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    Expert Overview
    Role of cholesterol metabolism in osteoarthritis: a review of research progresses
    ZHAO Zhibo, MAN Zhentao, LI Wei
    Journal of Shandong University (Health Sciences). 2024, 62(2):  1-9.  doi:10.6040/j.issn.1671-7554.0.2024.0045
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    Osteoarthritis(OA)is a degenerative disease associated with aging and has long been linked to obesity. Some studies suggest that OA might be a metabolic disease, impacting not only weight-bearing joints but also non-weight-bearing joints. Emerging evidence indicates abnormal cholesterol metabolism in osteoarthritis, with pathways leading to the production of pro-inflammatory substances crucial to OA development. Drugs capable of modulating abnormal cholesterol metabolism hold considerable therapeutic promise for OA. This article aims to summarize the role and comprehensive molecular mechanisms of cholesterol metabolism in osteoarthritis and proposes that a multi-faceted regulation of cholesterol metabolism could be a promising strategy for the clinical treatment of osteoarthritis.
    Preclinical Medicine
    Proteomic analysis of brown adipose tissue in diet-induced obese female mice
    LIANG Zhonghao, ZHUANG Xianghua, HUANG Shan, HAN Xiaolin, HUA Mengyu, JU Liping, CHEN Shihong
    Journal of Shandong University (Health Sciences). 2024, 62(2):  10-19.  doi:10.6040/j.issn.1671-7554.0.2024.0089
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    Objective To investigate the effects of high-fat diet(HFD)on the proteomics of brown adipose tissue(BAT)in female mice. Methods The obese mice models were established with HFD(HFP group). Mice in the control group were fed with normal diet, while those in the experimental group were fed with HFD. Both groups were fed for 21 weeks and body weight were detected weekly. Body composition was measured with small animal body composition analyzer. The glucose tolerance and insulin tolerance were measured with intraperitoneal glucose tolerance test(IPGTT)and insulin tolerance test(ITT)respectively. After the mice were sacrificed, BAT was quickly collected into liquid nitrogen, and then 4 samples from either group were analyzed with liquid chromatography-tandem mass spectrometry(LC-MS)and proteomics. Results Compared with the control group, the HFD group had significantly increased body weight and fat content, but impaired glucose tolerance and insulin tolerance. Differential proteins were screened with FC>1.5 or <0.67 and P<0.05. Cluster heatmap revealed an increased Ucp1 level in HFD mice, and Western blotting further confirmed higher Ucp1 expression in HFD mice. Subcellular localization analysis indicated that mitochondria were the organelles containing the largest number of differential proteins. Gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)analyses showed that the down-regulated proteins in the HFD group were mainly involved with muscle contraction and calcium signaling pathway, while the up-regulated proteins with lipid catabolism, lipid oxidation process, thermogenesis, oxidative phosphorylation and other pathways. Protein interaction analysis suggested that the central proteins of the network were associated with lipid synthesis and fatty acid β oxidation. Conclusion The thermogenic pathway of BAT was enhanced in obese female mice, accompanied with increased oxidation of fatty acid β and decreased fat synthesis.
    Rapid and accurate assessment of pulmonary hypertension in rats via diaphragmatic puncture method
    ZHAO Zihui, WANG Xuyang, ZHANG Peng, FANG Ningning, SHI Duanbo, YANG Fan, YANG Xiaomei, WU Jianbo
    Journal of Shandong University (Health Sciences). 2024, 62(2):  20-28.  doi:10.6040/j.issn.1671-7554.0.2023.0987
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    Objective To establish a simple, rapid and accurate method to measure the right ventricular pressure in rats. Methods A total of 30 male SD rats aged 8-10 weeks were randomly divided into 3 groups: the trans-thoracic right ventricular puncture manometry group(TTM group, n=10), trans-diaphragmatic puncture manometry group(TDM group, n=10), and the monocrotaline-induced pulmonary hypertension with trans-diaphragmatic manometry group(MCT-TDM group, n=10). The MCT-TDM group underwent subcutaneous injection of monocrotaline through the thoracoabdominal side(60 mg/kg), while the TTM and TDM groups were injected with an equivalent volume of sterile saline. Four weeks after model establishment, the right ventricular systolic pressure(RVSP)of the TDM and MCT-TDM groups was measured using the trans-diaphragmatic puncture method, followed by thoracotomy to verify the accuracy of the puncture site; RVSP of the TTM group was measured using the trans-thoracic right ventricular puncture method. The operation time, success rate, and RVSP were compared between the two manometry methods. The hearts and lung tissues of the rats were extracted, left and right ventricles were separated, and the right ventricular hypertrophy index(RVHI)was calculated. Lastly, the left lung tissue was stained with hematoxylin and eosin(HE)to evaluate the extent of pulmonary microvascular lesions. Results The time taken from anesthesia to successful measurement of RVSP was(6.83±1.36)minutes for the TTM group,(8.13±1.25)minutes for the TDM group, and(8.32±1.23)minutes for the MCT-TDM group. The success rate were 70% for the TTM group, 100% for the TDM group, and 90% for the MCT-TDM group. There were no significant differences in RVSP and RVHI between the TDM and TTM groups(P>0.05). The RVSP and RVHI in the MCT-TDM group were significantly higher than those in the TDM group(P<0.001). In the MCT-TDM group, the pulmonary arterioles showed notable thickening of the vessel walls and narrowing of the lumens. Conclusion Measuring the right ventricular pressure with diaphragmatic puncture technique negates the need for thoracotomy and circumvents the use of costly equipment. It enables precise, swift, and straightforward assessment of the right ventricular hemodynamics, holding considerable value for widespread application.
    Effects of CD300c-Ig on joint injury in mice with collagen-induced arthritis
    TIAN Xinxin, WANG Lijun, LI Lin, SUN Zhengda, LIU Haiyan
    Journal of Shandong University (Health Sciences). 2024, 62(2):  29-35.  doi:10.6040/j.issn.1671-7554.0.2023.0893
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    Objective To investigate the effects and mechanism of CD300c-Ig on joint injury in collagen-induced arthritis(CIA)mice. Methods To construct the CIA model, DBA/1J mice were immunized on day 1 and day 21, and then randomly divided into the treatment group and control group, with 10 mice in either group. Mice in the treatment group were intraperitoneally injected with 100 μL of 20 μg CD300c-Ig once every 3 days for 6 times, with a total dose of 120 μg; mice in the control group were intraperitoneally injected with control Ig of the same volume once every 3 days for 6 times. The degree of swelling in the joints of the extremities was observed and the arthritis index score was recorded. Forty days after the initial immunization, the spleens of the mice were taken to make single-cell suspension, and the expressions of T regulatory cells(Treg), T helper cells(Th17), tumor necrosis factor-α(TNF-α), and interferon-γ(IFN-γ)were detected with flow cytometry. The lower limbs of the mice were taken, decalcified, and sliced for hematoxylin-eosin staining and safranin O staining to visualize the pathological features of the joints and to score them. The mRNA expressions of forkhead box protein P3(Foxp3), interleukin-17(IL-17)and interleukin-23(IL-23)were detected with fluorescence quantitative PCR. Results The degree of joint swelling and AI in the treatment group were significantly reduced compared with those in the control group. Hematoxylin-eosin staining and saffron O staining showed that the proliferation of synoviocytes in the synovial joints of the treatment group was reduced, and the formation of vascular cataracts and the erosion of bone were significantly improved(P<0.05). Flow cytometry showed that the proportion of Th17 cells in the spleens of the treatment group was significantly lower(P<0.05)while the proportion of Treg cells was significantly higher(P<0.05). The expressions of TNF-α and IFN-γ in the spleen of the treatment group were significantly lower(P<0.05). Fluorescence quantitative PCR showed that the mRNA expressions of IL-17 and IL-23 in the treatment group were significantly lower. Conclusion CD300c-Ig can reduce joint injury in CIA mice, and the mechanism is related to its regulation of Th17/Treg cell balance and inhibition of inflammatory factor release.
    Clinical Medicine
    Diagnostic value of contrast-transthoracic echocardiography plus contrast-enhanced transcranial Doppler for patent foramen ovale-right to left shunt
    WANG Rui, ZHANG Wei, CHU Zhuxiu, GUO Linlin, WANG Qian, GE Lili, SHI Pei, WANG Yongmei
    Journal of Shandong University (Health Sciences). 2024, 62(2):  36-41.  doi:10.6040/j.issn.1671-7554.0.2023.1155
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    Objective To investigate the diagnostic value of contrast transthoracic echocardiography(c-TTE)plus contrast-enhanced transcranial Doppler(c-TCD)for patent foramen ovale right to left shunt(PFO-RLS). Methods The data of 218 PFO patients were examined with transesophageal echocardiography(TEE), and c-TTE plus C-TCD in the resting state and Valsalva state, to assess its diagnostic value for PFO-RLS. Results The detection rate of PFO-RLS was significantly higher in Valsalva state than in resting state(P<0.05). In both state, the c-TTE plus c-TCD examination showed a higher detection rate than c-TTE(P<0.05)or c-TCD alone(P<0.05). When patients had grade I disease, c-TCD had a higher detection rate than c-TTE(P<0.05), but there was no significant difference in the detection rate when the disease was Grade II or Grade III(P>0.05). In grade I and II cases, c-TTE plus c-TCD showed a higher detection rate than c-TTE(P<0.05)or c-TCD alone(P<0.05), but there was no significant difference in the detection rate between c-TTE or c-TCD alone, or combined examination in grade III cases(P>0.05). Conclusion The Valsalva maneuver which increases the right atrial pressure can significantly improve the detection rate of PFO-RLS. The sensitivity and accuracy of c-TTE plus C-TCD are significantly improved in the diagnosis of PFO-RLS compared with those of c-TTE and C-TCD alone(P<0.05).
    Postoperative pain associated with digestive endoscopic therapies: a retrospective cohort study
    WU Shanshan, WANG Shuren, ZHAO Tonghang, ZHANG Zongwang
    Journal of Shandong University (Health Sciences). 2024, 62(2):  42-50.  doi:10.6040/j.issn.1671-7554.0.2023.0903
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    Objective To analyze the degrees of postoperative pain after different digestive endoscopic surgeries. so as to optimize the analgesia program and improve the comfort of patients. Methods A total of 1,657 patients were surveyed with the Chinese version of the Brief Pain Inventory(BPI-C). BPI-C score ≥4 indicated poor pain control. Factors affecting postoperative pain were evaluated with Logistic regression analysis. The degrees of pain at different time points in different surgeries were analyzed with generalized estimation equation(GEE). Results Altogether 7 common endoscopic surgeries were enrolled. Approximately 19.2% of the patients had BPI-C ≥4. GEE analysis showed that there were differences in postoperative pain among the 7 types of surgeries, and the pain intensity was different at different time points. The peak of postoperative pain occurred approximately 6 h after all kinds of surgeries(P<0.001), and 12.19% of the patients received postoperative analgesia, 31.14% of whom needed further analgesics. Conclusion Moderate to severe pain may occur after minimally invasive digestive endoscopic surgeries, and patients have a high demand for postoperative analgesics. Clinicians need to improve the awareness of analgesia and optimize the analgesia program.
    Establishment and value assessment of colon cancer diagnostic models based on multiple variables and different machine learning algorithms
    LIANG Yongyuan, CAI Peifei, ZHENG Guixi
    Journal of Shandong University (Health Sciences). 2024, 62(2):  51-59.  doi:10.6040/j.issn.1671-7554.0.2023.1092
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    Objective To establish a colon cancer diagnostic model based on multiple variables using various machine learning algorithms and to assess its clinical application value. Methods Serum samples from 119 colon cancer patients and 125 healthy controls were collected. Serum exosome was extracted, and miRNA 214-3p(miR-214-3p)level was measured using RT-qPCR. Receiver operating characteristic(ROC)curve was plotted to evaluate the diagnostic efficiency of colon cancer. Additionally, 30 routine laboratory items of colon cancer patients and healthy controls were collected. Characteristic variables were screened, and 11 algorithms were used to establish the diagnostic model. The optimal model was selected with ROC and machine learning curves. Results The expression level of miR-214-3p in colon cancer patients was significantly higher than that in healthy controls(P<0.001), with the area under the ROC curve(AUC)being 0.820, indicating good diagnostic performance. After the expression level of miR-214-3p and other 30 routine laboratory items were enrolled, 4 characteristic variables were screened to establish the diagnostic model, including UREA, carcinoembryonic antigen, monocyte and miR-214-3p. The Logistic regression algorithm was identified as the optimal one(AUC=0.93). Conclusion Serum exosome miR-214-3p is a potential biomarker of colon cancer. The model based on 4 characteristic variables and Logistic regression algorithm has an excellent diagnostic performance for diagnosing colon cancer.
    Neutrophil-to-platelet ratio predicts adverse renal outcomes in anti-neutrophil cytoplasmic antibody-associated vasculitis and its synergistic multifactor optimization model
    DIAO Yujie, LIN Lin, LI Wenxuan, WANG Zhouyang, JIANG Bei, HU Yingying, LIU Guangyi
    Journal of Shandong University (Health Sciences). 2024, 62(2):  60-68.  doi:10.6040/j.issn.1671-7554.0.2023.1044
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    Objective To explore the relationship between neutrophil-to-platelet ratio(NPR)and the first-year renal prognosis in patients with renal damage caused by anti-neutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV), so as to find the cut-off value of NPR for assessing first-year renal prognosis, and to construct a high-performance prognostic prediction model. Methods Clinical data of 258 patients with renal damage caused by AAV who were admitted to Qilu Hospital of Shandong University during Jan. 2010 and Nov. 2021 were retrospectively analyzed. The relationship between NPR and laboratory indicators at diagnosis as well as the first-year renal replacement therapy(RRT)rate was analyzed. Receiver operating characteristic curve was plotted to calculate the cut-off value of NPR. After that, patients were classified into high NPR group(n=41)and low NPR group(n=82). Mann-Whitney U test and chi-square test were used to analyze the differences between the two groups. The relationship between NPR and first-year RRT rate was analyzed by constructing a binary Logistic regression model. The first-year renal prognosis prediction model was established with NPR and other factors. Results There were 22 male(53.7%)and 19 female(46.3%)in the high NPR group, and 46 male(56.1%)and 36 female(43.9%)in the low NPR group. Altogether 24 patients(19.5%)underwent RRT within the first year. Univariate and multivariate binary Logistic regression analysis were performed, and significant variables in univariate analysis were included in multivariate analysis. High level of Birmingham vasculitis activity score(BVAS)(OR=1.272, 95%CI:1.034-1.567, P=0.023), high level of serum creatinine(SCR)(OR=1.008, 95%CI:1.004-1.012, P<0.001), and high level of NPR(OR=4.931, 95%CI:1.153-21.091, P=0.031)were predictors of RRT within the first year. NPR>0.033 2 was an independent predictor of RRT. The binary Logistic regression model of NPR combined with multifactor functioned well in predicting the first-year RRT rate, with an area under the curve(AUC)of 0.960(95%CI:0.889-0.997, P<0.001). Conclusion NPR is a convenient and cost-effective inflammation indicator. Patients with NPR >0.033 2 are more likely to enter end-stage renal disease(ESRD)and undergo RRT within the first year after initial diagnosis. The first-year renal prognostic prediction model constructed in this study, including BVAS, hemoglobin, albumin, SCR and NPR, has a good predictive performance.
    Comparison of medical abortion and surgical abortion in the management of missed abortion after in vitro fertilization/intracytoplasmic sperm injection-embryo transfer
    ZHAO Shengrui, QU Huiling, XU Xinxin, ZHANG Fangfang, YAN Lei
    Journal of Shandong University (Health Sciences). 2024, 62(2):  69-74.  doi:10.6040/j.issn.1671-7554.0.2023.1063
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    Objective To compare the efficacy of medical abortion and surgical abortion in the management of missed abortion after in vitro fertilization/intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET)and their effects on the pregnancy outcomes of subsequent embryo transfer. Methods Patients with missed abortion after IVF/ICSI-ET with gestation weeks less than 13 weeks, treated in the Reproductive Hospital Affiliated to Shandong University during Jan. 2016 and Jan. 2017 were selected and divided into medical group(n=134)and surgical group(n=130)according to random number table method. The success rate of abortion, changes of endometrial thickness before and after abortion, and the pregnancy outcomes of the first embryo transfer after abortion were observed. Results The success rate of surgiacal abortion was significantly higher than that of medical abortion(99.23% vs. 85.35%, P<0.001). The endometrial thickness before embryo transfer on the human chorionic gonadotropin(HCG)day was higher in the surgical group than in the medical group [(1.01±0.19)cm vs.(1.06±0.20)cm, P=0.040]. Furthermore, there was a great difference in endometrial thickness before and after embryo transfer in the surgical group compared to the medical group[(-0.01±0.17)cm vs.(0.06±0.17)cm, P=0.008]. There were no significant differences in the pregnancy outcomes following the first embryo transfer after abortion between the two groups. Conclusion For missed abortion after IVF/ICSI within 13 weeks of gestation, the efficacy of surgical abortion is higher than that of medical abortion. However, medicine may be more beneficial to endometrial preservation than surgery. The two treatments have no significant impact on the pregnancy outcomes following the first embryo transfer.
    Impact of iliac crest on the placement of L5-S1 transforaminal endoscopic surgical channel based on three-dimensional CT reconstruction
    WANG Jinjin, LIU Xiaoyang, GE Zhongpeng, CUI Xingang
    Journal of Shandong University (Health Sciences). 2024, 62(2):  75-82.  doi:10.6040/j.issn.1671-7554.0.2023.1079
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    Objective To analyze the impact of iliac crest on the feasibility of puncture placement of surgical channels. Methods The imaging data of 75 patients who underwent lumbar spine CT and lumbar spine DR examination at Shandong Provincial Hospital during Jan. 1, 2022 and Dec. 31, 2022 were retrospectively analyzed. Mimics 21.0 software was used to perform three-dimensional reconstruction of CT images and simulate surgical channel placement to evaluate the feasibility of channel placement in percutaneous endoscopic transforaminal lumbar discectomy(PETD)in patients’ L5-S1 segment. Based on the results, the patients were divided into two groups. In the implantable group, the channel could be placed; in the non-implantable group, the channel could not be placed. The relative height classification of the iliac crest, height of the iliac crest, inclination angle of the iliac crest, inclination angle of the articular process, distance from the highest point of the iliac crest to the midline, and the cohesion angle of the iliac crest were compared between the two groups to analyze the effects of iliac crest on the channel placement of the L5-S1 segment. Results The measurement results showed that height of the iliac crest, inclination angle of the iliac crest, and the cohesion angle of the iliac crest were significantly lower in the implantable group than in the non-implantable group [23.65(29.33-18.50)vs 38.20(39.80-34.40), P<0.001; 20.20(24.30-16.08)vs 29.15(31.98-26.65), P<0.001; 45.35(48.03-40.70)vs 47.75(49.98-45.33), P=0.003]. As the height of the iliac crest increased, the success rate of channel placement decreased. The success rate of channel establishment of high iliac crest(the relative height of the iliac crest was grade 2)was only 10%. When height of the iliac crest was higher than 31.95 mm, inclination angle of the iliac crest was greater than 24.35°, and the cohesion angle of the iliac crest was greater than 47.2°, the channel placement was prone to failure. Conclusion The iliac crest has a significant impact on the feasibility of the L5-S1 PETD surgical channel placement. Patients with higher and steeper iliac crest(greater iliac crest inclination angle and cohesion angle)are less likely to have the channel successfully placed. Patients with “high iliac crest”(iliac crest above the lower edge of the L4 pedicle)are often difficult to place the channel.
    Multisystemic Langerhans cell histiocytosis in adults: a case report and literature review
    LIU Huanjun, GUO Shuxia, SHI Ruiping, ZHANG Wenbang, ZHANG Xiaojuan
    Journal of Shandong University (Health Sciences). 2024, 62(2):  83-89.  doi:10.6040/j.issn.1671-7554.0.2023.0961
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    Objective To report the diagnosis and treatment of a case of multisystemic Langerhans cell histiocytosis(LCH)and review relevant literature, so as to improve the knowledge of clinicians about this disease and provide treatment plans. Methods The clinical data of a LCH case were retrospectively analyzed, and relevant literature was reviewed. Results The diagnosis of LCH was confirmed through the detection of CD1a(+), S100(+), and Langerin(+)in cervical spine spinoprocess, lymph nodes and colon tissues. After 3 cycles of cladribine + cytarabine, followed by 3 cycles of intensive cladribine treatment, 12 cycles of vindesine + prednisone consolidation treatment, and 2-year maintenance treatment with lenalidomide, the lesions significantly subsided over a 2-year follow-up. Conclusion The regimen of cladribine + cytarabine, vindesine + prednisone, and subsequent lenalidomide maintenance therapy is an effective chemotherapy for refractory LCH patients with BRAF V600E negative mutation.
    A case of Kabuki syndrome caused by KMT2D gene mutation
    DONG Jianing, ZHANG Piaopiao, XU Fenfen, ZHAO Hongyang
    Journal of Shandong University (Health Sciences). 2024, 62(2):  90-95.  doi:10.6040/j.issn.1671-7554.0.2023.1041
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    Objective To explore the clinical phenotype, gene variant types and diagnosis of genetic testing of Kabuki syndrome(KS). Methods The whole exon sequencing(WES)of peripheral blood of a child was performed and verified with Sanger DNA sequencing. Results The proband was a girl aged 6 years and 5 months, who showed special facial features, developmental delay, convulsive seizures, abnormal electroencephalogram, and recurrent otitis media. WES showed KMT2D gene(NM003482)c.3094del,(p.Leu1032TrpfsTer24)mutation, which was a frameshift mutation. Sanger DNA sequencing results showed that the father and mother of the proband did not carry the KMT2D mutation, indicating that this mutation was a de novo one. According to the(American College of Medical Genetics and Genomics, ACMG)mutation interpretation standard, the mutation was classified as PVS1+PS2+PM2, which was a pathogenic mutation of KS. Conclusion The child was diagnosed with KS type 1 caused by KMT2D gene mutation, which was autosomal dominant. Our study revealed that early diagnosis and intervention should be performed for suspected KS; for patients with no known genetic variation, clinical diagnosis should be confirmed according to international consensus criteria, follow-up and genetic counseling. This study enriched the genetic mutation spectrum of KS and provided a basis for the diagnosis and genetic counseling of this disease.
    External carotid artery-to-petrous internal carotid artery radial artery graft bypass for giant high cervical aneurysm
    GUO Wenqiang, GAO Kaiming, TONG Xiaoguang
    Journal of Shandong University (Health Sciences). 2024, 62(2):  96-100.  doi:10.6040/j.issn.1671-7554.0.2023.1021
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    Objective To investigate the treatment strategy of giant high cervical extracranial internal carotid artery aneurysm(EICAA). Methods The clinical data, surgical strategy and follow-up of one case were retrospectively analyzed, and the relevant literature was reviewed. Results A 52-year-old male was admitted to hospital due to “intermittent cough for 1 year, aggravation and headache for 2 months”. DSA showed a giant right high cervical EICAA. An external carotid artery-radial artery graft-internal carotid artery petrous segment bypass combined with aneurysm trapping was performed. There was no new cerebral ischemia or cerebral infarction after surgery, no new neurological dysfunction, and the original symptoms were significantly improved. Conclusion Cerebrovascular bypass surgery is still one of the effective treatment strategies for large internal carotid artery aneurysms with high cervical segments, and internal carotid artery bypass grafting in the external carotid artery-radial artery-petrosal segment can effectively deal with such lesions.
    Public Health & Management Sciences
    Current status of tuberculosis prevention and control knowledge, attitude and practice and the influencing factors of behavior among freshmen in colleges and universities in Jinan, Shandong Province
    JING Rui, ZHANG Wenqian, DONG Hui, DONG Yiran, YU Shengnan, DUAN Yong, YAN Qin, ZHAO Chuanlu, LI Xiujun, WANG Weibing
    Journal of Shandong University (Health Sciences). 2024, 62(2):  101-107.  doi:10.6040/j.issn.1671-7554.0.2023.0863
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    Objective To investigate the current status of tuberculosis(TB)prevention and control knowledge, attitude and practice and the influencing factors of behavior among freshmen in colleges and universities in Jinan, Shandong Province, in order to provide basis for health promotion. Methods A total of 7,564 freshmen from 8 colleges and universities were selected with multi-stage stratified cluster sampling method, and surveyed with questionnaire using WJX platform. The questionnaire included basic information, core knowledge of TB control, TB prevention and control behavior, access to knowledge and preferences for TB control. The influencing factors were analyzed with Logistic regression. Results The total awareness rate of TB was 89.81%, the awareness rate of “the right things to do if you suspect TB” was the highest(98.49%), and the awareness rate of “remission policy” was the lowest(79.71%). Students with different gender, major, family history, personal history had statistically significant differences in the pass rate of TB knowledge(χ2=12.42, 7.63, 6.80, 7.27; P<0.01). The correct attitude of TB prevention and control was 68.77%. There were statistically significant differences in the attitude of students with different gender, age, major, TB history of classmates and friends(χ2=34.81, 6.57, 324.40, 20.99; P<0.05). The incidence of positive behavior of TB prevention and control was 92.50%. The behavioral of students differed significantly by different majors, knowledge and attitude(χ2=77.84, 74.67, 27.79; P<0.01). Logistic regression analysis showed that non-medical major(OR=7.03, 95%CI: 4.11-12.02)was the risk factor affecting TB prevention and control behavior, while knowledge(OR=0.25, 95%CI: 0.17-0.37)and attitude(OR=0.78, 95%CI: 0.65-0.93)were the protective factors. Conclusion Freshmen in Jinan have sufficient knowledge, attitude and practice of TB prevention and control. The major, knowledge and attitude are the main influencing factors of prevention and control behavior.