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    10 June 2021
    Volume 59 Issue 6
    Diagnosis and management of primary osteoporosis
    XING Xiaoping
    Journal of Shandong University (Health Sciences). 2021, 59(6):  1-4.  doi:10.6040/j.issn.1671-7554.0.2021.0247
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    With the emerging era of aging in China, osteoporotic fracture has adversely affected the health and quality of life of the elderly population, bringing huge burden to families and society. Raising awareness of osteoporosis, and understanding the diagnosis and management will greatly help doctors achieve better disease control and reduce the risk of osteoporotic fracture.
    Osteoporosis in men: a chronically overlooked problem
    CHENG Xiaoguang, LU Yanhui
    Journal of Shandong University (Health Sciences). 2021, 59(6):  5-9.  doi:10.6040/j.issn.1671-7554.0.2021.0467
    Abstract ( 1036 )   HTML ( 86 )   PDF (1268KB) ( 150 )   Save
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    Osteoporosis is a systemic bone disease. The loss of bone mass and the destruction of bone microstructure increase bone fragility and ultimately lead to an increased risk of fracture. According to etiology, primary osteoporosis can be divided into postmenopausal osteoporosis(PMO)and senile osteoporosis(SO). Osteoporosis in men is mainly SO, so the onset of osteoporosis in men is later than that in women. Due to the current dependence on dual X-ray absorptiometry(DXA)in the diagnosis of osteoporosis and the survey results of DXA, the prevalence of osteoporosis in men is considered low. In addition, there are few indications of drugs for the treatment of osteoporosis in men, resulting in the overlook of the prevention and treatment of osteoporosis in men. Therefore, it is necessary to increase the application of various testing methods, including radiology, DXA and QCT in the diagnosis of osteoporosis, as well as strengthen the awareness of osteoporosis in men and its intervention.
    Advances on the etiology and pathogenesis of osteoporosis
    LUO Xianghang, ZHOU Ruoyu
    Journal of Shandong University (Health Sciences). 2021, 59(6):  10-14.  doi:10.6040/j.issn.1671-7554.0.2021.0324
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    Osteoporosis is the most common metabolic bone disease. The incidence of osteoporosis as well as osteoporotic fracture increases gradually with age, seriously endangering patients health. The core pathogenesis of osteoporosis is that various factors act on some stages of bone remodeling, resulting in stronger bone resorption than bone formation. These factors include genetic factors, age, endocrine and lifestyle. It is of great significance to study the pathogenesis and etiology of osteoporosis for its prevention and treatment.
    Research progress of oxidative stress regulating osteoporosis
    LI Minqi, DU Juan, YANG Panpan, KOU Yuying, LIU Shanshan
    Journal of Shandong University (Health Sciences). 2021, 59(6):  16-24.  doi:10.6040/j.issn.1671-7554.0.2021.0295
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    Osteoporosis is a systemic metabolic disease with bone mass reduction, bone microstructure destruction and bone fragility increase, which leads to patients susceptibility to fracture. With the aging of population, osteoporosis has become an important health problem for middle-aged and elderly people. The pathogenesis of osteoporosis is multifaceted. Aging and the decline of organ function caused by aging are the main factors. So far, the “oxidative stress aging theory” is still the most well-established hypothesis of aging mechanism. This review will focus on oxidative stress and bone formation, oxidative stress and bone resorption, antioxidants and bone homeostasis maintenance, and review the related research progress of oxidative stress-induced osteoporosis.
    Special Issue on New Progress in Osteoporosis
    Research advances on risk factors, diagnosis and treatment of Kümmell's disease
    Haipeng SI,Wencan ZHANG,Le LI,Xin ZHOU
    Journal of Shandong University (Health Sciences). 2021, 59(6):  25-32.  doi:10.6040/j.issn.1671-7554.0.2021.0052
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    Kümmell's disease is post-traumatic delayed vertebral compression fracture that occurs on the basis of severe osteoporosis. Failure to pay attention or improper treatment may cause kyphosis and severe neurological symptoms, which will have a huge blow on patients' quality of life and cause a heavy family burden. With the aging of population and improvement of medical standards, the incidence and diagnosis rate of Kümmell's disease have been increasing. New technologies of diagnosis and treatment are also emerging. This article summarizes the development, risk factors, pathogenesis, diagnosis, clinical stage, treatment options of Kümmell's disease so as to provide guidance for clinicians.

    Progress in glucocorticoid-induced osteoporosis
    CHEN Shihong
    Journal of Shandong University (Health Sciences). 2021, 59(6):  33-37.  doi:10.6040/j.issn.1671-7554.0.2021.0481
    Abstract ( 1389 )   HTML ( 25 )   PDF (810KB) ( 350 )   Save
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    Glucocorticoids are widely used in the treatment of allergic and autoimmune diseases. Glucocorticoid-induced osteoporosis(GIOP)is one of the adverse reactions of long-term application of glucocorticoids, which is characterized by continuous decrease of bone formation accompanied by increase of bone resorption, leading to increased incidence of fracture and bringing serious harm to patients. Herein, we review the pathogenesis of GIOP and its prevention and treatment drugs, in order to raise the attention of clinicians to GIOP.
    Correlation between diabetic peripheral neuropathy and sarcopenia
    ZHENG Fengjie, SONG Yuwen, SUN Aili, PAN Zhe, WANG Dianhui, LOU Nengjun, LYU Li, ZHUANG Xianghua, CHEN Shihong
    Journal of Shandong University (Health Sciences). 2021, 59(6):  38-44.  doi:10.6040/j.issn.1671-7554.0.2021.0380
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    Objective To investigate the relationship between diabetic peripheral neuropathy(DPN)and sarcopenia in patients with type 2 diabetes mellitus(T2DM). Methods A total of 166 patients with T2DM were selected and divided into sarcopenia group(n=62)and non-sarcopenia group(n=104)according to the skeletal muscle mass index, grip strength and gait speed. Patients with symptoms or signs of DPN and a decrease in nerve conduction were diagnosed as diabetic peripheral neuropathy. Single factor analysis and multivariate Logistic regression analysis were used for statistical processing to compare the differences of clinical characteristics, biochemical indicators and prevalence of diabetic peripheral neuropathy between the two groups. Results The patients in sarcopenia group were older, but the body mass index, alanine aminotransferase level, skeletal muscle mass index, grip strength, and gait speed were lower than those in the non-sarcopenia group(P<0.05). The proportion of DPN and osteoporosis in the sarcopenia group were 83.87% and 70.97%, respectively, which were higher than those in the non-sarcopenia group(P<0.05). Male sex(OR=0.025, 95%CI: 0.004-0.143)and DPN(OR=32.927, 95%CI: 6.169-175.742)were independent risk factors for sarcopenia. Higher body mass index was a protective factor for sarcopenia(OR=0.546, 95%CI: 0.420-0.710). Conclusion DPN is an independent risk factor for sarcopenia in patients with T2DM. For patients with DPN, clinical screening for sarcopenia is recommended.
    Changes of serum IL-31 and IL-33 levels in postmenopausal patients with osteoporosis
    DU Jiaojiao, ZHUANG Xianghua, CHEN Shihong, WANG Xuemeng, JIANG Dongqing, WU Fei, HAN Xiaolin, HUA Mengyu, SONG Yuwen
    Journal of Shandong University (Health Sciences). 2021, 59(6):  45-50.  doi:10.6040/j.issn.1671-7554.0.2021.0377
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    Objective To analyze the changes of interleukin-31(IL-31)and interleukin-33(IL-33)levels in the serum of postmenopausal osteoporosis(PMOP)patients, and to explore the correlation between PMOP and IL-31/IL-33. Methods A total of 146 postmenopausal women were selected and their bone density was detected with double-energy X-ray absorptiometry(DXA). According to the bone density, the patients were divided into three groups: normal group, low bone mass group and osteoporosis group. Calcium(Ca), phosphorus(P), parathyroid hormone(PTH), 25-hydroxyvitamin D([25(OH)D]), IL-31, IL-33, bone-specific alkaline phosphatase(BALP), type 1 procollagen N-terminal propeptide(P1NP), anti-tartrate acid phosphatase(TRACP-5b), and β-cross linked C-telopeptide of type 1 collagen(β-CTX)were evaluated. The differences in IL-31, IL-33 and bone turnover markers among the three groups were compared. Results In the three groups, the level of IL-31 showed an upward trend with the decrease of bone density, while the level of IL-33 reduced with the decrease of bone density(P<0.05). Multivariate Logistic regression analysis showed that in the low bone mass group, IL-33(OR: 0.987, 95%CI: 0.974-0.999, P=0.030)was statistically significant, while in the osteoporosis group, IL-31(OR: 1.019, 95%CI: 1.009-1.028, P<0.001)and IL-33(OR: 0.978, 95%CI: 0.960-0.995, P=0.013)were statistically significant. The OR value of IL-33 showed a downward trend with the decrease of bone mineral density, indicating that IL-31 and IL-33 were possible influencing factors of PMOP. Conclusion IL-31 is a possible risk factor for PMOP, while IL-33 is a possible protective factor for PMOP, suggesting that IL-31 and IL-33 play an important role in the pathogenesis of PMOP.
    Correlation between vitamin D deficiency and depression in patients with type 2 diabetes mellitus
    LIU Ping, SONG Yuwen, WANG Ping, TIAN Guangwei, ZHENG Fengjie, LYU Li, DU Jiaojiao, ZHANG Jing, ZHUANG Xianghua, CHEN Shihong
    Journal of Shandong University (Health Sciences). 2021, 59(6):  51-56.  doi:10.6040/j.issn.1671-7554.0.2021.0296
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    Objective To investigate the correlation between vitamin D deficiency and depression in patients with type 2 diabetes mellitus(T2DM). Methods A total of 175 T2DM patients were selected and divided into the depression group(n=74)and non-depression group(n=101)according to the Self-Rating Depression Scale(SDS). Serum concentration of 25OHD was measured. Bone mineral density was measured with dual energy X-ray. The differences in 25OHD and BMD between the two groups were compared. The correlation between serum vitamin D level and SDS score was evaluated with Spearman correlation analysis. Multivariate Logistic regression analysis was performed for the variables with small P value in univariate analysis. The receiver operating characteristic curve(ROC)was drawn and the area under the curve(AUC)was calculated to evaluate the diagnostic value of vitamin D deficiency and bone mineral density in T2DM patients with depression. Results The serum level of 25OHD and bone mineral density of femoral neck, hip joint and lumbar 1-4 in the depression group were significantly lower than those in the non-depression group(P<0.05). The prevalence of vitamin D deficiency and osteoporosis in the depression group were higher than those in the non-depression group(P<0.05). Logistic regression analysis showed that vitamin D deficiency(OR: 8.748, 95%CI: 1.724-44.375, P=0.009)and osteoporosis(OR: 6.385, 95%CI: 2.358-17.291, P<0.001)were influencing factors of T2DM complicated with depression. Conclusion Vitamin D deficiency may be a risk factor of T2DM patients with depression. Active prevention and treatment of vitamin D deficiency may help improve the depressive state of T2DM patients.
    Effects of WNT5A gene on insulin reactivity and insulin resistance in granulosa cells
    NIU Qun, SHI Jingjing, FU Jiang
    Journal of Shandong University (Health Sciences). 2021, 59(6):  57-63.  doi:10.6040/j.issn.1671-7554.0.2021.0304
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    Objective To explore the correlation between WNT5A gene overexpression and insulin resistance in granulosa cells. Methods Female Kunming mice aged 3 weeks(n=15)and 6 weeks(n=16)were selected. Expression of WNT5A in mice granulosa cells was detected with immunohistochemistry and real-time quantitative polymerase chain reaction(qRT-PCR). After human granulosa-like tumor cell line(KGN)were treated with Forskolin+pma to simulate luteinizing hormone(LH)peak for 24h, the effect of WNT5A on insulin reactivity was detected. After the KGN cells were transfected with p-EGFP-N1-WNT5A, the correlation between overexpression of WNT5A and insulin resistance was detected. Results Compared with preoestrus mice, oestrus mice (n=3, F=8.874, P=0.017)and postoestrus mice(n=3, F=8.874, P=0.001)had increased mRNA expression of WNT5A, and the protein expression of WNT5A increased in mature follicular granulosa cells. The expression of WNT5A in the granulosa cells of the ovulation-induced immature mice was also significantly increased(n=3, F=12.093, P=0.003). Ovulation induction inhibited insulin reactivity in KGN cells, which was improved by WNT5A. However, overexpression of WNT5A decreased insulin pathway responsiveness and lactate metabolism(n=3, F=15.281, P<0.001). Conclusion The expression of WNT5A benefits the insulin reactivity in granulosa cells during ovulation induction. However, when WNT5A is excessively elevated, such as in polycystic ovarian syndrome(PCOS), it may cause insulin resistance.
    Expression and significance of serum miR-33a in patients with stable angina pectoris
    ZHANG Mingming, GAO Wei, CUI Jia, HUO Lijing, HU Qingchuan, LI Weihao, WANG Chao
    Journal of Shandong University (Health Sciences). 2021, 59(6):  64-70.  doi:10.6040/j.issn.1671-7554.0.2021.0076
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    Objective To investigate the level and significance of serum miR-33a in patients with stable angina pectoris(SAP). Methods A total of 220 SAP patients treated during Jan. 2018 and Dec. 2019 were recruited as the SAP group, and 200 healthy cases were enrolled as control group. The SAP patients were divided into Ⅰ, Ⅱ, Ⅲ, Ⅳ according to the severity of the disease. The level of miR-33a in both groups was detected with real time PCR, and serum lipids and inflammatory factors were detected. Data in the GEO database was retrieved for bioinformatics analysis on the function of miR-33a. Results The level of serum miR-33a in the SAP group was significantly higher than that in control group(P<0.05). There were significant differences in miR-33a among patients with different severity of SAP(P<0.05). The levels of serum total cholesterol(TC), triglycerides(TG), low-density lipoprotein(LDLC), and very low-density lipoprotein(VLDL)were higher in the SAP group than in control group, while high-density lipoprotein(HDLC)level was lower(P<0.05). The serum inflammatory factors, including tumor necrosis factor(TNF-α), high-sensitivity C-reactive protein(hsCRP), and interleukin-6(IL-6), in SAP group were higher than those in control group(P<0.05). Level of serum miR-33a in SAP patients was positively correlated with LDL and VLDL, but was negatively correlated with HDL(P<0.05). Level of serum miR-33a in SAP patients was positively correlated with TNF-α and IL-6(P<0.05). Bioinformatic analysis showed that miR-33a was involved in regulating transcriptome genes, nucleic acid metabolism, signal transduction, cell growth, amino acid transport and other processes. Conclusion The expression of miR-33a increases in SAP patients, which is related to some lipids and inflammatory factors. miR-33a may play a role in the progression of SAP by regulating these indicators via complex molecular network mechanism.
    Association between MTHFR polymorphism and serum homocysteine in patients with unstable angina pectoris
    ZHANG Lin, WANG Yan, MA Xu, FAN Xuesong, YUAN Hui
    Journal of Shandong University (Health Sciences). 2021, 59(6):  71-75.  doi:10.6040/j.issn.1671-7554.0.2020.1648
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    Objective To investigate the relationship between methylenetetrahydrofolate reductase(MTHFR)gene polymorphism and serum homocysteine(Hcy)level in patients with unstable angina pectoris(UAP). Methods A total of 243 UAP patients(UAP group)and 269 healthy controls were selected during Jan. 2019 and Jun. 2019 in Beijing Anzhen Hospital. The serum Hcy level of the two groups was detected with double reagent circulating enzyme method, and the MTHFR gene polymorphism was detected with polymerase chain reaction and fluorescence method. The differences in serum Hcy level and MTHFR gene polymorphism between the two groups were compared with t test. MTHFR gene polymorphisms were classified into CT, CC and TT according to PCR products. Results The overall level of serum Hcy in UAP group was significantly higher than that in healthy control group [(13.37±7.72)μmol/L vs(11.50±5.05)μmol/L, P<0.05]. The Hcy level of CT genotype in UAP group was significantly higher than that in healthy control group [(13.08±7.33)μmol/L vs(10.78±2.45)μmol/L, P<0.05]. There was no difference in the distribution frequency of MTHFR C677T genotype(P>0.05), but the distribution frequency of T allele in the UAP group was higher than that in healthy control group(59.1% vs 52.5%, P<0.05). Conclusion The level of Hcy in UAP patients is significantly higher than that in healthy controls. There is no significant correlation between MTHFR C677T gene polymorphism and UAP, but T allele may be related to UAP.
    Clinical efficacy of laparoscopic radical hysterectomy without lift and tumor spillage in 25 cases of early-stage cervical cancer
    WANG Lu, ZHAO Xinrui, ZHU Lin
    Journal of Shandong University (Health Sciences). 2021, 59(6):  76-80.  doi:10.6040/j.issn.1671-7554.0.2021.0328
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    Objective To explore the feasibility and clinical efficacy of laparoscopic hysterectomy without lift and tumor spillage for cervical cancer at early stage. Methods A total of 25 patients with cervical cancer who received laparoscopic hysterectomy without lift and tumor spillage at The Second Hospital of Shandong University during Mar. 2020 and Jan. 2021 were enrolled. During the surgery, the neoplasia was sealed via the vagina. The lymph nodes were bagged immediately after dissection, sutures were pulled to lift the uterus, the vaginal end was ligated and occluded, and the uterus was bagged immediately after hysterectomy to ensure no tumor spillage. Results All 25 patients successfully completed laparoscopic hysterectomy without conversion to open surgery, and there were no ureteral or intestinal injuries. The average operation time was(205.3±18.7)min, and average intraoperative bleeding volume was(79.28±20.16)mL. The widths of the excised left and right parauterine tissues were(2.8±0.6)cm and(2.9±0.4)cm, respectively. The lengths of excised main ligament, uterosacral ligament and vagina were(2.9±0.35)cm,(3.18±0.36)cm, and(3.2±0.21)cm, respectively. The number of dissected pelvic lymph nodes was(22.5±4.3). No lymph node metastasis was observed. The margins of hysterectomy and vaginectomy were negative. The mean time of postoperative ventilation was(34.18±8.67)h, and the catheter removal time was(11.05±3.67)d. Conclusion This surgical approach is safe and feasible, which ensures not only enough resection range, but also no tumor spillage during operation.
    Effects of admission time on labor duration and delivery mode among primiparas under new partogram
    SUN Rongrong, ZHANG Wenmiao, LI Dong, XIAO Biru, CHEN Qiuyue
    Journal of Shandong University (Health Sciences). 2021, 59(6):  81-85.  doi:10.6040/j.issn.1671-7554.0.2020.1545
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    Objective To explore the effects of admission time on labor duration and delivery mode among primiparas under new partogram. Methods A retrospective analysis was conducted on the data of 1 057 primiparas during January 2017 and December 2018. The subjects were divided into group A(n=913, cervical dilatation <3 cm)and group B(n=144, cervical dilatation ≥3 cm). The effects of admission time on delivery mode and obstetric outcomes were explored using univariate and multivariate Logistic regression analyses. Results Compared with group B, group A had larger BMI(F=5.489, P=0.019), longer gestational weeks(F=6.776, P=0.009), heavier fetal weight(F=9.721, P=0.002); higher rate of painless delivery(χ2=38.145, P<0.001), higher usage rate of oxytocin(χ2=10.416, P<0.001)and phloroglucin(χ2=6.481, P<0.001); longer first labor duration(F=51.05, P<0.001), total labor duration(F=49.76, P<0.001)and hospitalization(F=40.613, P<0.001); higher rate of Cesarean section(χ2=3.929, P=0.047), higher incidence of fetal distress(χ2=5.085, P=0.024), and larger amount of postpartum bleeding(F=6.724, P=0.01). Multiple Logistic analysis revealed that early admission was independently associated with prolonged first stage of labor(OR=3.347, 95%CI=2.062-5.431)and total duration of labor(OR=3.792, 95%CI=2.292-6.271). Conclusion Admission when cervical dilatation ≥3 cm could avoid unnecessary interventions, shorten the stage of labor, reduce the high rate of Cesarean delivery and improve the pregnancy outcomes.
    Correlation analysis of freezing methods with different sperm sources and pregnancy outcomes
    ZHU Xuli, ZHOU Liang, WANG Yue, SUN Qingyun, CAO Mingya, DU Yuanjie, CAO Jinfeng, ZHAO Zhiming, HAO Guimin
    Journal of Shandong University (Health Sciences). 2021, 59(6):  86-93.  doi:10.6040/j.issn.1671-7554.0.2021.0253
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    Objective To investigate the relationship between the technical parameters of frozen micro-sperm and the clinical outcomes of in vitro fertilization(IVF)cycle. Methods A total of 118 cycles related to intracytoplasmic sperm microinjection(ICSI)after cryoresuscitation of rare spermatozoa during Jan. 2016 and Dec. 2020 were retrospectively analyzed. The cycles were divided into micro freezing group and conventional freezing group according to the method of freezing; husband ejaculation group, epididymal puncture group and testicular puncture group according to the source of sperm; types Ⅰ, Ⅱ and Ⅲ severe asthenia groups according to the quality of sperm. The general data, laboratory and clinical outcomes were compared. The effects of related parameters on the clinical outcomes were analyzed with multivariate binary Logistic regression. Results (1) General data: there were no significant differences in the age, body mass index(BMI), years of infertility, basal follicle stimulating hormone(FSH), anti-Mullerian hormone(AMH), Gn days, total dosage of Gn, E2 level on hCG day, number of oocytes retrieved, and number of MⅡ eggs among the groups when the cycles were grouped according to freezing method, sperm source and sperm quality. (2) Laboratory parameters and clinical outcomes: there were no significant differences in the transferable embryo rate or clinical pregnancy rate between the micro freezing and conventional freezing groups, but there were differences in the 2PN rate(P=0.002), 2PN cleavage rate(P=0.036), and the high quality embryo rate(P=0.002)(P<0.05). There were no significant differences in 2PN rate or clinical pregnancy rate among husband ejaculation, epididymal puncture and testicular puncture groups, but there were differences in 2PN cleavage rate(P<0.001), transferable embryo rate(P=0.048)and high quality embryo rate(P=0.002). There were no significant differences in 2PN rate, transferable embryo rate, and high quality embryo rate among the severe oligoasthenia types Ⅰ, Ⅱ, and Ⅲ, but there were significant differences in 2PN cleavage rate(P<0.001), implantation rate(P=0.005), and clinical pregnancy rate(P=0.048)among the three groups. (3) The multivariate binary Logistic regression analysis showed that the relative risk of a poor outcome was 0.287 in type Ⅲ versus type Ⅰ severe oligoasthenospermia groups(OR=0.259, 95%CI: 0.075-0.887, P<0.05). Conclusion Similar clinical pregnancy rates can be obtained by micro freezing and conventional freezing. The source of sperm does not affect the clinical pregnancy rate. A lower clinical pregnancy rate may be caused by very severe oligoasthenoteratozoospermia, and further confirmation with an expanded sample size is needed.
    Construction of circRNA-mediated ceRNA network and prognostic assessment model for bladder cancer
    MI Qi, SHI Shuang, LI Juan, LI Peilong, DU Lutao, WANG Chuanxin
    Journal of Shandong University (Health Sciences). 2021, 59(6):  94-102.  doi:10.6040/j.issn.1671-7554.0.2021.0231
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    Objective To identify the differentially expressed circular RNAs(circRNAs)and construct a circRNAs-mediated ceRNA network and a prognostic assessment model. Methods Data were downloaded from Gene Expression Omnibus(GEO)and The Cancer Genome Atlas(TCGA)database. Differential expressed analysis was performed to explore the differentially expressed RNAs in bladder cancer tissues with the standard of |log2 fold change(log2FC)|>1, P<0.05. Based on multiple detabases, such as TCGA and CircInteractome, the circRNA-miRNA-mRNA ceRNA network was constructed, and functional enrichment analysis of mRNAs was conducted. Subsequently, the relationship of mRNAs in ceRNA network was analyzed through the String database. The mRNAs related to prognosis were screened with univariate Cox regression model, and a prognostic assessment model was constructed. A ROC curve was drawn with “time ROC” package to evaluate the effectiveness of the model. Results Differential expressed analysis screened out 4 circRNAs, including hsa_circ_0102787, hsa_circ_0103114, hsa_circ_0102402 and hsa_circ_0104387. A ceRNA network was constructed, which contained 4 circRNAs, 23 miRNAs and 86 mRNAs. Functional enrichment analysis showed those mRNAs participated in several cancer-related pathways. The interaction between mRNAs in the ceRNA network was visualized by PPI network. Survival analysis revealed that 6 mRNAs were related to the prognosis of bladder cancer. Then, a prognostic assessment model was constructed based on “the risk score=(-0.356 9)×ABRACL+(-0.264 4)×MAP3K8.” Kaplan Meier analysis showed patients with high risks had a poor prognosis(P<0.001), and the AUC of the five-year overall survival rate was 0.744. Conclusion This study identififed 4 differentially expressed circRNAs, and constructed a circRNA-miRNA-mRNA network and a prognostic assessment model, which provides a new insight for the exploration of the occurrence and development of bladder cancer.
    Silencing PRRX1 gene expression enhances the sensitivity of prostate cancer resistant cell line PC-3/DTX to docetaxel
    XU Bing, LI Yong, LIU Ming, LIU Yonghui
    Journal of Shandong University (Health Sciences). 2021, 59(6):  103-110.  doi:10.6040/j.issn.1671-7554.0.2020.1656
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    Objective To explore the effects of paired-related homeobox 1(PRRX1)gene silencing on the sensitivity of drug-resistant prostate cancer cells to docetaxel(DTX)and the possible mechanism. Methods The cancer tissues of 35 patients who were DTX chemotherapy sensitive(DTX-S)and 29 patients who were DTX chemotherapy resistant(DTX-R)were collected. The mRNA expression of PRRX1 in cancer tissues was detected with qRT-PCR. Human prostate cancer PC-3 cells were cultured in vitro, and the DTX-resistant cell line PC-3/DTX was established by increasing DTX concentration intermittently. The mRNA and protein expressions of PRRX1 in the drug-resistant PC-3/DTX and the parental PC3 cells were detected with qRT-PCR and Western blotting. The expression of PRRX1 gene in PC-3/DTX cells was silenced by siRNA, and the mRNA and protein expressions of PRRX1 in PC-3/DTX cells after transfection were detected with qRT-PCR and Western blotting. After DTX intervention, PC-3/DTX cells were transfected for 24 hours. The cell proliferation was detected with MTT, and the half inhibitory concentration(IC50)and drug resistance index(RI)were calculated. The cell apoptosis was detected with flow cytometry. The protein expressions of cleaved caspase-3, p-mTOR, mTOR, Beclin-1 and LC-3 were detected with Western blotting. Results The mRNA expression of PRRX1 in DTX-R cancer was higher than that in DTX-S cancer(6.59±1.49 vs 1.07±0.34)(F=656.401, P<0.05). The IC50 values of the drug-resistant cell line PC-3/DTX and the parental PC-3 cells treated with different concentrations of DTX for 24 h were(89.88±6.86)nmol/L and(15.56±1.45)nmol/L, respectively, and the RI was 5.78. The mRNA and protein expressions of PRRX1 in the drug-resistant cell line PC-3/DTX were higher than those in the parental PC-3 cells(mRNA: 9.22±1.50 vs 1.00±0.17; protein: 0.50±0.04 vs 0.08±0.02)(FmRNA=59.05, Fprotein=171.70, P<0.05). After the PRRX1 gene was silenced, the mRNA and protein expressions of PRRX1 in PC-3/DTX cells reduced(mRNA: 1.01±0.02 vs 0.98±0.04 vs 0.22±0.10; protein: 0.62±0.01 vs 0.61±0.01 vs 0.11±0.01)(FmRNA=122.01, Fprotein=554.53, P<0.05). Silencing the PRRX1 gene reduced the resistance of PC-3/DTX cells to DTX, promoted cell apoptosis, and up-regulated the expressions of p-mTOR and cleaved caspase-3, and down-regulated the protein expressions of Beclin-1 and LC-3(P<0.05). Conclusion Silencing the expression of the PRRX1 gene can enhance the sensitivity of the prostate cancer drug-resistant cell line PC-3/DTX to DTX, and the mechanism may be related to the activation of the mTOR signaling pathway to inhibit autophagy.
    Effect of microecological enteral nutrition in 43 patients with severe craniocerebral injury
    ZHANG Luwen, FAN Ruixin, CHANG Ying, ZHANG Qing
    Journal of Shandong University (Health Sciences). 2021, 59(6):  111-116.  doi:10.6040/j.issn.1671-7554.0.2020.1702
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    Objective To investigate the effect of microecological enteral nutrition on patients with severe craniocerebral injury. Methods Eighty-five patients with severe craniocerebral injury treated in Peoples Hospital of Zhengzhou from May 2018 to June 2020 were selected and divided into control group(conventional enteral nutrition group, n= 42)and experimental group(probiotics enteral nutrition group, n= 43). The basic condition, nutritional indexes, immune function indexes and gastrointestinal complications were compared between the two groups. Results There was no significant difference in the basic condition between the two groups before treatment. However, after treatment, the values of TP, Hb, ALB, PA, GLO, IgA, IgM and IgG were increased in both groups, and the corresponding levels in the experimental group were higher than those in the control group(all P<0.05); the value of CD4+ increased while that of CD8+ decreased, and the incidence of gastrointestinal complications such as abdominal distension, vomiting and misinhalation showed no significant difference in either group(all P>0.05); the incidence of diarrhea in the experimental group was significantly lower than that in control group(P=0.031). Logistic regression analysis showed that ALB, PA, IgG and diarrhea were related to the effect of microecological enteral nutrition. Conclusion Microecological enteral nutrition can improve nutritional status and immune function in patients with severe craniocerebral injury.
    Relationship among the volume and surface area of the temporomandibular joint condyle and the sagittal position of disc in young adults
    LIU Xueye, LI Qiming, TANG Hongyi, XU Qiuping, CHEN Wenqian, GUO Jing
    Journal of Shandong University (Health Sciences). 2021, 59(6):  117-121.  doi:10.6040/j.issn.1671-7554.0.2020.1573
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    Objective To explore the relationship among the sagittal position of disc and the volume, surface area and morphometric index(MI)of bilateral temporomandibular joint(TMJ)condyle in young adults. Methods During Jan. 2019 and Dec. 2020, patients who came for cone beam computed tomography(CBCT)at the Department of Orthodontics, Stomatological Hospital of Shandong University were invited to participate in the study. After informed consent, the subjects agreed to receive MRI of bilateral TMJ. A total of 44 subjects were enrolled, including 20 males and 24 females, aged 18 to 30(mean 24.5±3.3)years. The CBCT data were imported into Mimics 20.0 to reconstruct the condyle. Mimics 20.0 automatically calculated the volume and surface area. MI equaled to volume / surface area. The sagittal position of disc was quantitatively evaluated with MRI. According to the degree of bilateral disc displacement, the data of condylar volume, surface area and MI on the side with more anterior sagittal displacement were divided into G1 and the data on the other side were divided into G2. Results There were significant differences in the volume, surface area and MI between bilateral condyles(P<0.001), but there were no significant differences between the male and female(P>0.05). The condylar volume and surface area were negatively correlated with the angle representing the sagittal position of TMJ disc(P=0.026; P=0.037). The mean values of condylar volume, surface area and MI in G2 were significantly higher than those in G1(P<0.001; P=0.004; P=0.014). Conclusion There were differences in volume and surface area between bilateral condyles, but no difference between the male and female. The volume and surface area of condyle were negatively correlated with sagittal displacement of TMJ disc in young adults.