor drugs. The follow-up time was 12 to 84 months. At the last follow-up, the visual acuity improved or stabilized in 5 eyes and decreased in 1 eye. There were 6 eyes with peripheral RCH, including 4 eyes with retinal detachment, 2 eyes with epiretinal membrane, and 1 eye with vitreous hemorrhage. The visual acuity at the first visit was 0.02-0.6. All patients were treated with PDT combined with transpupillary thermotherapy, extrascleral drainage, and vitrectomy. The follow-up time was 12 to 132 months. At the last follow-up, all eyesight decreased.Conclusions:Visual decrease cause by JRCH often occurs at young adults. Bilateral JRCH are more common in patients with von Hippel-Lindau's disease. The tumor can cause retinal exudation, macular edema, epiretinal membrane and macular hole, resulting in gradual vision loss. PDT and/or combined anti-vascular endothelial growth factor drugs for medium sized JRCH with retinal exudation can maintain long-term vision stability. Patients with large JRCH or severe complications such as retinal detachment tend to have poor prognosis.

Shan Qi soy has busting bags, bacteria sum overproof, continue acidification and other problems occasionally during the storage. It's probably caused by the Lactobacillus continue growth in the soy. We tried expounding the relationship between growth and producing acid when Lactobacillus growing in the thin fermented material.

There are two populations of bacteria to affect the formation of urinary stones in humanity. The first one can promote the formation of urinary stone by increasing urinary pH, decreasing concentration of urinary inhibitors , and damaging the protective urothelial glycosaminoglycan layer. The second inhibit the formation of urinary stones. These bacteria ( mainly the intestinal oxalate degrading bacteria such as Oxalobacter formigenes, lactic acid bacteria, Enterococcus faecalis etc) can decrease urinary oxalate concentration by regulating exogenous oxalate. The problems faced and the developing direction were also indicated.

A high Streptolydigin-producing strain Streptomyces lydicus AS 4.2501-L8 with genetic stability was obtained from the original strain S. lydicus AS 4.2501-P28 by mutagenesis with UV and acridine orange, followed by resistance selection. Its yield of Streptolydigin was 177.0 ?g/mL, 96.2% higher than the original strain.