Table of Content

  

10 June 2022
Volume 60 Issue 6

LncRNA-HOTAIR regulates migration of macrophages via H3K27me3 pathway

LIU Yan, ZHANG Man, JIANG Chaoyang, BIAN Shu, DU Aijia, CHEN He

Journal of Shandong University (Health Sciences). 2022, 60(6):  1-9.  doi:10.6040/j.issn.1671-7554.0.2021.1359

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Objective To explore the expressions of HOX transcribed antisense RNA(LncRNA-HOTAIR)and histone H3 lysine trimethylation at position 27(H3K27me3)in a macrophage model exposed to oxidized low density lipoprotein(oxLDL), and to explore the specific mechanism of HOTAIR regulating H3K27me3 on macrophage migration at the level of gene epigenetics. Methods RAW264.7 macrophages were cultured in vitro, and exposed to oxLDL to prepare the model. The cells were then divided into control group(group A), oxLDL group(group B), macrophage+histone demethylase inhibitor GSKJ4+oxLDL group(group C), macrophage+ histone A GSK126 + oxLDL group(group D), macrophage+oe-HOTAIR+oxLDL group(group E), macrophage+pcDNA+oxLDL group(group F), macrophage+oe-HOTAIR+GSKJ4+oxLDL group(group G), macrophage + pcDNA + GSKJ4 + oxLDL group(group H), macrophage + oe-HOTAIR + GSK126 + oxLDL group(group I), and macrophage + pcDNA + GSK126 + oxLDL group(group J). The protein expressions of H3K27me3 and tumor necrosis factor-α(TNF-α)were detected with Western blotting; the expression of HOTAIR was detected with qPCR, and the migration ability was determined with Transwell assay. Results (1)Compared with group A, group B had increased TNF-α expression and migration ability, but decreased HOTAIR and H3K27me3 expressions, which were positively correlated(P<0.01). (2) Compared with group B, group C had increased H3K27me3 expression, decreased TNF-α expression and migration ability (P<0.01), but the HOTAIR expression did not change significantly(P>0.05); compared with group B, group D had decreased H3K27me3 expression, increased TNF-α expression and migration ability(P<0.01), but the HOTAIR expression did not change significantly(P>0.05). (3) Compared with group B, group E had increased HOTAIR and H3K27me3 expressions, but decreased TNF-α expression and migration ability(P<0.01); compared with group B, group F had not significantly changed HOTAIR, H3K27me3 and TNF-α expressions, and migration ability(P>0.05). (4) Compared with group E, group G had unchanged HOTAIR expression(P>0.05), increased H3K27me3 expression, but decreased TNF-α expression and migration ability(P<0.01); compared with group E, group I had unchanged HOTAIR expression(P>0.05), decreased H3K27me3 expression, but increased TNF-α expression and migration ability(P<0.01). Conclusion In the oxLDL-exposed macrophage migration model, the expression of H3K27me3 is reduced, which affects the expression of TNF-α. LncRNA-HOTAIR is an upstream regulatory factor positively related to the expression of H3K27me3. HOTAIR reduces the expression of TNF-α and migration of macrophages via the H3K27me3 pathway.

Effects of Hanjingtang and its disassembled prescriptions on serum inflammatory factors, vascular endothelial function and fibrosis in hypertensive rats with cold coagulation syndrome

WU Yujie, ZHANG Mingquan, JI Yongli, ZHAO Lu, WANG Yue, CHEN Shasha

Journal of Shandong University (Health Sciences). 2022, 60(6):  10-18.  doi:10.6040/j.issn.1671-7554.0.2022.0380

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Objective To observe and compare the antihypertensive effects of Hanjingtang and its disassembled prescriptions on hypertensive rats with cold coagulation syndrome and the influence on serum inflammatory factors, vascular endothelial function and vascular collagen fiber, so that to explore the antihypertensive mechanism. Methods A total of 40 male SD rats aged 6 to 8 weeks were randomly divided into control group, model group, Hanjingtang group, Tongyang group and Tongluo group, with 8 rats in each group. The control group was fed with ordinary diet, and the other groups were given diet with 8% sodium chloride and high salt, and placed in a freezer at(-15±2)℃ for 3 hours every day for 6 weeks, followed by intragastric administration for 2 weeks. The control group and model group were given equal volume of normal saline. The blood pressure was measured twice a week with the rat noninvasive blood pressure analysis system, and the average value was taken. The changes of aortic pathological morphology and collagen deposition were observed with HE and Masson staining. The IL-1β, TNF- α and ET-1 were detected with ELISA, and NO was detected with colorimetry. The expressions of eNOS, type I collagen(ColI)and TGF-β1 in aortic tissue were detected with IHC. Results (1) Compared with the control group, the model group had raised blood pressure(P<0.01); incomplete aortic intima; thicker intima-media; disordered cell arranging; increased serum TNF-α, IL-1β, IL-6 and ET-1; decreased NO; increased collagen fibers. Meanwhile, IHC showed that eNOS expression decreased, but ColI and TGF-β1 expressions increased in aorta(P<0.01). (2) Compared with the model group, the Hanjingtang, Tongyang and Tongluo groups had decreased blood pressure(P<0.01, P<0.05); improved aortic structure at different levels; increased serum NO(P<0.05); Hanjingtang group had decreased TNF-α, IL-1β, ET-1 and IL-6(P<0.01, P<0.05); Tongyang group had decreased TNF-α, IL-1β and IL-6(P<0.05); Tongluo group had decreased ET-1 and TNF-α(P<0.05). IHC showed that the expression of ColI in aorta decreased but eNOS increased in the three treatment groups(P<0.05). The expression of TGF-β1 decreased in Hanjingtang and Tongyang groups(P<0.01, P<0.05); aortic collagen fibers decreased in the three treatment groups(P<0.01). (3) The antihypertensive effects and improvement of aortic collagen deposition were better in the Tongyang and Tongluo groups than those in the Hanjingtang group(P<0.05, P<0.01). Conclusion Hanjingtang can significantly reduce the serum inflammatory factors of IL-1β, TNF-α and IL-6, improve endothelial function, reduce collagen deposition in blood vessels, improve aortic fibrosis, partially explaining the antihypertensive mechanism of Hanjingtang. The Tongyang ingredients can mainly reduce inflammatory factors, while Tongluo ingredients can regulate NO / ET-1 levels to play a synergistic role.

Role of NOX4 in ROS induction by Helicobacter pylori in gastric cancer cells

BAO Shuqing, YANG Mingyue, LIU Duanrui, WANG Yunshan, JIA Yanfei

Journal of Shandong University (Health Sciences). 2022, 60(6):  19-25.  doi:10.6040/j.issn.1671-7554.0.2021.1348

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Objective To investigate the effect of nicotinamide adenine dinucleotide phosphate oxidase 4(NOX4)on reactive oxygen species(ROS)induced by Helicobacter pylori(H. pylori)in gastric cancer cells. Methods Gastric cancer cell line MKN-45 was co-cultured with H. pylori NCTC 26695 and NCTC 11637 for 6 hours respectively, the experiment included non-infection group and H. pylori infection group; MKN-45 cells were pretreated with 25mmol/L N-acetyl cysteine(NAC)for 30 minutes, NAC treated group and NAC untreated group were set up. The protein expression of NOX4 was detected with Western blotting. The level of ROS was detected with ROS detection kit. Changes in ROS level after H. pylori infection were observed with fluorescence microscope, and fluorescence intensity was detected with fluorescein microplate analyzer. Results ROS production increased in H. pylori infected group compared with non-infection group. NOX4 protein expression increased after NCTC 26695 infection(t=11.67, P<0.001), and increased after NCTC 11637 infection(t=17.29, P<0.001). After NAC pretreatment and H. pylori infection, NOX4 expression was significantly reduced ［NCTC 26695(P<0.001), NCTC 11637(P<0.001)］. Conclusion NOX4/ROS pathway may be involved in the activation of H. pylori redox signal in gastric cancer cells.

Value of abnormal methylation of cg16212145 on GZMB gene in early screening of gastric cancer

WANG Jing, XIE Yan, LI Peilong, DU Lutao, WANG Chuanxin

Journal of Shandong University (Health Sciences). 2022, 60(6):  26-34.  doi:10.6040/j.issn.1671-7554.0.2021.0110

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Objective To obtain the specific genome-wide methylation profile of gastric cancer derived from peripheral blood mononuclear cells(PBMC), and to explore the clinical value of methylation points derived from PBMC in the early diagnosis of gastric cancer. Methods The genome-wide DNA methylation status of PBMC in 20 gastric cancer patients and 20 healthy controls was detected with Methylation850 BeadChip. The gastric cancer-specific methylation profile was constructed and differentially methylated points(DMPs)were obtained. Gene Ontology(GO)analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis were performed on the genes where DMPs were located for functional prediction. Statistical screening of DMPs was performed using a random forest-based multi-factor filtering method. Next-generation sequencing-based multiplex target region methylation enrichment sequencing was performed on 34 patients with stage I gastric cancer and 21 healthy controls to verify the selected DMPs. Results The results of methylation BeadChip showed PBMC from gastric cancer patients had unique genome-wide methylation profile. A total of 5 883 DMPs were obtained with |Δβ|>0.06 and adjust P<0.05 as pre-screening conditions, including 2 513 hypermethylated sites and 3 370 hypomethylated sites. GO analysis and KEGG analysis showed that 2 677 genes where 5 883 DMPs were located were mainly associated with MAPK signaling pathway and transcriptional dysregulation in cancer. Granzyme B(GZMB)gene cg16212145 was hypermethylated in PBMC of gastric cancer patients, and the difference was statistically significant(Δβ=0.0807, adjust P=0.001). The results of multiple target region methylation enrichment sequencing showed that abnormal methylation status of CpG site cg16212145 could distinguish patients with stage I gastric cancer from healthy controls(AUC=0.807, P<0.001). Conclusion Gastric cancer patients have a specific genome-wide methylation profile derived from PBMC. The GZMB gene cg16212145 exhibits high methylation status in PBMC of gastric cancer patients, which has important clinical value in the early screening of gastric cancer.

Pregnancy outcomes of in vitro fertilization-intracytoplasmic sperm injection-embryo transfer in women 40 years and above

WU Richao, LIU Hong, WANG Ze, GAO Shanshan, LI Xiufang, SHI Yuhua

Journal of Shandong University (Health Sciences). 2022, 60(6):  35-39.  doi:10.6040/j.issn.1671-7554.0.2022.0082

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Objective To investigate the pregnancy outcomes in women 40 years and older who underwent in vitro fertilization and intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET). Methods From January 2017 to December 2019, 4 914 cycles of non-donor IVF/ICSI-ET performed in the Reproductive Hospital Affiliated to Shandong University were retrospectively analyzed. The women were divided into 5 groups according to their age: 40-year-old group(n=1 243), 41-year-old group(n=1 045), 42-year-old group(n=976), 43-year-old group(n=718), and ≥44-year-old group(n=932). The clinical characteristics and pregnancy outcomes were compared and analyzed. Results A total of 2,212 cycles were transplanted, 512 of which obtained clinical pregnancy, with a clinical pregnancy rate of 23.1%. The clinical pregnancy rate in the groups was 35.7%, 26.4%, 21.1%, 10.5% and 9.7%, respectively; the miscarriage rate was 39.5%, 47.8%, 49.5%, 54.8% and 67.6%, respectively; the live birth rate was 21.6%, 13.4%, 10.7%, 4.7% and 3.1%, respectively, with statistically significant differences(P<0.001; P=0.020; P<0.001). Conclusion The ovarian function of women aged 40 and above decreases, and the outcome of in vitro assisted pregnancy is poor. The fertility of these women should be comprehensively evaluated to tailor individualized treatment.

Human leukocyte antigen-G promotes trophoblast invasion by regulating decidual natural killer cells

SUN Lina, DU Xiaoxiao, ZHANG Hongjuan, MENG Jinlai

Journal of Shandong University (Health Sciences). 2022, 60(6):  41-45.  doi:10.6040/j.issn.1671-7554.0.2021.1333

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Objective To investigate the effects of decidual natural killer(dNK)cells on the invasion ability of trophoblast cells, and to explore the mechanism of human leukocyte antigen-G(HLA-G)regulating the invasion of trophoblast cells by dNK cells. Methods The first trimester decidua tissue(n=11)was obtained from women undergoing elective termination of normal pregnancies. dNK cells were extracted with flow cytometry, and co-cultured with HTR-8/Svneo cells. The co-cultured cells were divided into HLA-G group and anti-HLA-G group, which was treated with HLA-G antibodies. Additionally, untreated HTR-8/Svneo cells were cultured as the blank control. The invasion ability of HTR-8/Svneo cells was detected with Transwell assay. The concentrations of angiopoietin-2(Ang-2)and granulocyte-macrophage colony-stimulating factor(GM-CSF)in the supernatant of co-cultured cells were determined with ELISA. Results Compared with the blank control, HLA-G group had significantly reduced invasion of HTR-8/Svneo cells(P<0.001). Compared with the HLA-G group, anti-HLA-G group had significantly reduced invasion of HTR-8/Svneo cells (P<0.01). ELISA assay results of the supernatant of co-cultured cells showed that the expressions of Ang-2(t=2.370, P=0.028)and GM-CSF(t=2.209, P=0.039)were significantly lower in the anti-HLA-G group than in the HLA-G group. Conclusion dNK cells can significantly inhibit the invasion of HTR-8/Svneo cells, and HLA-G might promote the invasion of trophoblast cells by up-regulating the expressions of Ang-2 and GM-CSF in dNK cells.

Multiparametric magnetic resonance imaging combined with prostate health index in the diagnosis of prostate cancer in 142 patients within PSA grey zone

SUN Haoyu, JIANG Xin, CHEN Shouzhen, QU Sifeng, SHI Benkang

Journal of Shandong University (Health Sciences). 2022, 60(6):  46-50.  doi:10.6040/j.issn.1671-7554.0.2021.1496

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Objective To evaluate the value of multiparametric magnetic resonance imaging(mpMRI), prostate imaging reporting and data system(PIRADS)v2.1 and prostate health index(phi)in the diagnosis of clinically significant prostate cancer(CSPCa)within the prostate specific antigen(PSA)grey zone, and to establish a prediction model for CSPCa based on PIRADS score combined with phi. Methods A total of 142 patients who underwent prostate biopsy were enrolled. Binary Logistic regression was used to analyze the correlation between the variables with CSPCa. Logit(P)was established. Receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic efficacy of each variable. The optimal cut-off value and the diagnostic efficiency of each variable was calculated, and McNemar test was used to compare the differences in diagnostic efficacy among various variables. Results CSPCa was detected in 41(28.87%)patients. Binary Logistic regression showed CSPCa was significantly associated with higher PIRADS score(OR=3.521, P<0.001). The prediction model was established as: Logit(P)=1.123×PIRADS score+0.048×phi-6.287. The area under the ROC curve(AUC)of Logit(P)was higher than %fPSA(P=0.011), phi(P=0.041)and PIRADS score(P=0.003), and the differences were statistically significant. The positive predictive value(PPV)and negative predictive value(NPV)of Logit(P)were 62.75% and 96.70%, respectively. Conclusion The mpMRI PIRADS score has high specificity and PPV in prostate tumor screening, but relatively low sensitivity. The prediction model Logit(P)established by PIRADS score combined with phi has higher sensitivity and can effectively reduce the rate of misdiagnosis and unnecessary prostate biopsy of CSPCa.

Value of isoform［-2］proprostate-specific antigen and its derivatives in the diagnosis of prostate cancer

XU Zhen, DIAO Tongxiang, ZANG Zhenjie, SHAO Dingchang, ZHANG Qi, SUN Dingqi, FU Qiang

Journal of Shandong University (Health Sciences). 2022, 60(6):  51-56.  doi:10.6040/j.issn.1671-7554.0.2021.1491

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Objective To explore the value of isoform［-2］proprostate-specific antigen(p2psa), prostate health index(PHI)and prostate health index density(phid)in the diagnosis of prostate cancer. Methods Clinical data of 148 male patients who underwent prostate biopsy in our hospital during Aug. 2020 and Sep. 2021 were collected. According to the pathological results, the patients were divided into benign prostatic hyperplasia group(BPH, n=78)and prostate cancer group(PCa, n=70). Serum prostate specific antigen(PSA), free prostate specific antigen(fPSA)and p2PSA were determined before prostate biopsy, and prostate specific antigen density(PSAD), PHI and PHID were calculated. Receiver operating characteristic(ROC)curve was drawn to evaluate the efficacy of various indexes in the diagnosis of prostate cancer. The prostate pathological result was considered as the gold standard to evaluate the Gleason score of PCa patients and detect the value of various indexes in predicting high-grade PCa(Gleason score ≥7). Results Compared with BPH group, the PCa group had significantly higher PSA, PSAD, p2PSA, PHI and PHID(all P<0.001). ROC curve showed that the area under the curve(AUC)of PSA, PSAD, p2PSA, PHI and PHID in the diagnosis of PCa were 0.68, 0.81, 0.83, 0.88 and 0.92, respectively. The diagnostic value of p2PSA, PHI and PHID was better than that of PSA(all P<0.001). The AUC of p2PSA, PHI and PHID in the diagnosis of high-grade PCa were 0.75, 0.84 and 0.84, respectively, which were better than that of PSA(AUC=0.69)(P=0.026, P=0.009, P=0.028). Conclusion Detection of p2psa, PHI and PHID can improve the specificity of prostate cancer diagnosis and accurately predict high-grade prostate cancer. They are significant to evaluate the malignancy, biological behavior and prognosis of the tumor.

Application value of modified S.T.O.N.E score in predicting the stone-free rate of one-stage renal FURL

SU Wengui, XU Hailong, YANG Meng, CUI Wei, NIE Qingsheng

Journal of Shandong University (Health Sciences). 2022, 60(6):  57-63.  doi:10.6040/j.issn.1671-7554.0.2022.0034

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Objective To explore the modified S.T.O.N.E scoring system in predicting the stone-free rate(SFR)of one-stage renal flexible ureteroscopic lithotripsy(FURL). Methods The clinical data of 93 cases undergoing FURL during Jan. 2018 and Aug. 2021 were retrospectively analyzed. According to the modified S.T.O.N.E score, the affected kidneys were divided into simple group(5-7 points, n=31), intermediate group(8-11 points, n=52)and complex group(12-17 points, n=10), and the 1-month SFR after surgery among the three groups were compared. The receiver operating characteristic(ROC)curve of the modified S.T.O.N.E, SHA.LIN, S.T.O.N.E and RUSS scores were plotted to compare the differences in the area under the ROC curve(AUC). Results The intraoperative and 1-month SFR were 74.19% and 80.65%, respectively(P=0.0412). The modified S.T.O.N.E score showed the intraoperative SFR in the simple, intermediate and complex group were 96.77%, 69.23% and 30.00%, respectively; the 1-month SFR were 96.77%, 80.77% and 30.00%, respectively. There were significant differences in the intraoperative and postoperative SFR in the intermediate group(P=0.041 2), while there was no difference between the simple and complex groups(P>0.05). Compared with the SHA.LIN and S.T.O.N.E scores, the modified S.T.O.N.E score showed no difference in AUC for predicting intraoperative SFR(all P>0.05); but there was difference compared with the RUSS score(P=0.007 2). There was no significant difference in the AUC among the modified S.T.O.N.E score, SHA.LIN, S.T.O.N.E and RUSS score in predicting 1-month SFR(all P>0.05). Conclusion Among the four renal stone scoring systems, the modified S.T.O.N.E score has the highest accuracy in predicting SFR during one-stage renal FURL and 1-month SFR after surgery, and it is worthy of clinical promotion.

C-TIRADS-based nomogram for malignant risk prediction of thyroid nodules

YANG Lizhi, SUN Xiao, SHANG Mengmeng, GUO Lu, SHI Dandan, LI Jie

Journal of Shandong University (Health Sciences). 2022, 60(6):  64-69.  doi:10.6040/j.issn.1671-7554.0.2021.1444

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Objective To establish a nomogram based on Chinese Thyroid Imaging Reporting and Data System(C-TIRADS)to predict the malignant risk of thyroid nodules. Methods The clinical and ultrasonic data of 388 patients with thyroid nodules treated at the Department of Thyroid Surgery of Qilu Hospital of Shandong University during Jan. 2020 and Jun.2021 were collected. A total of 210 patients during Jan 2020 and Dec. 2020 were selected as the development group, and 118 patients during Jan. 2021 and Jun. 2021 were selected as the validation group. According to the postoperative routine pathological results, the patients in the developwent group were divided into benign nodules group(n=137)and malignant nodules group(n=133). The independent risk factors of malignant thyroid nodules screened by univariate analysis and multivariate Logistic regression analysis were included to establish the nomogram. The performance of the nomogram was evaluated with concordance index(C-index), receiver operating characteristic(ROC)curve and calibration curve. Results Multivariate Logistic regression analysis revealed that age, thyroid stimulating hormone(TSH), thyroglobulin(TG)and C-TIRADS classification were independent risk factors for malignant thyroid nodules. The area under the ROC curve(AUC)of the nomogram was 0.981(95%CI: 0.967-0.996), and the AUC of the validation group was 0.951(95%CI: 0.909-0.992), showing the nomogram had excellent predictive performance. The C-index for internal validation of the nomogram was 0.981, suggesting that the nomogram had good discriminability. The calibration curve was close to the ideal curve, indicating that there was a high consistency between the predicted risk and actual risk. Conclusion Age, TSH, TG and C-TIRADS classification are independent risk factors for predicting malignant risk of thyroid nodules. The developed nomogram can realize the individualized and accurate prediction of malignant risk of thyroid nodules.

Systemic lupus erythematosus, antiphospholipid syndrome with cerebral venous sinus thrombosis: a case report and literature review

CHENG Xuan, YANG Fan, PAN Zhenglun

Journal of Shandong University (Health Sciences). 2022, 60(6):  70-74.  doi:10.6040/j.issn.1671-7554.0.2021.1457

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Objective To investigate the clinical manifestations, diagnosis and treatment of systemic lupus erythematosus(SLE)and antiphospholipid syndrome(APS)complicated with cerebral venous sinus thrombosis(CVST). Methods The clinical data of the patient were analyzed, and relevant literature was reviewed. Results The patient was a 32-year-old woman with headache and fever as the main clinical manifestations. Brain MRV indicated CVST. Antibodies related to SLE and APS were positive. The patient successively experienced fever with different origins during the course of the disease. Her condition was improved after anti-infection, anticoagulation, intracranial pressure reduction, epilepsy prevention, and hormone therapy for the primary disease. Conclusion SLE and APS complicated with CVST are rare. Due to the atypical clinical symptoms, missed diagnosis is easy to occur. Brain MRI/MRV and antibody screening should be performed as soon as possible in patients with unexplained headache, seizures and local brain damage.

Comparison of portable accelerometer-based navigation versus conventional instrumentation for total knee arthroplasty in 20 patients: the outcomes at early follow-up

MA Liang, ZHANG Yuankai, JIANG Shuwei

Journal of Shandong University (Health Sciences). 2022, 60(6):  75-81.  doi:10.6040/j.issn.1671-7554.0.2021.1467

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Objective To explore the differences in operation time, mechanical axis of the lower limb, mechanical lateral distal femoral angle(mlDFA)and functional outcomes between portable accelerometer-based navigation device(PAD)and conventional instrument in total knee arthroplasty(TKA). Methods A total of 20 patients undergoing TKA at our hospital during May 2018 and Dec. 2018 were involved, including 5 males and 15 females, aged 56-79 years, mean(67.85±6.53)years. Based on the different surgical methods, they were divided into the navigation group(n=10)and conventional group(n=10). The differences in preoperative general data, operation time, deviation of hip-knee-ankle(HKA)angle, mlDFA and Knee Society Scoring System(KSS score)were compared between the two groups. Results The mean follow-up was(39.58±1.86)months. There were no significant differences in gender, age, body mass index(BMI), KSS score and preoperative deviation of HKA angle between the PAD group and conventional group(P>0.05), no significant differences in mean operation time［(111.50±12.70)min vs(109.00±15.42)min, t=0.40, P=0.70］, total blood loss［(644.56±231.40)mL vs(604.67±250.44)mL, t=0.37, P=0.72］, mlDFA［(89.50±0.80)° vs(89.62±1.34)°, t=-0.24, P=0.81］, deviation of HKA angle［(1.96±0.93)° vs(1.83±1.03)°, t=0.28, P=0.79］, and KSS score［(94.68±3.63)vs(87.54±10.01), t=2.01, P=0.07］ between the two groups. After surgery, the deviation of HKA angle［navigation group:(9.85±4.53)° vs(1.96±0.93)°, t=5.85, P<0.001; conventional group(8.83±4.14)° vs(1.84±1.03)°, t=5.40, P<0.001］ and KSS score［navigation group:(47.22±22.34)vs(94.68±3.63), t=-6.14, P<0.001; conventional group:(47.22±20.17)vs(87.54±10.01), t=-8.19, P<0.001］ were significantly improved. Conclusion There are no significant differences between the navigation group and conventional group in terms of mechanical axis, total blood loss and functional outcomes of the knee. PAD has advantage of technical simplicity without prolonging the operation time.

Acute intermittent porphyria with infantile spasm: a case report and literature review

ZHAO Haiqing, LI Baomin, YANG Xiaofan, ZHANG Tong, LI Jun, ZHAO Yongheng, GAO Liang

Journal of Shandong University (Health Sciences). 2022, 60(6):  82-89.  doi:10.6040/j.issn.1671-7554.0.2021.1317

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Objective To investigate the clinical features and treatment of acute intermittent porphyria(AIP)complicated with infantile spasm. Methods The clinical data of a child with AIP complicated with infantile spasm were retrospectively analyzed and relevant literature was reviewed. Results (1) The girl started to neue convulsions at the age of 7 months, accompanied by retardation of intelligence and motor development. The patient was diagnosed as infantile spasm and began to take antiepileptic drugs at the age of 1 year and 7 months, but with poor effects. At the age of 4, she still had convulsions. A heterozygous mutation was found c. 579_583del(p.Q194Hfs *13), which was from her father. Urine turned red after exposure to sunlight, and acute intermittent porphyria was confirmed. (2) A total of 71 patients with AIP reported in 59 literatures were retrieved. The main clinical manifestations of AIP were abdominal pain, peripheral neuropathy and mental disorder. Some patients had electrolyte disturbances(hyponatremia, hypokalemia, hypomagnesemia), anemia, and hypertension. Conclusion Acute intermittent porphyria is a rare autosomal dominant disease with low penetrance. Due to atypical clinical symptoms and unclear expression in children, AIP is easy to be missed and misdiagnosed. Early diagnosis and treatment can avoid unnecessary casualties caused by acute attack and improve prognosis.

Establishment of a risk prediction scoring model for nosocomial infection in rheumatic heart disease patients after valve replacement surgery

YAO Xue, LU Ranran, SUN Shuling, GAO Cuiping, XIAO Ru, WANG Shuhui

Journal of Shandong University (Health Sciences). 2022, 60(6):  90-96.  doi:10.6040/j.issn.1671-7554.0.2021.1425

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Objective To explore the risk factors of nosocomial infection in rheumatic heart disease(RHD)patients after valve replacement surgery and to establish a risk prediction scoring model. Methods The clinical data of RHD patients who underwent valve replacement surgery in a general hospital in Shandong Province during Jan. 2018 and Dec. 2019 were retrospectively analyzed. The independent risk factors of postoperative infection were analyzed with univariate and multivariate Logistic regression, and a risk prediction scoring model was constructed by assigning a score to each risk factor according to the odds ratio(OR). The predictive efficiency of the model was evaluated with receiver operating characteristic(ROC)curve. Results The nosocomial infection rate was 23.40%, and the primary pathogens of infection were Acinetobacter baumannii(13 cases)and Klebsiella pneumonia(5 cases). Stress hyperglycemia, postoperative Braden score <14, duration of pericardial mediastinal drainage ≥7 d, duration of endotracheal intubation ≥3 d, and glucocorticoid use ≥4 d were independent risk factors for nosocomial infection, and the score of each risk factor in the scoring model was 3, 3, 3, 5 and 3, respectively. Patients with total score ≥6 had high risk of infection. The validation results of the model: the area under the ROC curve was 0.853(95%CI: 0.805-0.902), and the sensitivity and specificity were 84.4% and 74.2%, respectively. Conclusion The incidence of infection in RHD patients undergoing valve replacement surgery is relatively high, and the scoring model can effectively predict risks of postoperative infection.

The independent and cumulative associations of childhood household dysfunction with depressive symptoms during pregnancy

CAO Danfeng, LIU Zonghua, WANG Junzhi, ZHANG Guoxiang

Journal of Shandong University (Health Sciences). 2022, 60(6):  97-101.  doi:10.6040/j.issn.1671-7554.0.2021.1185

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Objective To explore the independent and cumulative associations of childhood household dysfunction with depressive symptoms during pregnancy. Methods A total of 871 subjects were enrolled in the obstetric outpatient department of a comprehensive tertiary-class hospital in Shandong Province during Jan. and Nov. 2020. The general demographic data, pregnancy-related characteristics, depressive symptoms and childhood household dysfunction were assessed with the self-designed General Information Questionnaire, Edinburgh Postpartum Depression Scale and Family Dysfunction Scale, respectively. Hierarchical multiple linear regression was used to investigate the independent and cumulative associations of childhood household dysfunction with depressive symptoms during pregnancy. Results After age, gestational age and average monthly household income were adjusted, of the 5 types of childhood family dysfunction, only “mother treated violently” was independently and positively associated with depressive symptoms during pregnancy(β=0.14, P<0.001). Accumulation of family dysfunction in childhood was positively associated with depressive symptoms during pregnancy(β=0.09, P=0.010). Conclusion “Mother treated violently” is independently and positively associated with household dysfunction, which has a cumulative effect on pregnancy depression symptoms.

Tobacco use status and influencing factors of cancer patients in shandong province

HOU Runan, SHAO Di, QIN Tingting, SHANG Meimei, SHEN Yuzhen, SUN Xiaojie

Journal of Shandong University (Health Sciences). 2022, 60(6):  102-106.  doi:10.6040/j.issn.1671-7554.0.2021.1213

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Objective To analyze the tobacco use status in cancer patients after diagnosis and the influencing factors so as to provide scientific evidence for smoking cessation intervention and prognosis. Methods From July to August 2020, a total of 405 subjects meeting the inclusion criteria were selected from two hospitals in Shandong Province, including 296 males and 109 females aged 18 to 92 years, with an average age of(60.43±11.52)years. Cluster sampling method was adopted to conduct a questionnaire survey. The tobacco use status and influencing factors were analyzed with t-test, Chi-square test and binary Logistic regression analysis. Results Of the 405 subjects, 197 were non-smokers, 208 were smokers, 121 were quitters after diagnosis, and 87 were smokers after diagnosis. The smokers after diagnosis accounted for 21.5% of all respondents and 41.8% of the smokers or ever smokers. The significant influencing factors of smoking after cancer diagnosis included age, time since diagnosis, pathological stage, years of smoking and depression. Conclusion The smoking rate of cancer patients after diagnosis is relatively high. Targeted measures should be taken to help cancer patients quit smoking, so as to improve their prognosis and quality of life.

Long-acting injectable application in patients with schizophrenia in communities of three provinces: current status and problems

LI Jiabo, OUYANG Jiangfeng, YANG Ding, GAO Jing, SUN Qiang

Journal of Shandong University (Health Sciences). 2022, 60(6):  107-113.  doi:10.6040/j.issn.1671-7554.0.2021.1237

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Objective To analyze the current status and problems of long-acting injectable(LAI)application in patients with schizophrenia in communities of three provinces, so as to provide reference for promoting its application and promotion. Methods Purpose sampling was used to select Yunfu, Chengdu and Linyi according to the principle of maximum differentiation. Data were obtained through interviews with various stakeholders.Thematic framework approach was adopted for analysis, and nonparametric test was used to compare the frequency differences of common concerns among the three sample areas. Results The three sample areas were comparable in the acceptance degree, injection qualification and support policies of LAI, but there were differences in the application scope, inclusion criteria, injection location, capital guarantee and participating departments.There were also problems in the application of LAI in patients with schizophrenia in communities, such as limitations in cognitive and treatment concept, insufficient access to treatment, insufficient funding sustainability, inadequate involvement and collaboration of departments, and so on. Conclusion The sample areas have both similarities and differences in the current status of LAI application in patients with schizophrenia in communities. For the existing problems, the following measures are necessary: strengthen publicity and communication; provide LAI for patients as soon as possible; implement a more reasonable injection scheme according to local conditions; reduce injection prices; formulate and implement reasonable medical insurance policies; give full play to the organization and coordination role of relevant government departments.

Cause of death and disease burden of residents of Zibo City, Shandong Province in 2019

LIU Ying, YANG Shuxia, SHE Kaili, CHENG Chuanlong, FANG Qidi, HAN Chuang, CUI Feng, LI Xiujun

Journal of Shandong University (Health Sciences). 2022, 60(6):  114-121.  doi:10.6040/j.issn.1671-7554.0.2021.1124

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Objective To analyze the death characteristics and disease burden of registered residents of Zibo City in 2019 and provide scientific evidence for health decision-making and disease prevention and control. Methods The monitoring data of death of registered residents of Zibo City in 2019 were collected and collated. The disease burden of indicators such as years of life lost(YLLs), years lived with disability(YLDs)and disability-adjusted life years(DALYs)were calculated. Results In 2019, the mortality was 706.03/100,000, standardized mortality was 402.47/100,000, DALYs was 941.36 thousand person-years and DALY rate was 216.71‰. YLLs was the major part of DALYs(62.14%). The standardized mortality and DALY rate of males were higher than those of females; people aged 65 and over accounted for 77.50% of the total deaths and DALYs accounted for 47.97% of the total DALYs; non-communicable diseases accounted for 89.77% of deaths and 86.87% of DALYs, respectively. The top three causes of death were circulatory diseases, malignant neoplasms and various injuries. The top three causes of DALYs were circulatory diseases, malignant neoplasms, and musculoskeletal and connective tissue diseases. Conclusion The major causes of death and disease burden of registered residents of Zibo City in 2019 are non-communicable diseases. The prevention and control of circulatory diseases, malignant neoplasms, and musculoskeletal and connective tissue diseases that may seriously affect residents healthy life years should be strengthened for middle-aged and elderly men and other key groups.

Influence of the gender of children being followed on the subjective well-being of the 656 MEFC in Jinan

ZHAO Yang, KONG Fanlei, LI Shixue

Journal of Shandong University (Health Sciences). 2022, 60(6):  122-128.  doi:10.6040/j.issn.1671-7554.0.2021.1338

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Objective To explore the relationship between the gender of children being followed and subjective well-being among migrant elders following their children(MEFC)in Jinan, so as to provide reference for improving the well-being of MEFC and coping with the trend of aging. Methods A total of 656 MEFC(36.3% males and 63.7% females)in Jinan were selected with multi-stage cluster random sampling. A descriptive analysis was performed using SPSS 25.0 to describe the characteristics of the sample. The relationship between gender of the children being followed and subjective well-being of MEFC was analyzed with binary Logistic regression. Results Our study found that about 94.2% of the MEFC felt happy after moving to live with their children. Gender of the children being followed, willingness to follow, disagreement with children in terms of education of grandchildren, way of migration, like to the current city, and number of chronic diseases had a statistically significant impact on the subjective well-being. The subjective well-being of the MEFC living with daughters was statistically higher than those living with sons(OR=2.707, 95%CI:1.371-5.344). This was true even after other variables were controlled(OR=2.354, 95%CI:1.134-4.887). Willingness to follow the children(OR=3.289, 95%CI:1.399-7.732), like to the current city(OR=2.975, 95%CI:1.300-6.808)and no disagreement with children on grandchildrens education(OR=4.149, 95%CI:1.602-10.740)were associated with a higher level of subjective well-being. Conclusion The gender of children being followed can affect the subjective well-being of MEFC, and those who live with daughters are more likely to feel happy.