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 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.

Objective:To analyze the delivery room disaster vulnerabilities of 7 tertiary hospitals in Liaoning Province, evaluate the nursing management disasters vulneratility, and provid support for emergency management of delivery room nursing.Methods:The Kaiser model analysis was used to design a disaster vulnerability assessment form for the delivery room, combined with the actual risk prevention and control in the delivery room. The survey was conducted from March 18 to 27, 2020 by paper questionnaire among 200 nursing staff in the delivery room, and the risk values for emergencies were calculated and the matrix distribution was analyzed and evaluated.Results:Totally 190 valid questionnaires were collected. The top 10 risk events faced by the delivery room were epidemic outbreaks, failure to adequately protective equipment for emergency admission to the delivery room, maternal poor protection awareness, nursing staff were contaminated with amniotic fluid and body fluids, poor maternal compliance with midwife orders, shortage of supplies of medical care protective equipment, nursing staff suffered needlestick injuries, high fever in patients, masks and gloves were worn or removed incorrectly, and doctor-patient tension due to poor compliance.Conclusion:Kaiser model-based hazard vulnerability analysis of delivery rooms can provide an important basis for risk identification and early warning and emergency plan improvement and formulation, which should be applied flexibly with the actual and specific characteristics of delivery rooms and dynamic changes of risks.

Objective:To analyze the interim clinical efficacy of laparoscopic and open distal gastrectomy for gastric cancer in elderly patients.Methods:The prospective randomized controlled study was conducted. The clinicopathological data of 102 patients aged ≥65 years who underwent distal gastrectomy for gastric cancer in the Nanfang Hospital of Southern Medical University from September 2014 to May 2018 were collected. After excluding 6 patients, 96 patients were finally included. Based on random number table, patients were allocated into two groups. Patients undergoing laparoscopic distal gastrectomy were allocated into laparoscopic group, and patients undergoing open distal gastrectomy were allocated into open group, respectively. Obser-vation indicators: (1) grouping situations of the enrolled patients; (2) intraoperative situations; (3) postoperative situations; (4) follow-up. Follow-up using outpatient examination and telephone interview was conducted to detect complications in the postoperative 30 days up to July 2018. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M( P25, P75) or M(range), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Comparison of ordinal data was analyzed using the non-parameter Mann-Whitney U test. Results:(1) Grouping situations of the enrolled patients: a total of 96 patients were selected for eligibility. There were 66 males and 30 females, aged from 65 to 85 years, with a median age of 69 years. There were 49 of 96 patients in the laparoscopic group and 47 patients in the open group. (2) Intraoperative situations: patients in the two groups underwent distal gastrectomy successfully with D 2 lymphadenectomy, without intra-operative conversion to laparotomy. The volume of intraoperative blood loss and surgical incision length were 50 mL(50 mL,100 mL) and (7.1±1.7)cm for the laparoscopic group, respectively, versus 100 mL(100 mL,200 mL) and (19.1±1.7)cm for the open group, showing significant differences between the two groups ( Z=?3.779, t=?34.880, P<0.05) . (3) Postoperative situations: the number of lymph node dissected, time to postoperative initial out-of-bed activities, time to postoperative first flatus, time to postoperative first liquid food intake, time to postoperative first semi-liquid food intake, time to drainage tube removal, duration of postoperative hospital stay were 49(35,62), 1.9 days(1.3 days,2.9 days), 2.6 days(2.2 days,2.9 days), 3.4 days(2.7days,4.0 days), 5.9 days(4.7 days,7.7 days), 4.9 days(3.5 days,6.8 days), 7.7 days(6.7 days,8.9 days) for the laparoscopic group, respectively, versus 40(27,51), 2.5 days (1.8 days,3.3 days), 2.6 days(2.2 days,2.9 days), 3.9 days(2.9 days,5.7 days), 4.9 days(3.9 days, 5.9 days), 6.3 days(4.7 days,8.9 days), 8.7 days(6.9 days,11.7 days), showing significant differences between the two groups ( Z=?2.354, ?2.210, ?2.743, ?2.474, ?2.906, ?2.503, ?2.359, P<0.05). (4) Follow-up: patients in the two groups received 30 days of follow-up. During the follow-up, 8 patients in the laparoscopic group had postoperative complications, including 1 case with Clavien-Dindo grade Ⅰ complications, 7 cases with Clavien-Dindo grade Ⅱ complications, and no patient with Clavien-Dindo grade Ⅲ complications. Thirteen patients in the open group had postoperative complications, including 2 cases with Clavien-Dindo grade Ⅰ complications, 10 cases with Clavien-Dindo grade Ⅱ complications, and 1 case with Clavien-Dindo grade Ⅲ complications. There was no significant difference in the above indicators between the two groups ( χ2=1.135, 1.973, 1.054, P>0.05). The overall complication rate was 16.3%(8/49) and 27.7%(13/47) for the laparoscopic group and open group, respectively, showing no significant difference between the two groups ( χ2=1.803, 99.7% confidence interval as ?∞ to 2.4%, P>0.05). The upper limit of 99.7% confidence interval was less than non-inferiority level of 15%, interim analysis of which showed that the complication rate of the laparoscopic group was non-inferior to the open group. Conclusion:For elderly patients undergoing laparoscopic or open distal gastrectomy for gastric cancer, laparoscopic surgery does not increase intraoperative or postoperative complications, and has advantages of minimally invasiveness, fine operation, quicker recovery, and shorter hospital stay. Registry: this study was registered at clinicaltrials.gov in United States, with the registry number of NCT02246153.

Objective To study the mechanical properties of porcine descending aorta. Methods The porcine descending aortas were divided into 5 groups by the distance from the heart, and tissues in each group were subdivided into ventral-quadrant part and lateral-quadrant part. Stress-stretch curves were obtained by using uniaxial tension test. The moduli of elastic and collagen fiber and collagen fiber recruitment parameter of tissues in 5 groups (Position 1-5) were first analyzed by a classical mathematical model. Then the mechanical differences between tissues of ventral quadrant and lateral quadrant were compared. Results The modulus of circumferential collagen fibers increased gradually away from the heart. The modulus of circumferential elastic fibers had the same trend except for tissues at Position 5 (the most distal one). The elastic fibers modulus of tissues decreased at Position 5. At the most distal position, the circumferential and axial elastic fiber modulus of the lateral quadrant was lower than that of ventral quadrant by 19% and 33%, respectively. The axial and the elastic fiber modulus of the ventral quadrant was similar with that of tissues at Position 4 and 5. For the whole descending aorta, the circumferential collagen fiber modulus of the lateral quadrant was higher than that of ventral quadrant by 26% and the circumferential elastic fiber modulus of the lateral quadrant was higher than that of ventral quadrant by 16% at the proximal 4 positions. Conclusions The circumferential mechanical properties of porcine descending aorta were related with regions. The ventral quadrant of the most distal aorta showed abnormally soft trend. The research findings can be used to better understand the mechanism of aorta and improve the spatial accuracy of computer models.

Objective To study the changes of transcriptome levels in a Bama minipig model of hypertrophic scar during wound healing and pressure therapy by using RNA sequencing (RNA-seq) technique. Methods The Bama minipig model was established by skin wounds from the back and pressure (3.4 kPa) was initiated at 60 days after skin injury. Total RNA was extracted from scar tissues at 0, 14, 30, 60, and 90 days after skin injury and then sequenced. The resulting sequences were mapped to porcine reference genomes and transcriptomes were reconstructed to search for differentially expressed genes (DEGs). The DEGs were further subjected to GO and KEGG analysis using bioinformatics method, while part of the genes were selected for verification using qRT-PCR. Results After preprocessing, more than 78% reads in each group were accurately aligned to the reference sequence. The DEGs identification result showed that 568 genes were differentially expressed after pressure treatment, with 289 up-regulated and 279 down-regulated. GO enrichment analysis revealed that DEGs in each group were mainly associated with extracellular matrix, tissue development and skin development. KEGG analysis showed that the DEGs in each group during wound healing were mainly enriched in extracellular matrix-receptor interactions, focal adhesion and apoptosis pathways; while the DEGs after pressure treatment were mainly enriched in PI3K-Akt and MAPK signaling pathway except the pathways mentioned. qRT-PCR showed that the expression patterns of 6 DEGs were consistent with RNA-seq analysis, confirming the reliability of RNA-seq result. Conclusions RNA-Seq analysis identified differentially expressed genes in animal model of scars during wound healing and pressure therapy, which provided experimental evidence for clinical scar treatment.