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 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 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 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 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 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 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.

Objective To discuss the psychological behavior intervention methods on reducing the violence behavior of schizophrenia patients. Methods 120 schizophrenia patients were admitted from January to December, 2007 and randomly assigned into the behavior intervention group (group A), the psy-chological support group (group B), the health education group (group C) and the control group (group D) with 30 cases in each group. Group A received routine nursing plus behavior intervention, group B was giv-en routine nursing plus psychological support, group C adopted routine nursing plus health education, group D only received routine nursing. The intervention effect was evaluated with MOAS and the relapse rate of violence behavior went through statistics. Results After intervention, the scores of MOAS decreased sig-nificantly in group A, B, C and D compared with those before intervention. The reduction of MOAS scores in group A, B and C was significantly higher than that of group D, with the highest reduction score in group A and group B and C followed subsequently. The relapse rates of the violence behavior in group A, B and C were significantly lower than those of group D. Conclusions Routine nursing, health education, psycho-logical support and behavior intervention can all reduce and decrease the violence behavior and the inci-dence of the violence behavior, among which behavior intervention proves to be the most effective, and psy-chological support and health education go subsequently.

Objective To investigate the application and needs' survey of mobile App health software in the patients with respiratory chronic disease. To make mobile App health software development more targeted and practical in the near future. To provide the foundation for continuous nursing service. Methods A survey research method was adopted in which self-designed questionnaires were administered to 163 patients with respiratory chronic disease from respiratory ward and outpatient clinic. Results Totally 119(73.0%) patients used smartphone, the mean score of experience in using mobile phones was (32.4 ± 14.1), which was in the medium range. There were 80 patients had ever installed and used this kind of App. The frequency of use of mobile App health software was Breathing Exercises App, Healthy Exercise App, Healthy Diet App and Medicine Remind App. The major reason for using of these App was disease prevention, self health care, disease and health monitoring and rehabilitation exercises. There were 120 patients would like to install App health software specific to respiratory chronic disease. They hope the characters of these App were simple operated, practical and without product placement. These App health software should include following function:timely feedback and guidance, providing practical method and help to register. Conclusion Most patients with respiratory chronic disease had the hardware basis and experience basis of using mobile App health software. More targeted and practical mobile App health software for the patients with respiratory chronic diseases should be developed to provide the foundation for continuous nursing service and patient′s self-management.