ObjectiveTo study the epidemiological characteristics of leprosy in China,2001-2010.MethodsData were collected from the database of the national system of leprosy surveillance.A descriptive and comparative analysis was performed.ResultsTotally,15 507 new leprosy cases were detected from 2001 to 2010 with an average case detection rate of 0.118 per 100 000 population.Among these cases,2.7％ were children under 15 years,86.5％ multibacillary,and 22.5％ suffered from grade 2 disability.From 2001 to 2010,a total of 1506 relapse cases were detected,and relapse occurred after multi-drug therapy(MDT) in 464 of these cases.There were significant differences between low and high endemic areas in the proportion of children under 15 years,females,immigrant patients among newly detected patients as well as the proportion of cases of relapse after MDT among all the relapse cases.By the end of 2010,the registered leprosy cases were 6032 with a prevalence rate of 0.450 per 100 000 population,among whom 2886 were under MDT.ConclusionsThe leprosy case detection rate continued to decrease in China from 2001 to 2010 with an unequal distribution.The pocket areas were in Yunnan province,Guizhou province,Sichuan province,Guangdong province,Hunan province and Tibet Autonomous Region.It is warranted to enhance the control of leprosy and reduce the prevalence of disability due to leprosy.

Objective To analyze the epidemiological features of leprosy in China from 2011 to 2015,and to provide scientific evidences for prevention and treatment strategies.Methods An epidemiological analysis and a trend analysis were conducted based on the national leprosy surveillance data from 2011 to 2015.Results The leprosy detection rate in China decreased from 0.085 per 100 000 in 2011 to 0.049 per 100 000 in 2015,with an average annual decline rate being 12.9％.A total of 4 775 leprosy cases were newly detected during 2011-2015,including 106 (2.2％) children,1 499 (31.4％) females,518 (10.8％) floating people,4 041 (84.6％) multibacillary cases and 1 134 (23.7％) cases with grade 2 disabilities.From 2011 to 2015,328 relapsed cases were reported,including 153 (46.6％) cases recurring after combined chemotherapy.The prevalence rate of leprosy in China decreased from 0.407 per 100 000 in 2011 to 0.235 per 100 000 in 2015,with an average annual decline rate being 12.9％.By the end of 2015,there had been 3 230 registered leprosy cases and 124 counties with a prevalence rate above 1 per 100 000.Conclusions The detection rate and prevalence rate of leprosy in China were both decreasing continuously from 2011 to 2015.The high-epidemic provinces were Yunnan,Guizhou,Sichuan and Guangdong.However,leprosy control in middle-and low-epidemic provinces can not be ignored.

BACKGROUND:StageIorIIKummel’s diseaseisusualy suggested to be treated with percutaneous vertebroplasty (PVP) orpercutaneous kyphoplasty (PKP). Stage IIIKummel’s diseasewith neurologic deficit is treated with open decompression, cement-augmented combined with internalfixation. However, surgical options for stage IIIKummel’s diseasewithdural saccompression butwithnonervous symptoms arein disputeand rarely reported. OBJECTIVE:To investigatethesurgical options of Kummel’s disease with vertebral posterior walcolapse. METHODS:Fourteen patients with Kummel’s disease with vertebral posterior wal colapse wereenroled as experimental groupandtreated with PVP or PKP based on the degree of postural reduction.Another28 patients with osteoporotic vertebral fracture as control group were treated with PKP. Thenalpatients were folowed up to observe vertebralheight, Cobb angle, visual analog scale and the Oswestry disability index. RESULTS AND CONCLUSION:After folowed up for 10 to 42 months, therestoredvertebralheight, Cobb angle, visual analog scale and Oswestry disability index were significantly improved inthetwo groups (P<0.05). Thepostoperativevertebralheight intheexperimental group was significantly higher than thatinthe control group(P< 0.05).Butno significant differencesin Cobb angle, visual analog scalescoresand Oswestry disability indexwere found between thetwo groups after operation (P> 0.05). These data suggest that based on the degree of postural reduction, individualizedPVP or PKP for Kummel’s disease with vertebral posterior wal colapsecanattain satisfactoryoutcomes.

Objective To observe the mortality of fragile hip fractures and evaluate the death-associated risk factors.Methods 100 men and 186 women aged 50 to 97 (mean,77.09± 10.65) years old who had fragile hip fracture over 50 years old from 2010 to 2012 were followed up,and the clinical data were retrospectively analyzed.Three months,one year and the total mortality of following time were calculated.Mortality-related risk factors were evaluated including age,gender,and surgery,duration from injury to operation,pulmonary infection,number and kind of complications.Results The 286 patients were followed up between 6 months and 42 months,with 21.42±9.88 months in average.The three month mortality was 7.69％,the patients who were followed up over one year were 231 cases,the one year mortality was 16.02％,and the total mortality of following time was 17.48％.The mortality was associated with age,gender,surgery,duration from injury to operation,number of complications,pre-injury cardiovascular disease and respiratory system diseases,and pulmonary infection.A Binary Logistic Regression analysis revealed that the independent risk factors affecting the mortality included age (OR=5.385,P=0.003),surgery (OR=21.217,P=0.000),number of complications (OR=9.038,P=0.000),pre-injury cardiovascular disease (OR=3.201,P=0.041).Conclusion The early mortality of fragile hip fractures was high and was associated with many risk factors.Age,surgery,number of complications and pre-injury cardiovascular disease were the independent risk factors affecting the mortality of fragile hip fractures.The positive treatment with complications,early surgery in condition allowed,can lower the early mortality.

Objective To investigate the correlation of incident pneumonia and serum 25-hydroxyvitamin D[25(OH)D] levels in elderly patients with fragility hip fractures.Methods 132 patients with fragility hip fractures were divided into the pneumonia group [n=43,14 males and 29 females,aged 63-97 years,a mean age of (83.8±7.1) years] and the non-pneumonia group [n=89,28 males and 61 females,aged 60-93 years,a mean age of (77.1±8.1) years].Fasting venous blood samples were taken on the second day after admission.Serum 25 (OH)D levels were measured by radioimmunoassay.Results Vitamin D deficiency was found in 90.7％ of the patients in the pneumonia group,52.8％ in the non-pneumonia group (x2=24.953,P＜0.05).The age and smoking rate were higher in the pneumonia group than in the non-pneumonia group (t=4.661,P＜ 0.05;x2 =4.459,P=0.035).Logistic regression analysis showed that serum 25(OH)D levels,age and smoking were independent impact factors for pneumonia.When serum 25(OH)D levels were less than or equal to 20 g/L,the incidence of pneumonia was increased and the risk of pneumonia was 8.66 times higher than that for patients with normal 25 (OH)D levels.Conclusions The risk of pneumonia in patients with brittle hip fractures is correlated with age,smoking and the serum 25-hydroxyvitamin D level,with the latter as a major risk factor.Patients with brittle hip fractures should be supplemented with vitamin D as early as possible in order to reduce the risk of incident of pneumonia.

BACKGROUND:Pathogenesis of Parkinson’s disease is not completely understood, and there is yet no effective therapy that can prevent the neurodegenerative process of the disease fundamentaly. OBJECTIVE:To explore the effects of pituitary adenylate cyclase-activating polypeptide (PACAP) on lactacystin-induced Parkinson’s disease dopaminergic PC12 cel apoptosis and its molecular mechanism. METHODS: Under induction by nerve growth factors, PC12 cels differentiated into dopaminergic neurons, and then were treated with different concentrations of lactacystin for different time. When the cel survival rate was about 50%,the concentration and action time oflactacystin were selected to establish cel models of Parkinson’s disease. In the study, there were control group, lactacystin group, PACAP1-27 group (intervention group 1) and PACAP1-27+PACAP6-27 co-intervention group (intervention group 2). Changes of cel morphology were observed under inverted microscope; cel viability was detected with MTT method; the expression of endoplasmic reticulum stress specific protein caspase-12 was detected by western blot. Then the action of PACAP1-27 and PACAP6-27 to the cytoxicity of lactacystin was observed. RESULTS AND CONCLUSION: With different concentrations and action time of lactacystin, the viability of PC12 cels presented a concentration- and time-dependent decline. When the lactacystin at 20μmol/L acted for 24 hours, the cel viability was declined by about 50%. Under same conditions of lactacystin concentration and action time (20 μmol/L, 24 hours), the cels in the lactacystin group appeared to have damaged changes, declined cel viability, and increased caspase-12 activity in comparison with the control group (P< 0.01). Compared with the lactacystin group, the cel damage was relieved and cel viability was increased significantly in the intervention group 1 as wel as the expression of caspase-12 was decreased (P < 0.01). Experimental findings in the intervention group 2 were similar to those in the lactacystin group. These results suggest that lactacystin, an ubiquitin proteasome inhibitor, can lead to cel damage; PACAP1-27 plays a protective role by regulating the above-mentioned signal pathway. As one PACAP1-27 receptor antagonist, PACAP6-27 can attenuate this effect of PACAP1-27.

Objective:To explore the psychometric characteristics of the Chinese version of the health-related social capital scale.Methods:From March to May 2020, after the original scale was translated into Chinese following the Brislin improved translation model, 251 community-dwelling senior citizens aged 65 and above were selected by convenient sampling method. Data analysis was conducted using SPSS 22.0 and AMOS 22.0, including tests of significance, correlation analysis, exploratory factor analysis, and confirmatory factor analysis.Results:Exploratory factor analysis extracted three factors: social participation, social cohesion, and reciprocity, which accounted for a cumulative contribution rate of 61.72%. Confirmatory factor analysis showed that the three-factor model fitted well(χ 2/ df=1.22, RMSEA=0.04, CFI=0.98, GFI=0.93, IFI=0.98, TLI=0.97). Social capital was significantly correlated with perceived social support positively ( r=0.36, P<0.01), and with loneliness negatively ( r=-0.30, P<0.01). The three factors were significantly correlated with the total scale ( r=0.85, 0.50 and 0.52, respectively, all P<0.01). And correlations between the items of each factor were 0.24-0.55, 0.30-0.59, 0.44-0.70, respectively(all P<0.01). The Cronbach's α coefficients of the total scale and three factors were 0.74, 0.72, 0.65 and 0.62, respectively(all P<0.01), and their retest reliability were 0. 92, 0. 87, 0. 82 and 0. 96, respectively(all P<0.01). Conclusion:The Chinese version of health-related social capital scale conforms to the three-factor model with good reliability and validity, which can be used to assess the social capital status of community-dwelling older adults in China.

ABSTRACT:Objective To assess the effectiveness of the disease management model of stepped-nursing intervention in the metabolic control in patients with type 2 diabetes (DM2). Methods 114 patients with DM2 were randomized in experimental group and control group.The experimental group applied stepped-nursing model while the control group applied conventional nursing.Blood glucose,glycated hemoglobin A1c,body mass index (BMI),waist -hip ratio (WHR),blood pressure,lipids and control criteria were observed.Results BMI,glycated hemoglobin A1c,fasting blood sugar(FBS),triglycerides,systolic blood pressure (SBP)levels and diabetic knowledge score decreased significantly in the stepped-nursing group(P <0.05).The decrease levels in postprandial blood sugar(PBS),diastolic blood pressure (DBP),total cholesterol (TC),LDL cholesterol and WHR reduced,which showed no significant difference(P >0.05). The levels of HDL cholesterol were slightly improved,which showed no significant difference(P >0.05).Conclusion Stepped-nursing model is useful in overall treatment of patients with type 2 diabetes,it improves the condition of glycated hemoglobin A1c,SBP levels FBS and triglycerides and increases the command of diabetic knowledge.

ABSTRACT:Objective To assess the effectiveness of the disease management model of stepped-nursing intervention in the metabolic control in patients with type 2 diabetes (DM2). Methods 114 patients with DM2 were randomized in experimental group and control group.The experimental group applied stepped-nursing model while the control group applied conventional nursing.Blood glucose,glycated hemoglobin A1c,body mass index (BMI),waist -hip ratio (WHR),blood pressure,lipids and control criteria were observed.Results BMI,glycated hemoglobin A1c,fasting blood sugar(FBS),triglycerides,systolic blood pressure (SBP)levels and diabetic knowledge score decreased significantly in the stepped-nursing group(P <0.05).The decrease levels in postprandial blood sugar(PBS),diastolic blood pressure (DBP),total cholesterol (TC),LDL cholesterol and WHR reduced,which showed no significant difference(P >0.05). The levels of HDL cholesterol were slightly improved,which showed no significant difference(P >0.05).Conclusion Stepped-nursing model is useful in overall treatment of patients with type 2 diabetes,it improves the condition of glycated hemoglobin A1c,SBP levels FBS and triglycerides and increases the command of diabetic knowledge.

Objective:To analyze the factors influencing sarcopenia in older patients with chronic diseases, both in community settings and hospitals, and to develop a risk prediction model for sarcopenia.Methods:We recruited a total of 403 older adults with chronic diseases, consisting of 251 individuals from a community in Nanjing, Jiangsu Province, and 152 hospitalized patients from the Department of Geriatrics at Jiangsu Province Hospital.Assessments were conducted using a general information questionnaire, serum sample collection, the mini nutritional assessment-short form(MNA-SF), the mini-mental state examination(MMSE), and the geriatric depression scale(GDS).Binary Logistic regression analysis was employed to identify influencing factors and to construct a risk prediction model for sarcopenia, which was illustrated using a nomogram.The model's discrimination was evaluated using the receiver operating characteristic(ROC)curve and the area under the curve(AUC).Results:The prevalence of sarcopenia among community-dwelling older adults with chronic conditions was found to be 4.0%(10/251).In contrast, the prevalence in hospitalized older adults with chronic conditions was significantly higher at 36.2%(55/152).Binary Logistic regression analysis identified several independent risk factors for sarcopenia, including hospitalization( OR=14.391、95% CI: 6.284-32.955、 P<0.001), male gender( OR=3.321、95% CI: 1.587-6.950、 P=0.001), lower low-density lipoprotein cholesterol(LDL-C)levels( OR=2.542、95% CI: 1.160-5.572、 P=0.020), cognitive impairment( OR=2.654、95% CI: 1.269-5.550、 P=0.010), and the use of four or more types of medication( OR=2.328、95% CI: 1.952-5.689、 P=0.044).Based on these risk factors, a nomogram was developed as a predictive model for assessing sarcopenia risk.The AUC for this prediction model was 0.860(95% CI: 0.815-0.912), indicating a sensitivity of 0.831 and a specificity of 0.760. Conclusions:The incidence of sarcopenia is notably high among older patients with chronic diseases.A risk prediction model that incorporates factors such as hospitalization history, gender, LDL-C levels, cognitive function, and types of medication demonstrates significant potential for predicting sarcopenia.This model serves as a valuable foundation for the early screening and intervention of sarcopenia.