Objective To analyze the current status of occupational stress among primary and secondary school teachers, and explore the dose-response relationship between weekly work hours and occupational stress. Methods A total of 1 252 teachers from 13 primary and secondary schools in three prefecture-level cities of a central province of China were selected as the research subjects by the convenience sampling method. The Core Occupational Stress Scale was used to assess occupational stress levels of the teachers. Multivariate logistic regression analysis combined with restricted cubic spline models was applied to study the dose-response relationship between weekly work hours and occupational stress. Results The average weekly work hours were (55.3±15.9) hours, with 78.6% of teachers working more than 40.0 hours per week. The total score of occupational stress was (40.3±8.2) points, and the detection rate of occupational stress was 29.8%. Multivariate logistic regression analysis combined with restricted cubic spline models revealed a linear dose-response relationship in weekly work hours and occupational stress among teachers (P for overall trend <0.05, P for nonlinearity was 0.22). Result of age-stratified analysis showed that weekly work hours had a linear dose-response relationship with occupational stress risk in teachers aged 21-<31 and 31-<46 years (P for overall trend <0.05, P for nonlinearity was 0.71 and 0.27, respectively). However, no association was found between weekly work hours and occupational stress risk among teachers aged ≥46 years (P for overall trend =0.08, P for nonlinearity was 0.09). Conclusion There is a linear dose-response relationship between weekly work hours and occupational stress among primary and secondary school teachers in the province, with younger teachers being more susceptible to suffer occupational stress due to long working hours.

Purpose To investigate the expression of SNRPA in gastric cancer and its effect on the proliferation,migration and invasion of gastric cancer cells.Methods The expression of SNRPA in gastric cancer tissues was ana-lyzed using The Cancer Genome Atlas(TCGA)database.The level of SNRPA was detected by immunohistochemistry(EnVision method),and its relationship with clinicopathological parameters was analyzed.Western blot was used to detect the expression of SNRPA in 15 cases of fresh gastric cancer and paracancerous tissues.The expression of SNRPA in MGC-803 and GES-1 cells was detected by immunofluorescence staining.The effects of SNRPA expression on the proliferation,migration and invasion of gastric cancer cell lines were determined by RNA interference technology and cell function assays,and the expression levels of Cyclin D1 protein and EMT-related proteins(E-cadherin,N-cadher-in)were detected by Western blot.Results The expression level of SNRPA in gastric cancer tissues was significantly higher than that in normal gastric mucosal tissues(P＜0.05),with an area under the curve(AUC)of 0.902 for diag-nostic accuracy.The Kaplan-Meier survival curves showed that the survival time of the group with high expression of SNRPA was shorter.SNRPA expression correlated with tumor size,Ki67,infiltration depth,and p53 status(P＜0.05).Compared with the corresponding control group,SNRPA silencing inhibited the proliferation,migration and in-vasion ability of gastric cancer cells,accompanied by decreased Cyclin D1 and N-cadherin expression and increased E-cadherin expression(P＜0.05).Conclusion SNRPA expression is upregulated in gastric cancer tissues and cell lines,promoting the proliferation,migration,and invasion of gastric cancer cells,and may be a potential molecular marker for gastric cancer.

Purpose To investigate the expression of SNRPA in gastric cancer and its effect on the proliferation,migration and invasion of gastric cancer cells.Methods The expression of SNRPA in gastric cancer tissues was ana-lyzed using The Cancer Genome Atlas(TCGA)database.The level of SNRPA was detected by immunohistochemistry(EnVision method),and its relationship with clinicopathological parameters was analyzed.Western blot was used to detect the expression of SNRPA in 15 cases of fresh gastric cancer and paracancerous tissues.The expression of SNRPA in MGC-803 and GES-1 cells was detected by immunofluorescence staining.The effects of SNRPA expression on the proliferation,migration and invasion of gastric cancer cell lines were determined by RNA interference technology and cell function assays,and the expression levels of Cyclin D1 protein and EMT-related proteins(E-cadherin,N-cadher-in)were detected by Western blot.Results The expression level of SNRPA in gastric cancer tissues was significantly higher than that in normal gastric mucosal tissues(P＜0.05),with an area under the curve(AUC)of 0.902 for diag-nostic accuracy.The Kaplan-Meier survival curves showed that the survival time of the group with high expression of SNRPA was shorter.SNRPA expression correlated with tumor size,Ki67,infiltration depth,and p53 status(P＜0.05).Compared with the corresponding control group,SNRPA silencing inhibited the proliferation,migration and in-vasion ability of gastric cancer cells,accompanied by decreased Cyclin D1 and N-cadherin expression and increased E-cadherin expression(P＜0.05).Conclusion SNRPA expression is upregulated in gastric cancer tissues and cell lines,promoting the proliferation,migration,and invasion of gastric cancer cells,and may be a potential molecular marker for gastric cancer.

Objective: To investigate the trends in mortality of malignant tumors in Ningbo City, Zhejiang Province from 2002 to 2022, so as to provide the evidence for formulating malignant tumor control strategies in Ningbo City. Methods The data regarding the mortality of malignant tumors in Ningbo City from 2002 to 2022 were collected through the Ningbo Municipal Death Cause Monitoring System, and the crude mortality and age-specific mortality of malignant tumors were calculated in Ningbo City. The mortality of malignant tumors was standardized by the population of the sixth National Population Census in China in 2010 (Chinese-standardized mortality) and the world standard population in 1960 (world-standardized mortality). The trends in mortality of malignant tumors were evaluated with annual percent change (APC) and average annual percent change (AAPC). Methods: The data regarding the mortality of malignant tumors in Ningbo City from 2002 to 2022 were collected through the Ningbo Municipal Death Cause Monitoring System, and the crude mortality and age-specific mortality of malignant tumors were calculated in Ningbo City. The mortality of malignant tumors was standardized by the population of the sixth National Population Census in China in 2010 (Chinese-standardized mortality) and the world standard population in 1960 (world-standardized mortality). The trends in mortality of malignant tumors were evaluated with annual percent change (APC) and average annual percent change (AAPC). Results: The crude mortality of malignant tumors was 186.43/105 to 221.24/105 in Ningbo City from 2002 to 2022, which showed a tendency towards a rise (AAPC=0.76%), and both the Chinese- (AAPC=-2.64%) and world-standardized mortality (AAPC=-2.74%) appeared a tendency towards a decline (all P<0.05). The world-standardized mortality of malignant tumors presented three changes in Ningbo City from 2002 to 2022, with a more remarkable decline from 2011 to 2018 (APC=-3.53%) than from 2002 to 2011 (APC=-2.10%) and from 2018 to 2022 (APC=-2.00%) (all P<0.05). The annual decline in mortality of malignant tumors was higher in men (Chinese-standardized mortality: AAPC=-2.68%; world-standardized mortality: AAPC=-2.75%) than in women (Chinese-standardized mortality: AAPC=-2.45%; world-standardized mortality: AAPC=-2.57%), and higher in urban areas (Chinese-standardized mortality: AAPC=-2.85%; world-standardized mortality: AAPC=-2.92%) than in rural areas (Chinese-standardized mortality: AAPC=-2.45%; world-standardized mortality: AAPC=-2.57%) (all P<0.05). The mortality of malignant tumors appeared a tendency towards a rise with age in Ningbo City, with the highest mortality in residents at ages of 85 years and older (1 447.13/105). Death from malignant tumors were responsible for 31.86% of all causes of death in Ningbo City, and the five most common causes of cancer death included lung cancer, liver cancer, gastric cancer, colorectal cancer and esophageal cancer. In addition, the world-standardized mortality of pancreatic cancer (AAPC=3.92%), prostate cancer (AAPC=4.71%), and cervical cancer (AAPC=1.60%) appeared a tendency towards a rise in Ningbo City (all P<0.05). Conclusions The crude mortality of malignant tumors appeared a tendency towards a rise in Ningbo City from 2002 to 2022, while the standardized mortality showed a tendency towards a decline. Management of malignant tumors should be given a high priority among men and rural residents, and lung cancer, liver cancer, gastric cancer, colorectal cancer and esophageal cancer should be emphasized.

Objective: To investigate the trends in incidence and mortality of gastric cancer in Ningbo City, Zhejiang Province from 2011 to 2022, so as to provide insights into improving gastric cancer control strategy. Methods: The incidence and mortality of gastric cancer in Ningbo City from 2011 to 2022 were collected through Ningbo Municipal Chronic Disease and Cause of Death Monitoring System. The incidence and mortality of gastric cancer were calculated, and standardized by the data from the Sixth Chinese National Population Census in 2020 (Chinese-standardized rate) and the world standard population first introduced by Segi in 1960 (world-standardized rate). The trends in incidence and mortality of gastric cancer were evaluated using annual percent change (APC) and average annual percent change (AAPC). Results : The crude incidence of gastric cancer was 45.69/105 in Ningbo City from 2011 to 2022, with no significant changing patterns seen during the study period (AAPC=-0.02%, P>0.05), and the Chinese- and world-standardized incidence of gastric cancer was 28.61/105 and 21.87/105, which both appeared a tendency towards a decline (AAPC=-3.19% and -3.05%, both P<0.05). The crude, Chinese-standardized and world-standardized mortality rates of gastric cancer were 28.56/105, 17.07/105 and 12.57/105, respectively, all showing a tendency towards a decline (AAPC=-3.00%, -6.26% and -6.34%, all P<0.05). The Chinese- and world-standardized incidence and mortality of gastric cancer all appeared a tendency towards a decline in urban (AAPC=-2.72%, -2.53%, -5.91% and -5.96%, all P<0.05) and rural areas (AAPC=-3.61%, -3.53%, -6.79% and -6.89%, all P<0.05), and the Chinese- and world-standardized incidence and mortality of gastric cancer were significantly higher among urban residents than among rural residents. The Chinese- and world-standardized incidence and mortality of gastric cancer all appeared a tendency towards a decline among men (AAPC=-3.18%, -3.00%, -5.82% and -5.91%, all P<0.05) and women (AAPC=-2.98%, -2.90%, -7.12% and -7.12%, all P<0.05), and the Chinese- and world-standardized incidence and mortality of gastric cancer was significantly higher among men than among women. In addition, the crude incidence and mortality of gastric cancer both appeared a tendency towards a rise with age among residents in Ningbo City (both P<0.05). Conclusions The incidence and mortality of gastric cancer both appeared a tendency towards a decline in Ningbo City from 2011 to 2022; however, the incidence and mortality remained high. Males and urban residents should be given a high priority for gastric cancer control, and gastric cancer screening should be strengthened among individuals at ages of 40 years and older.

Objective: To explore the risk factors of predicting white matter hyperintensities progression based on radiomics of MRI of whole-brain white matter. Methods: The imaging and clinical data of 152 patients with white matter hyperintensities admitted to Zhejiang People′s Hospital from March 2014 to October 2018 were retrospectively analyzed. The whole brain white matter on baseline T₁WI images of each patient were segmented by SPM12 software package, and images of white matter were imported into AK software for texture feature extraction and dimensionality reduction. At last, least absolute shrinkage and selection operator(LASSO) was used to calculate the score of radiomics signature of each patient. According to the improved Fazekas scale, patients with WMH progression were divided into three groups: any white matter hyperintensities (AWMH), periventricular white matter hyperintensities (PWMH) and deep white matter hyperintensities (DWMH). Statistical differences of clinical factors and radiomics signature between WMH progression subgroups and non-progression subgroups were compared with independent sample t test or Mann-Whitney U test, and Univariate logistic regression was used to select independent clinical risk factors and multivariate logistic regression along with imaging omics tags were used to construct predictive models, which was evaluated by ROC curve. And the correlation between the clinical indicators of independent risk factors and the texture feature of radiomics signature was analyzed. Results: The efficacy of the model for the detection for AWMH progression, PWMH progression and DWMH progression was 0.818,0.778 and 0.824, respectively. Age is an independent risk factor for AWMH progression and DWMH progression[OR(95%CI), 4.776(2.152-10.601) vs. 3.851(1.101-8.245); P<0.05]. BMI is an independent risk factor for DWMH[OR(95%CI), 3.004(1.204-7.370); P<0.05], and hyperlipidemia is an independent risk factor for AWMH and PWMH[OR(95%CI), 4.062(1.834-8.998) vs. 3.549(1.666-7.563); P<0.05]. In AWMH subgroup, Surface Area was negatively correlated with age and low density lipoprotein(LDL) (r=-0.401, -0.312), and Inverse Difference Moment_ALLDirection_offset 1_SD was negatively correlated with age(r=-0.412). In PWMH subgroup, Compactness 1 was negatively correlated with LDL(r=-0.198), and Inverse Difference Moment_angle 0_offset 7 was positively correlated with LDL(r=0.252). In DWMH subgroup, LongRunEmphasis_ALLDirection_offset 7 was negatively correlated with age(r=-0.322), and GLCMEntropy_angle0_offset 4 was negatively correlated with age(r=-0.278). GLCMEntropy_AllDirection_offset4 was negatively correlated with body mass index(r=-0.514). Conclusion Radiomics based on whole-brain white matter MR imaging can predict WMH progression and identify the risk factors in high-risk populations, thus providing early additional information to conventional magnetic resonance imaging to predict WMH progression.

Objectives: To understand the status of studies about influenza economic burden in mainland China and summarize their major results. Methods: The words of influenza, flu, cost, economic, burden, effectiveness, benefit, utility, China, and Chinese, were used as search keywords. Journal papers published during 2000-2018 were searched from Chinese electronic databases (CNKI and Wanfang) and English electronic databases (PubMed, Web of science, EconLit and Cochrane Library). The language of literature was restricted to Chinese and English. A total of 23 effective documents were included, and the descriptive characteristics, research indexes and methods included in the literature were analyzed. The monetary unit used in this review is Chinese Yuan (CNY). Results: The 23 study sites were mainly in the relatively developed and populous regions. The total cost per capita of laboratory-confirmed influenza,of all age-group was reported in 6 literatures, and only 4 literatures reported it in out-patients (range: 768.0-999.9 CNY), Only one study reported this indicator in inpatients (9 832.0 CNY). One literature reported the total cost per capita of influenza-like illness,, which was 205.1 CNY. And one literature reported that the direct medical cost of inpatients per capita in children under 5 years of age was 6 072.0 CNY while two literature reported this index for the elderly over 60 years of age, ranging from 14 250.0 to 19 349.1 CNY. Four articles reported the economic burden of influenza in urban and rural areas, one of which showed that the related expenses of urban influenza inpatients accounted for 31% of the average annual income, while which for the rural flow was 113%. Conclusion The average economic burden of lab-confirmed influenza case is higher than that of influenza-like illness, and there are differences in outpatient indirect expenses and inpatients direct medical expenses. The direct medical burden for the hospitalized 60-years-and-beyond influenza case group is heavier thar other age group. By region, the influenza associated individual economic burden in rural area is higher than that of urban area..

Objective: To systematically review the mortality burden study of influenza in mainland China. Method: "influenza", "flu", "H1N1", "pandemic", "mortality", "death", "fatality", "burden", "China" and "Chinese" were used as keywords, and a systematic literature search was conducted to identify articles in three English databases (PubMed, Web of Science and Embase) and three Chinese database (CNKI, WanFang and VIP) during 1990-2018 (excluding Hong Kong, Macao and Taiwan). The language of literature was restricted to Chinese and English. The inclusion criteria were human-oriented researches with method based on population, and research indexes included mortality and excess mortality. The exclusion criteria were non-primary research materials, predictive research and research on the burden of avian influenza related deaths. A total of 17 literatures were included, and the basic information to descriptive characteristics, methodology of modeling and the corresponding results were extracted. Results: All the 17 studies adopted indirect statistical models, with 14 of which adopted the regression model, and all the research index was excess mortality. All causes (16 studies), respiratory and circulatory diseases (14 studies) and pneumonia and influenza (10 studies) were the main causes of death associated with influenza. Influenza associated mortality burden in the elderly was higher, with the lowest excess mortality rates of all causes, respiratory and circulatory diseases, pneumonia and influenza being 49.57, 30.80 and 0.69 per 100 000 people, and the highest rates being 228.16, 170.20 and 30.35 per 100 000 people, respectively. In the non-elderly, the corresponding lowest rates were -0.27, -0.08 and 0.04 per 100 000 people respectively, and the highest rates were 3.63, 2.6 and 0.91 per 100 000 people, respectively. The influenza-related excess mortality was higher in the north, with a minimum of 7.8 per 100 000 and a maximum of 18.0 per 100 000, and slightly lower in the south, with a minimum of 6.11 per 100 000 and a maximum of 18.7 per 100 000. There were also differences in deaths caused by different influenza virus subtypes, with influenza A(H3N2) and influenza B virus possibly posing a heavier mortality burden. Conclusions Studies on influenza mortality burden is mainly based on indirect model and urban level in China. The mortality burden of influenza in the elderly, the northern and subtype A(H3N2) and B were more severe.

Objectives To understand the status of studies about influenza economic burden in mainland China and summarize their major results. Methods The words of influenza, flu, cost, economic, burden, effectiveness, benefit, utility, China, and Chinese, were used as search keywords. Journal papers published during 2000-2018 were searched from Chinese electronic databases (CNKI and Wanfang) and English electronic databases (PubMed, Web of science, EconLit and Cochrane Library). The language of literature was restricted to Chinese and English. A total of 23 effective documents were included, and the descriptive characteristics, research indexes and methods included in the literature were analyzed. The monetary unit used in this review is Chinese Yuan (CNY). Results The 23 study sites were mainly in the relatively developed and populous regions. The total cost per capita of laboratory?confirmed influenza,of all age?group was reported in 6 literatures, and only 4 literatures reported it in out?patients (range: 768.0-999.9 CNY), Only one study reported this indicator in inpatients (9 832.0 CNY). One literature reported the total cost per capita of influenza?like illness,, which was 205.1 CNY. And one literature reported that the direct medical cost of inpatients per capita in children under 5 years of age was 6 072.0 CNY while two literature reported this index for the elderly over 60 years of age, ranging from 14 250.0 to 19 349.1 CNY. Four articles reported the economic burden of influenza in urban and rural areas, one of which showed that the related expenses of urban influenza inpatients accounted for 31% of the average annual income, while which for the rural flow was 113%. Conclusion The average economic burden of lab?confirmed influenza case is higher than that of influenza?like illness, and there are differences in outpatient indirect expenses and inpatients direct medical expenses. The direct medical burden for the hospitalized 60?years?and?beyond influenza case group is heavier thar other age group. By region, the influenza associated individual economic burden in rural area is higher than that of urban area..

Objective To systematically review the mortality burden study of influenza in mainland China. Method "influenza","flu","H1N1","pandemic","mortality","death","fatality","burden","China" and"Chinese" were used as keywords, and a systematic literature search was conducted to identify articles in three English databases (PubMed, Web of Science and Embase) and three Chinese database (CNKI, WanFang and VIP) during 1990-2018 (excluding Hong Kong, Macao and Taiwan). The language of literature was restricted to Chinese and English. The inclusion criteria were human?oriented researches with method based on population, and research indexes included mortality and excess mortality. The exclusion criteria were non?primary research materials, predictive research and research on the burden of avian influenza related deaths. A total of 17 literatures were included, and the basic information to descriptive characteristics, methodology of modeling and the corresponding results were extracted. Results All the 17 studies adopted indirect statistical models, with 14 of which adopted the regression model, and all the research index was excess mortality. All causes (16 studies), respiratory and circulatory diseases (14 studies) and pneumonia and influenza (10 studies) were the main causes of death associated with influenza. Influenza associated mortality burden in the elderly was higher, with the lowest excess mortality rates of all causes, respiratory and circulatory diseases, pneumonia and influenza being 49.57, 30.80 and 0.69 per 100 000 people, and the highest rates being 228.16, 170.20 and 30.35 per 100 000 people, respectively. In the non?elderly, the corresponding lowest rates were-0.27,-0.08 and 0.04 per 100 000 people respectively, and the highest rates were 3.63, 2.6 and 0.91 per 100 000 people, respectively. The influenza?related excess mortality was higher in the north, with a minimum of 7.8 per 100 000 and a maximum of 18.0 per 100 000, and slightly lower in the south, with a minimum of 6.11 per 100 000 and a maximum of 18.7 per 100 000. There were also differences in deaths caused by different influenza virus subtypes, with influenza A(H3N2) and influenza B virus possibly posing a heavier mortality burden. Conclusions Studies on influenza mortality burden is mainly based on indirect model and urban level in China. The mortality burden of influenza in the elderly,the northern and subtype A(H3N2) and B were more severe.