Objective: To investigate the awareness of monkeypox prevention knowledge and its influencing factors among inbound personnel, so as to provide insights into intensified health education for monkeypox prevention and control. Methods: Inbound personnel at ages of 16 years and older were sampled using a convenient sampling method from centralized medical isolation observation points in Gongshu District, Hangzhou City in November and December 2022. Participants' demographic features, history of travel in countries where monkeypox cases were reported and awareness of monkeypox prevention knowledge were collected through questionnaire surveys, and factors affecting the awareness of monkeypox prevention knowledge were identified using a multivariable logistic regression model. Results: A total of 306 questionnaires were allocated, and 293 valid questionnaires were recovered, with an effective response rate of 95.75%. The respondents included 192 men (65.53%) and 101 women (34.47%), and hand a median (interquartile range) age of 36 (16) years. The overall awareness of monkeypox prevention knowledge was 44.71%, and the awareness rates of preventive measures, source of infection, transmission route, susceptible populations and clinical manifestations were 82.94%, 79.18%, 75.09%, 60.75% and 60.07%, respectively. Multivariable logistic regression analysis showed that workers (OR=0.179, 95%CI: 0.040-0.800), self-employed individuals (OR=0.090, 95%CI: 0.018-0.451), and those with other occupations (OR=0.157, 95%CI: 0.034-0.728) had lower awareness of monkeypox prevention knowledge than students, and individuals who had never heard of monkeypox (OR=0.056, 95%CI: 0.007-0.447) had lower awareness of monkeypox prevention knowledge than those who had heard of it. In addition, individuals who were not concerned about monkeypox epidemics (OR=0.048, 95%CI: 0.004-0.563) had lower awareness than those who were very concerned. Conclusions Inbound personnel have low awareness of monkeypox prevention knowledge, and occupation, having heard of monkeypox and concern about monkeypox epidemics may affect the awareness of monkeypox prevention knowledge. Intensified health education about monkeypox is required to improve the preventive awareness among inbound personnel.

Objective: To investigate the mortality and probability of premature death due to cardio-cerebrovascular diseases, malignant tumors, diabetes and chronic respiratory diseases and their trends among residents at ages of 30 to 69 years in Xiacheng District, Hangzhou City from 2005 to 2020, so as to provide insights into the development of the chronic disease control strategy. Methods: The data regarding the mortality of cardio-cerebrovascular diseases, malignant tumors, diabetes and chronic respiratory diseases among residents at ages of 30 to 69 years in Xiacheng District, Hangzhou City from 2005 to 2020 were captured from the Zhejiang Provincial Chronic Diseases Surveillance Information Management System, and the crude mortality, standardized mortality by the sixth population census data in Zhejiang Province in 2010 and probability of premature death for these four chronic diseases were estimated. The trends in mortality and probability of premature death were analyzed in Hangzhou City from 2005 to 2020 using average annual percent change (AAPC). Results: A total of 6 436 deaths occurred due to cardio-cerebrovascular diseases, malignant tumors, diabetes and chronic respiratory diseases among residents at ages of 30 to 69 years in Xiacheng District, Hangzhou City from 2005 to 2020. The crude and standardized mortality rates were 183.33/105 and 152.88/105, which both appeared a tendency towards a decline from 2005 to 2020 (AAPC=-1.099% and -2.926%, both P<0.05), and the probability of premature death reduced from 10.40% in 2005 to 6.78% in 2020, which appeared a tendency towards a decline (AAPC=-2.827%, P<0.05). The probability of premature death due to malignant tumors, diabetes and cardio-cerebrovascular diseases all appeared a tendency towards a decline from 2005 to 2020 (AAPC=-2.681%, -6.571% and -2.286%, all P<0.05), while no significant changing trend was seen in the probability of premature death due to chronic respiratory diseases (AAPC=-4.263%, P>0.05). The probability of premature death for these four chronic diseases reduced from 13.55% in 2005 to 9.36% in 2020 among male residents (AAPC=-2.150%, P<0.05), and reduced from 7.18% in 2005 to 4.22% in 2020 among female residents (AAPC=-4.149%, P<0.05). Conclusions The mortality and probability of premature death due to chronic diseases appeared a tendency towards a decline in Xiacheng District, Hangzhou City from 2005 to 2020, and there was a significant decline in the probability of premature death for malignant tumors, cardio-cerebrovascular diseases and diabetes.

Objective:To explore the impact of the number of pathological lymph node metastasis areas on the prognosis of patients with thoracic esophageal squamous cell carcinoma (ESCC) after radical surgery.Methods:The clinicopathologic data of 153 patients with ESCC treated by radical surgery at the Department of Thoracic Surgery of the Affiliated Taixing People′s Hospital of Yangzhou University from January 2012 to December 2014 were retrospectively analyzed. Among these patients, 76 had no adjuvant therapy, and 77 received adjuvant radiotherapy or chemoradiotherapy after surgery. According to the lymph node classification criteria of American Thoracic Association and the number of pathological lymph node metastasis areas, the patients were divided into non-regional lymph node metastasis group ( n=68), oligo-regional lymph node metastasis group (1-2 regional lymph node metastasis, n=54) and multi-regional lymph node metastasis group (≥3 regional lymph node metastasis, n=31). Kaplan-Meier method was used to calculate survival rate and survival comparison was performed by log-rank test. The Cox proportional hazards model was used to analyze prognostic factors, receiver operating characteristic (ROC) curve was used to analyze the predictive value of the number of lymph node metastasis areas. Results:The median overall survival (OS) was 37.0 months for the 153 patients, and the 1-, 3- and 5-year OS rates were 97.4%, 51.0% and 30.7% respectively. In the non-regional lymph node metastasis group, the median OS was 46.0 months, and the 1-, 3- and 5-year OS rates were 97.1%, 58.8% and 39.7% separately. In the oligo-regional lymph node metastasis group, the median OS was 39.0 months, and the 1-, 3- and 5-year OS rates were 94.4%, 55.6% and 35.2% respectively. In the multi-regional lymph node metastasis group, the median OS was 26.0 months, and the 1-, 3- and 5-year OS rates were 98.1%, 25.8% and 3.2% separately. There was a statistically significant difference among the three groups ( χ2=18.257, P<0.001). Among the 76 patients without adjuvant treatment, the 1-, 3- and 5-year OS rates were 94.7%, 50.0% and 34.2% in patients with non-regional lymph node metastasis, 90.9%, 36.4% and 9.1% in patients with oligo-regional lymph node metastasis, 97.4%, 18.8% and 0 in patients with multi-regional lymph node metastasis, and there was a statistically significant difference ( χ2=8.201, P=0.017). Among the 77 patients with adjuvant therapy, the 1-, 3- and 5-year OS rates were 97.7%, 66.7% and 46.7% in patients with non-regional lymph node metastasis, 96.9%, 68.8% and 53.1% in patients with oligo-regional lymph node metastasis, 93.3%, 26.7% and 6.7% in patients with multi-regional lymph node metastasis, and there was a statistically significant difference ( χ2=18.083, P<0.001). Univariate analysis showed that age ( HR=1.534, 95% CI: 1.041-2.260, P=0.030), T stage ( HR=1.757, 95% CI: 1.197-2.579, P=0.004), N stage ( HR=1.548, 95% CI: 1.043-2.297, P=0.030), TNM stage ( HR=1.392, 95% CI: 1.114-2.459, P=0.015), adjuvant therapy ( HR=0.545, 95% CI: 0.370-0.803, P=0.002) and number of lymph node metastasis areas (multi-regional lymph node metastasis versus non-regional lymph node metastasis: HR=0.385, 95% CI: 0.238-0.624, P<0.001; multi-regional lymph node metastasis versus oligo-regional lymph node metastasis: HR=0.442, 95% CI: 0.269-0.726, P=0.001) were closely related to OS in patients with ESCC after operation. Multivariate analysis showed that T stage ( HR=1.699, 95% CI: 1.143-2.525, P=0.009), adjuvant therapy ( HR=0.577, 95% CI: 0.386-0.864, P=0.008) and number of lymph node metastasis areas (multi-regional lymph node metastasis versus non-regional lymph node metastasis: HR=0.553, 95% CI: 0.411-0.996, P=0.011; multi-regional lymph node metastasis versus oligo-regional lymph node metastasis: HR=0.550, 95% CI: 0.328-0.924, P=0.024) were independent prognostic factors for OS. The number of lymph node metastasis areas (AUC=0.648, 95% CI: 0.560-0.735, P=0.004) was better than the number of lymph node metastasis (AUC=0.595, 95% CI: 0.497-0.694, P=0.061) in predicting OS of patients with ESCC after radical surgery. Conclusion:The number of postoperative pathological lymph node metastasis areas in thoracic ESCC has important value in predicting survival prognosis, and adjuvant therapy can significantly improve the OS of patients with oligo-regional lymph node metastasis.

Objective To evaluate the value and feasibility of tissue mitral annular displacement (TMAD) in the assessment of left ventricular global and segmental longitudinal systolic function and synchronization in patients with hypertrophic cardiomyopathy.Methods The study population consisted of 39 on-obstructive hypertrophic cardiomyopathy (nHCM) patients and 39 healthy volunteers matched by gender and age.Left ventricular global and segmental longitudinal were measured by speckle tracking imaging(STI).The mitral annular displacement (MAD) (anterioseptal,posterioseptal,anterior,lateral,posterior and inferior sites,respectively),peak of time (PT) and left ventricular systolic dyssynchrony index (SDI) were measured by TMAD.The correlation between LSR and MAD was analyzed,and the parameters of MAD and SDI for tow groups were compared.Results The rate of effectively track segments of TMAD was significantly higher than that of STI(98.7％ vs 77.9％,P ＜0.001).There were high correlationship between segmental LSR and MAD(r =-0.784,P ＜0.001),and global and MADglobal (r =-0.897,P ＜0.001).Compared with the control group,MAD of six spots and MADglobal were significantly decreased (P ＜ 0.001,respectively),SDI was significantly increased(P ＜0.001).Conclusions TMAD is a sensitive and reproducible method for the assessment of LV longitudinal functionin patients with nHCM.

Lean management,when introduced to optimize emergency operations,may improve medical service.It has been proved in practice that ideas and methodology of lean management guarantee emergency services by ensuring safety and quality of emergency operation process.In addition,it minimizes costs and enhances the business and social efficiency of the hospital.

Objective: To investigate the pedestrian traffic safety behaviors of primary and secondary school students in Xiacheng District of Hangzhou,and to provide reference for formulating traffic safety strategy. Methods: In October 2015,nine campuses of six schools in Xiacheng District were selected to observe the pedestrian traffic safety behaviors of the primary and secondary school students walking to and from school,such as taking the zebra crossing,observing the traffic condition,running and playing with cellphones when walking across the road. Results: Totally 2 585 students were investigated,and 2 580 students were valid（99.81%）. When walking across the road,1 887 people took the zebra crossing,accounting for 73.14%;71.89% of boys and 74.51% of girls took the zebra crossing,and there was no significant difference（P>0.05）;64.76% and 81.32% of the students took the zebra crossing on the way to school and home,with a significant difference（P<0.05）. When walking across the road,1 683 students people observed the traffic conditions,accounting for 65.23%;63.61% of boys and 67.02% of girls observed the traffic conditions,and there was no significant difference（P>0.05）;64.05% and 66.39% of the students observed the traffic conditions on the way to school and home,with a significant difference（P<0.05）.There were 362 students running across the road, accounting for 14.03%;15.31% of boys and 12.62% of girls ran across the road,and there was no significant difference（P>0.05）;9.26% and 18.68% of the students ran across the road on the way to school and home,with a significant difference（P<0.05）. There were 53 students playing with cellphones when crossing the road,accounting for 2.05%;2.29% of boys and 1.79% of girls played with cellphones,and there was no significant difference（P>0.05）;1.41% and 2.68% of the students played with cellphones on the way to school and home,with a significant difference（P<0.05）. Conclusions Primary and secondary school students have dangerous behaviors when walking across the road. We should focus on the intervention of not taking the zebra crossing and not observing traffic conditions when crossing the road on the way to school,and playing with cellphones on the way home.

Objective: To learn the status of knowledge,attitude and behaviors of road traffic safety in primary and secondary school students in Xiacheng District of Hangzhou. Methods: The students of fourth to seventh grade from seven schools in Xiacheng District were selected and surveyed for their knowledge,attitude and behaviors of road traffic safety by self-designed questionnaires. Results: Totally 4 006（99.98%）students completed the survey,who mostly had awareness rates of over 90% in knowledge about safe behaviors when walking,walking across the road and riding a bicycle or an electric bicycle. The awareness rates of"should not run across the road","should not ride side by side"and"should not ride on the motorway"were relatively low,which were 81.65%,85.72% and 82.78%,respectively. About 68.47% of students thought it necessary to wear a helmet when riding a bicycle or an electric bicycle,72.22% of students thought it necessary to wear seatbelt or use child safety seat when taking a car. The two rates were significantly higher in girls than boys and in primary school students than secondary school students（P<0.05）. The top three unsafe behaviors the students did in the past six months were"not wear a helmet when riding a bicycle or an electric bicycle","run across the road"and"ride on the motorway",the rates of which were 86.84%,10.06% and 7.91%,respectively. Conclusion The knowledge of road traffic safety among primary and middle school students in Xiacheng District is mastered well. Interventions should be focused on unsafe behaviors including not wearing a helmet when cycling,riding on the motorway and running cross the road.

Objective To investigate the stroke burden (prevalence, incidence, and mortality) and its risk factors for men and women, urban and rural residents at the provincial level in Shandong province. Methods This study formed part of the National Epidemiological Survey of Stroke in China (NESS?China). This population?based study included 25 190 adults living in Shandong province and was conducted in 2013. The data were derived from eight disease surveillance points (DSPs). They were located in Qingdao Shibei district, Zaozhuang Xuecheng district, Yantai Zhifu district, Laiwu Laicheng district, Yantai Penglai, Weifang Gaomi, Zaozhuang Yiyuan, Linyi Junan. All living subjects who had suffered a stroke by August 31, 2013 were considered as having a prevalent stroke. Incident stroke was defined as a first?ever stroke (both fatal and non?fatal) between September 1, 2012 and August 31, 2013. Fatal cases of incident strokes were used to estimate stroke mortality rate. Stroke cases were subcategorized as follows:ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH). Stroke cases with no brain imaging within the first week of stroke onset or cases where the results of imaging were not available were classified as stroke of undetermined pathological type (UND). Results Of the 25 190 participants, 449 had experienced a prevalent stroke, 118 participants were diagnosed as having an incident stroke, 33 fatal cases were identified over the 12?month period. The crude rate of prevalence, incidence and mortality were 1 782.5 per 100 000 people, 468.4 per 100 000 person?years and 131.0 per 100 000 person?years. The age?standard rate of prevalence, incidence and mortality were 1 059.0 per 100 000 people, 279.7 per 100 000 person?years, and 76.0 per 100 000 person?years. Compared to women, the prevalence of stroke was markedly higher among men (1 463.3 per 100 000 people vs 2 265.0 per 100 000 people). Compared to urban residents, the prevalence of stroke was markedly higher among rural residents (563.7 per 100 000 people vs 2 203.6 per 100 000 people). Among all prevalent cases, there were 348 people suffering from IS, 75 cases suffering from ICH, 6 cases suffering from SAH, and 20 cases of UND. The prevalece rates of IS, ICH, SAH and UND were 1 385.5 per 100 000 people, 301.7 per 100 000 people, 23.8 per 100 000 people and 79.4 per 100 000 people, respectively. The three most prevalent risk factors in stroke cases were hypertension (66.4%), current smoking (26.1%), and alcohol drinking (24.9%). Conclusions Stroke was highly prevalent in Shandong province, China. The prevalence and incidence rates of stroke were significantly greater for men than women. Large geographical variations in the stroke burden were also observed in Shandong province, with a greater stroke burden observed in rural areas.

ObjectiveTo evaluate the value of tissue mitral annular displacement (TMAD) in the assessment of left ventricular long axis systolic function and the relationship of obese degree with left ventricular long axis systolic function in patients with abdominal obesity.MethodsThirty-eight abdominal obesity cases and thirty-four healthy cases were investigated using echocardiography.The images of apical four-chamber view and apical two-chamber view were obtained,systolic mitral annular displacement (MADs),mid-point of mitral annular displacement(MAD-midpt),mid-point of mitral annular normalized displacement(MAND-midpt) and mid-point of mitral annular biplanar normalized displacement(MABNDmidpt) were measured by the technique of TMAD.Their characteristics between patients with abdominal obesity and healthy group were compared,and the relationship of waist-hip ratio(WHR) and related indexes of MAD were analyzed.ResultsIn abdominal obesity group,the MADs at the four site were significantly decreased compared with control group (P＜0.001,respectively),the MAD-midpt and MAND-midpt of apical four-chamber view and apical two-chamber view were significantly decreased compared with control group (P＜0.001,respectively).The WHR related with MABND-midpt independently by the analysis of partial correlation(r=-0.697,P=0.000).ConclusionsThe left ventricular long axis systolic function were damaged in patients with abdominal obesity.The technique of TMAD could quantitatively assess the left ventricular long axis systolic function in patients with abdominal obesity.

Objective To detect the expression levels of high mobility group box chromosomal protein 1 (HMGB1) and Th17 cells transcription factors, related cytokines in peripheral blood of rheumatoid arthritis (RA) patients and analyze the relations between HMGB1 and CRP, ESR, RF in RA patients. The other aim of this study is to identify the expression level of HMGBI and the relationship between HMGB1 and Th17 in RA patients. Methods The mRNA levels of HMGB1, RORyt, interleukin (IL)-17 in the peripheral blood mononuclear cells (PBMC) were determined by quantitative real-time PCR (QRT-PCR) from 80 patients with rheumatoid arthritis,including 32 RA patients in stable phase and 48 patients in active phase, and 50 healthy volunteers. The concentration of HMGB1, IL-23, IL-17 in plasma were detected by enzyme linked immunosorbent assay (ELISA), one-way ANOVA and Spearman's correleation were adopted for statistical analysis.Results The mRNAs of HMGBI, RORyt and IL-17 in RA patients were higher than that in healthy control group (P<0.05), especially in active RA patients [ HMGB 1 (0.424±0.262) pg/ml, RORγt (0.34±0.25) pg/ml,IL-17 (1.42±0.38) pg/ml,P<0.01 ] when compared with patients with stable disease. The concentration of HMGB1, IL-23 and IL-17 in the plasma of RA patients was higher than that of the healthy control group (P< 0.05), and was positively correlated with the expression levels of HMGB1, Th 17-associated factors and the level of CRP, ESR, RF in RA patients' plasma(P<0.05). Conclusion The HMGB1 and Thl7 cells levels are higher in active RA patients than those in patients with stable disease, arid there is significant positive correlation between them. Detection of peripheral HMGB1 and Thl7 cell-specific transcription factors or related cytokines can help to understand the development and progress of rheumatoid arthritis and provide clues for new treatment targets for RA.