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Table of Content

    Expert Consensus
    Expert consensus on standardized electrocardiogram reporting(2026)
    Electrocardiography Branch of Shandong Medical AssociationElectrocardiography Branch of Shandong Society of Medical Ethics
    Journal of Shandong University (Health Sciences). 2026, 64(4):  1-7.  doi:10.6040/j.issn.1671-7554.0.2025.1583
    Abstract ( 93 )   PDF (2881KB) ( 96 )   Save
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    Electrocardiography is one of the most widely used non-invasive techniques for cardiac evaluation in clinical practice. However, substantial variation exists in the format, diagnostic terminology, and structural hierarchy of electrocardiogram(ECG)reports across medical institutions at different levels in China. This phenomenon—often described as “different reports for the same ECG”—poses significant challenges for clinical diagnosis and treatment, medical education, and scientific research. To promote the standardization, normalization, and homogenization of electrocardiogram diagnostic reports in China, the Electrocardiography Branch of Shandong Medical Association orga-nized experts from relevant fields to develop this expert consensus. The consensus was formulated through a comprehensive review of domestic and international literature and guidelines, combined with clinical practice in China. It systema-tically addresses key considerations in electrocardiogram data acquisition, clarifies the basic structure and essential elements of ECG reports, and standardizes diagnostic terminology and hierarchical organization for normal and abnormal electrocardiograms. Particular emphasis is placed on diagnostic features specific to pediatric electrocardiograms. In addition, the consensus discusses the standardized application of artificial intelligence-assisted ECG interpretation and outlines potential working models for wearable device integration. The objective is to provide scientific and practical guidance for electrocardiogram report writing, thereby enhancing the clinical diagnostic value of electrocardiography.
    Shandong Provincial expert consensus on investigational product management in drug clinical trials
    Shandong Pharmaceutical Association
    Journal of Shandong University (Health Sciences). 2026, 64(4):  8-13.  doi:10.6040/j.issn.1671-7554.0.2025.1094
    Abstract ( 43 )   PDF (426KB) ( 24 )   Save
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    “Investigational medicinal products” refer to drugs used in clinical trials, including experimental drugs and control drugs, the safety and effectiveness of which have not been fully verified. Improper management of these drugs may not only directly endanger the safety of subjects, but also affect the authenticity and reliability of test data. At present, there are differences in the management process, temperature control compliance and responsibility determination of the test drugs among the clinical trial institutions in Shandong Province, and there is an urgent need to establish unified and standardized management standards. In this regard, the Shandong Pharmaceutical Association has organized experts in related fields and formulated this consensus based on the requirements of the national “Good Clinical Practice for Drug Clinical Trials” and the practice of the province. After two rounds of expert discussion and demonstration, the consensus was passed with a 97% approval rate. The content covers the division of responsibilities and the whole process operation specification of the management of the test drugs, aiming to provide scientific and feasible standardization guidance for the clinical trial institutions in the province, and further improve the quality and safety management level of the drug clinical trials in the whole province.
    Preclinical Medicine
    Galectin-3 promotes autophagy and polarization of macrophages via the PI3K/Akt/mTOR pathway
    CHEN Yang, FENG Ying, LU Xiao, ZHENG Rong
    Journal of Shandong University (Health Sciences). 2026, 64(4):  14-22.  doi:10.6040/j.issn.1671-7554.0.2025.0658
    Abstract ( 64 )   PDF (5823KB) ( 19 )   Save
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    Objective To explore the role of galectin-3(Gal-3)in regulating autophagy and polarization of macrophages through the phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin(PI3K/Akt/mTOR)pathway, thus providing a new theoretical basis for targeted therapy of inflammatory diseases. Methods RAW264.7 cells were divided into four groups: control group(untreated), model group(treated with 100 nmol/L rapamycin for 6 hours to induce autophagy), Gal-3 overexpression group(Gal-3 OE, transfected with pcDNA3.1-Gal-3 plasmid), and Gal-3 knockdown group(Gal-3 KD, infected with shRNA-Gal-3 lentivirus). Immunofluorescence was used to detect the level of microtubule-associated protein 1 light chain 3B(LC3B), Western blotting to assess autophagy markers p62 and related proteins in the PI3K/Akt/mTOR pathway, flow cytometry to evaluate macrophage polarization(CD86/CD206)and apoptosis, enzyme-linked immunosorbent assay to measure inflammatory factors(tumor necrosis factor-α, interleukin-6, interleukin-10, transforming growth factor-β), RT-qPCR to detect the expression of autophagy-related genes arginase 1 and inducible nitric oxide synthase, and fluorescent staining to determine reactive oxygen species levels. Results Compared with the model group, the Gal-3 OE group showed downregulated levels of p-PI3K, p-Akt, and p-mTOR(P<0.01), increased LC3B(P<0.05), with statistical significance. The proportion of CD206-positive cells and the expressions of IL-10, TGF-β, and Arg-1 mRNA increased(P<0.01), while iNOS mRNA expression decreased(P<0.01), with statistical significance. Simultaneously, ROS levels and apoptosis rate increased(P<0.05). The Gal-3 KD group exhibited opposite effects. Conclusion Gal-3 participates in macrophage autophagy and M2-type polarization by inhibiting the PI3K/Akt/mTOR pathway, accompanied by ROS-dependent apoptosis regulation.
    Clinical Medicine
    Correlation between perioperative heart rate variability and inflammatory indicators in gastric cancer patients
    WANG Ye, WANG Gang, NAN Haiou, CAI Yuling, LI Jiayu, WANG Haifeng, YAN Yingjie, JIANG Zhiwei
    Journal of Shandong University (Health Sciences). 2026, 64(4):  23-30.  doi:10.6040/j.issn.1671-7554.0.2025.0490
    Abstract ( 35 )   PDF (1901KB) ( 12 )   Save
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    Objective To investigate the correlation between perioperative heart rate variability(HRV), inflammatory markers, and recovery patterns in patients with gastric cancer. Methods The present retrospective study involved 85 patients who underwent laparoscopic radical gastrectomy and were hospitalized at Affiliated Hospital of Nanjing University of Chinese Medicine from March 2022 to December 2024. Patients included 58 males and 27 females with the age of(64.7±10.3)years. HRV indices(SDNN, SDANN Index, PNN50, LF, HF)and serum inflammatory markers(hs-CRP, WBC, IL-2, IL-6, IL-1β, TNF-α, IFN-γ)were assessed before surgery, and on postoperative days 1 and 3. The study examined the correlations between HRV and inflammatory markers, as well as between HRV/inflammatory markers on postoperative day 1 and postoperative recovery indicators. A receiver operating characteristic(ROC)curve was generated using core diagnostic performance analysis to assess the predictive value of HRV for postoperative flatus within 48 hours following gastric cancer surgery. Results On preoperative day 1, SDNN exhibited a negative correlation with hs-CRP(r=-0.25), the SDANN Index correlated negatively with WBC(r=-0.25), and LF was negatively correlated with IL-1β(r=-0.28)and TNF-α(r=-0.26)(all P<0.05). On postoperative day 1, negative correlations were identified as follows: SDNN with hs-CRP(r=-0.46), WBC(r=-0.33), IL-2(r=-0.25), and IL-6(r=-0.40); PNN50 with hs-CRP(r=-0.40), WBC(r=-0.36), and IL-6(r=-0.33); LF with hs-CRP(r=-0.32), WBC(r=-0.21), IL-2(r=-0.53), and IL-6(r=-0.39); and HF with hs-CRP(r=-0.50), IL-2(r=-0.40), and IL-6(r=-0.60)(all P<0.05). On postoperative day 3, the following negative correlations were observed: SDNN with hs-CRP(r=-0.35), WBC(r=-0.29), IL-2(r=-0.24), and IL-6(r=-0.27); PNN50 with WBC(r=-0.49), IL-2(r=-0.25), IL-6(r=-0.28), and TNF-α(r=-0.23); LF with hs-CRP(r=-0.39), WBC(r=-0.28), and IL-2(r=-0.45); and HF with hs-CRP(r=-0.42), WBC(r=-0.39), IL-2(r=-0.44), and IL-6(r=-0.27)(all P<0.05). Additionally, postoperative initial flatus time(r=0.47)and bowel sound recovery time(r=0.36)were positively correlated with WBC. The Visual Analog Scale(VAS)score on postoperative day 1 showed a negative correlation with hs-CRP(r=-0.22)and IFN-γ(r=-0.23). Furthermore, postoperative flatus time(r=-0.22), ambulation time(r=-0.23), and bowel sound recovery time(r=-0.30)were negatively correlated with SDNN(all P<0.05). LF significantly predicted postoperative flatus within 48 hours(AUC=0.671 5, P=0.009 3). Conclusion Patients with gastric cancer show significant inverse correlations between perioperative HRV and inflammatory markers. HRV is expected to be a novel, non-invasive digital biomarker for perioperative stress states, thereby enabling prediction of postoperative recovery patterns in patients.
    Preliminary application of photoelectric detection devices in thyroid cancer surgery
    LI Jingxiu, LI Zhonghui, LI Wentian, WANG Yunan, SONG Zehui, ZHUANG Dayong, HE Qingqing, ZHOU Peng
    Journal of Shandong University (Health Sciences). 2026, 64(4):  31-37.  doi:10.6040/j.issn.1671-7554.0.2025.0553
    Abstract ( 39 )   PDF (4387KB) ( 12 )   Save
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    Objective To explore the safety and practicality of using near-infrared autofluorescence(NIRAF)and intraoperative neural monitoring(IONM)techniques in thyroid surgery for thyroid cancer, and to assess their impact on postoperative complications. Methods Twenty-one patients with thyroid cancer who underwent surgery at the 960th Hospital of the PLA Joint Logistics Support Force of China from January to March 2025 were enrolled. The intraoperative photoelectric detection device(equipped with NIRAF and IONM technologies)was used for thyroid surgery. The parathyroid glands were successively identified by empirical judgment and photodetection instrumentwith postoperative paraffin pathological examination as the gold standard. The function of the recurrent laryngeal nerve was monitored by the detection instrument, and postoperative complications were observed. Results A total of 101 suspicious parathyroid glands were identified using a combination of experience-based judgment and intraoperative photoelectric detection. The sensitivity, specificity, and accuracy of intraoperative photoelectric detection were 97.6%, 91.7%, and 94.1%, respectively; the corresponding indicators for experience-based judgment were 61.0%, 75.0%, and 69.3%, respectively. Per patient analysis revealed a statistically significant difference in diagnostic accuracy(Z=-3.91,P< 0.001). The intraoperative signal stability rate of IONM was 100.0%, and the median amplitude decreased by 3% from baseline postoperatively(IQR: -1.5% to 6.5%). No postoperative recurrent laryngeal nerve injury was observed, yielding a 95% confidence interval for nerve injury of 0% to 13.3% based on the exact binomial distribution. Conclusion The photoelectric detector, a novel device integrating NIRAF and IONM technologies, enables accurate identification and effective protection of parathyroid glands and nerves during thyroid surgery, thereby reducing postoperative complications.
    Vestibular evoked myogenic potential in children with vestibular neuritis
    LI Dongmei, BIAN Tianshuai, WANG Xiaohua, ZHANG Jing, ZHAO Yan, SUN Sufen, MU Hong, XU Anting
    Journal of Shandong University (Health Sciences). 2026, 64(4):  38-43.  doi:10.6040/j.issn.1671-7554.0.2024.0757
    Abstract ( 39 )   PDF (1570KB) ( 7 )   Save
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    Objective To analyze the vestibular evoked myogenic potential(VEMP)and explore the application value of VEMP examination in children with vestibular neuritis(VN). Methods A total of 59 children who visited the Otolaryngology Clinic of Childrens Hospital Affiliated to Shandong University from January 2023 to March 2024 were selected and divided into the control group(36 cases)and the VN group(23 cases)for retrospective analysis. All patients completed VEMPs examinations as required. Results The cervical vestibular-evoked myogenic potential(cVEMP)test results showed that the P1-N1 amplitude of both ears in the VN group was lower than that in the control group, with a statistically significant difference(P<0.05). There was no significant difference in the P1 and N1 latency between the two groups(P>0.05). The number of children in the VN group with a cVEMP amplitude asymmetry ratio(AR)value >35% was higher than that in the control group, with a statistically significant difference(P<0.05). The ocular vestibular-evoked myogenic potential(oVEMP)test results showed that the N1-P1 amplitude of the right ear in the VN group was lower than that in the control group, with a statistically significant difference(P<0.05). There was no significant difference in the N1-P1 amplitude of the left ear, and the P1 and N1 latency of both ears between the two groups(P>0.05). The number of children in the VN group with an oVEMP AR value >21% was higher than that in the control group, with a statistically significant difference(P<0.05). Conclusion The cVEMP and oVEMP waveforms in children with VN showed abnormal changes, suggesting that there were functional disorders in the saccule, utricle, and their conductive pathways. VEMP examination can be used as a diagnostic basis for VN and has important clinical significance.
    Impact of orthognathic surgery on upper airway dimensions in patients with severe skeletal class Ⅲ malocclusion and identification of key influencing factors
    ZHOU Zhiyuan, SHI Yuxin, GU Heze, HOU Yiyang, XU Xin
    Journal of Shandong University (Health Sciences). 2026, 64(4):  44-50.  doi:10.6040/j.issn.1671-7554.0.2025.1576
    Abstract ( 42 )   PDF (1537KB) ( 5 )   Save
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    Objective To investigate the impact of orthognathic surgery on the upper airway dimensions in patients with severe skeletal class Ⅲ malocclusion and to identify key craniofacial factors influencing upper airway size, thereby providing scientific evidence for optimizing surgical plans and ensuring airway safety. Methods This retrospective study included 21 patients with severe skeletal class III malocclusion who underwent combined orthodontic-orthognathic treatment by the same medical team. All patients underwent bimaxillary orthognathic surgery, with some receiving concomitant genioplasty. Cone-beam computed tomography images were collected preoperatively and at least 6 months postoperatively. Craniofacial and upper airway parameters(total volume, segmental volumes, and minimum cross-sectional area)were measured. Changes in these parameters before and after surgery were analyzed, along with correlations between changes in craniofacial and upper airway indicators. Results Postoperatively, patients showed significant improvements in sagittal and vertical relationships: effective mandibular length decreased by 5.35 mm, Wits appraisal improved by 8.77 mm, APDI decreased by 9.92°, mandibular plane angle decreased by 1.51°, and ODI increased by 13.45°(all P<0.05). Soft tissue profile also improved significantly: lower lip protrusion decreased by 7.09 mm, and soft tissue pogonion decreased by 6.36 mm(both P<0.001). No statistically significant differences were found in total upper airway volume, segmental volumes, or minimum cross-sectional area between preoperative and postoperative measurements(P>0.05). Correlation analysis revealed that ΔCo-ANS(maxillary advancement), ΔCo-Pog(mandibular setback), and ΔL6-MP(change in mandibular molar height)were significantly positively correlated with changes in total upper airway volume, minimum cross-sectional area, and oropharyngeal volume(r=0.442-0.548, P<0.05). Conclusion An orthognathic surgery strategy with an airway-oriented approach, emphasizing adequate ma-xillary advancement and coordinated mandibular adjustment, effectively correct maxillofacial deformities in patients with severe skeletal Class III malocclusion while maintaining upper airway space.The amount of maxillary advancement(ΔCo-ANS), mandibular setback amount(ΔCo-Pog), and changes in mandibular molar height(ΔL6-MP)are key factors contributing to increased upper airway volume, providing a reference for individualized surgical planning in clinical practice.
    Application and clinical outcomes of rotating hinge knee prosthesis in complex primary total knee arthroplasty
    WANG Xingshan, ZHANG Haotian, ZHANG Yunfeng, ZHOU Yixin
    Journal of Shandong University (Health Sciences). 2026, 64(4):  51-57.  doi:10.6040/j.issn.1671-7554.0.2025.1535
    Abstract ( 43 )   PDF (4067KB) ( 8 )   Save
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    Objective To investigate the clinical application of rotating hinge knee(RHK)prosthesis in complex primary total knee arthroplasty(TKA)and evaluate the clinical efficacy. Methods A retrospective analysis was conducted on 36 patients(38 knees)who underwent primary TKA using a RHK prosthesis between April 2012 and November 2024 for severe knee deformity or ligamentous insufficiency. The cohort included 15 males(16 knees)and 21 females(22 knees), with(62.1±11.4)years at surgery. Preoperative diagnoses included severe varus/valgus deformity, neuropathic arthropathy, and post-traumatic arthritis. The American Knee Society Score(KSS)was used to assess knee pain, stability and function, and the active range of motion(ROM)of the knee was measured using a gonio-meter. Preoperative and final follow-up KSS and ROM were compared. The postoperative complications and patient satisfaction were assessed. Prosthesis survival was calculated using the Kaplan-Meier method, with revision for any reason or symptomatic radiographic loosening defined as the endpoint. Results All patients were followed up for(75.8±38.1)months. At the final follow-up, significant improvements were observed: the KSS knee score increased from(26.1±12.1)to(77.2±18.5)points, the function score from(26.3±15.9)to(70.5±22.6)points, and ROM from(79.5±32.9)° to(99.6±19.4)°(P<0.001). Patient satisfaction was 86.7%. Three knees(7.9%)reached the endpoint by the final follow-up. The 5-year cumulative survival rate was 94.6%(95%CI: 87.6-100). The overall complication rate was 26.3%(10/38 knees), including intraoperative fracture, delayed wound healing, postoperative hinge post dislocation, prosthetic loosening, and joint stiffness. Conclusion The application of rotating hinge knees in complex primary TKA can significantly improve knee function and yield satisfactory mid-term prosthesis survival. However, the procedure is associated with a high complication rate. Successful outcomes depend on strict patient selection.
    Feasibility and short-to-medium-term efficacy of stent implantation for the treatment of aortic coarctation complicated by hypertension in children
    SUN Honglin, GUAN Yuqiang, YU Peiru, LI Lei, DU Qingxia, DING Hao
    Journal of Shandong University (Health Sciences). 2026, 64(4):  58-62.  doi:10.6040/j.issn.1671-7554.0.2025.0343
    Abstract ( 33 )   PDF (8311KB) ( 4 )   Save
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    Objective To evaluate the feasibility and short- to mid-term efficacy of stent implantation for the treatment of coarctation of the aorta(CoA)complicated by hypertension in children. Methods A retrospective analysis was conducted on five children(3 boys and 2 girls, aged 6-10 years)diagnosed with CoA and hypertension. The clinical cha-racteristics, procedural details of interventional therapy, and follow-up outcomes were reviewed. Results The procedural success rate was 100%. The median trans-coarctation pressure gradient significantly decreased from 28.0(25.5,33.0)mmHg(1 mmHg=0.133 kPa)preoperatively to 5.0(3.5,6.5)mmHg postoperatively. Concurrently, the median diameter at the coarctation site increased significantly from 4.8(3.1, 6.1)mm to 18.0(13.0,21.5)mm after stenting. Two children required continued oral antihypertensive therapy with a single agent. During a median follow-up period of 15 months, no complications such as stent migration, aortic dissection, or recoarctation were observed. Conclusion Balloon-expandable stent implantation is a feasible and effective treatment for children with CoA and hypertension, demonstrating excellent immediate and short- to mid-term outcomes. However, long-term follow-up is necessary to confirm its sustained efficacy.
    Mendelian randomization study on the association of intrinsic emotions with coronary atherosclerosis risk in patients with rheumatoid arthritis
    DUAN Yingzhu, DONG Bo, YU Rui
    Journal of Shandong University (Health Sciences). 2026, 64(4):  63-71.  doi:10.6040/j.issn.1671-7554.0.2025.0604
    Abstract ( 28 )   PDF (9891KB) ( 7 )   Save
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    Objective To investigate the causal relationship between rheumatoid arthritis(RA), intrinsic emotions, and coronary atherosclerosis(CAs), providing a basis for improving the comprehensive management of cardiovascular risk in RA patients. Methods A two-sample Mendelian randomization(MR)approach was employed, with instrumental variables(IVs)selected from public genome-wide association study(GWAS)databases. The primary analysis method was inverse-variance weighted(IVW), with a random-effects model used in the presence of heterogeneity. MR-Egger regression, leave-one-out analysis, and reverse MR were conducted to assess the robustness of the results. Multivariable MR and mediation analysis were performed to evaluate the mediating role of intrinsic emotions. Results A positive causal association was found between RA and CAs(OR=1.035, 95%CI: 1.011-1.060, P<0.05). Additionally, a causal relationship was observed between RA and intrinsic emotions(pain: OR=1.006, 95%CI: 1.001-1.010, P<0.05; nervousness: OR=1.006, 95%CI: 1.000-1.011, P<0.05; depression: OR=1.006, 95%CI: 1.001-1.011, P<0.05). There was also a causal association between intrinsic emotions and CAs(pain: OR=1.840, 95%CI: 1.295-2.614,P<0.05; nervousness: OR=1.388, 95%CI: 1.141-1.689,P<0.05; depression: OR=1.561, 95%CI: 1.195-2.039, P<0.05). Mediation analysis revealed that intrinsic emotions partially mediated the causal pathway between RA and CAs, with effect proportions of 11.76%, 5.88%, and 8.82%, respectively. MR-Egger regression did not detect horizontal pleiotropy, and reverse MR analysis suggested no reverse causality. Conclusion Both RA and intrinsic emotions have positive causal associations with CAs, with intrinsic emotions playing a partial mediating role in this relationship.
    Mendelian randomization analysis of the causal relationships between gut microbiota, blood metabolites, and obesity
    ZHAO Wanxia, ZHAN Qunzhang, JIN Ting, LIU Yuxin, QU Chongzheng, WU Jianchun
    Journal of Shandong University (Health Sciences). 2026, 64(4):  72-82.  doi:10.6040/j.issn.1671-7554.0.2025.0279
    Abstract ( 34 )   PDF (10159KB) ( 7 )   Save
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    Objective To utilise the Mendelian randomisation method to investigate the causal relationships between gut microbiota, blood metabolites, and obesity. Methods The human gut microbiota genome-wide association study(GWAS)data were obtained from the MiBioGen consortium database and utilised as exposure factors. The obesity data were obtained from the MRC Integrative Epidemiology Unit openGWAS database(IEU OpenGWAS)as outcomes. The data on 1,400 blood metabolites were sourced from the National Human Genome Research Institute-European Bioinformatics Institute Genome-Wide Association Studies Catalog(NHGRI-EBI GWAS Catalog)as mediators. Five methods(random-effects inverse variance weighting, MR Egger regression, weighted median, weighted mode, and simple mode)were employed for two-step Mendelian randomisation(TSMR)and multivariable Mendelian randomisation(MVMR)to explore the causal relationships between gut microbiota, blood metabolites, and obesity. Sensitivity analyses were conducted to assess the robustness of the MR results. Results A total of seven gut microbiota taxa were identified as having a causal relationship with obesity, while obesity was found to cause changes in five gut microbiota taxa. In the TSMR analysis, the genus Eubacterium hallii group, genus Oscillibacter, genus Oxalobacter, and genus Sutterella were found to be causally associated with obesity. MVMR analysis indicated that the association between genus Oxalobacter and obesity may be facilitated by 5alpha-androstan-3alpha,17alpha-diol monosulfate levels, with a mediation proportion of 8.504%. The association between genus Sutterella and obesity was likely mediated by the ratio of cholic acid to adenosine 5'-monophosphate(AMP), with a mediation proportion of 12.135%. Conclusion Current MR studies provide evidence supporting a causal relationship between genus Oxalobacter, genus Sutterella and obesity and potentially mediating metabolites.
    Optimizing neonatal meropenem dosage regimens based on pharmacokinetic/pharmacodynamic models
    WANG Cuicui, ZHENG Fengjia, ZHANG Yahui, WANG Xiaokang, YU Ruihua, HAO Wei
    Journal of Shandong University (Health Sciences). 2026, 64(4):  83-91.  doi:10.6040/j.issn.1671-7554.0.2025.0098
    Abstract ( 32 )   PDF (3526KB) ( 10 )   Save
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    Objective To analyze the population pharmacokinetics/pharmacodynamics(PPK/PD)characteristics of meropenem in Chinese neonates and to optimize the dosing regimen for neonatal Meropenem therapy. Methods A total of 50 neonates with confirmed bacterial infections, who received intravenous meropenem treatment at the Affiliated Provincial Hospital of Shandong First Medical University between January 1, 2023, and June 30, 2024, were included in this study. Blood samples were collected following the standard clinical dosing regimen of meropenem. Plasma concentrations of meropenem were determined using high-performance liquid chromatography. Nonlinear mixed-effect modeling software NONMEM V7.4 was employed for population pharmacokinetic analysis of meropenem. Monte Carlo simulations were used to evaluate the probability of target attainment(PTA)under different dosage regimens. Results Population pharmacokinetic analysis revealed that the pharmacokinetic characteristics of meropenem were best described by a first-order elimination, one-compartment model. The typical population pharmacokinetic parameters were a clearance rate of 0.301 L/h and a distribution volume of 0.885 L. The most significant covariates affecting the metabolism of meropenem in neonates were current body weight, gestational age, and birth age. Pharmacodynamic analysis showed that for bacteria with a minimum inhibitory concentration(MIC)≤2 mg/L, the minimum effective dosing regimen was 15 mg/kg administered as a 1-hour intravenous infusion every 8 hours, with a PTA of 70.76%. For bacteria with an MIC of 4 mg/L, the minimum effective dosing regimens were 20 mg/kg as a 3-hour intravenous infusion, 25 mg/kg as a 2-hour intravenous infusion, and 30 mg/kg as a 1-hour intravenous infusion, all administered every 8 hours, with PTAs of 74.74%, 72.67%, and 70.76%, respectively. When the pathogen was a highly resistant strain with an MIC of 8 mg/L, the minimum effective dosing regimen was 35 mg/kg as a 3-hour intravenous infusion every 8 hours, with a PTA of 71.69%. For bacteria with an MIC of 16 mg/L, the PTA of each monotherapy regimen of meropenem was below 70%. Conclusion Treatment optimization of meropenem for neonates can be significantly informed by actual therapeutic drug monitoring data and PPK/PD analysis.
    Preventive effects of continued out-of-hospital management based on risk factor screening for ovarian hyperstimulation syndrome
    HUANG Yuzhen, LYU Chen, YAN Lei, LI Shuaishuai, ZHANG Jingxue, LIU Chao, WANG Yinxia, SANG Yanyan, FANG Mei
    Journal of Shandong University (Health Sciences). 2026, 64(4):  92-99.  doi:10.6040/j.issn.1671-7554.0.2025.0477
    Abstract ( 28 )   PDF (1472KB) ( 4 )   Save
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    Objective To evaluate the efficacy of a risk factor-guided continued out-of-hospital management protocol in preventing ovarian hyperstimulation syndrome(OHSS). Methods A retrospective-prospective hybrid study design was adopted. First, a retrospective cohort analysis(428 cases)was conducted to identify independent risk factors for OHSS. logistic regression analysis was employed to examine contributing factors for OHSS occurrence, with receiver operating characteristic(ROC)curve analysis used to evaluate the predictive efficacy of risk factors. Subsequently, a prospective trial was performed, enrolling 79 patients in the intervention group and 74 in the control group. The intervention group received dynamic management through a WeChat platform including high-protein dietary guidance, symptom monitoring, and real-time consultation, while the control group maintained traditional management. The χ2 test was used to compare hospitalization rates, and the independent samples t-test to analyze differences in ovarian diameter changes(ultrasound-measured), sleep quality, and quality of life scores. Results The retrospective analysis identified the number of retrieved oocytes(cut-off value 11.50, AUC=0.825)and trigger-day E2 levels(cut-off value 2 995.50 pg/mL, AUC=0.788)as independent risk factors for OHSS(P<0.001). In the prospective trial, the intervention group showed significantly lower hospitalization rates(3.8% vs. 13.5%, P=0.031). The experimental group exhibited a significantly lower degree of deterioration in sleep quality scores compared to the control group [median(IQR): 4.00(2.00,6.00)vs. 0(-1.00,2.00), P<0.001]. Moreover, the experimental group demonstrated statistically significant improvements in both the total quality-of-life scores [55.15(47.61,65.63)vs. 70.59(57.35,83.82)] and the core module scores[54.69(44.53,66.67)vs. 70.83(58.33,85.42)] compared to the control group(both P<0.001). No statistically significant differences were found in post-intervention ovarian diameter changes between groups(P>0.05). Conclusion A continued out-of-hospital management guided by risk factor screening effectively reduces hospitalization rates for OHSS and alleviates the physical and psychological burden on patients.
    Association between body mass index and hyperuricemia based on propensity score matching method
    ZHANG Chunhui, WANG Chaoyi, YANG Jinghan, ZHANG Wenxia, KONG Yujia, SHI Fuyan, WANG Suzhen
    Journal of Shandong University (Health Sciences). 2026, 64(4):  100-108.  doi:10.6040/j.issn.1671-7554.0.2025.1055
    Abstract ( 21 )   PDF (2225KB) ( 5 )   Save
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    Objective To explore the association between body mass index(BMI)of the physical examination population and hyperuricemia(HUA). Methods A retrospective selection was made of 1,305 physical examinees who underwent physical examinations at the physical examination center of a tertiary hospital in Gansu Province from January to December 2023 with complete important variables as the research subjects. Their demographic data and related biochemical indicators were collected. They were divided into the normal BMI group(BMI < 24)(n=569)and the high BMI group(BMI≥24)(n=736). The propensity score matching(PSM)method was used to conduct a 1∶1 match between the two groups to balance the potential confounding factors. The association between BMI and HUA was analyzed through univariate and multivariate logistic regression. The dose-response relationship between the two was analyzed using restricted cubic splines(RCS), and further stratified analysis was conducted for each subgroup of BMI. Results After controlling the covariates between groups by PSM, 343 pairs were successfully matched, and the balance of covariates in both groups was good(SMD <0.1). The differences in the prevalence of HUA between the high BMI group and the normal BMI group before and after matching were statistically significant(30.3% vs. 10.7%, χ2=72.245, P<0.001; 20.1% vs. 14.3%, χ2=4.094, P=0.043). Multivariate logistic regression after PSM showed that the risk of HUA in the high BMI group was 1.781 times larger than that of the normal BMI group(95%CI: 1.078-2.736, P=0.023). RCS analysis indicated that BMI was positively correlated with the risk of HUA. The higher the BMI, the higher the risk of HUA. There was no significant nonlinear association between the two indicators(nonlinear P=0.725). The results of stratified analysis showed that BMI≥26 significantly increased the risk of HUA, especially among men, those aged ≤50 years, and those without chronic diseases(P<0.05). Conclusion High BMI is an independent risk factor for HUA, and the association is more significant in specific populations. PSM effectively controls confounding bias. Paying attention to BMI levels in the physical examination population is of great significance for the prevention and control of HUA. It is recommended to reduce the risk of HUA through body mass management, thereby reducing the burden of metabolic diseases and improving the health level of the population.
    Medical Psychology
    Mediating effect of perceived stress between mindfulness and demoralization syndrome in maintenance hemodialysis patients
    ZHENG Jinai, WANG Yanmei, QU Yan, LI Liwei, LIU Yong, ZHANG Yuan
    Journal of Shandong University (Health Sciences). 2026, 64(4):  109-116.  doi:10.6040/j.issn.1671-7554.0.2025.0819
    Abstract ( 35 )   PDF (1023KB) ( 5 )   Save
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    Objective To investigate the current status and influencing factors of demoralization syndrome in maintenance hemodialysis(MHD)patients, and analyze the mediating effect of perceived stress between mindfulness and demoralization syndrome. Methods A cross-sectional survey was conducted among 350 MHD patients from two tertiary hospitals in Yantai, China, from August to September 2024. Data were collected via structured questionnaires including general information, the Demoralization Syndrome Scale-II(DSS-II), the Perceived Stress Scale(PSS), and the Mindful Attention Awareness Scale(MAAS). Statistical analyses were performed using univariate analysis, Pearson or Spearman correlation analysis, multiple linear regression analysis, and the Bootstrap mediation analysis. Results The median score of demoralization syndrome in MHD patients was 9 points, and the proportion of patients with moderate to severe demoralization syndrome was 47.0%(41.8% for moderate and 5.2% for severe). The score of mindfulness level was(60.12±12.60), and the score of perceived stress was(26.71±7.15). Perceived stress was positively correlated with demoralization syndrome(rs=0.783, P<0.001), while mindfulness level was negatively correlated with demoralization syndrome(rs=-0.699, P<0.001). Mindfulness level(β=-0.249, P<0.001)negatively predicted demoralization syndrome, while perceived stress(β=0.550, P<0.001)and unemployment(β=0.105, P=0.012)positively predicted demoralization syndrome. The total effect of mindfulness level on demoralization syndrome was -0.29(P<0.001), including a direct effect of -0.12(41.38%)and a mediating effect of perceived stress between mindfulness level and demoralization syndrome of -0.17(58.62%). Conclusion Among MHD patients, the incidence proportion of moderate to severe demoralization syndrome is relatively high. Perceived stress plays a partial mediating role between patients mindfulness level and demoralization syndrome.
    Review
    ATPase copper transporting alpha mediated cuproptosis pathway and its value in cancer therapy
    LIN Mingxia, LIU Guibin, MA Yanhua, LIAN Zhaoyu, REN Yangyang
    Journal of Shandong University (Health Sciences). 2026, 64(4):  117-124.  doi:10.6040/j.issn.1671-7554.0.2025.1013
    Abstract ( 22 )   PDF (1902KB) ( 11 )   Save
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    The ATPase copper transporting alpha(ATP7A)protein plays a pivotal role in maintaining intracellular copper ion homeostasis, and its aberrant expression in tumors is closely associated with chemoresistance. Cuproptosis, a newly discovered copper-dependent form of cell death, offers innovative strategies for overcoming tumor resistance. However, a systematic overview of how ATP7A mediates cuproptosis and its translational value in cancer therapy is lacking. This review focuses on the dual role of ATP7A in cuproptosis, encompassing the ATP7A-mediated cuproptotic pathway, its physiological functions, and role in copper homeostasis, the mechanisms of ATP7A in tumor chemoresistance, the core molecular pathways regulated by ATP7A in cuproptosis, and the therapeutic strategies targeting the ATP7A-cuproptosis axis in cancer. Integrating high-quality research from recent years, this paper systematically elucidates the potential value and challenges of ATP7A as a therapeutic target in cancer, aiming to provide a theoretical basis and direction for future research in developing precision anti-tumor strategies based on the ATP7A-cuproptosis axis.