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    10 September 2018
    Volume 56 Issue 9
    Management of non-lactational infectious breast abscesses
    YU Zhigang, ZHOU Fei
    Journal of Shandong University (Health Sciences). 2018, 56(9):  1-5.  doi:10.6040/j.issn.1671-7554.0.2018.684
    Abstract ( 578 )   PDF (1525KB) ( 90 )   Save
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    Non-lactational breast abscesses are a group of non-specific inflammatory disease that occurred in non-lactating women. The main clinical manifestations are subareolar or peripheral abscesses. If not treated, the abscess will brust spontaneously and form mammary duct fistula, which seriously affect the quality of life of wowen. The etiology and 山 东 大 学 学 报 (医 学 版)56卷9期 -余之刚,等.非哺乳期感染性乳腺脓肿诊疗策略 \=-pathogenesis of non-lactational breast abscesses have not been fully elucidated yet and there is no definitive therapeutic strategy for such disease. Here, in summary of the up-to-date research progress, we review the epidemiology, risk factors and the treatment of this disorder.
    Recombinant human vascular endostatin enhances antitumour activity of EGFR-TKIs for lung cancer
    SHI Shuyuan, GUAN Zhiyu, SUN Daqiang
    Journal of Shandong University (Health Sciences). 2018, 56(9):  6-10.  doi:10.6040/j.issn.1671-7554.0.2018.535
    Abstract ( 583 )   PDF (1492KB) ( 15 )   Save
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    Objective To study the inhibitory effect of recombinant human vascular endostatin(endostar)combined with epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI), erlotinib, on the resistant cell lines of EGFR-TKIs H1975(with L858R and T790M)in vitro and in vivo. Methods The cell activity of H1975 cell line was detected, and the absorbance values of erlotinib, endostar and erlotinib + endostar were determined. The xenograft tumor model of H1975 lung cancer cell line was established, and the nude mice were randomly divided into 4 groups(control group, erlotinib group, endostar group and combined medication group), 6 in each group. The tumor diameter was measured once every 3 days since the administration of the drug, and all the experimental mice were executed 2 weeks later. The tumors were taken out, measured and photographed. Results Cell experiments in vitro showed that, erlotinib had a statistically significant inhibitory effect on H1975 cell proliferation(P=0.043), while endostar had no statistically significant inhibitory effect on H1975 cell proliferation(P=0.261). The effect of erlotinib + endostar coincided with erlotinib. The animal experiments in vivo showed that, endostar could not inhibit the tumor cell growth(P= 山 东 大 学 学 报 (医 学 版)56卷9期 -石树远,等.重组人血管内皮抑素增强EGFR-TKIs对肺癌的抗瘤作用 \=-0.112), and erlotinib could inhibit the tumor cell growth (P=0.018). Meanwhile, the two drugs exhibited a synergistic effect(P=0.048). Further pairwise comparison showed statistically significant differences between the combined medication group and control group/erlotinib group(P=0.046, P=0.023). Conclusion Endostar combined with erlotinib can enhance antitumour activity of erlotinib for lung cancer and reverse the T790M-related drug resistance. Endostar combined with erlotinib has a promising application prospect for patients with EGFR-TKIs resistance.
    Combinatorial anti-PD-1 and endostatin therapeutic efficacy in Lewis lung cancer mice
    JIANG Yunfeng, DONG Xiaopeng, ZHAO Xiaogang
    Journal of Shandong University (Health Sciences). 2018, 56(9):  11-16.  doi:10.6040/j.issn.1671-7554.0.2018.251
    Abstract ( 506 )   PDF (8620KB) ( 112 )   Save
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    Objective To explore the antitumor effect of anti-PD-1 combined with angioendostatin on lung cancer in Lewis mice. Methods Lewis lung cancer C57BL/6 mice models were constructed and randomly divided into 4 groups: group A(PBS control), group B(anti-PD-1), group C(endostatin)and group D(anti-PD-1 combined with endostatin). The tumor volume was measured. The content of INFγ in the plasma was detected with ELISA, and the CD31 and VEGF contents were determined with immunohistochemistry. Results Compared with group A, group B and D had significantly inhibited tumor growth(P<0.001); group C had reduced tumor size but there was no statistical difference(P=0.084). Compared with group A, groups D, C and B had significantly elevated INFγ concentration(P<0.001), and group D showed the most obvious increase. Compared with group A, group D had significantly lower positive expression of VEGF(P<0.001). MVD count decreased significantly in group D compared with that in group A(P<0.001), group D compared with group B(P=0.019), and group D compared with group C(P<0.001). Conclusion Anti-PD-1 combined with endostatin can significantly slow down the tumor growth, effectively improve the tumor microenvironment, and play a synergistic antitumor effect.
    Chemical constituents from hemp seeds and hemp flowers
    ZHANG Li, ZHOU Yuefang, WANG Shanshan, WU Xuyi, LIANG Xiaomin, YAN Xiaoli, FAN Peihong
    Journal of Shandong University (Health Sciences). 2018, 56(9):  17-22.  doi:10.6040/j.issn.1671-7554.0.2018.588
    Abstract ( 920 )   PDF (1268KB) ( 30 )   Save
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    Objective To isolate and identify the chemical constituents from hemp seeds and hemp flowers, and study their bioactivities. Methods The chemical constituents were isolated and purified by macroporous adsorption resin, silica gel, octadecylsilyl, sephadex LH-20 column chromatography and HPLC. The structures of compounds were identified by 1HNMR, 13CNMR, HSQC, and HMBC spectral data. The anti-neuroinlammatory activity of the compounds were screened using lipopolysaccharide(LPS)stimulated BV2 microglia cell model, and the inflammatory factors in BV2 cells were measured using ELISA test. Results Five compounds isolated from the hemp seeds, and were identified as 1-monolinolein(1), 1-monopalmitin(2), 4-methoxy-3H-benzofuran-2-one(3),(E)-3-(4-hydroxyphenyl)acrylic acid ethyl ester(4)and polybotrin(5). Furthermore, five compounds were isolated from hemp flowers and identified as β-sitosterol(6), acacetin(7), cannflavin A(8), apigenin-7-O-β-D-glucuronide(9), and kaempferol-3-O-sophoroside(10). In addition, compounds 8-10 exhibited inhibitory effects on tumor necrosis factor α(TNF-α)released from lipopolysaccharide(LPS)-induced BV2 microglia cells. Conclusion Compounds 3 and 4 are obtained from hemp seed for the first time, and compounds 7, 9, and 10 are obtained from hemp flowers for the first time; compounds 8, 9, and 10 have potential anti-neuroinflammation effects.
    Sodium butyrate ameliorates visceral hypersensitivity by down-regulating IRAK1 in irritable bowel syndrome
    LI Zhuqing, ZHANG Wenxue, LI Lixiang, WANG Peng, YU Yanbo, ZUO Xiuli, LI Yanqing
    Journal of Shandong University (Health Sciences). 2018, 56(9):  23-28.  doi:10.6040/j.issn.1671-7554.0.2018.186
    Abstract ( 681 )   PDF (4324KB) ( 66 )   Save
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    Objective To investigate the role and mechanism of sodium butyrate in the treatment of irritable bowel syndrome(IBS). Methods A total of 49 participants comprised of 27 diarrhea-dominant IBS(IBS-D)patients and 22 controls were included. The protein expression of interleukin-1 receptor-associated kinase 1(IRAK1)in the colonic epithelium was detected with immunohistochemistry staining. The relationship between the IRAK1 protein expression and abdominal pain scores was analyzed with Spearman correlation analysis. After the animal models of IBS were established by 2,4,6-trinitrobenzene sulphonic acid enema, they were treated with sodium butyrate enema. The visceral hypersensitivity was observed using colorectal distension. The IRAK1 expression was determined with enzyme linked immunosorbent assay(ELISA). The relationship between IRAK1 expression and visceral pain threshold was analyzed with Spearman correlation analysis. After the HT-29 cell lines were treated with IL-33 and sodium butyrate, the IRAK1 protein expression was detected with Western blotting. Results Patients with IBS-D showed a higher expression of IRAK1 in colonic epithelium than the controls and IRAK1 expression was positively correlated with abdominal pain severity scores(r=0.676, P<0.001)and frequency scores(r=0.725, P<0.001). IBS animal models treated with sodium butyrate enema exhibited a lower expression of IRAK1 in the colon tissues and a higher visceral pain threshold. The IRAK1 protein expression was negatively correlated with pain threshold(r=-0.655, P<0.001). IL-33 stimulation could upregulate the protein expression of IRAK1 in HT-29 cell lines, while sodium butyrate pretreatment could diminish the effect. Conclusion Sodium butyrate may ameliorate visceral hypersensitivity in irritable bowel syndrome by down-regulating the protein expression of IRAK1.
    Clinical analysis of gefitinib versus pemetrexed combined with cisplatin in patients with stage Ⅱ-ⅢA lung adenocarcinoma harbouring positive EGFR mutations
    XIE Hounai, LI Meng, XU Lin, WANG Hui, PENG Yue, PENG Zhongmin
    Journal of Shandong University (Health Sciences). 2018, 56(9):  29-34.  doi:10.6040/j.issn.1671-7554.0.2018.419
    Abstract ( 617 )   PDF (1089KB) ( 4 )   Save
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    Objective To compare the efficacy of geftinib versus pemetrexed/cisplatin in patients with EGFR-mutant stage Ⅱ-ⅢA lung adenocarcinoma, and to provide a reference for the therapy of postoperative lung adenocarcinoma. Methods A total of 103 patients with pathological stage Ⅱ-ⅢA lung adenocarcinoma combined with positive epidermal growth factor receptor(EGFR)mutations were enrolled between January 2013 and April 2017, and divided into pemetrexed + cisplatin(PC)group and gefitinib(GE)group. All events continued untill disease relapse, death, or unacceptable toxic effects. Factors affecting survival were assessed by Kaplan-Meier method and Cox regression analysis. 山 东 大 学 学 报 (医 学 版)56卷9期 -谢厚耐,等.吉非替尼对比培美曲塞联合顺铂治疗术后EGFR突变阳性Ⅱ~ⅢA期肺腺癌的临床分析 \=- Results The median follow-up time was 32.3 months in PC group and 37.0 months in GE group. Median disease-free survival(DFS)was significantly longer in GE group than that in PC group(34.9 vs 21.0 months, P=0.002). Overall survival(OS)was not significantly different between the two groups(P=0.182). The most common adverse events in PC group were neutropenia(58.8%)followed by nausea or vomiting(56.9%)and anemia(45.1%), and in GE group were rash(76.9%), aminotransferase elevation(48.1%)and diarrhoea(42.3%). The incidence of hematological toxicity, gastrointestinal toxicity and alopecia in PC group was significantly higher than that in GE group(P=0.001; P<0.001; P=0.020). Interstitial lung disease(ILD), which was regarded as the most severe treatment-related adverse event, was diagnosed in one patient after receiving gefitinib three months. The incidence of sever adverse events(grade≥3)was significantly lower in GE group than that in PC group(13.5% vs 33.3%, P=0.020). Conclusion Compared with chemotherapy with pemetrexed/cisplain, gefitinib shows a significant DFS benefit in patients with EGFR mutation-positive and completely resected stage Ⅱ-ⅢA lung adenocarcinoma and is associated with more favourable tolerability. Adjuvant geftinib could be a potential treatment option compared with adjuvant chemotherapy in these patients.
    Cryopreservation-replantation of autologous skin in the treatment of cutaneous degloving injury of upper limb
    SUN Yuliang, LIN Junhao, CUI Yidong, PEI Yantao, WANG Juntao, WANG Gang, XU Qingjia, ZHU Lei
    Journal of Shandong University (Health Sciences). 2018, 56(9):  35-40.  doi:10.6040/j.issn.1671-7554.0.2018.495
    Abstract ( 695 )   PDF (10577KB) ( 36 )   Save
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    Objective To explore the application of cryopreservation-replantation technique of autologous skin in the treatment of degloving injuries of upper limbs. Methods The clinical data of 10 patients with upper limb degloving injuries during January 2016 and June 2017 were retrospectively analyzed, including 6 males and 4 females, averaged 46(ranging from 22 to 77)years. The injuries were caused by traffic accidents in 4 cases, and by machine extrusion in 6 cases. The location of injuries involved unilateral forearm in 6 cases and unilateral hand in 4 cases. The skins stayed in vitro for 2 to 14(average 5.8)hours and were cryopreserved for 8 to 38(average 24.8)days. The size of cryopreserved skin was 3 cm×5 cm to 20 cm×24 cm. The degloved skins could not be transplanted immediately due to severe contamination, tissue contusion and local bone tendon exposure. After cryopreservation and debridement, they were transplanted in situ or ectopically. Results Of the 10 cases, 1 case developed necrosis due to infection, others survived 50%~100%, 3 received a second skin grafting and recovered well. During the 6-month follow-up, the replanted skin was soft and resilient, the sensation recovered at different levels, but the skin showed different degrees of depigmentation, and there was no hair growth. Conclusion Cryopreservation-replantation technique of autologous skin provides time for wound preparation. The survival rate of replanted skin is high, and the resilience and function are satisfying. Besides, this technique can utilize the degloved skins efficiently, decrease the donor site area, relieve patients’ pain and reduce financial burden.
    Retrospective analysis of eye disease screening for 0-6 years old infants in Jinan City during 2015 and 2017
    YANG Haixia, CHENG Kai, HOU Qian, ZHANG Min, SUN Ming, ZHANG Linna
    Journal of Shandong University (Health Sciences). 2018, 56(9):  41-46.  doi:10.6040/j.issn.1671-7554.0.2018.478
    Abstract ( 475 )   PDF (977KB) ( 192 )   Save
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    Objective To retrospectively analyze the results of eye diseases screening for 0-6 years old infants in Jinan Maternity and Child Care Hospital from Sep. 2015 to Sep. 2017. Methods The eye diseases were screened for the infants at the age of 2-7 days(19 927 cases), 30-42 days(19 003 cases), 3 months(8 425 cases), 6 months(9 756 cases), 1 year(9 238 cases), 2 years(7 035 cases), 3-6 years(9781 cases)old. The screening contents and methods included the anterior segment examination, fundus photography, visual acuity assessment, strabismus and refractive examination, etc. Results A total of 44 types of ocular disorders, including congenital cataract, congenital glaucoma, congenital retinal abnormalities, retinopathy of prematurity, familial exudative vitreoretinopathy, retinoblastoma, congenital ptosis, congenital nasolacrimal duct obstruction, ametropia, amblyopia, strabismus, were detected. The detection rate were respective 298.34‰, 25.94‰, 1.90‰, 2.36‰, 5.41‰, 8.96‰ and 61.24‰ in 2~7 days, 30~42 days, 3 months, 6 months, 1 year, 2 years, 3-6 years old infants. Conclusion Eye diseases screening for infants should be periodic, systemic as early as possible, which could be helpful to find the vision dropping and the dangerous factors affecting the vision in time and to minimize avoidable blindness and visual impairment in children.
    Analysis on the proportion and changes of causes for cancellation of fresh embryo transfer from 2008 to 2017
    FAN Huarui, ZHANG Yang, GUO Qingqing, LI Fuxia, TANG Rong, SHENG Yan, DING Lingling, QIN Yingying
    Journal of Shandong University (Health Sciences). 2018, 56(9):  47-53.  doi:10.6040/j.issn.1671-7554.0.2018.512
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    Objective To analyze the proportion and changes of causes resulting in the cancellation of fresh embryo transfer of in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI)from 2008 to 2017 in the Reproductive Hospital Affiliated to Shandong University. Methods A retrospective analysis was performed among 17 601 cycles of IVF/ICSI fresh embryo transfer cancellation, including 3 018 cycles during 2008 and 2012, and 14 583 cycles during 2013 and 2017. The causes of cancellation included ovarian hyperstimulation syndrome(OHSS), high level of serum progesterone, endometrial factors, poor embryo quality, hydrosalpinx, and others. Further analysis was performed 山 东 大 学 学 报 (医 学 版)56卷9期 -范华蕊,等. 2008~2017年体外受精/卵胞浆内单精子显微注射周期取消新鲜胚胎移植的原因构成与变化 \=-according to the female age(<35 years and ≥35 yrs)and different protocols. Results The major cause for cancellation was OHSS risk, which showed an increasing trend in all age groups in the past 10 years. For women ≥35 years, the dominant cause was poor embryo quality, whereas for women <35 years, the major cause was OHSS risk. An obvious increase was observed in the proportion of hydrosalpinx in all age groups in the past 10 years. For long, GnRH antagonist and ultra-long GnRHa protocols, the prominent cause for cancellation was OHSS risk. For short, mini-stimulation protocols, the major cause was poor embryo quality. Conclusion OHSS risk was the commonest cause for cancellation of fresh embryo transfer, followed by poor embryo quality and endometrial factors. Embryo quality was a challenge for female of advanced aged. Effective methods could be considered to reduce the rate of cancellation, such as preventing ovarian hyperresponsiveness, improving embryo quality, and controlling pelvic inflammation.
    Clinical outcomes of IVF/ICSI-ET after thyroid cancer surgical treatment
    YU Na, GUO Qingqing, SUN Mei, SHENG Yan, MA Zengxiang, QIN Yingying
    Journal of Shandong University (Health Sciences). 2018, 56(9):  54-58.  doi:10.6040/j.issn.1671-7554.0.2018.516
    Abstract ( 727 )   PDF (1023KB) ( 26 )   Save
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    Objective To investigate the effect of thyroid carcinoma on the pregnancy outcomes, obstetric and neonatal complications during in vitro fertilization/follicle intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET)treatment. Methods Forty-two patients who underwent IVF/ICSI-ET after thyroid cancer surgery from January 1, 2012 to December 31, 2016 were retrospectively analyzed. Ninety patients with normal thyroid hormone level and thyroid ultrasound images were included as control group. The total amount of Gn, endometrial thickness on HCG day, and the number of retrieved oocytes were compared between cases and controls. The normal fertilization rate, good quality embryo rate, implantation rate, clinical pregnancy rate, miscarriage rate, live birth rate, and maternal and neonatal complications were also compared. Results The level of serum thyroid stimulating hormone(TSH)was significantly lower in cases than controls [(1.70±1.50)μIU/mL vs(2.20±0.84)μIU/mL, P<0.05]. The total Gn [(2 048.22± 山 东 大 学 学 报 (医 学 版)56卷9期 -于娜,等. 甲状腺癌术后行IVF/ICSI-ET助孕临床结局 \=-774.40)U vs(1 867.64±899.79)U], endometrial thickness on HCG day [(1.08±0.16)cm vs(1.10±0.17)cm], number of oocytes [(12.19±7.91)vs (10.92±4.65)], normal fertilization rate(57.30% vs 58.09%)and good quality embryo rate(61.38% vs 65.10%)were comparable between cases and controls. No difference was observed in the clinical pregnancy rate(61.11% vs 61.67%), implantation rate(41.43% vs 43.14%), abortion rate(9.09% vs 10.81%), and live birth rate(55.55% vs 50.0%). The incidence of obstetric complications(25.0% vs 6.45%)and birth weight of newborns [(3.21±0.63)kg vs (3.10±0.56)kg] were not statistically different(P>0.05). One baby from case group was diagnosed with neonatal hypothyroidism. There was no recurrence of thyroid carcinoma during IVF/ICSI-ET treatment. Conclusion Compared with controls, patients with history of thyroid cancer surgery present normal ovarian response and pregnancy outcomes undergoing IVF/ICSI-ET treatment. However, more attention is needed for neonatal hypothyroidism after maternal thyroid surgery.
    Effects of single-energy metal artifact reduction algorithm: a systematic review and Meta-analysis
    QI Meng, HUANG Yan, WU Shanshan, LIU Bo, ZHANG Siwei
    Journal of Shandong University (Health Sciences). 2018, 56(9):  59-64.  doi:10.6040/j.issn.1671-7554.0.2018.207
    Abstract ( 511 )   PDF (1954KB) ( 105 )   Save
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    Objective To evaluate the effects of single-energy metal artifact reduction algorithm(SEMAR)by systematic review and Meta-analysis. Methods Studies on SEMAR and non-SEMAR technique published during Jan. 2009 to Jan. 2018 were searched in PubMed, Embase, Web of science, the Cochrane Library and Chinese National Knowledge Infrastructure(CNKI). Articles were reviewed and screened according to the inclusion and exclusion criteria. The quality was evaluated with Cochrane collaborations tool for assessing risk of bias. Data were extracted and then analyzed with Review Manager 5.0 software. Subgroup analysis and sensitivity analysis were performed according to the heterogeneity of the literature. Results A total of 9 articles were enrolled, including 8 English articles and 1 Chinese article. Meta-analysis indicated that SEMAR could significantly improve the scores of the metal artifacts and surrounding organs, and correct the CT value and image noise: MD(metal artifact score)=1.19(95%CI: 0.99-1.39), MD(prostate/uterus image quality score)=1.87(95%CI: 0.69-3.05), MD(bladder image quality score)=2.31(95%CI: 1.28-3.340), MD(metal artifact CT)=118.7 Hu(95%CI: 50.48-186.93), MD(surrounding soft tissue noise)=298.05(95%CI: 61.66-534.43). It could also increase the detection rate of nearby lesions RD=0.07(0.02-0.13), but did not affect the CT 山 东 大 学 学 报 (医 学 版)56卷9期 -齐萌,等.单能量去金属伪影算法重建效果的系统评价及Meta分析 \=-values of nearby structures[MD=-21.35(95%CI:-44.0-1.31)] and artifact index[MD=3.11(95%CI: -0.97-7.15)]. Conclusion SEMAR has a good effect on the removal of metal artifacts and the detection of peripheral lesions, without affecting the CT values of surrounding soft tissues.
    Mental health status and its relationship with gratitude and perceived social support in inpatients with hematologic malignancies
    WANG Xinqi, LI Qiuhuan, ZHANG Hongjing
    Journal of Shandong University (Health Sciences). 2018, 56(9):  65-70.  doi:10.6040/j.issn.1671-7554.0.2018.114
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    Objective To investigate the mental health status and its relationship with gratitude and perceived social support in inpatients with hematological malignancies. Methods A total of 566 inpatients were surveyed with the Mental Status Scale in Non-psychiatric Setting(MSSNS), Perceived Social Support Scale(PSSS), and Gratitude Questionnaire-6(GQ-6). According to the diagnostic results, the subjects were divided into non-cancer group, hematologic malignancy group and other malignant tumor group. Results Compared with non-cancer group, the hematologic malignancy group and other malignant tumor group had higher level of anxiety, depression and loneliness(P<0.05). The hematologic malignancy group had higher score of loneliness than the other malignant tumor group(P<0.05). Gratitude and perceived social support were negatively correlated with anxiety, depression, anger and loneliness in the hematological malignancy group(rs=-0.37 - 0.50, P<0.001). The results of structural equation model showed that perceived social support indirectly affected mental health status and gratitude played a mediating role. Conclusion Compared with non-cancer patients, patients with hematological malignancies show obvious anxiety, depression and loneliness. Compared with patients with other malignant tumors, patients with hematological malignancies have higher level of loneliness. Gratitude acts as the mediator between perceived social support and mental health status.
    Application of multiple seasonal model in prediction of tuberculosis epidemic
    LIU Xiaodi, MA Jie, XIU Jingwei, CUI Qingxia, LI Wangchen,WANG Zaixiang
    Journal of Shandong University (Health Sciences). 2018, 56(9):  71-76.  doi:10.6040/j.issn.1671-7554.0.2017.1266
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    Objective To explore the feasibility of moving multiple seasonal model for predicting tuberculosis and provide a scientific evidence for the targeted prevention and control policy of tuberculosis. Methods Based on the national tuberculosis data reported by the Chinese Center for Disease Control and Prevention from January 2011 to December 2016, a multiplicative seasonal model was established. The model was used to predict the number of cases of tuberculosis in China from January to September 2017 and to evaluate its predicted effect. Results From January 2011 to December 2016, the number of pulmonary tuberculosis cases in China showed a seasonal effect with annual cycle, and the trend of long-term declining. All parameters of ARIMA(0,1,1)(0,1,1)12(without constant term)were statistically tested(P<0.05). The residual sequence was a white noise sequence(P>0.05). Goodness of fit was the best(AIC=1 223.004, SBC=1 227.159). The projections for January to September 2017 were generally consistent with the actual values. Conclusion ARIMA(0,1,1)(0,1,1)12(without constant term)can be used to predict the epidemic situation of pulmonary tuberculosis in China. The model has good popularization and application value.
    Reliability and validity of MNA scale used in community elderly
    YUAN Huacai, ZHANG Tiantian, GUO Dongmei, ZHANG Huanhuan, SHEN Deqiang, CHEN Liyong, LIN Xinying
    Journal of Shandong University (Health Sciences). 2018, 56(9):  77-82.  doi:10.6040/j.issn.1671-7554.0.2018.430
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    Objective To assess the reliability and validity of mini nutritional assessment(MNA)scale in community elderly, and to lay the foundation for the development of the new nutrition screening tool suitable for Chinese community elderly. Methods A total of 550 elderly in communities of Jinan were randomly selected and 544 were finally analyzed in our study. MNA scale was used to assess the nutrition status. Anthropometric parameters and laboratory indexes were also measured. The reliability, construct validity and criterion-related validity were calculated and assessed. Results Cronbachs α coefficient of MNA scale was 0.287. Factor analysis yields 9 common factors. Cumulative factor contribution rate was 60.94%. Factor analysis indicated that the factor loads of some items(MNA14 and MNA17)were less than 0.4. There were significant correlations between total MNA score and BMI, MAC and CC. Using BMI and serum 山 东 大 学 学 报 (医 学 版)56卷9期 -袁华财,等.微型营养评价量表在社区老年人群中的信效度评价 \=-albumin as objective criteria for assessing nutritional status, the sensitivity of malnutrition by MNA in older adults was 0.884 with a specificity of 0.683. Kappa value of two methods above for evaluating nutritional status was 0.215. Item analysis suggested that the scores of MNA6, MNA9, MNA10 and MNA12 were not related to total score. Conclusion Although the reliability and validity of MNA indicate this scale is not a reliable assessment tool for nutrition assessment of Chinese community elderly, it is still the cornerstone of the following revise process.