Journal of Shandong University (Health Sciences)

Shandong Provincial expert consensus on control indexes of VATS/RATS perioperative quality for non-small cell lung cancer

Thoracoscopic Committee of Shandong Provincial Endoscopic Surgery Quality Control Center

Journal of Shandong University (Health Sciences). 2025, 63(12): 1-5. doi:10.6040/j.issn.1671-7554.0.2025.0494

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Lung cancer is the malignancy with the highest incidence and mortality rates, and surgical resection remains the most effective treatment for early-stage lung cancer. However, there are differences in the level of perioperative management of lung cancer among medical centers in Shandong Province, highlighting an urgent need to improve the standardization and homogenization of lung cancer diagnosis and treatment. Under the framework of the "Healthy China 2030" initiative, relevant policies have imposed higher requirements for the quality control of cancer diagnosis and treatment. Based on this, the Thoracoscopic Committee of the Shandong Provincial Endoscopic Surgery Quality Control Center has formulated the Shandong Provincial expert consensus on control indexes of video-assisted thoracic surgery(VATS)/ robot-assisted thoracic surgery(RATS)perioperative quality for non-small cell lung cancer based on the latest evidence and guidelines, aligning with characteristics of Shandong Province, and referencing quality control indicators from the National Health Commission and national examination. This consensus aims to promote standardization of perioperative management of lung cancer in Shandong Province, improve patients outcomes, and contribute to achieving the goals of "Healthy China 2030."

Causal association between 20 amino acids and coronary heart disease: a Mendelian randomization study

YANG Huimin, GONG Wanli, HOU Yaqi, WU Jing, WANG Yang, HE Peifeng, YU Qi

Journal of Shandong University (Health Sciences). 2025, 63(12): 6-16. doi:10.6040/j.issn.1671-7554.0.2025.0386

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Objective To evaluate the causal relationship between genetically predicted amino acid levels and coronary heart disease(CHD)using Mendelian randomization(MR)methods. Methods We used publicly available datasets from OpenGWAS and FinnGen databases to investigate genome-wide association results between 20 amino acids and CHD from a genetic perspective. Bayesian weighted Mendelian randomization(BWMR)was employed to verify the associations, while reverse MR was used to assess potential reverse causality. Subsequently, sensitivity analyses were performed to limit the effects of heterogeneity and horizontal pleiotropy. Finally, multivariate Mendelian randomization(MVMR)was applied to determine the independent regulatory effects of amino acids on CHD. Results Inverse variance weighted analysis indicated that alanine(OR=1.151, 95%CI: 1.029-1.288, P=0.014)and glutamine(OR=1.087, 95%CI: 1.002-1.179, P=0.044)positively regulate the development of CHD, while higher levels of glycine(OR=0.921, 95%CI: 0.881-0.963, P<0.001)were associated with lower CHD risk, the overall significance level was controlled at 0.05 using the Bonferroni correction. BWMR strengthened the reliability of these causal associations. Cochrans Q test, MR-Egger intercept test, and MR-PRESSO global test demonstrated the robustness of the results(P<0.05). In the reverse MR analysis, CHD risk was positively correlated with tyrosine levels(OR=1.029, 95%CI: 1.007-1.052, P=0.010). MVMR suggested an independent regulatory effect of glycine on CHD(OR=0.879, 95%CI: 0.775-0.997, P=0.004). The promoting effects of alanine and glutamine on CHD may be influenced by factors such as diabetes, triglycerides, C-reactive protein, and hypertension. Conclusion This study demonstrates a significant causal relationship between alanine, glutamine, glycine, and CHD. Additionally, it reveals that genetically predicted higher CHD risk is associated with tyrosine levels.

Clinical analysis of rifampicin-soaked grafts in the treatment of Brucella infection in aorto-iliac artery aneurysms

YANG Jianping, GUAN Sheng, GE Xiaohu

Journal of Shandong University (Health Sciences). 2025, 63(12): 17-25. doi:10.6040/j.issn.1671-7554.0.2025.0723

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Objective To explore the efficacy and safety of rifampicin-soaked grafts in the treatment of Brucella-induced aorto-iliac artery infectious aneurysms. Methods This study retrospectively analyzed the clinical data of 10 consecutive patients with Brucella-induced infectious aneurysms(B-IAA)who received rifampicin-soaked grafts at the Peoples Hospital of Xinjiang Uygur Autonomous Region from October 2016 to November 2021. All 10 patients(9 males and 1 female)underwent emergency/urgent surgery. Seven patients underwent endovascular repair with rifampicin-soaked covered stents, and 3 patients underwent open in situ reconstruction with rifampicin-soaked Dacron grafts. Based on the case data and follow-up information, the 30-day survival rate after surgery, treatment-related complications, re-infection rate, graft patency, and aortic-related mortality were statistically analyzed. Results All 10 patients achieved successful surgery. There were no deaths within 30 days after surgery. Three patients experienced perioperative and postoperative complications. One patient developed coagulation dysfunction and retroperitoneal hemorrhage after surgery and recovered after conservative treatment such as blood transfusion. One iliac artery stent patient developed re-infection 10 months after surgery and underwent open surgery, and died of cerebrovascular disease 15 months later. One patient died of multiple organ failure caused by sepsis 40 days after surgery. The average follow-up was 1-103(41.8±27.6)months. One patient died of unknown causes 2 years after surgery, and one patient developed a small thoracic aortic aneurysm 4 years after endovascular repair of the abdominal aortic aneurysm(no intervention). The remaining patients had no aortic or graft-related interventions. Conclusion Rifampicin-soaked grafts is an effective treatment for B-IAA, and both endovascular and open surgeries have achieved good results.

EBUS-guided iodine-125 seed implantation for the treatment of central lymph node metastases in lung cancer

LI Yiyuan, MA Shan, LI Aihua, LONG Fei

Journal of Shandong University (Health Sciences). 2025, 63(12): 26-34. doi:10.6040/j.issn.1671-7554.0.2025.0359

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Objective To investigate the clinical efficacy, safety, and impact on survival of endobronchial ultrasound(EBUS)-guided iodine-125(¹²⁵I)seed implantation in patients with central lymph node metastases from lung cancer. Methods A total of 39 patients with central lymph node metastasis of lung cancer who underwent ¹²⁵I particle implantation guided by EBUS between 1, January 2021 and 1, November 2024 were selected for this study. The efficacy of the treatment was evaluated at one and three months after treatment on the target lesions. The diameters of the target lesions, karnofsky performance status(KPS)scores, carcinoembryonic antigen(CEA), neuron-specific enolase(NSE), and cytokeratin 19 fragments were compared before and three months after treatment. Subsequent chest CT reexamination at 3 months post-surgery resulted in the division of patients into two groups: stable disease(SD)cases were included in the stable group, while partial response(PR)and complete response(CR)cases were included in the remission group. The progression of the disease, survival rates, and mortality were the primary focus of the study. The survival differences between the stable group and the remission group were compared using the Log-rank test. Multivariate logistic regression analysis was performed to examine the correlation between recent efficacy and the dose delivered to 90% of the target volume(D90)post-surgery. Furthermore, multivariate Cox regression analysis was employed to identify independent factors affecting patient survival. Preoperative and postoperative symptoms, intraoperative adverse reactions, and postoperative complications were collated for the purpose of statistical analysis. Results Three months after the seed implantation procedure, local efficacy evaluations revealed a complete response(CR)in 7 patients(17.95%), a partial response(PR)in 13 patients(33.33%), stable disease(SD)in 19 patients(48.72%), and no progressive disease(PD), yielding an overall response rate(ORR)of 51.28% and a local control rate(LCR)of 100%. No occurrence of airway restenosis was observed at the target lesion site. Statistically significant differences were observed between baseline and 3-month post-treatment in tumor diameter(P<0.001)and KPS score(P<0.001). The follow-up period ranged from six to 12 months, with a median of 11 months. The progression-free survival(PFS)ranged from 3 to 12 months, the overall survival(OS)ranged from 3 to 12 months, and the survival rate was 69.23%. Log-rank analysis indicated higher survival in the response group than in the stable group, although the difference was not statistically significant(P=0.081). Multivariate logistic regression analysis revealed that postoperative D90 was higher in the response group than in the stable group(OR=1.115, 95%CI: 1.002-1.241, P=0.046), thereby identifying D90 as an independent factor influencing recent efficacy. Multivariate Cox regression analysis indicated that the number of prior treatment lines was an independent predictor of patient survival ［hazard ratio(HR)=0.181, 95%CI: 0.037-0.878, P=0.034］. During the procedure, 6 patients(15.38%)experienced puncture-site bleeding, which resolved after hemostatic treatment, and postoperative minor hemoptysis occurred in 3 patients(7.69%). No severe complications, such as radiation esophagitis, radiation-induced lung injury, or pericarditis, were observed during the follow-up period. Conclusion Patients with central lymph node metastases from lung cancer who undego EBUS-guided ¹²⁵I seed implantation achieves favourable short-term efficacy with minimal complications. Postoperative D90 is identified as an independent predictor of short-term efficacy and patients who attain complete or partial response have a better prognosis than those with stable disease. The number of treatment lines is an independent determinant of patient survival.

Effect of Yiqidaozhi Decoction in postoperative intestinal recovery of colorectal cancer patients based on I-FEED scoring system

YU Jing, WANG Gang, WANG Ye, SHAO Mingyue, PAN Huafeng, GE Miaomiao, WANG Haifeng, JIANG Zhiwei

Journal of Shandong University (Health Sciences). 2025, 63(12): 35-43. doi:10.6040/j.issn.1671-7554.0.2025.0259

Abstract ( 78 )

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Objective To observe the effect of the Yiqidaozhi decoction(YQDZ)on the postoperative intestinal recovery of patients who had undergone radical resection for colorectal cancer,as assessed using the Intake, Nausea, Vomiting, Bloating and Duration of Symptoms(I-FEED)scoring system. Methods A total of 114 colorectal cancer patients who underwent surgery between January 2021 and December 2022 were enrolled in the study and randomly divided into two groups: intervention group(n=57)and control group(n=57). The randomisation process was conducted using a random number allocation method. Both groups received perioperative management of enhanced recovery after surgery(ERAS). The intervention group ingested 100 mL of a concentrated solution of YQDZ, while the control group received 100 mL of an isocaloric solution of water. The present study was conducted from postoperative days 1-3. Postoperative I-FEED scores, intestinal function recovery indicators(times of bowel sound recovery, first flatus, first defecation, first oral intake and semi-liquid diet resumption, and postoperative hospital stay), gastrointestinal hormone levels(serum gastrin and motilin), inflammatory markers(CRP, IL-1β, IL-2, IL-6, TNF-α, IFN-γ), and postoperative complications. The statistical analysis of the data was conducted using SPSS 27.0. Results The YQDZ group demonstrated significantly superior I-FEED scores in the domains of intake(Z=-2.196, P=0.028), nausea(Z=-2.068, P=0.039), bloating(Z=-2.293, P=0.022)and symptom duration(Z=-2.538, P=0.011)when compared to the control group. There was a statistically significant difference in the recovery of gastrointestinal function between the two groups(Z=-2.153, P=0.031). The times of bowel sound recovery, first flatus, first defecation and semi-liquid diet resumption were all shortened in the intervention group(P<0.05). The duration of hospitalisation following surgery was found to be significantly longer in the YQDZ group(P<0.05). On the third day following the operation, the serum levels of gastrin(Z=7.299, P<0.05)and motilin(Z=2.717, P=0.008)were elevated in the intervention group, while the levels of CRP(Z=-2.581, P=0.010)and IL-6(Z=-3.678, P<0.05)were reduced. No statistically significant difference in postoperative complications was observed between the two groups(P=0.788). Conclusion The YQDZ decoction has been demonstrated to be both safe and effective in promoting postoperative intestinal function recovery and reducing gastrointestinal dysfunction in colorectal cancer patients following radical resection. The mechanism may be associated with the regulation of gastrointestinal hormone secretion and the inhibition of postoperative inflammation.

Relationship between gut microbiota and pancreatic cancer in East Asians: genetic evidence based on Mendelian randomization

DU Kaihao, HOU Lizhao, DONG Xiaoge, XUE Weiwei, HE Jiejie, LUO Lanminghui, JIANG Wei, WANG Zhanjin, WANG Zhan

Journal of Shandong University (Health Sciences). 2025, 63(12): 44-52. doi:10.6040/j.issn.1671-7554.0.2024.1248

Abstract ( 72 )

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Objective To explore the causal relationship between gut microbiota(GM)and pancreatic cancer(PC)in East Asians to reveal the potential pathological mechanisms of PC and provide a theoretical basis for clinical interventions. Methods Mendelian randomization(MR)analysis was conducted using data from genome-wide association studies(GWAS)databases to analyze the relationships between 500 gut microbiota features and PC in East Asians. Single nucleotide polymorphisms were used as instrumental variables, and various MR methods, including inverse variance weighting(IVW), weighted median method, and Bayesian weighted MR, were employed to assess the causal relationship between GM and PC. Results The results of the inverse-variance weighted method showed that g_Eremococcus ［Biobank Japan(BBJ): OR=0.847, 95%CI: 0.734-0.978, P=0.024; European Bioinformatics Institute(EBI): OR=0.829, 95%CI: 0.727-0.945, P=0.005), s_Acinetobacter_baumannii(BBJ: OR=0.775, 95%CI: 0.667-0.900, P=0.001; EBI: OR=0.828, 95%CI: 0.731-0.937, P=0.003), methionine metabolism I(MF0038)(BBJ: OR=0.299, 95%CI: 0.097-0.917, P=0.035; EBI: OR=0.260, 95%CI: 0.110-0.615, P=0.002), and g_Helicobacter(BBJ: OR=0.771, 95%CI: 0.657-0.905, P=0.001; EBI: OR=0.807, 95%CI: 0.700-0.930, P=0.003)were associated with a reduced risk of PC, whereas s_Prevotella_amnii(BBJ: OR=1.328, 95%CI: 1.086-1.623, P=0.006; EBI: OR=1.258, 95%CI: 1.041-1.520, P=0.018), s_Bacteroides_salanitronis(BBJ: OR=1.473, 95%CI: 1.150-1.887, P=0.002; EBI: OR=1.242, 95%CI: 1.030-1.497, P=0.023), and g_Acidovorax(BBJ: OR=1.184, 95%CI: 1.021-1.374, P=0.026; EBI: OR=1.166, 95%CI: 1.015-1.339, P=0.030)were associated with an increased risk of PC, and the results of the Bayesian weighted MR method similarly showed that g_Eremococcus(BBJ: OR=0.844, 95%CI: 0.725-0.983, P=0.029; EBI: OR=0.825, 95%CI: 0.717-0.949, P=0.007), s_Acinetobacter_baumannii(BBJ: OR=0.766, 95%CI: 0.647-0.906, P=0.002; EBI: OR=0.823, 95%CI: 0.720-0.939, P=0.004), methionine metabolism I(MF0038)(BBJ: OR=0.270, 95%CI: 0.082-0.888, P=0.031; EBI: OR=0.245, 95%CI: 0.098-0.610, P=0.003), and g_Helicobacter(BBJ: OR=0.768, 95%CI: 0.647-0.912, P=0.003; EBI: OR=0.802, 95%CI: 0.689-0.934, P=0.004)were associated with a reduced risk of PC, while s_Prevotella_amnii(BBJ: OR=1.340, 95%CI: 1.076-1.668, P=0.009; EBI: OR=1.262, 95%CI: 1.030-1.547, P=0.025), s_Bacteroides_salanitronis(BBJ: OR=1.487, 95%CI: 1.145-1.931, P=0.003; EBI: OR=1.256, 95%CI: 1.031-1.531, P=0.024), and g_Acidovorax(BBJ: OR=1.189, 95%CI: 1.017-1.390, P=0.029; EBI: OR=1.170, 95%CI: 1.011-1.353, P=0.036)were associated with an increased risk of PC. Sensitivity analyses suggested that the results were robust. Conclusion g_Eremococcus, s_Acinetobacter_baumannii, methionine metabolism pathway I(MF0038), and g_Helicobacter may serve as protective factors for PC, while s_Prevotella_amnii, s_Bacteroides_salanitronis, and g_Acidovorax may increase the risk of PC.

Influencing factors of bacterial culture negative after the first surgery of acute hematogenous osteomyelitis caused by Staphylococcus aureus

DING Yangkun, LIU Tao, LIU Yu, YU Jiazhi, MU Pengfei

Journal of Shandong University (Health Sciences). 2025, 63(12): 53-60. doi:10.6040/j.issn.1671-7554.0.2025.0581

Abstract ( 72 )

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Objective To investigate the influencing factors of bacterial cutural negative after the first surgery of acute hematogenous osteomyelitis(AHO)caused by Staphylococcus aureus and to provide scientific basis for optimizing surgical strategies and reducing surgical frequency. Methods A retrospective analysis was conducted on a cohort of 82 children with Staphylococcus aureus AHO who were admitted to Childrens Hospital Affiliated to Shandong University between January 2020 and November 2024. All patients underwent a procedure known as “bone fenestration combined with negative pressure wound therapy”. The bacterial culture of the pus obtained after the initial surgical procedure revealed the presence of Staphylococcus aureus. Following one or more surgical procedures, the bacterial culture yielded a negative result. The subjects were divided into two groups based on the result of the initial surgical procedure: a negative group(n=56)and a control group(n=26). A comprehensive clinical data were collected for two groups of AHO patients. The data include the following: gender, age, the time of onset, the present or absence of recurrent fever before and after surgery, long or short bones,combined arthritis, the number of surgeries, the results of bacterial culture, inflammatory markers(complete blood count, C-reactive protein, erythrocyte sedimentation rate)at the time of admission and 5-7 days after surgery, and the present of chronic osteomyelitis and pathological fractures during the postoperative period. Univariate analysis and binary Logistic regression analysis were used to evaluate and determine independent risk factors for bacterial culture negativily following the initial AHO surgery. The receiver operating characteristic(ROC)curve and the area under the curve(AUC)were used to evaluate the predictive efficacy of each independent risk factor for bacterial culture negative after the initial AHO surgery. Results There were significant differences between the two groups of children in terms of the number of surgeries(P<0.001), MRSA(P<0.001), preoperative CRP(P=0.004), postoperative neutrophil count(P=0.044), postoperative CRP(P<0.001), postoperative recurrent fever(P=0.048), and chronic osteomyelitis during follow-up(P=0.002), all of which were statistically significant. Binary Logistic regression revealed that preoperative CRP(OR=0.986, 95%CI: 0.974-0.998, P=0.023), postoperative CRP(OR=0.946, 95%CI: 0.910-0.984, P=0.006), and MRSA(95%CI: 0.015-0.307, P<0.001)were the independent risk factors.The ROC curve showed that cut-off values of preoperative and postoperative CRP were 53.76 mg/L and 9.25 mg/L, respectively.The analysis of the ROC curve indicated that the AUC of preoperative CRP combined with postoperative CRP was 0.812(P<0.001), and the predictive value was found to be significantly higher than that of each individual variable. Conclusion The majority of bacterial culture negative children with AHO demonstrate significant clinical improvement following the initial surgical intervention, accompanied by a substantial decrease in inflammatory markers and a reduction in postoperative complications. Independent risk factors for a negative bacterial culture following the initial surgical treatment of AHO include preoperative CRP≥53.76 mg/L, postoperative CRP≥9.25 mg/L, and the presence of MRSA. For low-risk AHO patients with MSSA infections and postoperative CRP ≤9.25 mg/L without recurrent fever, a single surgery is recommended.

Classification and treatment of irreducible intertrochanteric femoral fractures based on CT 3-D imaging

LIN Jinxiu, LI Ye, YIN Dechao, WANG Kunpeng, TAN Baoli

Journal of Shandong University (Health Sciences). 2025, 63(12): 61-73. doi:10.6040/j.issn.1671-7554.0.2025.0443

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Objective To establish a classification system for irreducible intertrochanteric fractures of the femur(IIFF)based on CT three-dimensional imaging and validate its clinical value in preoperative identification and intraoperative reduction. Methods A retrospective analysis was conducted on 678 patients with intertrochanteric fractures admitted between January 2015 and December 2021. Seventy-eight IIFF cases were identified, defined as those achieving “poor” reduction quality(Baumgaertner/Kim criteria)after ≤3 attempts of standard closed reduction. A novel 5-type classification system(Type Ⅰ: lesser trochanter-related; Type Ⅱ: greater trochanter-related; Type Ⅲ: reverse intertrochanteric; Type Ⅳ: completely displaced; Type Ⅴ: combined with subtrochanteric fracture)was proposed based on preoperative CT 3D imaging characteristics, including fracture morphology, displacement direction, and soft tissue attachment. Corresponding reduction strategies were formulated. Seventy-eight matched controls were selected from 600 non-IIFF patients via 1∶1 propensity score matching(PSM)for factors including age, sex, and AO classification. Results The incidence of IIFF was 11.5%(78/678). After applying targeted reduction strategies, the acceptable reduction rate in the IIFF group was 83.3%(65/78), showing no significant difference compared to the control group(84.6%, 66/78; P>0.05). Operative time in the IIFF group ［(67.3±24.2)min］ was significantly longer than that in the control group ［(55.8±19.5)min］(P<0.001), and intraoperative blood loss ［(210.5±75.1)mL］ was significantly greater than in controls ［(165.3±65.8)mL］(P<0.001). No significant differences were observed in Harris hip scores, fracture healing time, or complication rates at the final follow-up(all P>0.05). Conclusion The CT 3D imaging-based classification system enables effective preoperative identification of IIFF. The corresponding targeted reduction strategies, although increasing operative time and blood loss, can achieve satisfactory reduction and clinical outcomes comparable to those of reducible fractures, demonstrating significant clinical guiding value.

Effet of miR-125a-3p on the proliferation of rheumatoid arthritis synovial fibroblasts

SONG Huishu, SUN Zhijian, ZHANG Qiuting, MI Xue, ZHANG Ni, WANG Zhilun, YIN Zhe, HAO Xuexi, WANG Yingxue

Journal of Shandong University (Health Sciences). 2025, 63(12): 74-78. doi:10.6040/j.issn.1671-7554.0.2025.0692

Abstract ( 65 )

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Objective To investigate the effects of miR-125a-3p on the proliferation capacity and inflammatory factor secretion levels in rheumatoid arthritis synovial fibroblasts(RA-FLS). Methods Synovial tissues were aseptically obtained from 25 patients with rheumatoid arthritis(RA)after joint replacement surgery, and RA-FLS were isolated for experimental study. MiR-125a-3p mimics and miR-NC were transfected into RA-FLS via cell transfection, and the cultured cells were divided into Control, miR-NC, and miR-125a-3p mimics groups. The expression of miR-125a-3p in each group was detected by real-time quantitative PCR(RT-qPCR). Cell counting kit-8(CCK-8)was used to determine the cell proliferation capacity, and enzyme-linked immunosorbent assay(ELISA)was employed to detect the levels of tumor necrosis factor α(TNF-α), interleukin-6(IL-6), and interleukin-1β(IL-1β)in the cell culture supernatant. Results The cell viability of RA-FLS and the levels of TNF-α, IL-1β, and IL-6 in the cell culture supernatant in the miR-125a-3p mimics group were significantly lower than those in the miR-NC group(P<0.001). Conclusion MiR-125a-3p inhibits the proliferation of RA-FLS and the secretion of inflammatory factors, potentially serving as a new target for studying the pathogenesis of RA.

Impact of axial length on circumferential choroidal thickness and vessel density using SS-OCTA

LIU Xuefen, YANG Ru, WANG Shuxia, HAO Haitao, LIANG Lu, LIU Chang, GONG Rui, JIANG Shuang

Journal of Shandong University (Health Sciences). 2025, 63(12): 79-95. doi:10.6040/j.issn.1671-7554.0.2025.0159

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Protective role of GABAergic system in retinal pigment epithelium under hypoxia

QU Zhonghua, CHI Lingyi, MA Zhiyong, CHENG Zhenying, WANG Xuping

Journal of Shandong University (Health Sciences). 2025, 63(12): 96-104. doi:10.6040/j.issn.1671-7554.0.2025.1124

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Objective To investigate the role and mechanism of the γ-aminobutyric acid-ergic(GABAergic)system in human retinal pigment epithelial(RPE)cells under hypoxic conditions, and to provide a theoretical basis for the prevention and treatment of hypoxia-related retinal diseases. Methods Human RPE cells were isolated and cultured. The expression of GABA-related molecules-glutamic acid decarboxylase 65/67(GAD65/67), GABA transaminase(GABA-T), vesicular GABA transporter(VGAT), and GABA transporters 1/2(GAT-1/2)-was detected by RT-PCR and Western blotting. Immunofluorescence was employed to examine the expression and localization of GAD67, GABA-T, and GAT-2 in cultured human RPE cells and human retinal tissue. Cells were exposed to a hypoxic environment(1% O₂, 37 ℃, 48 h), and changes in GAD67, GABA-T, and GAT-2 expression, monolayer permeability, and zonula occludens-1(ZO-1)level were analyzed. RPE cells were divided into four groups: empty vector + normoxia, gene overexpression + normoxia, empty vector + hypoxia, and gene overexpression + hypoxia. Adenoviral vectors were used to overexpress GAD67, GABA-T, and GAT-2, and their protective effects against hypoxia-induced barrier dysfunction in RPE cells were evaluated. Results RT-PCR and Western blotting analyses revealed that human RPE cells expressed GAD67, GABA-T, and GAT-2, whereas GAD65, VGAT, and GAT-1 were undetectable. Compared with the normoxic group, hypoxia significantly downregulated GAD67 ［(17.54±6.89)%, t=2.595, P<0.05］, GABA-T ［(18.64±3.56)%, t=3.563, P<0.01］, and GAT-2 ［(31.79±8.49)%, t=4.147, P<0.01］; increased RPE monolayer permeability ［(78.83±34.79)%, t=-3.222, P<0.05］; and reduced ZO-1 levels ［(22.24±8.31)%, t=3.217, P<0.01］. Compared with the hypoxic empty vector, overexpression of GAD67 or GABA-T alleviated the hypoxia-induced increase in RPE cell permeability by(21.97±11.02)% and(21.40±7.65)%, respectively. The differences were statistically significant(F_GAD67=14.146, F_GABA-T=35.715, P_GAD67<0.05, P_GABA-T<0.01). In contrast to the hypoxic empty vector control group, GAT-2 overexpression did not exhibit a significant protective effect in the absence of exogenous GABA(intergroup P=0.001, P>0.05). However, with the addition of exogenous GABA, GAT-2 overexpression reduced the hypoxia-induced RPE cell permeability by(34.49±14.70)%(F=20.084, P<0.01). None of the overexpressed genes reversed hypoxia-induced reduction of ZO-1 protein. Conclusions Human RPE cells express key components of the GABAergic system. Hypoxia reduces the expression of GABA-related proteins and impairs barrier integrity. Upregulation of GAD67 or GABA-T expression significantly alleviates hypoxia-induced barrier dysfunction in RPE cells. Overexpression of GAT-2 also exhibits a protective effect when supplemented with exogenous GABA. These findings suggest that the GABAergic system may serve as a potential target for improving RPE barrier function in hypoxia-related retinal diseases.

Analysis of the current status for residents depression, anxiety symptoms, mental health literacy and influencing factors of mental health literacy

MU Hongjie, LU Wei, LYU Juncheng

Journal of Shandong University (Health Sciences). 2025, 63(12): 105-111. doi:10.6040/j.issn.1671-7554.0.2025.0815

Abstract ( 63 )

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Objective To understand the current status of mental health literacy among residents in a certain city and analyze the factors influencing their mental health literacy level, so as to effectively implement mental health service policies and carry out targeted mental health promotion activities. Methods Stratified random sampling was used to select community residents aged ≥18 years in four districts of the city as the survey subjects. Multiple psychological questionnaires were applied to assess the compliance status of mental health literacy and the prevalence of psychological disorders among community residents. Logistic regression was used to analyze the influencing factors of residents mental health literacy levels. Results The mental health literacy level in this city is 17.99%, with the mental health knowledge dimension showing the lowest correct response rate among all items(22.03%). The mental health literacy pass rate was lower among residents with symptoms of depression or anxiety. Educational level and health status were identified as main influencing factors. Compared to residents with elementary school education or less, those with junior college degree or higher education level were more likely to attain mental health literacy(OR=2.58). Conversely, self-reported "relatively good"(OR=0.47)and "average or poor" health status(OR=0.39)had negative effects on mental health literacy rates compared to those reporting "good" health. Conclusion The level of mental health literacy in this city needs urgent improvement. In the implementation of mental health literacy promotion activities, it is necessary to focus on populations with lower educational attainment and residents in poor health, so as to enhance residents' mental health literacy and reduce the incidence of mental health problems.

Advances in influencing factors of in-stent restenosis after iliofemoral vein stenting

CHENG Zhenyu, LAI Qingguo, WU Mengtao

Journal of Shandong University (Health Sciences). 2025, 63(12): 112-117. doi:10.6040/j.issn.1671-7554.0.2025.0536

Abstract ( 58 )

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The management of in-stent restenosis(ISR)after iliofemoral vein stenting(IVS)is a challenge currently in vascular surgery. It is difficult for the process of endovascular treatment of ISR. Maintaining long-term stent patency is also a great challenge. Identifying the risk factors and pathological characteristics of ISR may help maintain long-term stent patency. In this article, a retrospectively analysze was conducted on the surgical indications for IVS and the short-term and long-term risk factors for ISR through literature retrieval. Based on hemodynamic principles, the mechanism of ISR was further analyzed. The latest progress in ISR treatment was summarized according to its pathological characteristics. It may provide references for the management of ISR.

Research progress on the mechanism and intervention strategies of cyclic stretch in the intimal hyperplasia after vein graft in coronary artery bypass grafting

QI Zaiwen, BAI Xiao, QIN Yuan

Journal of Shandong University (Health Sciences). 2025, 63(12): 118-124. doi:10.6040/j.issn.1671-7554.0.2025.0340

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Intimal hyperplasia of vein graft is a common complication after coronary artery bypass grafting, but the mechanism and prevention strategies of intimal hyperplasia are not fully understood. The cyclic stretch, as a mechanical force stimulation on the vascular wall, was significantly increased after vein graft. The elevated cyclic stretch could affect the content of various gene expression products through epigenetic mechanisms, while regulating various biological functions of cells, ultimately leading to the occurrence of intimal hyperplasia. This article elaborated on the mechanism and intervention measures of cyclic stretch in intimal hyperplasia after vein graft to provide a new perspective for the prevention and treatment of intimal hyperplasia.

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