Table of Content

  

10 February 2021
Volume 59 Issue 2

Effects of signal Crosstalk between glioma cells and vascular endothelial cells on the proliferation and invasion of glioma cells

GU Jinhai, LU Ning, GU Jiarong, WEN Yujun, QIANG Yuanyuan, HE Zhenquan, YANG Yong, WANG Feng, SUN Tao, NIU Jianguo

Journal of Shandong University (Health Sciences). 2021, 59(2):  1-6.  doi:10.6040/j.issn.1671-7554.0.2020.0934

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Objective To explore the signal Crosstalk between glioma cells and human brain microvascular endothelial cells(HBMECs)and its effects on the proliferation and invasion of glioma cells. Methods HBMECs were divided into four groups: the control group was cultured with conventional endothelial cell medium(ECM); the vascular endothelial growth factor(VEGF)group was cultured with ECM treated with VEGF₁₆₅(50 ng/mL); U87MG co-culture group was co-cultured with U87MG cells; U251 co-culture group was co-cultured with U251 cells. Then ElISA was performed to detect the effects of glioma cells and VEGF on the secretion of CXCL8. The glioma cells(U87MG/U251)were divided into four groups: the control group was cultured with conventional DMEM; U87MG/U251+HBMEC group was co-cultured with HBMECs, U87MG/U251+HBMEC+rhCXCL8 group was co-cultured with HBMECs in DMEM containing rhCXCL8(50 ng/mL, Akt pathway agonist), U87MG/U251+HBMEC+ LY29400 group were co-cultured with HBMECs in DMEM containing LY294002(1 μmol/L, Akt pathway inhibitor). Then Western blotting, CCK-8 and Transwell assays were performed to examine the effects of HBMECs and secretion of CXCL8 on the proliferation and invasion of glioma cells and expression of Akt. Results The secretion of CXCL8 in the VEGF group, U87MG co-culture group and U251 co-culture group were significantly increased compared with that in the control group(P<0.05), which indicated that glioma cells and VEGF could promote the secretion of CXCL8. Compared with the control group, the U87MG/U251+HBMEC group had elevated P-Akt, proliferation and invasion(P<0.05); exposure to CXCL8 further increased P-Akt, proliferation and invasion(P<0.01), whereas exposure to LY294002 suppressed P-Akt(P<0.01), which indicated that HBMECs could activate Akt signaling pathway by secreting CXCL8, and promote the proliferation and invasion of glioma cells. Conclusion There is a crosstalk of VEGF-CXCL8-Akt signal network between glioma cells and HBMECs, which might play an important role in the proliferation and invasion of glioma cells.

Construction and significance of a rat model of OSAHS with chronic intermittent hypoxia

WANG Haipeng, ZOU Juanjuan, GAO Chunmiao, WANG Xiao, WANG Yan, LI Yanzhong

Journal of Shandong University (Health Sciences). 2021, 59(2):  7-13.  doi:10.6040/j.issn.1671-7554.0.2020.1469

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Objective To construct a rat model of obstructive sleep apnea hypopnea syndrome(OSAHS)with chronic intermittent hypoxia. Methods A color touch screen, a programmable logic controller(PLC)automatic control, and an automated data acquisition and monitoring system were used to assemble the equipment needed to construct the experimental model. The hypoxic chamber was composed of the main engine, the hypoxic chamber and the gas path control. A total of 30 rats were randomly divided into two groups, normoxic control(CON)group and CIH model(CIH). After 9 weeks of normal feeding, the rats were sacrificed, and liver samples were collected for hematoxylin and eosin(HE)staining, transmission electron microscopy, and Oil Red “O” staining. Results Morphological changes: HE staining of the CIH group showed lipid accumulation and lipid vacuole formation leading to hepatocyte steatosis. Microscopy of the ultrastructure showed large clusters of fat droplets and appearance of large numbers of autophagosomes and lysosomes, focal accumulation of glycogen in the rough endoplasmic reticulum, and sparse microvilli in the bile canaliculi. these were rarely seen in the CON group. The CIH group showed obvious morphological changes. Oil Red O staining results: the difference in IOD/Area was statistically significant between the CIH group and CON group(The test statistic=-56.308, P=0.001). Hepatocytes in the CIH group were obviously stained red. Conclusion The rat model of OSAHS with chronic intermittent hypoxia is successful, reliable and effective, which is consistent with the pathophysiological characteristics of OSAHS, and lays a solid foundation for further research on the pathogenesis of abnormal function of various tissues and organs in rats and the possible therapeutic effects of related drugs.

Clinical application of third-generation double-source CT in coronary CT angiography for patients with atrial fibrillation

CAI Fanfan, JI Congshan, YANG Shifeng, GU Hui, YUAN Xianshun, LIU Hongwu, QIN Songnan, GAO Lin, WANG Ruopeng, WANG Ximing

Journal of Shandong University (Health Sciences). 2021, 59(2):  14-18.  doi:10.6040/j.issn.1671-7554.0.2020.1428

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Objective To evaluate the feasibility of third-generation double-source CT retrospective ECG-gated technology in coronary CT angiography(CCTA)for patients with atrial fibrillation. Methods CCTA was consecutively performed in 40 patients with atrial fibrillation(atrial fibrillation group)and 40 patients with sinus rhythm(control group)respectively. Subjective image quality was evaluated using a five-point Likert scale; objective image quality was measured with signal-to-noise(SNR), contrast-to-noise ratio(CNR), CT dose index volume(CTDIvol), effective dose(ED), and evaluable rate of coronary artery segments. Results The control group had significantly higher image quality scores(P<0.001). The image quality scores of right coronary artery(RCA)was the highest, followed by left main artery(LMA), left anterior descending(LAD), and left circumflex(LCX). There were no statistical differences in SNR and CNR between the two groups(P=0.694, P=0.663). The CTDIvol and ED in control group were significantly lower than those in AA group(P=0.004, P=0.004). There were 515 coronary artery segments(excluding one which was undiagnostic)in the control group and 507 in AA group, all of which could be evaluated. Conclusion The third-generation double-source CT retrospective ECG-gated technology can produce satisfactory image quality in CCTA for patients with atrial fibrillation, and the radiation dose is within acceptable range.

Primary pulmonary angiosarcoma: a case report and literature review

ZENG Rong, WU Jinxiang, ZHANG Jintao, SHANGGUAN Hong, ZHOU Shengyu, TIAN Tian, DONG Liang

Journal of Shandong University (Health Sciences). 2021, 59(2):  19-25.  doi:10.6040/j.issn.1671-7554.0.2020.1533

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Objective The clinical symptoms, imaging manifestations, pathological features, treatment and prognosis of primary pulmonary angiosarcoma were summarized in order to enhance the clinical diagnosis and treatment. Methods The clinical diagnosis and treatment of one case of pulmonary angiosarcoma were analyzed, and the characteristics of primary pulmonary angiosarcoma were reviewed. Key words including “lung angiosarcoma” and “pulmonary angiosarcoma” were searched in PubMed, China Wanfang and CNKI databases from 1992 to 2020. Results A 47 year-old female patient complaining of right chest pain for more than ten days was admitted to our department on March 28, 2020. Pulmonary angiosarcoma was diagnosed with CT-guided percutaneous lung biopsy. Altogether 30 studies with complete data(including history, diagnosis, treatment and prognosis)were retrieved, involving 36 patients, including 25 males and 11 females, aged 18-81 years, average(52±17)years. The clinical symptoms of primary pulmonary angiosarcoma included cough, hemoptysis, chest pain and dyspnea. The imaging characteristics were single or multiple nodules or masses with or without ground-glass opacity, pleural effusion and filling defects. The diagnosis depended on histopathology and immunohistochemistry. Conclusion Primary pulmonary angiosarcoma is a rare disease, with manifestations such as hemoptysis, chest pain, and pulmonary nodules/masses. Early diagnosis and appropriate treatment can prolong patients survival.

Expression and activity mechanism of acetyl-CoA acyltransferase 1 in clear cell renal cell carcinoma based on bioinformatics

LI Canxuan, CHEN Jie

Journal of Shandong University (Health Sciences). 2021, 59(2):  26-33.  doi:10.6040/j.issn.1671-7554.0.2020.0636

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Objective To explore the expression of acetyl-CoA acyltransferase 1(ACAA1)in clear cell renal cell carcinoma(ccRCC)and investigate the correlative mechanism. Methods The GEO datasets(GSE36895, GSE66272, GSE53737), TCGA-KIRC dataset and Human Protein Atlas database were used to analyze the expression of ACAA1 in normal renal and ccRCC samples. Ualcan database was applied to analyze the correlation between ACAA1 mRNA and clinicopathological characteristics of ccRCC patients. The relationship between the ACAA1 mRNA levels and prognosis of ccRCC patients was determined using GEPIA database. Additionally, STRING and Metascape databases were used to construct a functional protein interaction network of ACAA1 and investigate its functional mechanism. Finally, the potential miRNAs that regulated ACAA1 were predicted by mirDIP and DIANA-TarBase v8 databases. Results ACAA1 expression level in ccRCC tissues was significantly lower than that in normal renal tissues, and ACAA1 mRNA expression was negatively correlated with the clinical stage and histological grade of ccRCC. Survival analysis showed that patients with low ACAA1 expression levels had significantly lower overall survival rate and disease-free survival rate than those with high ACAA1 expression levels. In addition, the ACAA1 protein interaction network was constructed through the STRING database and functional analysis showed that ACAA1 and its related genes were mainly involved in fatty acid β-oxidation, fatty acid metabolism, mitochondrial β-saturated fatty acid oxidation, peroxisomal protein transport, lipid regulation of metabolic processes and steroid metabolic processes. Finally, hsa-miR-25-3p and hsa-miR-363-3p might affect the occurrence and development of ccRCC by targeting ACAA1. Conclusion ACAA1 is down-expressed in ccRCC and related to its occurrence and development, which may provide theoretical assistance for in-depth study of the mechanism of ACAA1 in ccRCC.

Expression and clinical significance of circulating CD56^bright subset of NK cells in patients with Parkinsons disease

LI Xiangqing, YIN Xin, ZHAO Xuelian, ZHAO Peiqing

Journal of Shandong University (Health Sciences). 2021, 59(2):  34-40.  doi:10.6040/j.issn.1671-7554.0.2020.1588

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Objective To analyze the expression and clinical significance of circulating CD56^bright subset of NK cellsinpatients with Parkinsons disease(PD). Methods A total of 56 PD patients treated during Oct. 2017 and Dec. 2019 and 50 healthy controls matched in age, sex and living environment were enrolled. The levels of cytokines in the peripheral blood of PD patients were detected with ELISA; the ratios of NK cells and CD56^bright subset were analyzed with flow cytometry; PD patients were stratified with Hoehn-Yahr staging scale and unified Parkinsons disease rating scale(UPDRS); the correlation between the ratio of CD56^bright subset and disease progression was analyzed. Finally, CD56^bright subset was selected and cultured to clarify the differences in cytokines between PD group and control group. Results The levels of cytokines in PD group were significantly higher than those in the control group［IL-1β(t=2.46, P=0.015 4), IL-6(t=3.19, P=0.001 9), TNF-α(t=3.37, P=0.001 1), IFN-γ(t=6.36, P<0.001)］. The ratio of NK cells(t=3.13, P=0.007 8)and CD56^bright subset(t=4.23, P<0.001)in PD group were significantly increased. The ratio of CD56^bright subset was positively correlated with the progression of PD［Hoehn-Yahr staging scale(t=3.79, P=0.005 2), UPDRS(t=3.08, P=0.041)］. PD group could secrete more cytokines than control group after LPS stimulation［IL-1β(t=2.89, P=0.044 6), IL-6(t=3.15, P=0.034 7),TNF-α(t=4.59, P=0.010 1), IFN-γ(t=4.79, P=0.008 7)］. Conclusion NK cells and CD56^bright subset are highly expressed in PD patients. CD56^bright subset can promote the progression of PD by secreting cytokines, and CD56^bright subset can become a new biomarker for diagnosis and a new target for predicting PD prognosis.

Expression of hypoxia-inducible factor-1α in the serum of patients with endometriosis and its effect on epithelial mesenchymal transition of eutopic endometrial stromal cells

XUE Yuan, LIN Xueyan, XU Ge, TIAN Yongjie

Journal of Shandong University (Health Sciences). 2021, 59(2):  41-47.  doi:10.6040/j.issn.1671-7554.0.2020.1628

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Objective To explore the expression level and diagnostic value of hypoxia-inducible factor-1α(HIF-1α)in the serum of patients with endometriosis(EM_S), and to investigate the effect of HIF-1α on epithelial mesenchymal transition(EMT)of eutopic endometrial stromal cells in EM_S. Methods The serum HIF-1α levels in 36 EM_S cases(EM_S group)and 43 uterine leiomyoma cases(control group)were determined with ELISA. In the EM_S group, patients with clinical stages I and II were classified as mild cases and those with stages Ⅲ and Ⅳ were classified as severe cases. The diagnostic value of HIF-1α was calculated with the receiver operating characteristic(ROC)curve and the area under the curve(AUC). Primary endometrial stromal cells were isolated and cultured from eutopic endometrium with EM_S. Sh-HIF-1α and sh-NC cells were transfected with lentivirus and blank virus respectively. The expressions of N-cadherin, vimentin and Slug were detected with Western blotting. The migration and invasion were detected with Transwell assay, and the apoptosis was determined with Flow cytometry. Results The EM_S group had elevated serum HIF-1α (P<0.001). The ROC curve and AUC suggested that HIF-1α had certain diagnostic efficacy on EM_S. There was no significant difference in the expression of HIF-1α between endometrial proliferative phase and secretory phase(P=0.593). The serum HIF-1α level in severe EM_S cases was significantly higher than that in mild EM_S cases(P<0.001). In sh-HIF-1α group, the expressions of N-cadherin(P=0.013), vimentin(P=0.045)and Slug(P=0.038)decreased, cell migration and invasion reduced(P<0.001), while the apoptosis rate increased(P=0.013). Conclusion HIF-1α is highly expressed in EM_S patients, which can be used as a potential clinical diagnostic index. HIF-1α may affect the development of endometriosis by regulating EMT.

Effects of evening primrose oil on the metabolism and intestinal flora of obese infertile women

HAN Xiaoting, YU Xia, DONG Laihui, NA Li, NIU Yanling, ZHAO Junli

Journal of Shandong University (Health Sciences). 2021, 59(2):  48-54.  doi:10.6040/j.issn.1671-7554.0.2020.1360

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Objective To explore the effects of evening primrose oil on the metabolism and intestinal flora of obese infertile women. Methods A total of 22 obese infertile women were treated with evening primrose oil capsules for one month in the Reproductive Medicine Center of General Hospital of Ningxia Medical University from August 2018 to May 2019. Triglyceride(TG), total cholesterol(TC), high density lipoprotein-cholesterol(HDL-C), low density lipoprotein-cholesterol(LDL-C), fasting blood glucose(FBG), 2-hour postprandial blood glucose(2hPBG), fasting insulin(FINS), 2-hour postprandial insulin(2hPINS), body weight, body mass index(BMI), hip circumference, waist hip ratio(WHR), body fat percentage(PBF), intestinal flora and short chain fatty acids(SCFAs)were compared before and one month after intervention. Results After the intervention, 12 patients complained that the symptoms of seborrhea, snoring, acne, amenorrhea and anovulation were improved. All patients had no oil discharge and other adverse reactions. The results of blood lipid test of 21 patients showed that the levels of TG, TC and LDL-C decreased(P=0.25, 0.10, 0.63, respectively), while the level of HDL-C increased(P=0.48), but there was no significant difference(P>0.05). Blood glucose monitoring was performed in 14 patients, and the results showed that the levels of FBG, 2hPBG, FINS and 2hPINS had no significant changes, with no statistical differences(P=0.38, 0.23, 0.14, 0.56, respectively). The body composition analysis of 9 patients showed that body weight, BMI, hip circumference, WHR and PBF decreased, but there were no statistical differences(P=0.29, 0.41, 0.17, 0.87, 0.38, respectively), while the waist circumference decreased significantly(P=0.04). The results of intestinal flora and SCFAs analysis in 6 patients showed that ACE, Shannon and Simpson indices had no significant changes(P=0.11, 0.67, 0.72, respectively), but the Chaol index decreased(P=0.01). The results of NMDS analysis showed that there was no difference in β diversity. There was no characteristic change of intestinal flora at the level of phylum and genus after intervention(P>0.05). Only caproic acid content in SCFAs decreased(P=0.04). Conclusion Evening primrose oil can improve blood lipid level and obesity-related symptoms in obese infertility women, and the drug is safe, convenient and cheap. Short-term intervention of evening primrose oil has little effects on intestinal flora diversity, abundance and SCFAs.

Imaging manifestations of 6 cases of aggressive angiomyxoma

CHEN Guodan, ZHOU Qin, LIU Zhiling, LI Fuyan, ZHU Qingzhang, YU Yongmei, ZENG Qingshi

Journal of Shandong University (Health Sciences). 2021, 59(2):  55-59.  doi:10.6040/j.issn.1671-7554.0.2020.1416

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Objective To explore the imaging characteristics of pelvic aggressive angiomyxoma(AA)and to differentiate it from other pelvic masses. Methods The clinical and imaging data of 6 AA patients AA group and 14 patients with pelvic masses(controls)who had similar clinical and imaging manifestations treated during April 2012 and May 2020 were retrospectively analyzed. Fishers exact test was used for statistical analysis. Results In the AA group, all cases showed high signal on T₂WI. Contrast-enhanced scan showed significant enhancement in 5 cases, and moderate enhancement in 1 case. “Layering” or “swirling” low signals and diffusion restriction were observed in all cases. The angiomyxoma crossed the pelvic diaphragm and extended to perineum in 5 cases, showed “finger-like” projections in 3 cases, and had cystic changes in 3 cases. In the control group, the imaging manifestations of angiomyofibroblastoma(AMF)were the most similar to those of AA group. There were significant differences in the neoplasm crossing the pelvic diaphragm and extending to the perineum(P<0.001), and “layered” or “swirled” signals(P<0.001)between the two groups. Conclusion AA has certain imaging characteristics on MRI, commonly arising in the pelvic cavity and perineum in females. “Layered” or “swirled” signals in soft tissue neoplasms may indicate the presence of AA.

Clinical characteristics of 9 cases of pituitary stalk interruption syndrome in infants with intractable hypoglycemia as the primary manifestation

MA Xue, WANG Fengxue, ZHANG Shule, LI Guimei

Journal of Shandong University (Health Sciences). 2021, 59(2):  60-65.  doi:10.6040/j.issn.1671-7554.0.2020.1705

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Objective To investigate the clinical characteristics of pituitary stalk interruption syndrome(PSIS)in neonates and infants with intractable hypoglycemia as the primary manifestation, so as to improve the diagnosis and treatment level. Methods The clinical data of 9 PSIS patients(21 d-11 months, median age 60 d)were retrospectively analyzed. Neonatal hyperinsulinemic hypoglycemia, febrile convulsion, history of encephalitis, stroke, and history of other neurological diseases and trauma were excluded. The clinical features, pituitary hormone levels, pituitary MRI features and difference of blood glucose levels before and after hormone replacement therapy were recorded. Results There were 4 boy and 5 girl babies, with recurrent hypoglycemia as the primary manifestation. All 9 cases began to show intractable hypoglycemia, growth retardation and poor response to external stimulation in the neonatal period. Neonatal pathological jaundice was observed in 7 cases, recurrent convulsion in 4 cases, polydipsia in 2 cases, elevated glutamous transaminase in 7 cases, and small penis and cryptorchidism in all 4 boy babies. Endocrine examinations showed growth hormone deficiency, thyroid hormone deficiency, adrenocorticotropic hormone or cortisol deficiency. Pituitary MRI indicated PSIS in all 9 cases, including pituitary anterior dysplasia in 6 cases, pituitary anterior disappearance in 3 cases, pituitary posterior disappearance in 2 cases, and ectopic posterior pituitary in 7 cases. All patients were treated with hydrocortisone, levothyroxine and recombinant human growth hormone. Desmopressin was given to 2 cases. Symptoms such as persistent hypoglycemia and convulsion gradually disappeared, and growth rate was improved. Conclusion Neonatal or infant PSIS is characterized by intractable hypoglycemia, which can be improved with hydrocortisone, levothyroxine and recombinant human growth hormone. PSIS can lead to multiple pituitary hormone deficiency in newborns or infants. Pituitary MRI is of great value in the diagnosis of PSIS. With pituitary target gland hormones, early diagnosis and early treatment can be achieved to improve the prognosis.

Diagnostic value of dual-energy photons CT in gout

GUAN Shuai, DUAN Shifei, XIA Xiaona, MENG Xiangshui, MA Xiangxing

Journal of Shandong University (Health Sciences). 2021, 59(2):  66-70.  doi:10.6040/j.issn.1671-7554.0.2020.1177

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Objective To explore the diagnostic value of dual-energy photons CT in gout. Methods The clinical data of 111 confirmed gout cases were retrospectively analyzed, including 105 males and 6 females. The original CT and GOUT reconstruction images were acquired from dual-energy photons CT scan. In the two kinds of images, the numbers of urate crystals displayed were analyzed with Wilcoxon Matched-Pairs Signed-Ranks Test. The number of urate crystals displayed in GOUT reconstruction images, course of disease, and serum urate level were analyzed with Spearman rank correlation. Results Gout was detected in the feet in 51 cases(45.95%), in the first metatarsophalangeal joints in 30 cases(27.03%), in the knees in 41 cases(36.94%), in the ankles in 12 cases(10.81%), in the hands in 4 cases(3.60%), in the wrists in 2 cases(1.80%), and in the lumber vertebra in 1 case(0.90%). In the original CT images, no abnormal-density nodules were observed in 39 patients(35.14%); single and multiple high-density nodules were observed in 25(22.52%)and 47(42.34%)cases, respectively. In the reconstruction images, single and multiple urate crystals were observed in 45(40.54%)and 66(59.46%)cases, respectively; 15 cases(13.51%)had the same number of urate crystals as in the original images; 96 cases(86.49%)displayed more urate crystals than in the original images. There was statistically significant difference in the number of urate crystals displayed between original and reconstruction images(Z=-8.522, P<0.001). The course of disease ranged from 3 days to 3 years and level of serum urate ranged from 319 to 800 μmol/L. The number of urate crystals displayed in GOUT reconstruction images was significantly correlated with the course of disease and level of serum urate(r_s=0.465, 0.433, P<0.001). Conclusion Dual-energy photons CT has a high detection rate of urate crystals, which is helpful in the diagnosis of suspected gout patients.

Cosmetic effects of staged resection of congenital facial nevus combined with external dilatation in 78 children

ZHOU Zifu, ZHANG Jin, WANG Song, LI Zhiyu, YE Xiaoyun, BI Jianhai, XU Guangqi, ZHANG Jian, LYU Renrong, HUO Ran

Journal of Shandong University (Health Sciences). 2021, 59(2):  71-75.  doi:10.6040/j.issn.1671-7554.0.2020.1253

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Objective To explore the effects of staged excision combined with external dilatation in children with congenital facial nevus. Methods A retrospective analysis was performed on the clinical data of 78 children with congenital facial nevus who visited hospital in 2019. The children were divided into 4 groups according to the treatment methods: one-stage excision group(group A, n=16), staged excision group(group B, n=14), one-stage excision combined with external dilatation group(group C, n=27), staged excision combined with external dilatation(group D, n=21). The ratio of scar area to original skin lesion area and the differences in final scar width among different groups were analyzed with independent t-test, the average scar widths in different facial regions were compared with descriptive analysis. Results (1) Analysis of the ratio of scar area to original skin lesion area showed that group B had more significant reduction than group A (P=0.02), and group D had more significant reduction than group C(P<0.001). (2) Group C had smaller width of scar than group A(P<0.001), and group D had smaller width of scar than group B(P<0.001). (3) The average scar width in group D was the smallest. Conclusion Staged excision combined with external dilatation can achieve good cosmetic results in the treatment of congenital facial nevus and is worthy of clinical application.

Transverse characteristics of skeletal class Ⅱ malocclusion molars and basal bone in 70 cases with different vertical facial types

ZHANG Jiahao, LIU Dongxu

Journal of Shandong University (Health Sciences). 2021, 59(2):  76-82.  doi:10.6040/j.issn.1671-7554.0.2020.1421

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Objective To explore the transverse characteristics of basal bone and maxillary mandibular first molars in adult patients with skeletal class Ⅱ malocclusion, and to analyze the correlation between the characteristics and vertical facial types. Methods A total of 70 adult patients(35 males and 35 females, age 18-47 years, mean 25.26 years)with skeletal class Ⅱ malocclusion(∠ANB ≥ 5 °)were divided into three groups according to the mandibular plane angle(∠FH-MP): hypodivergent group(∠FH-MP<22°, n=23), normodivergent group(∠FH-MP=22°-28°, n=24)and hyperdivergent group(∠FH-MP>28°, n=23). Data were scanned with cone beam computed tomography(CBCT). The maxillomandibular basal bone width, intermolar widths, maxillomandibular intermolar width between centers of resistance, molar inclination, and thickness of alveolar bone were measured with Mimics21.0. Relevant factors were assessed with One-way ANOVA, LSD method and Pearson correlation analysis. Results The maxillomandibular basal bone width and intermolar width between centers of resistance of the upper first molars were shorter in the hyperdivergent group than in the other two groups(P<0.05). The mandibular plane angle was negatively correlated with the maxillary basal bone width and the intermolar width between centers of resistance of the upper first molars(r=0.279, -0.468). The width difference between centers of resistance of the upper and lower first molars in hyperdivergent group was smaller than that in hypodivergent group(P<0.05). The buccal inclination of upper first molar and the lingual inclination of lower first molar in hyperdivergent group were higher than those in hypodivergent group(P<0.05). The mandibular plane angle was positively correlated with the buccal-lingual inclination of the upper first molar(r=0.422), and negatively correlated with the buccal-lingual inclination of the lower first molar(r=-0.272). The buccolingual width at the alveolar crest of upper first molar at centers of resistance level in hyperdivergent group was lower than that in hypodivergent group(P<0.05), and that of the lower first molar in hyperdivergent group was lower than that in the other two groups(P<0.05). Conclusion Compared with the normodivergent and hypodivergent patients, skeletal class Ⅱ hyperdivergent patients have smaller width of the maxillary base, more buccal inclined upper first molar, more lingual inclined lower first molar, and thinner buccolingual width at the alveolar crest of upper and lower first molar at centers of resistance.

Infertility stress and posttraumatic stress disorder in infertile women: mindfulness as a mediator and moderator

BAI Lu, ZHANG Yuqing, FANG Yuying

Journal of Shandong University (Health Sciences). 2021, 59(2):  83-87.  doi:10.6040/j.issn.1671-7554.0.2020.1516

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Objective To investigate the influencing factors of posttraumatic stress disorder(PTSD)in infertile women and to evaluate the protective effect of mindfulness on the relationship between infertility stress and PTSD. Methods Totally 362 patients in a reproductive center in Shandong Province were enrolled and surveyed with Fertility Problem Inventory(FPI), Mindful Attention Awareness Scale(MAAS), PTSD Cheeklist-Civilian Version. The mediating effect and moderating effect of mindfulness were analyzed with hierarchical regression analysis. Results The average score of PTSD of infertile women was 31.27±11.68, and 24.2% of patients had score ≥38. Logistic regression analysis showed that mindfulness partially mediated the effect of infertility stress on PTSD, with a mediating effect of 0.188, accounting for 33.04% of the total effect. Mindfulness also moderated the association between infertility stress and PTSD. Conclusion Infertility stress has both direct and indirect effects via mindfulness on PTSD. Mindfulness buffers the effect of infertility stress on PTSD and is a protective factor of PTSD in infertile women.

Effect of resilience on compassion fatigue in 335 nurses treating patients with COVID-19

REN Minmin, WANG Guangmei, ZHANG Li, YANG Yaoyao, FENG Danjun

Journal of Shandong University (Health Sciences). 2021, 59(2):  88-94.  doi:10.6040/j.issn.1671-7554.0.2020.1370

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Objective To explore the chain mediating effect of perceived social support and coping strategies on resilience and compassion fatigue of first-line nurses treating patients with COVID-19. Methods Totally 335 nurses were surveyed with questionnaires of Professional Quality of Life Scale(ProQOL), 10-item Connor-Davidson Resilience Scale(CD-RISC-10), Simplified Coping Style Questionnaire(SCSQ), and Perceived Social Support Scale(PSSS). The data were analyzed with independent sample t-test, One-Way analysis of variance, Pearson correlation and structural equation modeling methods. Results Positive coping strategies were positively correlated with resilience and perceived social support(r=0.54, r=0.57, both P<0.05), but negatively correlated with compassion fatigue(r=-0.38, P<0.05). Moreover, perceived social support was positively related with resilience(r=0.48, P<0.05), but negatively related with compassion fatigue(r=-0.46, P<0.05). Negative coping strategies had no correlation with resilience and perceived social support. Moreover, resilience affected compassion fatigue through the chain mediating effect of perceived social support and positive coping strategies(95%CI: -0.37 - 0.21), and the mediating effect was 50.0%. Conclusion Resilience can reduce compassion fatigue through perceived social support and positive coping strategies.

Observation on “five no” behaviors of 316 children with language development retardation

GUO Lingling, CHE Chao, CHEN Kunping, CHAI Runyu, YANG Bingshang, CAO Aihua

Journal of Shandong University (Health Sciences). 2021, 59(2):  95-101.  doi:10.6040/j.issn.1671-7554.0.2020.1367

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Objective To explore the application of “five no” behaviors in language clinic, including no(less)seeing, no(less)responding, no(less)referring, no(less)language and inappropriateness. Methods The clinical data of 316 children complaining of “language retardation” in the Department of Child Health and Developmental Behavior, Qilu Hospital of Shandong University were reviewed. According to the DSM-5 diagnosis, the children were divided into autism spectrum disorder(ASD)group, general growth retardation(GDD)group and language disorder(LD)group. The “five no” behaviors observed at the first visit were compared among the three groups. Correlation analysis and Logistic regression analysis were conducted between the “five no” behaviors and scores of autism behavior scale(ABC), childhood autism rating scale(CARS), symbolic play ability test(SPT), and Gesell developmental diagnosis scale(GDS). Results There were statistically significant differences in no(less)seeing, no(less)responding, no(less)referring, and inappropriateness between ASD group and GDD group, LD group(P<0.001). There was a positive correlation between “five no” behaviors score with ABC and CARS scores(P<0.001), and a moderate negative correlation with SPT and GDS in coping with human ability, material ability and speech ability(P<0.001). Regression analysis showed that younger children with lower score of coping ability and higher score of CARS had higher score of “five no” behaviors(P<0.05). Conclusion By analyzing the characteristics of “five no” behaviors in ASD, GDD and LD children, we found that examining “five no” behaviors is an effective method to identify children with language development retardation in language clinic.

Physical frailty as a mediator between sleep quality and quality of life in rural elderly with chronic diseases in Shandong Province, China

HAO Wenting, LI Jie, JING Zhengyue, ZHAO Dan, YUAN Yemin, YU Caiting, ZHOU Chengchao

Journal of Shandong University (Health Sciences). 2021, 59(2):  102-107.  doi:10.6040/j.issn.1671-7554.0.2020.1354

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Objective To investigate the mediating role of physical frailty between sleep quality and quality of life(QoL), so as to provide reference for improving QoL of rural elderly with chronic diseases. Methods Multistage stratified cluster sampling method was used for sampling. A total of 3 243 rural elderly were investigated with Frailty Phenotype(FP), Pittsburgh Sleep Quality Index(PSQI)and EQ-5D. The mediating effect of physical frailty was examined using SPSS 24.0 plugin, Process V3.3. Results Compared with rural elderly without chronic diseases, those with chronic diseases had significantly lower scores of physical frailty, sleep quality and QoL(P<0.001). Physical frailty was positively correlated with sleep quality(r=0.29, P<0.001). Physical frailty(r=-0.43, P<0.001)and sleep quality(r=-0.36, P<0.001)were negatively correlated with QoL. Physical frailty played a mediating role between sleep quality and QoL, accounting for 32.26% of the total effect. Conclusion Physical frailty has a partial mediating effect on sleep quality and QoL. Due attention should to paid to sleep quality and physical frailty of rural elderly with chronic diseases to improve their QoL.

Spatial epidemiological characteristics and prediction of tuberculosis in Shigatse City from 2011 to 2018

ZHANG Bei, ZHANG Xiulei, BASANG Pianduo, NIMA Ciren, SHI Dachun, CIREN Jiabu, YIN Tingting, HU Jun

Journal of Shandong University (Health Sciences). 2021, 59(2):  108-113.  doi:10.6040/j.issn.1671-7554.0.2020.1105

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Objective To analyze the spatial distribution and transmission characteristics of tuberculosis in Shigatse City from 2011 to 2018, explore the distribution and aggregation conditions and hot spots, provide scientific basis for prevention and control. Methods Spatial autocorrelation analysis, hotspot analysis and Kriging interpolation prediction were used to describe, analyze and predict the spatial distribution of tuberculosis incidence in Shigatse City from 2011 to 2018. Results From 2011 to 2018, the areas with high incidence of tuberculosis in Shigatse City were mainly distributed in Gyangzê County, Kangmar County, Lazi County and Saga. The low incidence areas were mainly distributed in Zhongba County, Saga County and Namling County. Global autocorrelation Morans I index is 0.331 2, Z=2.65, P=0.008 3. The local autocorrelation LISA aggregation map showed that the high-high aggregation areas were Gyangzê County and Bainang County. Low-low concentration area was Saga County. Compared with the local autocorrelation results, the hot spot analysis results showed a new cold point in Zhongba County. The Kriging interpolation prediction results showed that in the future, there would be a new high-risk area in Lazi County and new low-risk areas in Namling County, Yadong County and its neighboring counties. The cross-evaluation index results showed that M-PE=0.003 2, MS-PE=0.038 2, RSS-PE=0.962 2, RMS-PE=0.063 3, and ASE-PE=0.066 5. Conclusion From 2011 to 2018, the spatial distribution of tuberculosis incidence in Shigatse City is unbalanced, and the tuberculosis epidemic in Shigatse City presents positive spatial autocorrelation, with local spatial autocorrelation, hot spots and cold spots co-existing. In the future, areas with high risk and low risk will continue to expand. Therefore, targeted prevention and control work should be carried out.