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 investigate the biological effect of wild p16 gene on senescence of human keloid fibroblasts (HKFb) and discuss the feasibility of gene therapy on keloid. Methods Firstly, the HKFb was transfected with pcDNA3-p16 and the positive clones selected by G418. Then, the fibroblast changes were investigated by determining growth curve, cycle profile and ultrastructure of the transfected HKFb. Meanwhile, morphological changes of the transfected HKFb were identified by senescence associated-?-galactosidase staining. Results After HKFb was transfected by p16, the morphology of HKFb changed obviously from the third passage on. The cell proliferation was inhibited markedly and the cell cycle profile analysis showed that about 96.7% cells were trapped in stage G1. The electroscopic analysis of HKFb also showed that the lysosomes were overloaded. Senescence associated-?-galactosidase staining identified the senescence of HKFb. Conclusions The wild p16 gene can induce the HKFb into senescence in advance, as may provide experimental basis for gene therapy on human keloid.

Objective To investigate the biological and neurobehavioral effect of Yizhi Ningshen Oral Liquid(YNOL) on Tourette's syndrome(TS) model rats.Methods Sixty SD rats with specific-pathogen free were randomized into blank control group,model group,YNOL(2 mL/d) group,and haloperidol(0.15 mg/d) group.Except for the blank control group,the rats in other groups received intraperitoneal injection of iminodipropionitrile to induce TS,and then were treated with the corresponding medicine on the second day of the modeling.The scores of motor behavior and stereotyped movement were observed.After treatment for 14 days,the cerebral levels of dopamine(DA) and norepinephrine(NE) were detected by liquid chromatography in various groups.Results In the model group,the scores of motor behavior and stereotyped movement and cerebral NE level were increased(P

Objective:To observe the response and changes of cranial suture to the distraction forces in growing goats.Methods:A custom-made distractor was used for expanding coronal suture of 11 growing goats at the rate of 0.4 mm/day for 8 days.The animals were killed 0,2 and 4 weeks respectively after completion of suture distraction application. X-ray examination was taken and the distracted suture samples were harvested and processed for scanning electron microscopic observation and immunohistochemistry examination of BMP and TGF-? expression. The coronal sutures taken from other undistracted animals were used as the controls. Results:The coronal sutures were separated successfully in distracted goats. 0 and 2 weeks after application of suture distraction, the collagen fiber bundles were strengthened and aligned in the direction of the distraction. Strong expression of BMP and TGF-? were detected in the fibroblast-like cells and the active osteoblasts. 4 weeks after suture distraction, signs of intramembranous ossification were found in the edge areas of the distracted suture, and the positive staining of BMP and TGF-? was still noted in the osteoblasts around the newly formed bone trabeculae. Conclusion:BMP and TGF-? may play important roles in the process of bone formation and remodeling during suture distraction osteogenesis.

Objective To explore the value of diagnostic and differential diagnostic with the Neutrophil‐lymphocyte count ratio (NLCR) and C‐reactive protein cmmunity‐acquired pneumonia(CAP) .Methods The NLCR ,as well as white blood cell counts , neutrophil count ,lymphocyte count and the concentration of CRP were measured in 40 patients with bacterial pneumonia ,40 pa‐tients with mycoplasma pneumonia ,40 patients with viral pneumonia and 40 healthy subjects ,and the results was analyzed by statis‐tical methods .Results In bacterial group ,the NLCR and the concentration of CRP were significantly higher than those in myco‐plasma group ,viral group and normal controls(P<0 .05) .According to the results of ROC curve analysis in the diagnosis of bacte‐rial CAP ,the areas of NLCR and CRP under ROC curve are 0 .911 and 0 .896 ,respectively ,which have good diagnostic sensitivity and specificity .Conclusion The NLCR and CRP in peripheral blood have great significance in diagnosis and differential diagnosis of bacterial community‐acquired pneumonia .

Objective To detect the expressions of nerve growth factor (NGF) and its receptors tyrosine kinase A (TrkA) as well as p75 neurotrophin receptor (p75NTR) in the lesions of lichen planus.Methods Biopsy specimens were collected from the lesions of 32 patients with lichen planus and normal skin of 12 healthy human controls and subjected to paraffin embedding.Immunohistochemical avidin-biotin complex (ABC) method was used to detect the expressions of NGF,TrkA and p75NTR.Results NGF and TrkA,which were located in the cytoplasm of keratinocytes,were strongly or moderately expressed in the lesional skin specimens,but absent or weakly expressed in the normal skin specimens (both P ＜ 0.01).No significant differences were observed in the expression of p75NTR between the lesional and normal skin specimens,or in the expressions of NGF,TrkA or p75NTR among specimens from patients in different age groups,patients of different gender or lesions at different sites (all P ＞ 0.05).There was a positive correlation between the expression of NGF and TrkA in the lesions of lichen planus (R2 =0.535,P ＜ 0.01).Conclusion NGF may play a certain role in the development of lichen planus via its highaffinity receptor TrkA.

Objective To discuss the demands of replacement care service for family caregivers of the aged in Zhengzhou City,so as to provide the reference for replacement care service of the aged.Methods A total of 145 family caregivers of the aged were collected in Zhengzhou city and were investigated with a self-designed questionnaire.Results In the 145 questionnaires,106 were valid.81 (76.4％) of them expressed needing to be replaced in the process of care,and 68 (64.1％) were willing to accept replacement care service.Order of demands of replacement service content was daily life nursing (77,72.6％),disease (66,62.3％) and psychological care (60,56.6％),etc.Influencing factors of selecting replacement care service for family caregivers included quality of service (63,59.4％),service price (38,35.8％) and professional skill (37,34.9％).The degree of demand of different ages,different careers,as well as different duration of daily care of family caregivers was statistically significant for replacement care service.Conclusions The degree of demand of family caregivers of the aged for replacement care service was higher.The government needs to establish replacement care service mechanism which is suitable for China's national conditions through policy guidance and support.

Objective To study the concurrence of congenital ptosis and hypospadias and the relationship between the two. Methods The incidence rate and degree of ptosis were recorded for 254 cases of hypospadias. Results The morbidity of ptosis in hypospadias cases was 4.72％.The posterior hypospadias group had a higher ptosis rate than the anterior and middle hypospadias groups,P ＜ 0.05. While there was no statistical difference of severe ptosis morbidity rates between these two groups. Conclusions Congenital ptosis is a common concurrent anomaly of hypospadias outside the urogenital system.The severity of hypospadias is relevant with the morbidity of ptosis but not with the degree of ptosis.Hypospadias and ptosis may share common pathogenic or susceptive factors.

Objective To investigate the effects of sensorimotor therapy on patients with knee osteoarthritis.Methods Ninety-two patients with knee osteoarthritis were divided into a treatment group and a control group by using random digits table. Both groups received conventional rehabilitation therapy, including knee isometric and isotonic contraction training, ultrashort wave diathermy as well as aerobic exercise. The treatment group was also administered with sensorimotor training, in addition to the conventional training,including the muscle strengthening and control training of quadriceps and hamstring muscle using sling exercise therapy system and on the Thera-band mattress. The visual analogue scale (VAS) for pain, manual muscle testing and knee range of motion as well as the Japanese Orthopedic Association knee function evaluation form were used to evaluate the patients. Results There was no statistic difference between the 2 groups before treatment, with regard to the evaluation parameters used in this study. After 2 months of treatment, both groups improved significantly (P ＜0.05),with the treatment group improved to a significantly greater extent (P ＜0.05). Conclusions Sensorimotor training in addition to the conventional rehabilitation treatment can further relieve the pain of patients with knee osteoarthritis joints arthritis and improve the function of patients with knee osteoarthritis.

Objective The aim of the study is to explore the efficacy of Carbamazepine with manual massage on grand mal epilepsy.Methods Using a prospective research method,the grand mal epilepsy patients were randomly divided into the experimental group(40 cases)and the control group(40 cases).The experimental group was given manual massage based on oral Carbamazepine treatment.The control group was given oral Carbamazepine treatment.The treatment effect was compared between two groups.Results The curative efficacy of the experimental group was 92.5％,higher than 80.0％ of the control group.Conclusions Carbamazepine with manual massage for treatment of grand mal epilepsy can obviously improve curative efficacy,which is worthy of popularization and application.