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    10 September 2022
    Volume 60 Issue 9
    Status and progress of female fertility protection
    WU Ruifang, LI Changzhong
    Journal of Shandong University (Health Sciences). 2022, 60(9):  1-7.  doi:10.6040/j.issn.1671-7554.0.2022.0916
    Abstract ( 1143 )   HTML ( 25 )   PDF (1344KB) ( 318 )   Save
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    Fertility protection, as a new and rapidly developing interdisciplinary field in recent years, has made great progress and applied fertility preservative technology(FPT)which plays important roles in preserving fertility and solving infertility problems. FPT such as in vitro cryopreservation of the eggs or ovarian tissues from young tumor patients can protect patients' fertility from disease-related damages or environmental-impacted infertility. Surgical measures with primary purpose to keep fertility can solve problems resulting in infertility and repair or reconstruct the structure and function of the reproductive organs. Assisted reproductive treatment as a complement measure can rate up the success of assisted reproduction. In this article, we will highlight the significant developments of fertility preservation, identify the challenges to be faced and put forward recommendations for the development of fertility preservative technology in China.
    Fertility assessment of women
    LI Ping, HE Xuemei
    Journal of Shandong University (Health Sciences). 2022, 60(9):  8-11.  doi:10.6040/j.issn.1671-7554.0.2022.0802
    Abstract ( 873 )   HTML ( 8 )   PDF (1013KB) ( 214 )   Save
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    With the aging of the population and the decline of fertility, our country has released the three-child policy, and it is very necessary to carry out fertility assessment for couples who have fertility requirements. Female fertility is closely related to age and reproductive organs such as, ovaries, fallopian tubes and uterus. This article discusses the factors that affect female fertility.
    Latest advances of embryo cryopreservation technology
    SHI Yuhua, PAN Ye, XIE Yanqiu
    Journal of Shandong University (Health Sciences). 2022, 60(9):  12-18.  doi:10.6040/j.issn.1671-7554.0.2022.0794
    Abstract ( 1153 )   HTML ( 34 )   PDF (1382KB) ( 317 )   Save
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    With the development of cryopreservation technology, embryo cryopreservation has become the core step of assisted reproduction and an important method of fertility preservation. The number of embryo freezing cycles has increased dramatically all over the world in the past few years. Thanks to the outstanding advantages of embryo freezing, frozen embryo transfer has attracted more and more attention. How to improve embryo freezing technology and improve clinical outcomes are the current research hotspots. Therefore, this paper will make a comprehensive review of the development history, application, classification and current research progress of embryo freezing technology.
    Status and progress of oocyte cryopreservation
    MA Xiang, ZHAO Feiyan
    Journal of Shandong University (Health Sciences). 2022, 60(9):  19-23.  doi:10.6040/j.issn.1671-7554.0.2022.0874
    Abstract ( 644 )   HTML ( 16 )   PDF (1233KB) ( 269 )   Save
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    Oocyte cryopreservation has a history of more than 30 years, which is mainly applicable to the fertility preservation of cancer patients before radiotherapy and chemotherapy, or non-cancer patients and people who delay childbearing due to personal factors. In addition, it can also be used as a remedy for male inability to provide sperm due to special factors in the process of assisted reproduction. At present, the commonly used methods of oocyte cryopreservation include slow cryopreservation and vitrification cryopreservation, and with the progress of research, vitrification has gradually replaced slow cryopreservation. Many studies have shown no significant differences in clinical pregnancy rates, obstetric and perinatal outcomes between embryos transferred using frozen eggs and fresh eggs.
    Ovarian tissue cryopreservation and preservation
    RUAN Xiangyan, CHENG Jiaojiao, DU Juan, GU Muqing
    Journal of Shandong University (Health Sciences). 2022, 60(9):  24-30.  doi:10.6040/j.issn.1671-7554.0.2022.0822
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    Ovarian tissue cryopreservation and transplantation(OTCT)is a new fertility preservation(FP)technology, which can preserve not only the fertility, but also the ovarian endocrine function. Without ovarian stimulation and delaying anticancer treatment, thousands of follicles can be cryopreserved at one time, and natural pregnancy can be achieved after ovarian tissue transplantation, which is the only way to preserve fertility for prepubertal girls and young women who cannot delay anticancer treatment. In 2019, the American Society of Reproductive Medicine(ASRM)claimed that OTCT was no longer an experimental technique.
    Fertility preservation in patients with endometriosis
    YAN Lei, YUE Caixin, LIU Yichun
    Journal of Shandong University (Health Sciences). 2022, 60(9):  31-34.  doi:10.6040/j.issn.1671-7554.0.2022.0843
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    Endometriosis can affect female fertility by reducing ovarian reserve, changing the immune system and pelvic anatomical structure, and reducing endometrial receptivity. Therefore, fertility should be protected and preserved in patients with endometriosis. For such patients, early diagnosis, standardized treatment and long-term management can help to protect fertility. In addition, measures such as embryo freezing, mature oocyte freezing and ovarian tissue freezing, can help to preserve fertility. Fertility protection requires a multidisciplinary consultation mechanism.
    Progress on assisted reproductive technology for women with atypical endometrial hyperplasia and endometrial carcinoma receiving fertilitysparing treatment
    LU Qun, ZHAO Lulu
    Journal of Shandong University (Health Sciences). 2022, 60(9):  35-41.  doi:10.6040/j.issn.1671-7554.0.2022.0973
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    As the incidences of endometrial carcinoma(EC)and atypical endometrial hyperplasia(AEH)are rising and patients tend to be younger, the demand for fertility preservation is also increasing. Although fertility-preserving therapy based on high-dose progesterone has achieved high rate of complete response(CR), fertility remains low. Pregnancy for women with EC/AEH has attracted attention, but there is a lack of systematic research for increasing pregnancy after fertility-sparing treatment for women with EC and AEH. The paper focuses on the optimal time of initiating in vitro fertilization and embryo transfer(IVF-ET), appropriate ovarian stimulation protocol in women after fertility-sparing treatment for EC and AEH and the difficulties during IVF-ET.
    Fertility protection and preservation in breast cancer patients
    LIN Yun, XIE Yanqiu
    Journal of Shandong University (Health Sciences). 2022, 60(9):  42-46.  doi:10.6040/j.issn.1671-7554.0.2022.0880
    Abstract ( 606 )   HTML ( 4 )   PDF (1326KB) ( 47 )   Save
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    Breast cancer is the most common female malignant tumor all over the world. With the promotion of breast cancer screening and the development of comprehensive treatment, the disease-free survival rate and overall survival rate of breast cancer patients have been greatly improved. Physicians are concerned about the infertility problem of young breast cancer patient, and fertility preservation is the most effective treatment. This article illustrates the effects of breast cancer treatment on ovarian function, strategies of fertility preservation and research progress in assisted reproduction for breast cancer patients, which provides evidence for fertility preservation among breast cancer patients in clinical practice.
    Ethical issues and considerations in fertility preservation
    HAO Guimin, LUO Zhuoye, WANG Yizhuo
    Journal of Shandong University (Health Sciences). 2022, 60(9):  47-52.  doi:10.6040/j.issn.1671-7554.0.2022.0909
    Abstract ( 811 )   HTML ( 9 )   PDF (1282KB) ( 168 )   Save
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    As an emerging technology, fertility preservation technology has gradually developed from experimental to clinical application in recent years. On the one hand, it meets peoples growing demand for maintaining fertility. On the other hand, ethical issues inevitably arise when implementing this technology. On the basis of adherence to the ethical principles of respect, beneficence and justice in clinical practice, developing technology, optimizing the allocation of medical resources, improving policies, and strengthening ethical scrutiny may provide methods for solving ethical problems.
    Effects of tanshinone IIA on the proliferation and apoptosis of endometrial carcinoma cells
    ZHAO Ge, ZOU Cunhua, SONG Dongdong, ZHAO Shuping
    Journal of Shandong University (Health Sciences). 2022, 60(9):  53-58.  doi:10.6040/j.issn.1671-7554.0.2021.1471
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    Objective To investigate the effects of tanshinone IIA on the proliferation and apoptosis of endometrial carcinoma cells. Methods According to the experimental requirements, endometrial carcinoma cells treated with tanshinone IIA were divided into the control group, low concentration group(1 μg/mL), medium concentration group(2.5 μg/mL)and high concentration group(5 μg/mL). Meanwhile, cells co-treated with CK2 specific phosphorylation inhibitor(TBB)and tanshinone IIA were divided into the control group, TBB group(60 μmol), drug group(5 μg/mL)and drug(5 μg/mL)+ TBB group(60 μmol). The effects of tanshinone IIA on the proliferation of cells were detected with crystal violet staining; expressions of P53, Cleaved caspase-3, B-cell lymphoma-2(Bcl-2), casein kinase 2α(CK2α), deletion in breast cancer 1(DBC1), silent information regulator 1(SIRT1)and p-deletion in breast cancer 1(p-DBC1)were detected with Western blotting. After TBB was added, expressions of CK2α, DBC1 and p-DBC1 were also detected. Results The results of crystal violet staining showed that the proliferation rates of the control group and high concentration group at each time point(24 h, 48 h, 72 h)were(0.87±0.05)%,(0.61±0.04)%,(0.30±0.04)% and(0.09±0.04)%, respectively(F=217.976, P<0.001). The results of Western blotting showed that under the action of tanshinone IIA, the expressions of P53(F=244.261)and Cleaved caspase-3(F=290.842)increased in a concentration-dependent manner, while the expression of Bcl-2(F=198.170)decreased in a concentration-dependent manner(P<0.001), and the expression of p-DBC1/DBC1 decreased in a concentration-dependent manner(F=187.092, P<0.001), but there was no significant difference in CK2α and SIRT1 expressions(P>0.05). The expression of p-DBC1/DBC1 was inhibited by TBB(F=7.847), tanshinone IIA(F=827.715)and their combination(F=22.174), and the difference was statistically significant compared with the control group(P=0.023,P<0.001, P=0.002), but there was no significant difference in CK2α expression(P>0.05). Conclusion Tanshinone IIA can significantly inhibit the proliferation and induce apoptosis of endometrial carcinoma cells, and the mechanism may be related to the CK2/DBC1/SIRT1/P53 signaling pathway.
    Effects and mechanism of overexpression of miR-27a on hippocampal neuronal injury in rats with acute cerebral infarction
    ZOU Pinheng, CHEN Tianguo, HU Kang, LI Weicai
    Journal of Shandong University (Health Sciences). 2022, 60(9):  59-66.  doi:10.6040/j.issn.1671-7554.0.2021.1383
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    Objective To investigate the effects of miR-27a overexpression on hippocampal neuron injury in rats with acute cerebral infarction(ACI)and its possible mechanism. Methods A total of 60 SD rats were randomly divided into sham operation group(Sham group), Model group, agomir negative control group(Agomir-NC group)and miR-27a agomir group(Agomir group), with 15 rats in each group. Modified Longa thread embolization method was used to establish the rat models of ACI. One day before modeling and the time when modeling was successful, 15 mg/kg agomir-NC or miR-27a agomir were injected through the lateral ventricle. The neurological deficits of rats were evaluated with Zea-Longa score 72 h after operation. The cerebral infarct size of rats was measured with triphenyltetrazole chloride(TTC)staining. The apoptosis level of hippocampal tissue was detected with TUNEL. The expression of miR-27a in the hippocampus was detected with qRT-PCR. The percentage of Iba-1+/CD68+ microglia in the hippocampus was detected with flow cytometry(FCM). The levels of IL-1β, IL-6, TNF-α and iNOS in hippocampus were detected with enzyme-linked immunosorbent assay(ELISA). The expressions of toll-like receptor 4(TLR4)signaling pathway related proteins including TLR4, MyD88, p-NF-κB p65 and NF-κB p65 in hippocampus were detected with Western blotting. Results Compared with Sham group, the Model group had significantly increased apoptosis of hippocampal cells and level of Iba-1+/CD68+ microglia(P<0.001), and significantly increased levels of IL-1β, IL-6, TNF-α and iNOS and protein expressions of TLR4, MyD88 and p-NF-κB p65(P<0.05), but significantly decreased expression of miR-27a(P<0.001). Compared with Model group, the agomir group had significantly decreased neurological deficits score, cerebral infarction area, apoptosis level of hippocampal cells and level of Iba-1+/CD68+ microglia(P<0.001), and significantly decreased levels of IL-1β, IL-6, TNF-α and iNOS and protein expressions of TLR4, MyD88 and p-NF-κB p65(P<0.05), but significantly increased expression of miR-27a(P<0.001). Conclusion Overexpression of miR-27a can alleviate hippocampal neuronal injury in ACI rats by inhibiting microglia M1-type polarization, and the mechanism may be related to the inhibition of TLR4/NF-κB signaling pathway.
    Changes of intestinal B lymphocytes in 6 mice with non-alcoholic fatty liver disease
    ZHANG Feng, WU Zhe, XU Jun, LIU Yulan
    Journal of Shandong University (Health Sciences). 2022, 60(9):  67-73.  doi:10.6040/j.issn.1671-7554.0.2022.0686
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    Objective To investigate the changes of intestinal B lymphocytes in mice with non-alcoholic fatty liver disease(NAFLD)induced by high fat diet. Methods A total of 12 male C57BL/6J mice were randomly divided into the experimental group and control group, with 6 in either group. The experimental group was fed with 45% high fat diet, while the control group with normal diet. After 16 weeks, the mice were killed to collect liver, small intestine mucosa, colon mucosa, mesenteric lymph nodes(MLN), Peyers patches(PP)and small intestine contents. Hepatic steatosis in experimental group was confirmed with hematoxylin and eosin(HE)staining. The distribution and expression of B cells in small intestine and colon mucosa were detected with immunohistochemical staining and real-time quantitative PCR, respectively. Proportion of B and T lymphocytes in the MLN and PP were analyzed with flow cytometry. The sIgA level in the small intestinal contents was detected with enzyme linked immunosorbent assay(ELISA). B lymphocytes were enriched with a magnetic-activated cell sorting method and cultured in vitro with or without the stimulation of lipopolysaccharide(LPS)or anti-CD40/IgM(BCR). The levels of IL-6, IL-10 and TNF-α in the cultural supernatants were monitored with cytometric bead arrays(CBA). Results B lymphocytes scattered throughout the lamina in both groups. The proportion of B lymphocytes was increased significantly in MLN and PP in experimental group than in control group(PMLN-B=0.025, PPP-B=0.004). The experimental group had higher level of sIgA in the small intestinal contents(P=0.042), which was in line with the higher proportion of IgA+ B lymphocytes in the PP(P=0.023). B lymphocytes in MLN in the experimental group secreted more IL-6 upon the stimulation of LPS or anti-CD40/IgM(BCR)(PLPS<0.001, PBCR=0.003)than in the control group. Conclusion Proportion of B lymphocytes in PP and MLN increased significantly in NAFLD mice. Small intestine secreted higher level of sIgA, and B lymphocytes in MLN produced more IL-6 upon stimulation in NAFLD mice.
    IGF2BP2/m6A/ITGA5 signal axis regulates the proliferation and migration of renal clear cells
    ZHANG Zhenwei, LI Jia, CHEN Keming
    Journal of Shandong University (Health Sciences). 2022, 60(9):  74-84.  doi:10.6040/j.issn.1671-7554.0.2022.0429
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    Objective To explore the potential role of m6A “recognition protein” insulin-like growth factor 2 mRNA binding protein(IGF2BP2)in clear cell renal cell carcinoma(ccRCC). Methods The expression of IGF2BP2 in ccRCC was searched in cancer gene database TCGA and analyzed with qRT-PCR and Western blotting. The m6A modification of ITGA5 mRNA was identified with methylated RNA immunoprecipitation qPCR combined with bioinformatics. IGF2BP2 on the regulation of ITGA5 expression was detected with gene knockdown/overexpression experiments, qRT-PCR and Western blotting. The biological roles of IGF2BP2 and ITGA5 in ccRCC cells were determined with gain- and loss-of-function experiments. Results Data from TCGA showed that IGF2BP2 was highly expressed in ccRCC, while the high expression was not conducive to the overall survival(HR=1.6, P=0.005)and disease-free survival(HR=1.9, P=0.014). Western blotting and qRT-PCR also indicated that IGF2BP2 was highly expressed. Western blotting revealed that IGF2BP2 expression was significantly higher in ccRCC cell lines than in normal renal epithelial cells. Gene set enrichment analysis(GSEA)showed that ITGA5 might be a downstream target of IGF2BP2. Further knockdown or overexpression suggested that IGF2BP2 regulated ITGA5 at the post-transcriptional level. Methylated RNA immunoprecipitation qPCR showed that m6A modification sites were in the 3'UTR region of ITGA5, and low m6A modifications helped to maintain the stability of mRNA. Conclusion IGF2BP2 is upregulated in ccRCC, which is unfavorable for the prognosis and survival. IGF2BP2/m6A/ITGA5 signal axis regulates the proliferation, migration and angiogenesis in ccRCC.
    Sensitivity of GPCR-G protein fusion sensor to detect the interaction between GPCR and G protein
    MA Chuanshun, LIN Hui, SUN Jinpeng, ZHANG Daolai
    Journal of Shandong University (Health Sciences). 2022, 60(9):  85-90.  doi:10.6040/j.issn.1671-7554.0.2022.0368
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    Objective GPR56-G protein fusion sensor was used as a prototype to establish a highly sensitive method to detect the interaction between GPCR and G protein. Methods The N-terminus of the G protein α subunit with NanoLuc luciferase(Nluc)was fused to the C-terminus of the GPCR. The fusion protein of both GPCR and G protein α subunit was constructed as the experimental group, and the receptor and G protein were co-expressed as a control group. The constitutive activity of GPR56-Gα12 subunit fusion protein, GPR56 and Gα12 subunit co-expression were compared with bioluminescence resonance energy transfer(BRET)at the same level of receptor expression. The effect of agonist(P19)on the interaction of GPR56-Gα12 subunit fusion protein was detected with BRET. Results The BRET ratio results showed that the GPR56-Gα12 subunit fusion protein had stronger constitutive activity than the control group co-expressed with GPR56 and Gα12 subunits(F=424.7, P<0.001). Compared with the control group, the experimental group had decreased half effective concentration(EC50)of P19 activation (t=13.36, P<0.001). The GPR56-Gα12 subunit fusion protein was more sensitive to P19 and had a stronger affinity. Conclusion The GPCR-Gα subunit fusion protein system is a sensitive method to detect the interaction between GPCRs and G protein.
    Correlation between EEG variations and BASED evaluation of the efficacy of ACTH treatment in 54 cases of infantile spasms
    ZHENG Su, CHEN Shuhua, LI Hua, DENG Jie, CHEN Chunhong, WANG Xiaohui, FENG Weixing, HAN Xiaodi, ZHANG Yujia, LI Na, LI Mo, FANG Fang
    Journal of Shandong University (Health Sciences). 2022, 60(9):  91-96.  doi:10.6040/j.issn.1671-7554.0.2022.0654
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    Objective To explore the characteristics of electroencephalogram(EEG)after adrenocorticotropic hormone(ACTH)treatment and the efficacy in patients with infantile spasm(IS). Methods Clinical and EEG data of 54 IS patients treated with ACTH during Nov. 2019 and Apr. 2021 were retrospectively analyzed. EEG analysis included background activity(slow waves)and epileptic discharges(epileptic waves and hypsarrhythmia). Changes of EEG before and after ACTH treatment were evaluated with burden of amplitudes and epileptiform discharges score(BASED). According to whether epileptic seizure occurred 14 days after ACTH treatment, the patients were divided into none-seizure group(n=29)and seizure group(n=25). The changes of EEG before and after ACTH treatment were compared between the groups. Results Focal slow wave was observed in 18 cases and focal epileptic wave in 28 cases in the non-seizure group, which were significantly higher than those in the seizure group(P<0.05), while hypsarrhythmia was observed in 1 case in the non-seizure group, which was significantly lower than that in the seizure group(P<0.05). BASED results showed that EEG remission was observed in 26 cases in the non-seizure group, which was significantly higher than that in the seizure group(7 cases, P<0.000 1), and the EEG remission was consistent with the clinical efficacy(P<0.001). During the follow-up of 12 to 29 months, spasm recurred in 9 and 16 cases in the non-seizure group and seizure group, respectively, and the control rates of spasm were 68.97% and 36%, respectively. Conclusion There is a certain correlation between the characteristics of interictal EEG and clinical efficacy. The BASED result shows that EEG remission after ACTH treatment indicates good clinical efficacy. Thus, the quantification on BASED can assist the evaluation of clinical efficacy.
    Factors of preoperative rebleeding in 181 patients with poor-grade aneurysmal subarachnoid hemorrhage
    XU Kai, HAN Chao, DING Shouluan, DING Xuan, XING Deguang, WANG Chengwei
    Journal of Shandong University (Health Sciences). 2022, 60(9):  97-101.  doi:10.6040/j.issn.1671-7554.0.2022.1378
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    Objective To investigate the influencing factors of rebleeding in patients with poor-grade aneurysmal subarachnoid hemorrhage(aSAH). Methods A total of 181 patients who met the World Federation of Neurosurgical Societies(WFNS)grade IV or V criteria were enrolled in this retrospective cohort study. The patients were divided into rebleeding group(n=26)and non-rebleeding group(n=155). Case-control study analysis was used to compare the demographic characteristics, medical history, clinical status, WFNS grade, CT Fisher grade, aneurysm characteristics, treatment timing and outcomes at 6 months between the two groups. Results Preoperative relleeding was observed in 26 of 181 cases. There were no significant statistical differences between the two groups in gender, age, medical history(hypertension, diabetes and obesity), personal history(smoking and drinking), clinical status(cerebral hernia, intracerebral hematoma, low density area and hydrocephalus)and radiological characteristics(aneurysm location, aneurysm size, multiple aneurysms). In the rebleeding group, 13 cases had intraventricular hemorrhage, 15 cases were of WFNS grade V, 25 cases were of CT Fisher grade 3-4, and the differences were statistically significant compared with those in the non-rebleeding group. Multivariate analysis showed that intraventricular hemorrhage(OR=3.804, 95%CI: 1.161-12.462, P=0.027)was an independent risk factor for rebleeding. In the rebleeding group, 20 cases(76.92%)had poor prognosis(mRS 3-6), and the mortality rate was 26.9%. The difference was statistically significant compared with that in the non-rebleeding group. Unfavorable outcomes occurred more often in the rebleeding group. Conclusion IVH, WFNS grade V and CT Fisher grade 3-4 are associated with rebleeding. Demographic characteristics, medical history, clinical status, treatment timing, external ventricular drainage(EVD)or aneurysm characteristics are not significantly associated with rebleeding.
    Simplified paravaginal repair for both anterior and middle pelvic floor defect
    ZHANG Ying, ZHOU Jing, WANG Changhe
    Journal of Shandong University (Health Sciences). 2022, 60(9):  102-107.  doi:10.6040/j.issn.1671-7554.0.2022.0120
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    Objective To investigate the clinical value of simplified paravaginal repair in the treatment of anterior and middle pelvic floor defect(namely anterior vaginal prolapse and uterine prolapse). Methods This prospective observational study involved 41 consecutive patients with typical anterior vaginal prolapse and uterine prolapse. All patients received simplified paravaginal repair. The subjective symptoms and objective results of physical examinations were recorded during regular follow-up. Results All operations were successful. The average operation time was(56.6±18.6)min, and the median blood loss was 150.0(50.0, 200.0)mL. During the median follow-up of 12 months(range, 6-23 months), 5 cases were lost, 3 cases had relapse, but 2 of which were asymptomatic, and 1 case had vaginal pain. The objective and subjective cure rate was 91.7% and 94.4%, respectively. Conclusion Simplified paravaginal repair, as a novel surgical procedure, is safe and effective for treating anterior vaginal prolapse and uterine prolapse.
    Angiosarcoma of the uterus: a report of 2 cases and literature review
    WANG Lihui, GAO Min, KONG Beihua
    Journal of Shandong University (Health Sciences). 2022, 60(9):  108-112.  doi:10.6040/j.issn.1671-7554.0.2022.0099
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    Objective To analyze 2 cases of angiosarcoma of the uterus misdiagnosed as other types of uterine malignancies and to review relevant literature, so as to improve the clinicians awareness of the clinicopathological feature, treatment and prognosis of this disease. Methods The clinical data of 2 cases of uterine angiosarcoma were collected and analyzed, and relevant literature was reviewed. Results Case 1 received radical surgery and 6 cycles of ifosfamide + epirubicin chemotherapy after surgery. The postoperative progression-free survival was 62 months and the overall survival was 66 months. Case 2 received radical surgery and 4 cycles of ifosfamide + epirubicin chemotherapy, with no sign of recurrence. Conclusion Angiosarcoma of the uterus is extremely rare in clinical practice and is easily misdiagnosed. It should be differentiated from other uterine malignancies by pathology and immunohistochemistry. The combination of surgery and adjuvant chemotherapy might be effective.
    Effects of periodontal basic therapy on postoperative pneumonia in patients with lung cancer before thoracic surgery
    HAN Jing, JIA Chunling
    Journal of Shandong University (Health Sciences). 2022, 60(9):  113-118.  doi:10.6040/j.issn.1671-7554.0.2021.1094
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    Objective To investigate the effects of periodontal basic therapy on postoperative pneumonia(POP)in patients with lung cancer undergoing thoracic surgery. Methods Patients with lung cancer and periodontal disease who met the inclusion and exclusion criteria were divided into the experimental group and control group. The experimental group received periodontal basic therapy before thoracic surgery, while the control group maintained the oral hygiene habits. All subjects were followed up for 30 days, and the incidence of POP and related factors were analyzed. Results There were 206 cases in the experimental group and 190 cases in the control group. The incidence of POP in the experimental group was 2.91%, which was lower than that in the control group 14.21%(χ2=16.52, P<0.001). Logistic regression results showed that periodontal basic therapy had a protective effect on POP(OR=0.181, 95%CI=0.078-0.411). The incidence of POP in the experimental group was lower than that in the control group(P<0.05)in patients with gingivitis and periodontitis. In both groups, the incidence of POP increased with the severity of periodontal disease(P<0.05). The incidence of POP in the experimental group was significantly lower than that in the control group in those who underwent thoracotomy(wedge resection, lobectomy, segmental resection, sleeve resection)or video-assisted thoracoscopic surgery(P<0.05). Conclusion Periodontal basic therapy can reduce the incidence of POP in patients with lung cancer and periodontal disease before thoracic surgery.
    Influencing factors of cancer pain management disorder in 123 cancer patients
    XU Xiaofen, ZHU Xiao, MA Wei, LI Na
    Journal of Shandong University (Health Sciences). 2022, 60(9):  119-124.  doi:10.6040/j.issn.1671-7554.0.2022.0508
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    Objective To investigate the influencing factors of cancer pain management disorder in cancer patients. Methods A total of 123 patients with cancerous pain in different cancer categories and stages of disease progression were surveyed with the General Data Questionnaire, Pain Management Disorder Scale, Pain Knowledge Questionnaire, General Self-Efficacy Scale, and Pain Self-Management Behavior Scale. The influencing factors of pain management disorder were determined with multiple linear regression analysis. Results The total average score of pain management disorder was(2.63±0.43), which was at a high level, the score of pain knowledge level was(52.0±15.13)%, the general self-efficacy score was(2.55±0.55), and the overall pain self-management behavior score was(28.42±4.45). Multiple linear regression analysis showed that educational level, occupation, source of expenses, general self-efficacy, pain knowledge and self-management of pain were the influencing factors of pain management disorder(P<0.05), explaining 37.5% of the total variation. Conclusion Cancer patients with serious pain management disorder need targeted intervention.