Table of Content

  

10 March 2022
Volume 60 Issue 3

Regulatory role of histone deacetylase SIRT1 in pancreatic cancer metabolism

YUAN Baowen, WANG Pei, HUANG Wei

Journal of Shandong University (Health Sciences). 2022, 60(3):  1-12.  doi:10.6040/j.issn.1671-7554.0.2021.1036

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Objective To explore the regulatory role and mechanism of silent mating-type information regulation 2 homolog 1(SIRT1)in pancreatic cancer metabolism with metabolomic and transcriptomic techniques. Methods RNA-seq data of pancreatic cancer and normal pancreas tissues from TCGA, GTEx, and HPA were analyzed to identify the expression of SIRT1. A total of 6 pairs of SIRT1 knockdown and control groups of pancreatic cancer PANC-1 cell lines were constructed. The metabolite profiles and gene expression profiles were measured using ultra-high performance liquid chromatography-tandem mass spectrometry(UHPLC-MS/MS)and high-throughput RNA-seq, respectively. Metabolic pathways with significantly different metabolites involved were enriched. The relationship between SIRT1 gene expression and drug responsiveness and drug resistance was analyzed. Results Analysis of TCGA and GTEx data revealed that SIRT1 expression was significantly higher in pancreatic cancer than in normal pancreas tissues; immunohistochemical data from the HPA database further confirmed the higher expression of SIRT1 at the protein level. Untargeted metabolomics and high-throughput RNA-seq identified 59 statistically significantly different metabolites and 688 differentially expressed genes. The differential metabolites were mainly enriched in metabolic pathways such as choline metabolism in cancer, pyrimidine metabolism, and ABC transporters. Fourteen differentially expressed genes were involved in SIRT1-regulated metabolic pathways. These genes were mainly enriched in purine metabolic signaling pathways and involved in biological processes such as ATP binding and small molecule metabolism. CARE online tool showed that higher expression of SIRT1 led to higher responsiveness to many antitumor drugs and resistance to some antitumor drugs. Conclusion Our study reveals that SIRT1 has a regulatory role in pancreatic cancer metabolism, which paves the way for future study on the regulatory mechanism of SIRT1 and targeted therapy for pancreatic cancer.

Preventive effects of oral 5-methyltetrahydrofolate on Alzheimers disease in rats

ZHANG Zhengduo, WU Hong, QI Shaojun, TANG Yanjin, GAO Xibao

Journal of Shandong University (Health Sciences). 2022, 60(3):  13-23.  doi:10.6040/j.issn.1671-7554.0.2021.0947

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Objective To explore the preventive effects of 5-methyltetrahydrofolate(5-MTHF)on D-galactose(D-gal)and aluminum chloride(AlCl₃)induced cognitive decline in Alzheimers disease(AD)rats. Methods A total of 40 male Wistar rats were divided into control group, model group, low-5-MTHF group and high-5-MTHF group according to body weight, with 10 rats in each group. The model group was given intraperitoneal injection of 60 mg/kg BWD-gal and 10 mg/kg BW AlCl₃, and intragastric administration of physiological saline for 6 weeks. The low and high 5-MTHF groups were given intraperitoneal injection of 60 mg/kg BW D-gal and 10 mg/kg BW AlCl₃, and intragastric administration of 1 mg/kg BW(low-5-MTHF group)or 5 mg/kg BW(high-5-MTHF group)for 6 weeks. The learning and memory function of rats were evaluated with Morris water maze. The processing of amyloid precursor protein(APP)was evaluated with the content of β-amyloid protein 1-42(Aβ_1-42)and phosphorylated Tau protein(p-Tau), mRNA expression of disintegrin and metallopeptidase domain 10(ADAM10), and β-site amyloid precursor protein cleaving enzyme 1(BACE1). The cholinergic function was determined with the activity of acetylcholinesterase(AChE), oxidative stress was determined with superoxide dismutase(SOD)and malondialdehyde(MDA), and endothelial cell function was determined with cytokines. Results The water maze results showed that the escape latency of each group gradually decreased with the increase of training time(F_day=67.37, P<0.001; F_group=6.36, P=0.001). Moreover, there was an interaction between group and day factors in escape latency(F_{day x group}=2.72, P=0.007). Compared with the control group, the model group had longer escape latency, increased contents of Aβ_1-42 and p-Tau in the brain, higher activites of serum AChE and nitric oxide synthase(NOS), higher levels of tumor necrosis factor-α(TNF-α), endothelin-1(ET-1), MDA and interleukin-6(IL-6)and higher BACE1 mRNA expression in the hippocampus(P<0.05), but decreased activity of serum SOD and lower ADAM10 mRNA expression in the hippocampus(P<0.05), suggesting the success of AD modeling. Compared with the model group, the low-5-MTHF group had larger numbers of crossing the platform, longer time spent in the target quadrant, higher activity of serum SOD and higher ADAM10 mRNA expression in the hippocampus(P<0.05), but shorter escape latency, lower content of serum IL-6 and reduced BACE1 mRNA expression(P<0.05). Compared with the model group, the high-5-MTHF group had shorter escape latency, lower content of Aβ_1-42 in the brain, lower concentrations of serum nitric oxide(NO)and TNF-α(P<0.05). Moreover, the mRNA expression of ADAM10 between the 5-MTHF groups were dose-dependent(P=0.016). Conclusion 5-MTHF can prevent D-gal and AlCl₃ induced cognitive decline in AD rats. The underlying mechanism may be achieved via regulating APP processing and endothelial cell secretion and repressing oxidative stress.

Effects of D-mannose and glucose on ulcerative colitis in mice

JIAN Tianzi, CHEN Nuo, LI Lixiang, LI Yanqing, LI Yan

Journal of Shandong University (Health Sciences). 2022, 60(3):  24-28.  doi:10.6040/j.issn.1671-7554.0.2021.1264

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Objective To investigate the effects of D-mannose and glucose on ulcerative colitis(UC)in mice induced by dextran sodium sulfate(DSS). Methods A total of 60 C57BL/6 mice were randomly divided into 6 groups: control group, D-mannose group, glucose group, DSS group, DSS + D-mannose group and DSS + glucose group, with 10 mice in each group. The mice were free to drink sterile water, 20% D-mannose, 20% glucose, 3.5% DSS, 3.5% DSS + 20% mannose or 3.5% DSS + 20% glucose for 7 days. The general condition, body mass, disease activity index(DAI), fecal characteristics and occult blood were observed and recorded every day. After 7 days, the mice were sacrificed, the colon was separated, the length was measured and histopathological observation was carried out. The spleen was resected to observe and measure the shape, length and body mass. Results The mice in the control group were generally in good condition, and the mice in the DSS group showed UC symptoms such as decreased body mass, diarrhea and macroscopic bloody stool. Compared with DSS group, D-mannose group had higher body mass ［(84.02±3.47)g vs(89.71±2.02)g, P<0.001］, significantly lower DAI score ［(3.10±0.77)vs(2.43±0.32), P=0.002］, significantly increased colon length ［(5.20±0.03)cm vs(6.87±0.19)cm, P<0.001］, and lower histopathological score ［(6.00±0.37)vs(4.25±0.28), P<0.001］. In DSS + glucose group, body mass decreased sharply(P<0.001), DAI score increased(P=0.001), intestinal bleeding aggravated(P<0.001), and histopathological score increased(P<0.001). Conclusion D-mannose can effectively improve the clinical symptoms of UC mice, while glucose aggravates the clinical symptoms.

Exploration of Huangqi Guizhi Wuwutang in the treatment of ankylosing spondylitis based on network pharmacology

LI Mingbo, HUANG Yanbo, LIU Juncheng, REN Dongcheng, TAN Chengshuang, XU Jixi, DING Jinyong

Journal of Shandong University (Health Sciences). 2022, 60(3):  29-38.  doi:10.6040/j.issn.1671-7554.0.2021.0656

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Objective To investigate the molecular mechanism of Huangqi Guizhi Wuwutang in the treatment of ankylosing spondylitis(AS)by using network pharmacology and molecular docking technology. Methods The chemical components and targets of Huangqi Guizhi Wuwutang were searched in TCMSP database, and gene annotation of drug targets were carried out. AS disease-related targets were searched from Gene Cards, OMIM, PharmGkb, TTD, and DrugBank database. Then, a visual network of “traditional Chinese medicine-components-intersection target” was constructed by using Cytoscape 3.8.0 software among drugs, active chemical components and intersection target. The visual network result data were imported into the String database to construct the protein interaction network. R language software and R package were used to analyze GO and KEGG enrichment. Finally, molecular docking was conducted between the core active component and the core target. Results A total of 74 active compounds of Huangqi Guizhi Wuwutang were obtained. After the reverse screening of active ingredients of TCM decoction according to the common targets of diseases and TCM decoction, 32 active ingredients were reserved, and 997 corresponding targets were predicted. A total of 2,234 AS related targets and 78 genes were intersected. Eight core targets were selected after the second scoring using CytoNCA plug-in R software. A total of 1,990 and 135 enrichment terms were acquired by GO and KEGG enrichment analyses, respectively. The results of molecular docking showed that the target of the active component and the target of the core gene could be docked stably. Conclusion In the treatment of AS, Huangqi Guizhi Wuwutang acts on PTGS2, IL6, TNF, VEGFA, IL1B, ICAM1, STAT1, CXCL8 and other gene targets through quercetin, paeoniflorin, kaempferol and other components. Thus, it can affect the function of “lipid and atherosclerosis” “AGE-RAGE signaling pathway” “IL-17 signaling pathway” “TNF signaling pathway” “NF-kappa B signaling pathway” and other related pathways.

Neural mechanisms of explicit and implicit face aesthetic processing: an activate likelihood estimation meta-analysis of functional neuroimaging studies

JIA Fanlu, ZHANG Wenjun, LI Kaiyun, HOU Tingting, LIN Fengxun

Journal of Shandong University (Health Sciences). 2022, 60(3):  39-44.  doi:10.6040/j.issn.1671-7554.0.2022.0087

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Objective To explore the neural mechanisms of explicit and implicit face aesthetic processing. Methods An activation likelihood estimation(ALE)meta-analysis of 24 neuroimaging experiments was performed, and brain activations of healthy adults in face aesthetic processing tasks were examined. Firstly, individual ALE meta-analysis was conducted to identify the brain activation regions underlying explicit and implicit face aesthetic processing. After that, conjunction analysis and subtraction analysis were conducted respectively to investigate the similarities or differences of neural systems between explicit and implicit face aesthetic processing. Results The individual ALE analysis showed that anterior cingulate cortex(ACC)involved in explicit face aesthetic processing, while implicit face aesthetic processing aroused the activations of left caudate nucleus and anterior cingulate gyrus. The conjunction analysis showed that the anterior cingulate gyrus was recruited for both implicit and explicit aesthetic processing. However, no significant difference was identified on the brain activities between implicit and explicit aesthetic processing in the subtraction analysis. Conclusion The reward area might involve in both explicit and implicit face aesthetics processing, and ACC might be a crucial brain region for face aesthetics. The determination of the neural basis underlying face aesthetics provides reliable parameters for clinical intervention of aesthetic psychological disorders.

Clinical and imaging features of 19 cases of anti-myelin oligodendrocyte glycoprotein-IgG antibody associated disorders

FENG Baomin, WANG Zhou, XU Han, LI Jiacun, YU Qiaowen, XIU Jianjun

Journal of Shandong University (Health Sciences). 2022, 60(3):  45-50.  doi:10.6040/j.issn.1671-7554.0.2021.1149

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Objective To investigate the clinical and imaging features of anti-myelin oligodendrocyte glycoprotein-IgG antibody associated disorders(MOGAD). Methods The clinical and imaging data of 19 MOGAD patients confirmed in Shandong Provincial Hospital Affiliated to Shandong First Medical University during Sep. 2018 and Jun. 2021 were retrospectively analyzed. Results The patients included 9 males and 10 females, with a median age of 10 years. Seven cases manifested asaquaporin4(AQP4)negative neuromyelitis optica spectrum disorder(NMOSD); 6 cases presented with acute disseminated encephalomyelitis(ADEM); 4 cases presented with encephalitis, 1 of which complicated with anti-N-methyld-aspartate receptor(NMDAR)encephalitis; 1 case presented with transverse myelitis; 1 case presented with brainstem encephalitis. Abnormal signals were detected with brain MRI in 17 cases(17/19), and the lesions could be involved in any part of the brain, presenting multifocal ill-defined T₂WI hyperintensity. Spinal MRI found abnormal signals in 4 cases(4/13). Orbital MRI detected abnormal signals in 4 cases(4/9), presenting T₂WI hyperintensity in optic nerves, 2 of which(2/4)showed optic crossover and optic tract. The serum MOG-IgG antibody of all patients was positive; 1 case was NMDAR antibody positive; 1 case was thyroidperoxidase antibody positive. Conclusion The MOGAD clinical phenotype is associated with age, more common in children and adolescents, and prone to relapse. Lesions can involve the optic nerves, spinal cord, intracranial and other parts. The imaging performance is varied.

A prognostic risk model for LKB1 mutant lung adenocarcinoma based on aberrant DNA methylation sites

ZHENG Haotian, WANG Guanghui, ZHAO Xiaogang, WANG Yadong, ZENG Yukai, DU Jiajun

Journal of Shandong University (Health Sciences). 2022, 60(3):  51-58.  doi:10.6040/j.issn.1671-7554.0.2021.0821

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Objective To construct a methylation-related prognostic risk model of liver kinase B1(LKB1)mutant lung adenocarcinoma. Methods The RNA and methylation sequencing data from the The Cancer Genome Atlas(TCGA)database were downloaded and analyzed. Differentially expressed genes that significantly affected the prognosis and were regulated by different methylation sites were screened out to construct a prognostic risk model. Then, the LKB1 mutant lung adenocarcinoma patients were divided into the high-risk group and low-risk group and the corresponding function was analyzed. Results Three prognostic-related genes with low methylation levels and high expression levels were screened out and a prognostic risk model of LKB1 mutant lung adenocarcinoma was constructed. Multivariate COX regression analysis showed that Risk score could be used as an independent predictor(HR>2, P<0.001). The receiver operating characteristic(ROC)curve confirmed that the Risk score had better survival predictive ability than other clinicopathological characteristics. The cancer-promoting pathway was activated in the high-risk group and the degree of immune cell infiltration was significantly higher than that in the low-risk group. Conclusion Three biomarkers due to aberrant methylation are discovered in LKB1 mutant lung adenocarcinomas. The prognostic risk model can accurately screen the high-risk population among patients with LKB1 mutant lung adenocarcinoma, and provides accurate survival predictions. The study provides new ideas for the molecular mechanism and the clinical prognosis analysis of LKB1 mutant lung adenocarcinoma.

Pulmonary infection caused by Nocardia pneumoniae and Nocardia amamiensis: a case report and literature review

AN Yuanxiaoxue, DU Yiming, TIAN Tian, ZHANG Yi, XUE Yuwen

Journal of Shandong University (Health Sciences). 2022, 60(3):  59-63.  doi:10.6040/j.issn.1671-7554.0.2021.0092

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Objective To describe the clinical characteristics and treatment options of Nocardia pneumoniae and Nocardia amamiensis pulmonary infection. Methods The clinical characteristics and treatment option of a patient with Nocardia pneumoniae and Nocardia amamiensis pulmonary infection were collected and analyzed. A series of relevant literature was reviewed. Results The patient was an immunocompromised host and had structural lung disease. The clinical manifestations were fever, expectoration and dyspnea. Chest CT showed multiple nodules, masses and consolidation in both lungs, with cavity formation, protrusions on the wall of cavity and liquid pneumothorax. The pathogens were identified as Nocardia pneumoniae and Nocardia amamiensis by BALF mNGS and pleural fluid bacteria culture with mass spectrometry analysis. Both of the bacteria were susceptible to linezolid, trimethoprim-sulfamethoxazole, imipenem and ceftriaxone, and resistant to quinolones. Conclusion Nocardia pneumoniae and Nocardia amamiensis are important pathogens of pulmonary infection. Combined linezolid and imipenem with trimethoprim-sulfamethoxazole is an effective anti-infection therapy.

Preliminary observation of perioperative whey protein supplementation for the prevention of postoperative complications in 33 patients with esophageal cancer

WANG Yanlig, FENG Ye, ZHOU Xiugeng, YANG Yue, WU Nan, FANG Yu, YAN Shi, LI Shaolei, LYU Chao, HAN Chao, DU Songtao

Journal of Shandong University (Health Sciences). 2022, 60(3):  64-70.  doi:10.6040/j.issn.1671-7554.0.2021.0875

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Objective To investigate the effects of whey protein on the postoperative complications and nutritional status of patients with esophageal cancer. Methods Patients with esophageal squamous cell cancer who underwent elective surgery during April 2017 and June 2018 were enrolled and randomly divided into observation group and control group at a ratio of 1:1. Nutritional risk screening 2002(NRS2002), Patient-Generated Subjective Global Assessments(PG-SGA)and composition measurement were used to screen and evaluate the nutritional status before operation, one day before operation and one month after operation. All patients were given basic nutritional support. In addition, whey protein powder was given to the observation group, and the intervention was continued until 1 month after surgery. The incidence of complications(above grade 2 complications including lung infection, respiratory tract infection, anastomotic leakage)was compared one month after surgery; the differences in nutritional status were compared at baseline, one day before surgery and one month after surgery. Results The incidence of complications was 24% in the observation group and 49% in the control group(P<0.05). There were no differences in the other indicators. Conclusion Preoperative whey protein supplementation combined with enteral nutrition can effectively reduce the incidence of infectious complications in patients with esophageal cancer one month after surgery. However, our sample size is small and the research results need to be further verified.

Medium- and long-term efficacy of transvaginal mesh pelvic floor reconstruction

LI Qing, LIN Xueyan, LIU Tianhang, LI Xiaowen, FAN Mingzhe, ZHAO Ruirui, TIAN Yongjie

Journal of Shandong University (Health Sciences). 2022, 60(3):  71-75.  doi:10.6040/j.issn.1671-7554.0.2021.1244

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Objective To analyze the medium- and long-term efficacy of transvaginal mesh pelvic floor reconstruction with or without uterus preservation. Methods A total of 76 patients with pelvic floor organ prolapse who underwent surgical treatment during Jan. 2010 and Dec. 2016 were selected as the research objects and divided into two groups: uterus conservation(UC)group and concomitant hysterectomy(CH)group, with 38 cases in either group. The perioperative indicators and changes of POP-Q scores before operation, 6 months, 1 year and 5 years after operation as the objective curative effect were compared. The Pelvic Floor Disorder Scale(PFDI-20), Pelvic Floor Disorder Impact Simple Questionnaire(PFIQ-7)and Pelvic Organ Prolapse/Urinary Incontinence Quality of Life Questionnaire(PISQ-12)scores as the subjective curative effect were compared. Results The UC group had shorter length of hospital stay(P<0.001), operation time(P<0.001), postoperative exhaust time(P=0.004), urinary catheter indwelling time(P<0.001)and less intraoperative bleeding volume(P<0.001)than the CH group. The POP-Q scores in both groups were improved after operation. There were significant differences in PFDI-20, PFIQ-7 and PISQ-12 scores at different times(P<0.001). The UC group had higher PISQ-12 score at 6 months(P<0.001), 1 year(P<0.001)and 5 years(P<0.001)after the operation than the CH group. During the medium- and long-term follow-up, there were 3 cases of pelvic infection and 6 cases of dysuria, and no other complications were observed. Conclusion Transvaginal mesh pelvic floor reconstruction is safe and effective. Whether to preserve the uterus does not affect the postoperative efficacy, but preserving the uterus can improve perioperative indicators and quality of sexual life.

LncRNA-UCA1 effects invasion and metastasis of trophoblast cells by targeting miR-182-5p

ZHONG Lili, SHENG Ying, GUO Jianghong, YANG Shuangjian, HE Yijing

Journal of Shandong University (Health Sciences). 2022, 60(3):  76-82.  doi:10.6040/j.issn.1671-7554.0.2021.0660

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Objective To investigate the effect of long non-coding RNA urethelial carcinoma related gene 1(LncRNA-UCA1)on invasion and metastasis of trophoblast cells and its possible mechanism. Methods Thirty placentas tissues from patients with preeclampsia(PE)and other 30 normal placentas tissues were collected respectively. The expression levels of UCA1 and miR-182-5p in placentas tissues were detected by qRT-PCR. UCA1 overexpression plasmid(pcDNA3.1-UCA1)and its negative plasmid(Vector)were transfected into HTR-8/Svneo cells respectively, and the expression levels of UCA1 and miR-182-5p in cells were detected by qRT-PCR. The targeted regulatory relationship between UCA1 and miR-182-5p was verified by dual-luciferase reporter assay. HTR-8/Svneo cells were transfected with pcDNA3.1-UCA1 plasmid and miR-182-5p mimic respectively or simultaneously, and then cell proliferation activity was detected by CCK-8. Cell invasion and metastasis was detected by Transwell assay. The expression levels of matrix metalloproteinase(MMP)-2 and MMP-9 proteins were detected by Western blotting. Results (1) Results of clinical specimen determination: compared with the placental tissues of normal pregnant women, the expression of UCA1 in placental tissues of PE patients was significantly decreased(1.10±0.51 vs 5.74±1.63, t=14.947, P<0.001), while the expression of miR-182-5p was significantly increased(7.23±1.44 vs 1.07±0.72, t=20.961,P<0.001). (2) Results of cell experiment: UCA1 could specifically target and regulate miR-182-5p expression. Compared with the Vector group, overexpression of UCA1 decreased the expression level of miR-182-5p in HTR-8/SVneo cells(0.12±0.05 vs 0.97±0.06, t=19.028, P<0.001), promoted the proliferation, invasion and migration of HTR-8/SVneo cells(t=10.160, 17.228, 13.768, all P<0.001), and up-regulated the expressions of MMP-2 and MMP-9 protein(t=20.833, 24.793, both P<0.001). However, the overexpression of miR-182-5p significantly reduced the promotion of UCA1 overexpression on the proliferation, invasion and migration of HTR-8/SVneo cells. Conclusion UCA1 promotes trophoblast invasion and metastasis by targeting the down-regulation of miR-182-5p.

Application value of three-dimensional visualization combined with indocyanine green fluorescence technique in laparoscopic hepatectomy in the treatment of 51 patients with primary liver cancer

LI Bo, LIU Jingfang, BAO Jinpeng, LI Xiangze, QIN Guangyang, TIAN Hu

Journal of Shandong University (Health Sciences). 2022, 60(3):  83-88.  doi:10.6040/j.issn.1671-7554.0.2021.0996

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Objective To explore the advantages of three-dimensional visualization combined with indocyanine green(ICG)fluorescence imaging in laparoscopic liver resection of primary liver cancer(PLC). Methods A retrospective case-control study was conducted to involve 105 PCL patients treated during Jan. 2019 and Jan. 2021, including 51 cases treated with laparoscopic hepatectomy combined with ICG fluorescence imaging(observation group)and 54 cases treated with conventional laparoscopic hepatectomy resection of PLC(control group). The baseline data, operation time, hilar occlusion time, blood transfusion, hospital stay, postoperative pathology, complications and follow-up data at 1st, 3rd and 6th months after operation were collected. The curative effect, incidence of complications and short-term postoperative recurrence were compared between the two groups. Results The operation time ［225(135)vs 282.5(118)min, Z=-2.687, P=0.007］ and intraoperative portal occlusion time ［(35.9±8.5)vs(240.7±6.8)min, t=-3.183, P=0.002］ were shorter in the observation group than in the control group. The intraoperative bleeding volume ［300(200)vs 363(141)mL, Z=-2.621, P=0.009］, incidence of complications ［5(4.8%)vs 14(13.3%), χ2=-4.600, P=0.032］, and level of glutamic pyruvic transaminase(ALT)on day 1 ［332.1(131.7)vs 386.2(100.0), Z=-2.379, P=0.017］, day 3 ［(227.1±76.1)vs(274.8±74.0), t=-3.257, P=0.002］ and day 5 ［(114.4±51.7)vs(151.1±61.0), t=-3.254, P=0.001］ were lower in the observation group than in the control group. Conclusion Compared to the conventional laparoscopic liver resection, three-dimensional visualization combined with ICG fluorescence imaging technique has advantages of shorter operation time and intraoperative hepatic hilar occlusion time, less operative bleeding and liver function damage, and fewer postoperative complications, which best embodies the concept of precise hepatectomy.

Value of preoperative multiphase MRI for predicting microvascular invasion and early recurrence of 169 hepatocellular carcinoma

ZUO Liping, JIANG Fengyang, ZHOU Binbin, FAN Jinlei, LIANG Yongfeng, DENG Zhanhao, YU Dexin

Journal of Shandong University (Health Sciences). 2022, 60(3):  89-95.  doi:10.6040/j.issn.1671-7554.0.2021.1046

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Objective To investigate the significance of preoperative contrast-enhanced multiphase magnetic resonance imaging(MRI)in the identification of microvascular invasion and early recurrence in patients with hepatocellular carcinoma(HCC). Methods This retrospective study included 169 HCC patients treated with surgical resection during Feb. 2015 and Jan. 2019 who underwent preoperative multiphase MRI. Clinical, biologic and imaging features associated with microvascular invasion and early recurrence(within 2 years)were analyzed. MRI predictors for microvascular invasion were evaluated with univariate and multivariate Logistics analysis. Predictors of early recurrence were determined with Logistic regression and multivariate Cox analysis. Early recurrence and overall recurrence in microvascular invasion were evaluated with Kaplan-Meier analysis. Results In multivariate Logistics analysis, tumor size >5 cm(OR=7.1, 95%CI: 1.3-38.8,P=0.023), corona enhancement(OR=2.1, 95%CI: 0.8-5.5, P=0.018), and non-smooth tumor margin(OR=3.3, 95%CI: 1.0~10.5, P=0.045)were independent significant variables associated with microvascular invasion. In multivariate Cox analysis, microvascular invasion was a non-statistically significant factor(P=0.09). Kaplan-Meier curve showed that patients with microvascular invasion had lower early and overall recurrence-free survival. Conclusion Tumor size >5 cm, corona enhancement, and non-smooth tumor margin are independent predictors for microvascular invasion in HCC. Microvascular invasion is an important prognostic indicator but with a poor ability to predict early recurrence.

Two cases of periprosthetic tibial plateau fracture after fixed-bearing unicompartmental knee arthroplasty

LIN Junxin, LIU Yujiang, LIU Peilai, WAN Lianping, ZHANG Peng, DU Jianchun, LIU Zemiao, KONG Jie, GAO Shengtao

Journal of Shandong University (Health Sciences). 2022, 60(3):  96-99.  doi:10.6040/j.issn.1671-7554.0.2021.1289

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Objective To investigate the mechanism and treatment options for periprosthetic tibial plateau fracture(TPF)associated with unicompartmental knee arthroplasty(UKA). Methods The clinical data of 2 cases of TPF after UKA were retrospectively analyzed, and relevant literature was reviewed. Results For patients to undergo UKA, the preoperative indications should be strictly selected, operative condition should be accurately evaluated, operation should be cautiously conducted, and perioperative osteoporosis should be timely treated. Treatment of TPF should be individually tailed according to the size of fracture, displacement of fracture, osteoporosis and stability of the prosthesis. Conclusion Appropriate treatment can lead to a good prognosis for TPF.

Detection of middle mesial canal in 1,125 permanent mandibular first molars using CBCT and related factors

WANG Yu, YIN Zengzheng, NIE Xiaokun, MA Zhide, XIONG Shijiang

Journal of Shandong University (Health Sciences). 2022, 60(3):  100-109.  doi:10.6040/j.issn.1671-7554.0.2021.1182

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Objective To explore the incidence and relevant anatomy of the middle mesial canal(MMC)of permanent mandibular first molars in order to provide theoretical guidance for root canal therapy. Methods Cone-beam computed tomography(CBCT)images of 1,125 permanent mandibular first molars of 637 patients treated at Stomatological Hospital of Shandong University were observed. The detection rate and anatomic structure of MMC were recorded to analyze the relationship between the anatomic factors, incidence of MMC and types of mesial canal. Curvature of MMC was measured. Results (1) The detection rate of MMC was 12.8%, higher in male than in female, higher on the left side than on the right side. Patients with MMC had longer distance between MB-ML root canal orifices. The occurrence of MMC was correlated with the tooth position, distal lingual root and distance between MB-ML root canal orifices. (2) The 3-2 fusion type of MMC was the most common, and the fusion between MMC and MBC or MLC was correlated with the distance among the 3 proximal root canal orifices. (3) Most MMCs had severe curvature. The curvature in the proximal and distal direction was larger in female than in male, and patients aged 60-80 years had smaller curvature. The curvature in the proximal and distal direction was larger than that in the buccal and lingual direction. Conclusion The detection rate of MMC is higher in male than in female, higher on the left side than on the right side. The distance between MB-ML root canal orifices and the existence of distal lingual root are positively related with the incidence of MMC. The MMC of 3-2 type is prone to fuse with the canal close to it. The MMC in the proximal and distal direction has larger curvature, especially in female. The curvature of MMC in patients aged 60-80 years is smaller.

Evaluation of learning satisfaction of preventive medicine students with Health Statistics

HAN Xuan, SUN Xiubin, LIU Yi, WANG Shukang, LIU Jing, YUAN Zhongshang, ZHANG Tao, LI Xiujun, XUE Fuzhong, LIU Yunxia

Journal of Shandong University (Health Sciences). 2022, 60(3):  109-113.  doi:10.6040/j.issn.1671-7554.0.2020.1130

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Objective To investigate the learning satisfaction of preventive medicine students with the course of Health Statistics, and to explore the influencing factors, so as to provide reference for optimizing teaching design and teaching effects. Methods A self-designed questionnaire was distributed on the Wenjuanxing platform among undergraduates of two grades to collect their satisfaction with Health Statistics and the possible influencing factors. Data collected were analyzed with rank sum test, Chi-square test and multiple linear regression. Results A total of 190 effective questionnaires(97.44%)were collected. The score of learning satisfaction was 83, and the scores of learning motivation, learning environment, teacher-student interaction and teaching design were 16, 20, 20 and 24 respectively. Multiple linear regression analysis showed that student learning score rank, learning motivation, teacher-student interaction and teaching design had an impact on learning satisfaction. Conclusion Preventive medicine students have high satisfaction with Health Statistics. Future teaching should stimulate students learning motivation, increase the effective interaction between teachers and students, and optimize the teaching design, so as to improve students satisfaction and improve the overall teaching quality.