Objective: To explore the relationship between bullying among middle school students and family factors in a city of central China, so as to provide support for the prevention and reduction of school bullying among middle school students. Methods: The stratified cluster random sampling method was used to investigate the bullying involvement and family factors of 2 996 middle school students from first grade in junior high school to third grade in high school in a city in central China. Chi-square test and Logistic-regression analysis were used to analyze the relationship between family factors and bullying participation of middle school students. Results: Among 2 996 students, 390 students(13.0%) were found of having bullying behavior, and 1 127 students(37.6%) were found of being bullied. Univariate analysis showed that there were statistically significant differences in family factors such as whether she or he is the only child, father-child relationship, mother-child relationship, marital status of parents, whether the mother work away from hometown, education level of father and mother(χ2=8.88, 56.49, 30.85, 30.91, 3.89, 10.36, 11.72；25.00, 69.33, 46.76, 57.09, 3.93, 23.19, 45.49, P<0.05). Logistic regression analysis showed that the only child and mother’s education degree was junior college and below were the risk factors for middle school students’ bullying involvement (OR=1.37，1.39). Parents’ harmonious marital status and father’s not working outside are the protective factors of middle school students’ bullying(OR=0.53, 0.83).The only child is the risk factor of bullying in middle school students (OR=1.42), and good father relationship is the protective factor of bullying in middle school students (OR=0.38). Conclusion Family factors have a certain impact on the involvement of middle school students in bullying in a city of central China, and corresponding preventive measures should be formulated from the perspective of family to focus on the intervention of high-risk groups.

Objective: To understand the association between bullying and anxiety symptoms of boarding middle school students, and to provide a scientific basis for preventing bullying and promoting mental health of boarding middle school students. Methods: By using stratified cluster random sampling method, 2 823 students were selected from 10 schools in Anyang, Henan Province. Questionnaire survey using self-designed bullying items and Mental Health Scale of Chinese Middle School Students was administered. Results: The overall prevalence of school bullying was 37.9%， with boarding school students(38.9%) being higher than non-boarding school students (37.1%). The anxiety symptom reporting rate of boarding students (42.9%) was higher than that of non-boarding students (27.3%). Binary Logistic regression analysis showed that, compared with non-boarding students, bully victim and bully perpetuator/victim students were more likely to have anxiety symptoms (OR=2.30, 6.04，1.94, 4.23) (P<0.05). Conclusion There is a correlation between different roles of campus bullying and anxiety symptoms among boarding and non-boarding school students. Boarding school students have a higher risk of anxiety symptoms, especially among those with both experiences of bully perpetuator/victim.

Objective:To develop adjustable peel force tester with peel angle from 0° to 180°,so as to realize the test for the performance of interface adhesion of wearable electronic products under multi angles.Methods:The rotating platform of angle adjustment component was used to realize free adjustment of peel angle from 0° to 180°.A method of peel test procedure based on the peel force tester with full-angle was established,and the comparative experiment between that and tensile testing machine was conducted.The peel tests of various kinds of wearable electronic products were conducted under peel angle of 45°,90° and 180°.Results:The test results of the peel force tester with full-angle were consistent with those of the tensile testing machine,which function opposed reliability.The peel test results of more than 10 wearable electronic products indicated that the peel force tester with full-angle could effectively determinate the performance of interface adhesion.Conclusion:The peel force tester with full-angle can effectively appear the performance of the interface adhesion of wearable electronic products,which provides basis for establishing the standard of peel test of wearable electronic products.

Objective To investigate the effect and mechanism of cinobufotalin in inhibiting hepatocellular carcinoma(HCC)metastasis by regulating epithelial-mesenchymal transition(EMT).Methods A total of 36 male BALB/c nude mice,aged 6 weeks,were given injection of MHCC97H cells via the caudal vein to establish a model of HCC lung metastasis,and then the mice were randomly divided into high-and low-dose cinobufotalin groups and control group.Since the day of modeling,the mice in the high-and low-dose cinobufotalin groups were given intraperitoneal injection of cinobufotalin at a dose of 120 μL/kg and 60 μL/kg,respectively,and those in the control group were given intraperitoneal injection of normal saline,twice a week.After 8 weeks,HE staining was performed for lung tissue to measure the lung metastasis rate of HCC.MHCC97H cells were treated with high-dose(2.5 μL/mL)or low-dose(5 μL/mL)cinobufotalin for 24 hours,and wound healing assay,RT-PCR,and Western blot were used to measure cell migration ability and the expression of EMT-related molecules.MHCC97H cells were induced in a simulated hypoxic environment with CoCl2 incubation,with high-and low-dose cinobufotalin added for intervention,and wound healing assay and Western blot were used to investigate the effect of cinobufotalin on cell migration ability and EMT induced by hypoxia.Transcriptome analysis was used to investigate the effect mechanism of cinobufotalin on MHCC97H cells,and Western blot was used to observe the effect of cinobufotalin on the expression levels of protein kinase B(AKT)and phosphorylated AKT(P-AKT)in MHCC97H cells.A one-way analysis of variance was used for comparison of continuous data between multiple groups,and the least significant difference t-test was used for further comparison between two groups;the independent-samples t test was used for comparison of categorical data between two groups.Results Compared with the control group,the cinobufotalin group had a significant reduction in the lung metastasis rate of HCC.Compared with the control group,cinobufotalin intervention reduced the wound healing rate of MHCC97H cells,upregulated the expression of epithelial-type molecules(t=2.860,P<0.05),and downregulated the expression of EMT transcription factors(EMT-TFs)and mesenchymal molecules(t=3.545,2.022,2.852,and 2.341,all P<0.05).Hypoxia induction upregulated the wound healing rate of MHCC97H cells and the expression levels of mesenchymal molecules and EMT-TFs(P<0.05),and cinobufotalin intervention reversed EMT change and inhibited wound healing(P<0.05).The transcriptome analysis of MHCC97H cells showed significant gene differences between the cinobufotalin group and the control group,and cinobufotalin mainly affected the expression of genes associated with tumor,metabolism,immunity,and signal transduction,with the largest number of differentially expressed genes in the AKT signal transduction pathway.Further measurement showed that cinobufotalin intervention downregulated the expression levels of AKT,P-AKT,and P-AKT/AKT in MHCC97H cells(t=2.434,3.401,and 2.258,all P<0.05).Conclusion Cinobufotalin can inhibit the metastasis of HCC,especially hypoxia-induced HCC metastasis,and regulation of EMT mediated by the AKT signal transduction pathway in HCC cells might be one of its mechanisms of action.

Objective To explore the current status of research on economic burden of cancer in China from 1996 to 2014. Methods The key words including cancer, economic burden, expenditure, cost were used to retrieve the literatures published in CNKI and Wanfang ( the two most commonly used databases for literature in Chinese) and PubMed during 1996—2014. A total of 91 studies were included after several exclusionary procedures. Information on subjects and data source, methodology, main results were structurally abstracted. All the expenditure data were discounted to year of 2013 value using China′s health care consumer price indices. Results More than half of the included studies were published over the past 5 years, 32 of the studies were about lung cancer. Among the 83 individual?based surveys, 77 were hospital?based and obtained data via individually medical record abstraction, and most of which only considered the direct medical expenditure. Expenditure per cancer patient and expenditure per diem were the most commonly used outcome indicators. Majority of the findings on expenditure per cancer patient ranged from 10 thousands to 30 thousands Chinese Yuan (CNY), with larger disparity in lung and breast cancer (ranged from 10 thousands to 90 thousands CNY), narrower difference in esophageal and stomach cancer (ranged from 10 thousands to 50 thousands CNY) , and most stable trend in cervical cancer ( almost all the values less than 20 thousands CNY) . Without exception, the expenditures per diem for all the common cancers were increasing over the period from 1996 to 2014 ( 3?7 fold increase) . Only 8 population?level economic burden studies were included and the reported expenditure of cancer at national level ranged from 32. 6 billions to 100.7 billions CNY.Conclusions Evidence on economic burden of cancer in China from 1996 to 2014 are limited and weakly comparable, particularly at a population level, and the reported expenditure per patient may be underestimated.

Objective To explore the current status of research on economic burden of cancer in China from 1996 to 2014. Methods The key words including cancer, economic burden, expenditure, cost were used to retrieve the literatures published in CNKI and Wanfang ( the two most commonly used databases for literature in Chinese) and PubMed during 1996—2014. A total of 91 studies were included after several exclusionary procedures. Information on subjects and data source, methodology, main results were structurally abstracted. All the expenditure data were discounted to year of 2013 value using China′s health care consumer price indices. Results More than half of the included studies were published over the past 5 years, 32 of the studies were about lung cancer. Among the 83 individual?based surveys, 77 were hospital?based and obtained data via individually medical record abstraction, and most of which only considered the direct medical expenditure. Expenditure per cancer patient and expenditure per diem were the most commonly used outcome indicators. Majority of the findings on expenditure per cancer patient ranged from 10 thousands to 30 thousands Chinese Yuan (CNY), with larger disparity in lung and breast cancer (ranged from 10 thousands to 90 thousands CNY), narrower difference in esophageal and stomach cancer (ranged from 10 thousands to 50 thousands CNY) , and most stable trend in cervical cancer ( almost all the values less than 20 thousands CNY) . Without exception, the expenditures per diem for all the common cancers were increasing over the period from 1996 to 2014 ( 3?7 fold increase) . Only 8 population?level economic burden studies were included and the reported expenditure of cancer at national level ranged from 32. 6 billions to 100.7 billions CNY.Conclusions Evidence on economic burden of cancer in China from 1996 to 2014 are limited and weakly comparable, particularly at a population level, and the reported expenditure per patient may be underestimated.

Objective: To investigate the seroprevalence and epidemiological characteristics of hepatitis E virus (HEV) infection in pregnant women in Xiamen. Methods: Sera samples of 910 pregnant women were collected from September 2014 to June 2015 in Xiamen Huli District Maternity and Child Care Hospital. Those who intended to give birth in target hospital were included in a subgroup which was asked to collect the second serum sample. All samples were tested for anti-HEV IgM and IgG antibody by enzyme linked immunosorbent assay (ELISA). HEV RNA was tested by reverse transcription-polymerase chain reaction (RT-PCR) for the positive samples of anti-HEV IgM antibody, meanwhile, the quantitative detections for anti-HEV IgG were conducted in specimens positive for anti-HEV IgG. Results: Of the 910 pregnant women, 8 (0.88%, 95%CI 0.45%-1.73%) were anti-HEV IgM positive. HEV RNA was found in 3 cases through RT-PCR and viral load values were between 600 and 700 copies/ml; 140 (15.38%, 95%CI 13.19%-17.68%) were anti-HEV IgG positive and geometric mean concentration of the samples was 0.385 Wu/mL (95%CI 0.332-0.445 Wu/ml). The positive rate of anti-HEV IgG increased with age (P=0.004). In the subgroup, 150 pregnant women were included and followed up, 4 of those were defined as 'new HEV infection cases’ and the incidence was evaluated as 10.7/100 person-year (95%CI 3.39-25.7/100 person-year). Conclusions There were a low percentage of HEV carriers in pregnant women in Xiamen, but the risk of new primary infection in pregnant women during pregnancy was much higher than the general population, suggesting that it is necessary to expand sample size to clarify the burden of HEV infection during pregnancy.

Objective To investigate the distribution and antimicrobial resistance profiles of the common pathogens isolated from urine from 2015 to 2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods The bacterial strains were isolated from urine and identified routinely in 51 hospitals across China in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Antimicrobial susceptibility was determined by Kirby-Bauer method,automatic microbiological analysis system and E-test according to the unified protocol.Results A total of 261 893 nonduplicate strains were isolated from urine specimen from 2015 to 2021,of which gram-positive bacteria accounted for 23.8％(62 219/261 893),and gram-negative bacteria 76.2％(199 674/261 893).The most common species were E.coli(46.7％),E.faecium(10.4％),K.pneumoniae(9.8％),E.faecalis(8.7％),P.mirabilis(3.5％),P.aeruginosa(3.4％),SS.agalactiae(2.6％),and E.cloacae(2.1％).The strains were more frequently isolated from inpatients versus outpatients and emergency patients,from females versus males,and from adults versus children.The prevalence of ESBLs-producing strains in E.coli,K.pneumoniae and P.mirabilis was 53.2％,52.8％and 37.0％,respectively.The prevalence of carbapenem-resistant strains in E.coli,K.pneumoniae,P.aeruginosa and A.baumannii was 1.7％,18.5％,16.4％,and 40.3％,respectively.Lower than 10％of the E.faecalis isolates were resistant to ampicillin,nitrofurantoin,linezolid,vancomycin,teicoplanin and fosfomycin.More than 90％of the E.faecium isolates were ressitant to ampicillin,levofloxacin and erythromycin.The percentage of strains resistant to vancomycin,linezolid or teicoplanin was＜2％.The E.coli,K.pneumoniae,P.aeruginosa and A.baumannii strains isolated from ICU inpatients showed significantly higher resistance rates than the corresponding strains isolated from outpatients and non-ICU inpatients.Conclusions E.coli,Enterococcus and K.pneumoniae are the most common pathogens in urinary tract infection.The bacterial species and antimicrobial resistance of urinary isolates vary with different populations.More attention should be paid to antimicrobial resistance surveillance and reduce the irrational use of antimicrobial agents.

Objective To understand the distribution and changing resistance profiles of clinical isolates of Enterococcus in hospitals across China from 2015 to 2021.Methods Antimicrobial susceptibility testing was conducted for the clinical isolates of Enterococcus according to the unified protocol of CHINET program by automated systems,Kirby-Bauer method,or E-test strip.The results were interpreted according to the Clinical & Laboratory Standards Institute(CLSI)breakpoints in 2021.WHONET 5.6 software was used for statistical analysis.Results A total of 124 565 strains of Enterococcus were isolated during the 7-year period,mainly including Enterococcus faecalis(50.7％)and Enterococcus faecalis(41.5％).The strains were mainly isolated from urinary tract specimens(46.9％±2.6％),and primarily from the patients in the department of internal medicine,surgery and ICU.E.faecium and E.faecalis strains showed low level resistance rate to vancomycin,teicoplanin and linezolid(≤3.6％).The prevalence of vancomycin-resistant E.faecalis and E.faecium was 0.1％and 1.3％,respectively.The prevalence of linezolid-resistant E.faecalis increased from 0.7％in 2015 to 3.4％in 2021,while the prevalence of linezolid-resistant E.faecium was 0.3％.Conclusions The clinical isolates of Enterococcus were still highly susceptible to vancomycin,teicoplanin,and linezolid,evidenced by a low resistance rate.However,the prevalence of linezolid-resistant E.faecalis was increasing during the 7-year period.It is necessary to strengthen antimicrobial resistance surveillance to effectively identify the emergence of antibiotic-resistant bacteria and curb the spread of resistant pathogens.

Objective To examine the changing antimicrobial resistance profile of Enterobacter spp.isolates in 53 hospitals across China from 2015 t0 2021.Methods The clinical isolates of Enterobacter spp.were collected from 53 hospitals across China during 2015-2021 and tested for antimicrobial susceptibility using Kirby-Bauer method or automated testing systems according to the CHINET unified protocol.The results were interpreted according to the breakpoints issued by the Clinical & Laboratory Standards Institute(CLSI)in 2021(M100 31st edition)and analyzed with WHONET 5.6 software.Results A total of 37 966 Enterobacter strains were isolated from 2015 to 2021.The proportion of Enterobacter isolates among all clinical isolates showed a fluctuating trend over the 7-year period,overall 2.5％in all clinical isolates amd 5.7％in Enterobacterale strains.The most frequently isolated Enterobacter species was Enterobacter cloacae,accounting for 93.7％(35 571/37 966).The strains were mainly isolated from respiratory specimens(44.4±4.6)％,followed by secretions/pus(16.4±2.3)％and urine(16.0±0.9)％.The strains from respiratory samples decreased slightly,while those from sterile body fluids increased over the 7-year period.The Enterobacter strains were mainly isolated from inpatients(92.9％),and only(7.1±0.8)％of the strains were isolated from outpatients and emergency patients.The patients in surgical wards contributed the highest number of isolates(24.4±2.9)％compared to the inpatients in any other departement.Overall,≤ 7.9％of the E.cloacae strains were resistant to amikacin,tigecycline,polymyxin B,imipenem or meropenem,while ≤5.6％of the Enterobacter asburiae strains were resistant to these antimicrobial agents.E.asburiae showed higher resistance rate to polymyxin B than E.cloacae(19.7％vs 3.9％).Overall,≤8.1％of the Enterobacter gergoviae strains were resistant to tigecycline,amikacin,meropenem,or imipenem,while 10.5％of these strains were resistant to polycolistin B.The overall prevalence of carbapenem-resistant Enterobacter was 10.0％over the 7-year period,but showing an upward trend.The resistance profiles of Enterobacter isolates varied with the department from which they were isolated and whether the patient is an adult or a child.The prevalence of carbapenem-resistant E.cloacae was the highest in the E.cloacae isolates from ICU patients.Conclusions The results of the CHINET Antimicrobial Resistance Surveillance Program indicate that the proportion of Enterobacter strains in all clinical isolates fluctuates slightly over the 7-year period from 2015 to 2021.The Enterobacter strains showed increasing resistance to multiple antimicrobial drugs,especially carbapenems over the 7-year period.