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10 January 2019
Volume 57 Issue 1
Advances in focal therapy for prostate cancer
LÜ Jiaju, HU Jialin, DING Sentai
2019, 57(1):  1-5.  doi:10.6040/j.issn.1671-7554.0.2018.1067
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Focal therapy for localized prostate cancer has been proved effective and also has the potential to reduce side effects, medical burden, and the costs associated with treatments such as surgery or radiation therapy. This article reviews existing focal treatment methods, effects and research advances and looks for a tissue-preserving focal therapy, which is a minimally invasive treatment followed by most of other solid tumor treatment models.
Focal cryoablation for prostate cancer
ZHOU Fangjian, HUANG Hua, LI Yonghong
2019, 57(1):  6-10.  doi:10.6040/j.issn.1671-7554.0.2018.1331
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In recent years, advances in pathology, imaging, targeted biopsy and cryoablation techniques have promoted the development of focal cryoablation in the treatment of prostate cancer. Focal cryoablation targets on the index lesion and surrounding tissues. Multiparametric MRI(mpMRI)and prostate biopsy are performed to confirm the index lesion before focal cryoablation. Prostate specific antigen(PSA), mpMRI and prostate biopsy are regularly reviewed after focal 山 东 大 学 学 报 (医 学 版)57卷1期 -周芳坚,等.前列腺癌的局灶冷冻治疗 \=-therapy. Compared with whole gland therapy, focal cryoablation has comparable biochemical recurrence-free survival, but better preservation of urinary continence and sexual function. However, further clinical trials are needed for patient selection, operating techniques, assessment of outcome assessment, follow-up modalities and long-term efficacy.
Chinese prostate cancer screening: current situation and challenges
ZHU Gang, ZHANG Kai
2019, 57(1):  11-15.  doi:10.6040/j.issn.1671-7554.0.2018.1053
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The incidence of prostate cancer in China has been increasing rapidly in recent years. Randomized studies in Europe have showed that PSA-based screening can reduce mortality, but it may lead to overdiagnosis and subsequent 山 东 大 学 学 报 (医 学 版)57卷1期 -朱刚,等.中国前列腺癌筛查的现状和挑战 \=-overtreatment. Large-scale randomized controlled prostate cancer screening has not yet been conducted in China. Emerging techniques and strategies may improve prostate cancer screening; however, they will surely meet challenges which require new solutions.
Theory, technique and skills of “Sandwich” urethral reconstruction in laparoscopic radical prostatectomy
XING Nianzeng
2019, 57(1):  16-20.  doi:10.6040/j.issn.1671-7554.0.2018.1094
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Laparoscopic radical prostatectomy is the first choice for the treatment of localized prostate cancer, but urinary incontinence is one of the common postoperative complications. In particular, early urinary incontinence occupies the high incidence and seriously affects the postoperative life and physical and mental health of patients. In order to improve the early urinary control after radical prostatectomy, the “Sandwich” urethral reconstruction technique was firstly adopted by us, and the preliminary research results have been obtained and reported. This paper focuses on introducing the theoretical basis, technique and skills of the “Sandwich” urethral reconstruction.
Strategy and efficacy of surgical treatment in locally advanced prostate cancer
YAO Xudong
2019, 57(1):  21-25.  doi:10.6040/j.issn.1671-7554.0.2018.1226
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Prostate cancer is the most common malignancy in men worldwide. Locally advanced prostate cancer is characterized by extracapsular extension(pT3a), invasion of the seminal vesicles(pT3b), invasion of adjacent organs 山 东 大 学 学 报 (医 学 版)57卷1期 -姚旭东.局部晚期前列腺癌手术治疗策略及疗效 \=-(T4), and/or positive regional lymph node but no distant metastasis. Locally advanced prostate cancer shows remarkably malignant behavior and a high rate of recurrence and metastasis. In the past, surgical treatment was considered unfavorable for locally advanced prostate cancer due to the high positive surgical margin rates and increased complication rates. However, improvements in surgical techniques and combined endocrine therapy have enabled the outcomes for these patients as compared to local radiotherapy or radiotherapy combined with endocrine therapy. This paper reviews the rationality and advantages, prognosis, extensive lymph node dissection, and complications of surgical treatment in patients with locally advanced prostate cancer.
Clinical management of oligometastatic prostate cancer
HAN Bangmin, JING Yifeng
2019, 57(1):  26-29.  doi:10.6040/j.issn.1671-7554.0.2018.1151
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Oligometastatic prostate cancer may be a special stage of prostate cancer progression. Positive treatment of oligometastatic prostate cancer may achieve good results. However, there is still a lack of understanding and controversy about it. This article reviews the definition, diagnosis and management of oligometastatic prostate cancer.
Development of precision medicine in the treatment of castration-resistant prostate cancer
WANG Haitao
2019, 57(1):  30-35.  doi:10.6040/j.issn.1671-7554.0.2018.1423
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The incidence of prostate cancer in China has been increasing in recent years, and most cases have already reached the advanced stage when the diagnosis is confirmed. Although many patients are initially sensitive to androgen deprivation therapy(ADT)and experience temporary tumor regression, nearly all will develop castration-resistant prostate cancer(CRPC), which is difficult to cure and thus has poor prognosis. New therapies for CRPC remains an urgent need. The emergence of precision medicine and high-throughput sequencing of cancer genomes makes molecular typing of CRPC patients possible. This article reviews the molecular typing of prostate cancer and development of precision medicine in the treatment of CRPC.
Significance of 99mTc-PSMA SPECT/CT guided salvage lymph node dissection for prostate cancer patients with biochemical recurrence
SU Hengchuan, ZHU Yao, DAI Bo, LIU Chang, HU Silong, YE Dingwei
2019, 57(1):  36-40.  doi:10.6040/j.issn.1671-7554.0.2018.1316
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Objective To improve the value of salvage lymph node dissection for patients treated with radical prostatectomy(RP)with biochemical recurrence. Methods The clinical data of 3 typical cases treated with 99mTc-prostate-specific membrane antigen(PSMA)single photon emission computed tomography(SPECT)/CT guided salvage lymph node dissection during 2015 and 2017 were retrospectively analyzed. Results In case 1, the prostate specific antigen(PSA)control was not satisfactory after RP. PSMA SPECT/CT showed suspicious lymph node metastases near the left iliac blood vessels. After extended pelvic lymphadenectomy, the PSA level decreased to 0.2 ng/mL for 8 months and then increased again. In case 2, the PSA level increased to 22 ng/mL after RP. PSMA SPECT/CT showed suspicious retroperitoneal lymph node metastases. After retroperitoneal salvage lymph node dissection, the PSA level decreased to 10 ng/mL in 3 months and then bounced back. In case 3, after radical radiation, the PSA level gradually decreased and 山 东 大 学 学 报 (医 学 版)57卷1期 -宿恒川,等.PSMA SPECT/CT检查引导下的挽救性淋巴结清扫术在生化复发前列腺癌患者治疗中的价值 \=-then increased to 4 ng/mL. PSMA SPECT/CT showed suspicious lymph node metastases near the right iliac blood vessels. After salvage pelvic lymph node dissection plus radiation, the PSA level decreased to less than 0.2 ng/mL for 14 months and then increased. Conclusion For prostate cancer patients with biochemical recurrence, low PSA level and isolated nodal recurrence after RP, PSMA SPECT/CT guided salvage lymph node dissection can alleviate tumor burden and benefit the patients.
Effects of orexin receptors on the spatial learning and memory and proliferation of dentate gyrus cells in rats with sleep deprivation
MIAO Suyun, NI Liyan, WANG Li, SONG Limin, TANG Jiyou
2019, 57(1):  41-47.  doi:10.6040/j.issn.1671-7554.0.2018.468
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Objective To investigate the effects of lentivirus mediated siRNA silencing hippocampal orexin-1 receptor(OX1R)and orexin-2 receptor(OX2R)genes on the spatial learning and memory and the proliferation of dentate gyrus cells in sleep-deprived rats. Methods A total of 40 healthy adult male Wistar rats were screened and randomly divided into cage control group, treadmill control group, sleep deprivation group, lentivirus group and lentivirus mediated group, with 8 rats in each group. Rats in the sleep deprivation, lentivirus and lentivirus-mediated groups ran intermittently on treadmills for 72 hours for sleep deprivation. The spatial learning and memory ability of all rats was investigated with Morris water maze. The numbers of bromodeoxyuridine-labelled(BrdU+)cells, and BrdU+/NeuN+ cells were quantified with a confocal laser-scanning microscope. Results Compared with the treadmill control group, the sleep deprivation group showed significantly prolonged escape latency, decreased times across platform, and reduced numbers of BrdU+ and BrdU+/NeuN+ cells(P<0.05). Compared with the lentivirus group, the lentivirus-mediated group showed shortened escape latency, increased times across platform(P<0.05), and increased numbers of BrdU+ and BrdU+/NeuN+ cells(P< 山 东 大 学 学 报 (医 学 版)57卷1期 -苗素云,等. Orexin受体功能在睡眠剥夺大鼠空间学习记忆和海马齿状回细胞增殖中的作用 \=-0.05). No significant differences were observed between the lentivirus group and sleep deprivation group(P>0.05). Conclusion Sleep deprivation can impair the spatial learning and memory, and inhibit the proliferation of cells in dentate gyrus. Lentiviral mediated siRNA silencing of OX1R/OX2R genes can improve the spatial learning and memory ability of sleep-deprived rats, which may be related to the proliferation and maturation of neural cells in dentate gyrus.
Expression of polycystic ovary syndrome susceptibility gene dennd1a in zebrafish models
LIU Congcong, LIU Hongbin, FU Jiang, LI Lei
2019, 57(1):  48-54.  doi:10.6040/j.issn.1671-7554.0.2018.726
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Objective To study the expression characteristics of polycystic ovary syndrome(PCOS)susceptibility gene dennd1a in developing embryos and in adult organs of zebrafish, and to establish zebrafish models for studies of the mechanisms underlying PCOS. Methods Using reverse transcription-polymerase chain reaction(RT-PCR)and real-time fluorescence quantitative reverse transcription polymerase chain reaction(qRT-PCR)techniques, we detected the expression of dennd1a in zebrafish. We also determined the expression pattern of dennd1a gene in zebrafish embryos using whole-mount in situ hybridization(WISH)assays. Results In embryos and juveniles, the expression level of dennd1a increased with age, and in adult animals, the expression was found in different organs. qRT-PCR and WISH showed the expression of dennd1a especially in the nervous system and male reproductive system. Conclusion In early stages of zebrafish development, high expression of dennd1a was found in the nervous system and male reproductive system, indicating this gene may regulate the development and function of the endocrine system and interrupt androgen synthesis and release, thereby inducing PCOS.
Anti-inflammatory mechanism of ephedra treatment of asthma based on network pharmacology
CHEN Ou, LI Guoyong, LIU Aihong, ZHU Xiaobo, CHEN Shaojie, WANG Yibiao
2019, 57(1):  55-61.  doi:10.6040/j.issn.1671-7554.0.2018.1089
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Objective To explore the pathogenesis of asthma by predicting the anti-inflammatory targets and related signaling pathway of ephedra therapy based on network pharmacology. Methods The active ingredients of ephedra were searched and screened in TCMSP database. The targets of ingredients were predicted with PharmMapper and molecular docking was performed. Then ingredients-targets network was established and analyzed with cytoscape3.6.1. The anti-inflammatory targets in TTD database were searched to build PPI network, which was merged with the ingredients-targets network to screen anti-inflammatory targets connected with ephedra. The vivo reaction network of ephedra anti-inflammatory targets against asthma was constructed to screen anti-inflammatory targets related to asthma. KEGG enrichment analysis was performed with Enrichr database and cytoscape3.6.1. Results Altogether 23 active ingredients were screened and 156 targets were obtained. Epidermal active growth factor receptor(EGFR), E-selectin(SELE), macrophage migration inhibitory factor(MIF), mitogen-activated protein kinase 14(MAPK14)might be the important anti- 山 东 大 学 学 报 (医 学 版)57卷1期 -陈欧,等.网络药理学预测麻黄治疗哮喘的抗炎作用机制 \=-inflammatory targets of ephedra treatment of asthma. All these pathways had epithelial cell signaling pathways. Conclusion The anti-inflammatory mechanism of ephedra treatment of asthma may be related to EGFR, SELE, MIF, MAPK14 and their signaling pathways. To prevent the exacerbation of asthma, instead of a single pathway or a single target, all these targets and their signaling pathways should be controlled holistically.
Levels of soluble suppression of tumorigenicity 2 and galectin-3 as predictors of the classification and prognosis of chronic heart failure
MI Chuanxiao, LIU Junni, ZOU Chengwei, ZHOU Nannan
2019, 57(1):  62-67.  doi:10.6040/j.issn.1671-7554.0.2018.890
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Objective To investigate the value of soluble suppression of tumorigenicity 2(sST2)and galectin-3(Gal-3)in heart failure grading and prognosis by evaluating their levels according to New York Heart Association(NYHA)classification. Methods A total of 191 patients with chronic heart failure treated during Apr. 2015 and Jan. 2016 were chosen randomly, including 115 males and 76 females, average(62.36±11.09)years. According to the NYHA criteria and follow-up results, the patients were classified into three groups: non-cardiac events group, rehospitalization group 山 东 大 学 学 报 (医 学 版)57卷1期 -米传晓,等.血清可溶性肿瘤因子2抑制剂、半乳糖凝集素-3蛋白水平在慢性心衰分级及预后中的应用 \=-and death group. Plasma sST2 and Gal-3 levels were measured at admission and every 2 months during follow-up. The incidence of cardiac events were recorded. Results The levels of sST2 and Gal-3 were positively correlated with NYHA classification(r1=0.33, P1<0.001; r2=0.21, P2=0.004), and negatively correlated with left ventricular ejection fraction(LVEF)(r1=-0.25, P1=0.001; r2=-0.24, P2=0.002). There were significant differences in sST2 and Gal-3 levels among the three groups (F1=56.76, P1<0.001; F2=31.08, P2<0.001). The level of sST2 was significantly different between the non-cardiac events group and rehospitalization group, between the non-cardiac events group and death group, and between the rehospitalization group and death group(t1=6.15, P1<0.001; t2=11.36, P2<0.001; t3=3.22, P3=0.003). The level of Gal-3 was significantly different between the non-cardiac events group and rehospitalization group, and between the non-cardiac events group and death group(t1=6.28, P1<0.001; t2=5.91, P2<0.001). Gal-3<15.67 ng/mL and sST2< 31.74 ng/mL were the predictive factors of non-cardiac events. sST2>45.031 ng/mL was a predictive factor of recent mortality. Gal-3>21.90 ng/mL and sST2>45.03ng/mL were predictors of shortened survival. Conclusion The levels of Gal-3 and sST2 are somewhat positively correlated with NYHA classification, and can indicate the cardiac function of patients with heart failure. The sST2 level is useful to predict patients' prognosis, including death, rehospitalization or non-cardiac events, while Gal-3 level is useful to predict cardiac events. The combined detection of them is valuable for the diagnosis and prognosis of heart failure.
Clinical value of flash spiral dual-source CT with low-dose scan for children with superficial vascular anomalies
YU Xinxin, GUO Lei, CHENG Zhaoping, DUAN Yanhua, WANG Ximing
2019, 57(1):  68-74.  doi:10.6040/j.issn.1671-7554.0.2018.633
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Objective To evaluate the diagnostic and therapeutic value of flash spiral dual-source CT with low-dose scan for children with superficial vascular anomalies(VAs). Methods For patients with suspected VAs and affluent blood flow pre-detected by ultrasound, CT was performed with high-pitch mode, individualized low-dose scan protocol and three-dimensional reformation. Single-phase scan time, single-phase dose-length product and total dose-length product were recorded, and the effective radiation doses were calculated. Images were diagnosed by two physicians, therapeutic plans were formulated, and the therapeutic efficacy was followed up. Results Altogether 46 lesions were identified in 35 children(mean age of 7.4 years), including 9 with hemangioma(9/35, 25.71%), 14 with arteriovenous malformation(14/35, 40.00%), and 12 with venous malformation(12/35, 34.29%). The average effective radiation doses of a single phase and total procedure were(0.45±0.16)mSV and(1.31±0.42)mSV, respectively. The average scan time of a single phase was(0.69±0.15)s. Conclusion Flash spiral dual-source CT with high-pitch mode, low-dose scan protocol and 3D reformation is an effective modality for imaging VAs with affluent blood flow in children. It can clearly show lesions and significantly reduce the radiation doses at the same time.
Efficacy and safety of direct-acting antiviral therapy for hepatitis C after renal transplantation
MAO Yijie, ZHANG Xufeng, LIU Shuangde, LIU Xiaoli, YAN Jieke, XU Dongsheng, PAN Wengu, TIAN Chuan
2019, 57(1):  75-80.  doi:10.6040/j.issn.1671-7554.0.2018.075
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Objective To assess the efficacy and safety of direct-acting antiviral(DAA)therapy for hepatitis C after renal transplantation. Methods By a retrospective analysis, we recruited seven patients who were infected with hepatitis C virus(HCV RNA)and treated with direct-acting antiviral agents therapy after kidney transplantation in our transplantation department. Serum HCV RNA, alanine transaminase(ALT), estimate glomerular filtration rate(eGFR)and serum creatinine level were measured at baseline, 2nd, 4th, 12th week of treatment, and 12th, 24th, 48th week after the treatment. Survival rate of these patients at 1 year post-therapy was analyzed. Results Seven kidney graft recipients infected with HCV were enrolled in our study. All these patients were given DAA therapy for 12 weeks. At the end of therapy, HCV RNA was negative in all patients. The serological test had a rapid virologic response(RVR)of 100%(7/7), SVR12, SVR24 were 100%, and ALT at 2th week of treatment had improvement compared with that before treatment. ALT levels remained stable thereafter; eGFR and blood muscle levels remained stable throughout the study period. Conclusion During the 1 year follow-up period, the therapy for patients infected with hepatitis C virus after kidney transplantation is safe and effective, and kidney function after transplantation was relatively stable during the research period.
Risk factors and treatment of hemorrhage after pancreatoduodenectomy
WANG Chunming, LIU Qincheng, GUO Linghong, LIAO Caixian
2019, 57(1):  81-86.  doi:10.6040/j.issn.1671-7554.0.2018.652
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Objective To explore the risk factors and treatment strategies of postpancreatoduodenectomy hemorrhage(PPH). Methods The clinical data of 424 patients who underwent pancreatoduodenectomy(PD)during Jan. 1, 2005 and Dec. 31, 2017 were retrospectively analyzed to evaluate the risk factors and treatment strategies of the occurrence of PPH. The chi-square test and logistic regression were used for univariate and multivariate analyses. Results PPH occurred in 60 patients, 9 of whom died, and the mortality was 2.12%(9/424). Of these 9 patients, 6 died due to hemorrhage. Univariate analysis showed that complications such as hypertension, pancreatic fistula, biliary fistula, and intra-abdominal infection were related risk factors of PPH(χ2=7.832, 28.491, 7.086, 25.378, respectively, P<0.05). Logistic multivariate analysis showed that complications such as hypertension, intra-abdominal infection and pancreatic fistula were independent risk factors of PPH(OR=2.242,3.068, 2.953, respectively, 95%CI=1.169-4.300, 1.501-6.274, 1.491-5.849, respectively, P<0.05). Conclusion Complicated hypertension, pancreatic fistula, and intra-abdominal infection are the independent risk factors of PPH. The keys to prevent PPH are to maintain stable blood pressure, reduce pancreatic fistula and intra-abdominal infection perioperatively. In case of PPH, the choice of treatment strategies should be determined according to the onset, location and severity of hemorrhage.
Measurement of temporomandibular joint and surrounding accessory structures
ZHAO Qian, SUN Na, ZHANG Fenghe, SONG Dongxiao, LU Zhengling
2019, 57(1):  87-91.  doi:10.6040/j.issn.1671-7554.0.2018.766
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Objective To obtain the anatomical data of temporomandibular joint and its surrounding bone structures, evaluate the differences between the left and right joints and the ipsilateral joint fossa and condyle, in order to reconstruct the original joint anatomy and provide data support for the design of personalized artificial joint. Methods The craniofacial CT data of 60 cases were collected. The temporomandibular joint and its surrounding accessory structures were measured with Simplant Pro 11.0 software. The data were then analyzed using SPSS 23.0 software. Results Altogether 12 parameters were collected in three-dimensional direction. The ratios of anterior and posterior, and internal and external diameter of condyle and articular fossa were obtained. Conclusion The left and right temporomandibular joint are symmetrical with no significant differences, and the ipsilateral glenoid fossa and condyle are well matched. Our findings can help to reconstruct the original joint anatomy and provide data support for the design of personalized artificial joint.
Mental health and its influencing factors among rural elderly hypertensive patients in Shandong Province
WANG Qian, XU Lingzhong, ZHU Jing, ZHANG Jiao, XIE Su, YU Zihang
2019, 57(1):  92-100.  doi:10.6040/j.issn.1671-7554.0.2018.285
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Objective To investigate the mental health status and its influencing factors among rural elderly hypertensive patients in Shandong Province. Methods The objects were randomly chosen with cluster-based sampling method, who were then surveyed with Kessler Psychological Distress Scale 10(K10)and a self-made questionnaire. The data collected were analyzed with univariate analyses and ordinal polytomous Logistic regression analyses. Results A total of 2 203 rural elderly hypertensive patients were included in the study. The average K10 score was 16.43±7.35. Ordinal polytomous Logistic regression analyses showed that male, good activity of daily living(ADL), good self-rated health, controlled blood pressure, regularly diet and trust in others were significantly associated with sound mental health, while debts, introvert personality, high life pressure, past setbacks or accidents were associated with poor mental health. Conclusion The mental health of some rural elderly hypertensive patients is poor and its influencing factors are various. Risk factors such as poverty, introvert personality and high life pressure should be taken into concern, and individualized intervention should be adopted.
Reliability and validity of Brief COPE Scale in medical college students
YU Pengpeng, YUAN Lu, WANG Dongfang, Bob Lew, PING Fan, JIA Cunxian
2019, 57(1):  101-106.  doi:10.6040/j.issn.1671-7554.0.2018.795
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Objective To explore the potential factor structure of the Chinese version of Brief COPE Scale(CV-BCS)and to examine its reliability and validity. Methods A questionnaire was used to carry out a cross-sectional study in medical university students in Jinan City. The statistical software, SPSS 24.0, was used to examine the reliability and conduct exploratory factor analysis and the discriminant validity of the scale in coping scores. Cronbach α coefficient was used to test the internal consistency of the scale. The structural validity of the scale was tested with Amos 24.0 software. Results The sample consisted of 2 074 medical students in two universities. As a result, five factors were extracted through exploratory factor analysis, with a total reliability of 0.83. The results drawn from factor analysis suggested that the CV-BCS held good construct validity. The CV-BCS had significant discriminant validity for male and female college students in coping score. Conclusion The five-factor structure of CV-BCS is validated to be effective and practical in Chinese medical college students and can be used under the background of China.
Public risk perception on heat wave and influencing factors in Jinan City
SHI Wanying, BAN Jie, DU Zonghao, WANG Qiong, LIU Xia, JIANG Chao, HAN Lianyu, WANG Rui, CUI Liangliang
2019, 57(1):  107-113.  doi:10.6040/j.issn.1671-7554.0.2018.552
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Objective To explore the public risk perception of heat wave in three districts in Jinan city, Shandong Province and the influencing factors among residents. Methods Questionnaires were used to collect information about sociodemographic characteristics, physical condition, lifestyle and perception on heat wave among a total of 3 065 residents in Changqing District, Licheng District and Shizhong District of Jinan City, during July 18 and August 6, 2016. Multivariate ordinal Logistic regression analysis was used to analyze the influencing factors of public perception on heat 山 东 大 学 学 报 (医 学 版)57卷1期 -石婉荧,等.济南市三城区居民热浪健康风险感知水平及影响因素 \=-wave. Results We found that the level of concern perception on heat wave was relatively high, while other dimensions of public perception were at moderate levels. Age, BMI, education, air-conditioning use, and physical condition were influencing factors of public perception on heat wave. In addition, the temperature had a significant influence on the perceived level of heat wave in different dimensions, and the strongest effect occurred in self-perception of health risk(OR=1.33, 95% CI: 1.19-1.48). Conclusion Age, BMI, education, physical condition, air-conditioning use and temperature are influencing factors of public risk perception level on heat wave, and especially, temperature is related to all dimensions of risk perception.