Table of Content

  

10 December 2018
Volume 56 Issue 12

Construction of stable-expressed cell lines of human papillomavirus early oncoprotein E6/E7 and its effect on the expression of Rab12

ZHANG Wenhao, QIAO Lijun, ZHENG Jingyi, Jason Chen, ZHANG Weifang

Journal of Shandong University (Health Sciences). 2018, 56(12):  1-6.  doi:10.6040/j.issn.1671-7554.0.2018.369

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Objective To explore the impact of early oncoprotein E6/E7, encoded by human papillomavirus(HPV), on the expression of Rab12 protein, a small GTP enzyme protein. Methods The high titer of virus particles, containing pBabe-Vector plasmid and pBabe-16E7 plasmid, were obtained with retroviruses packing system. UMSCC 10A cell line was infected with the virus particles and selected by puromycin to get UMSCC 10A-16E7cell line, which stably expressed HPV16E7. Western blotting was used to detect the expression of E7 associated protein, including p53 and E2F1, to verify the infection. The expression level of Rab12 in UMSCC 10A-Vector and UMSCC 10A-16E7 cell lines was compared. Further verification was conducted in HaCaT and RPE1 cell lines as above. The expression of 16E6/E7 in SiHa cell line and Caski cell line(HPV-16 positive cervical cancer cell line), and the expression of 18E6/E7 in Hela cell line(HPV-18 positive cervical cancer cell line)were interfered by siRNA. Western blotting was used to compare the expression level of E6 and E7 associated protein(E2F1, p53 and Rab12)after the interference. Results These stable-expressed cell lines were successfully built up with retroviruses packaging system. The expression of Rab12 increased in E6/E7 over-expression cells, and decreased in the E6/E7 interfere cells. Conclusion Early oncoprotein E6/E7 coded by HPV can regulate the expression of Rab12.

Expression and prognostic significance of apoptosis antagonizing transcription factor in hepatocellular carcinoma

SHAO Qianqian, WANG Jingpu, WANG Qingjie

Journal of Shandong University (Health Sciences). 2018, 56(12):  7-12.  doi:10.6040/j.issn.1671-7554.0.2018.463

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Objective To analyze the expression and prognostic significance of apoptosis antagonizing transcription factor(AATF)in liver hepatocellular carcinoma(LIHC). Methods The mRNA and protein expressions and location of AATF in LIHC tissues and control tissues were detected with GEPIA and the Human Protein Atlas. The genomic alterations of AATF in LIHC tissues and the protein network diagram associated with AATF protein were assessed with cBioPortal. The effects of AATF on the 5-year survival and overall survival of liver cancer patients were determined with Kaplan-Meier Plotter. The prognostic significance of AATF in LIHC patients was analyzed with Tumor Immune Estimation Resource. Results Compared with the control tissues, the LIHC tissues showed significantly up-regulated mRNA(P<0.05)and protein expressions of AATF. AATF protein was located in the membrane and cytoplasm of LIHC cells. The genomic alterations of AATF had a low incidence in LIHC. The proteins that interacted with AATF included ATM, CHEK2, and so on, which were mainly involved in the regulation of cell cycle, apoptosis, and transcriptional regula- 山 东 大 学 学 报 (医 学 版)56卷12期 -邵倩倩,等. 抗凋亡转录因子在肝细胞肝癌中的表达及预后作用 \=-tion. The mRNA expression of AATF was negatively correlated with the prognosis of LIHC(log-rank P=0.003). Conclusion AATF is highly expressed in LIHC tissues and associated with poor prognosis.

Risk factors of portal vein thrombosis in patients with liver cirrhosis

DING Yanfei, YANG Zhuoxin, ZHENG Wenwen, YUAN Wenjie, GAO Yanjing

Journal of Shandong University (Health Sciences). 2018, 56(12):  13-18.  doi:10.6040/j.issn.1671-7554.0.2018.183

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Objective To investigate the risk factors of portal vein thrombosis(PVT)in cirrhotic patients. Methods The clinical data of 1 670 hospitalized cirrhotic patients were retrospectively analyzed, of whom 217 with PVT were classified into the PVT group, while 250 without PVT were randomized into the non-PVT group. The general information, laboratory results, clinical manifestations, complications, surgery and drug administration history of the two groups were recorded. The risk factors of PTV were analyzed with univariate analysis and multivariate Logistic regression analysis. Results Of the 1 670 cirrhotic patients, 13% developed PVT, whose liver function was classified as Child-Pugh B and C. Univariate analysis showed significant differences in d-dimer, hemoglobin(Hb), total bilirubin(TBiL), severe esophageal varices, previous splenectomy, hemostatic drugs and propranolol between the two groups. Multivariate Logistic regression analysis showed that severe esophageal varices(OR=6.918, P=0.018), previous splenectomy(OR=4.281, P=0.007)and increase of d-dimer(OR=5.007, P<0.001)were independent risk factors of PVT. Conclusion Hemostatic drugs, propranolol, increase of d-dimer, severe esophageal varices, previous splenectomy may be associated with the formation of PVT in cirrhotic patients. Severe esophageal varices, previous splenectomy and increase of d-dimer are independent risk factors of PVT.

Effect of adipose-derived stem cells on intrinsic skin aging

ZHANG Kun, YAN Bing, LI Fang, XIAO Dongjie, WANG Yunshan, LIU Hua

Journal of Shandong University (Health Sciences). 2018, 56(12):  19-25.  doi:10.6040/j.issn.1671-7554.0.2018.338

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Objective To observe the effects of adipose-derived stem cells(ADSCs)on intrinsic skin aging, and investigate the underlying mechanisms. Methods Mouse skin fibroblast cells(MSFCs)and human ADSCs were primarily cultured. MSFCs cells were randomly divided into control group, model group, ADSCs conditioned medium(ADSCs-CM)group. MSFCs were treated with D-galactose(D-gal)and ADSCs-CM. The changes of ROS and β-galactosidase were tested by microscopy and flow cytometry, the expressions of caspase3, p53 and sirt1 were detected by RT-PCR, and the expression of Sirt1 protein was detected by Western blotting. Results The level of ROS in model group was higher than that in control group(P<0.001), and the β-galactosidase staining was deepened. The level of ROS in ADSCs-CM group was lower than that in model group(P<0.001), and the β-galactosidase staining was lighter. RT-PCR showed that the expressions of caspase3(P<0.001)and p53(P=0.001)were increased while the expression of sirt1(P<0.001)was decreased in model group compared with those in control group. The expressions of caspase3 山 东 大 学 学 报 (医 学 版)56卷12期 -张坤,等.脂肪源性干细胞对内源性皮肤老化的治疗作用 \=-(P<0.001)and p53(P=0.001)were decreased while the expression of sirt1 (P<0.001)was increased in ADSCs-CM group compared with that in model group. Western blotting showed that the Sirt1 protein expression was decreased in model group compared with that in control group(P<0.001)and increased in ADSCs-CM group compared with that in model group(P=0.006). Conclusion ADSCs show a protective effect on intrinsic skin aging induced by D-gal via Sirt1 signal pathway.

Correlation between peripheral Syntaxin 8 expression and chronic inflammation and glucose-lipid metabolism in type 2 diabetes mellitus patients

CHEN Pan, JIANG Chunxia, LEI Yi

Journal of Shandong University (Health Sciences). 2018, 56(12):  26-32.  doi:10.6040/j.issn.1671-7554.0.2018.786

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Objective To investigate Syntaxin 8(STX8)expression in patients with type 2 diabetes mellitus(T2DM)and the potential correlations between STX8 and chronic inflammation and glucose/lipid metabolism. Methods A total of 144 T2DM paitents(case group)and 100 health subjects(control group)were enrolled. The difference of clinical parameters such as inflammatory indices and glucose/lipid metabolism were compared between two groups. Meanwhile, peripheral blood mononuclear cells(PBMCs)were collected and their expressions were compared in these two groups. PBMCs isolated from healthy subjects were cultured with 10 mmol/L glucose or 33.3 mmol/l glucose, respectively. The levels of STX8 expression and inflammatory cytokines were detected. Results The levels of body mass index(BMI), fasting blood glucose(FBG), fasting plasma insulin(FIN), total cholesterol(TC), trilycerides(TG), low-density lipoprotein cholesterol(LDL-C), free fatty acids(FFAs), homeostasis model assessment insulin resistence(HOMA-IR), tumor necrosis factor-α(TNF-α), interleukin 6(IL-6), STX8 in case group were significantly higher than that in control group, while HDL-C level in case group was significantly lower than that in control group(all P<0.05). The mRNA and protein expressions of STX8 in PBMCs of case group were significantly higher compared with that in control group(P<0.05). STX8 expression showed a positive correlation with FBG, FIN, TC, TG, LDL-C, FFAs, HOMA-IR, 山 东 大 学 学 报 (医 学 版)56卷12期 -陈攀,等.2型糖尿病患者外周血突触融合蛋白8表达与慢性炎症、糖脂代谢的相关性 \=-TNF-α, IL-6, while a negative correlation with HDL-C(all P<0.05). After treatment with high concentration, the levels of STX8 and TNF-α, IL-6 significantly increased, STX8 expression and TNF-α, IL-6 concentrations in 33.3 mmol/L glucose group was markedly higher than that in 10 mmol/L glucose group(all P<0.05). Conclusion STX8 level may be correlated with chronic inflammatory state and perturbed glucose and lipid metabolism in T2DM patients.

Changes of the incidence, antibiotic resistance, antibiotic therapy and prognosis in patients with Staphylococcus aureus bloodstream infection in Qilu Hospital of Shandong University

CUI Yi, YIN Mei, LI Wei, LI Yuan, HAN Hui, SHAN Tichao, YUE Jinfeng, DING Shifang, LI Chen, CHEN Xiaomei, WU Dawei, WANG Hao

Journal of Shandong University (Health Sciences). 2018, 56(12):  33-38.  doi:10.6040/j.issn.1671-7554.0.2018.466

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Objective To investigate the changes of the incidence, antibiotic resistance, antibiotic therapy and prognosis in patients with Staphylococcus aureus bloodstream infection(SABI)in Qilu Hospital of Shandong University in recent 山 东 大 学 学 报 (医 学 版)56卷12期 -崔毅,等. 山东大学齐鲁医院金黄色葡萄球菌血流感染发生率、菌株耐药性、抗菌药物使用及预后变化 \=-years. Methods The basic information of patients with SABI were retrospectively collected from January 2009 to December 2010(17 cases, A group)and from January 2015 to December 2016(32 cases, B group). The pathogen, laboratory and clinical data were also collected. Acute Physiology and Chronic Health Evaluation II(APACHEⅡ)score and Sequential Organ Failure Assessment(SOFA)score were then calculated. The incidence of SABI, the incidence of antibiotic resistance, antibiotic treatment, patient outcome and 28-day mortality were compared between these two groups. Results Compared with A group, the incidence and 28-day mortality of SABI in B group decreased(1.5 vs 1.1; 29.1% vs 18.8%)with no statistical difference(both P>0.05)in our hospital. The difference between the two groups in the basic information of SABI patients(including sex, age, length of stay, distribution of departments and primary diseases), hospitalization cost, primary source of bloodstream, and the severity of illness(including the rate of mechanical ventilation and renal replacement therapy, the incidence of septic shock, APACHE II score and SOFA score)were not statistically significant(all P>0.05). The proportion of methicillin-resistant Staphylococcus aureus(MRSA)in isolates increased with no statistical difference(P>0.05). The resistance rates of the isolates to penicillin, ciprofloxacin, vancomycin and linazolamide did not differ significantly(all P>0.05). No vancomycin or linezolid resistant strains were found in the both groups. The patients in A group received significantly more antibiotic therapy of glycopeptide antibiotics and less antibiotic therapy of β-lactamase antibiotics for targeted antimicrobial therapy compared with B group(χ2=5.244,P=0.022; χ2=4.895,P=0.027). Conclusion In the recent 8 years, the incidence and 28-day mortality of SABI decreased, while the isolation proportion of MRSA increased in Qilu Hospital of Shandong University. The usage of glycopeptide antibiotics was more and more common.

Tracheobronchial amyloidosis: a report of 3 cases and literature review

ZHUANG Maisong, WAN Yunyan, LIN Dianjie

Journal of Shandong University (Health Sciences). 2018, 56(12):  39-46.  doi:10.6040/j.issn.1671-7554.0.2017.640

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Objective To explore the clinical and imaging manifestations, differential diagnosis and treatment of tracheobronchial amyloidosis. Methods The clinical data of 3 cases of tracheobronchial amyloidosis were retrospectively analyzed, and relevant literature was reviewed. Results Tracheobronchial amyloidosis exhibited no specific clinical or imaging manifestations. The main clinical symptoms included cough, chest distress, dyspnea, hemoptysis, and so on. The imaging manifestations included calcification(which was specific), thickening of wall, and narrowing of the lumen. In enhanced scanning, strengthened lesions could be observed. Clinical misdiagnosis and missed diagnosis often occurred due to localized tracheobronchial amyloidosis. Diffused lesions with hilar lymph node enlargement, calcification, and pulmonary nodular or patchy high-density shadow were often misdiagnosed as bronchial asthma, tuberculosis, chronic bronchitis and other diseases. Conclusion Tracheobronchial amyloidosis is a rare disease with no specific symptoms. Misdiagnosis and missed diagnosis frequently occur due to insufficient clinical and imaging understanding of the disease. Comprehensive analysis of the imaging manifestations and clinical characteristics, together with bronchoscopy and pathological examination, can help avoid possible misdiagnosis.

Expression of karyopherin α2 and its effect on the biological behaviors of glioma

LI Jie, HE Dong, ZHANG Rui, YANG Fan, FENG Shaobin, YANG Yihang, XIN Tao

Journal of Shandong University (Health Sciences). 2018, 56(12):  47-54.  doi:10.6040/j.issn.1671-7554.0.2018.049

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Objective To explore the clinical significance and biological effects of karyopherin α2(KPNA2)on glioma. Methods A total of 90 specimens of cerebral astrocytoma were collected, including WHO grades Ⅱ, Ⅲ and Ⅳ(30 cases for each grade), and 15 normal peritumoral tissues served as controls. The expression of KPNA2 was detected with qRT-PCR and immunohistochemistry. After that, the lentiviruses expressing small hairpin RNAs(shRNAs)of KPNA2 were introduced into the U87 and U251 glioma cells. The effects of KPNA2-knockdown on the proliferation of glioma cells were detected with CCK8 and EdU, and the effects on the cell migration and invasion were assessed with Transwell assay. Results KPAN2 was overexpressed in glioma tissues, and high level of KPNA2 was positively correlated with the WHO classification of glioma(r_s=0.559, P<0.001)and negatively correlated with the prognosis of patients(overall survival: χ2=21.39, P<0.001; relapse-free survival: χ2=8.057, P=0.004). In addition, KPNA2-knockdown significantly weakened the proliferation, migration and invasion of glioma cell lines U87 and U251. Conclusion KPNA2 plays an important role in the tumorigenesis and development of glioma and may serve as a novel biomarker or therapeutic target for clinical diagnosis and treatment.

A comparative study of the effectiveness between surgically assisted rapid palatal expansion and miniscrew-assisted rapid palatal expansion in adults

WANG Xiaoya, LI Jiayu, GUO Jing, ZHANG Lihong

Journal of Shandong University (Health Sciences). 2018, 56(12):  55-61.  doi:10.6040/j.issn.1671-7554.0.2018.1230

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Objective To evaluate and compare the expansion effectiveness between surgically assisted rapid palatal expansion(SARPE)and miniscrew-assisted rapid palatal expansion(MARPE)in adults. Methods A total of 16 adult patients with transverse maxillary deficiency were selected and divided into 2 groups according to the expansion design: SARPE group(n=9)and MARPE group(n=7). CBCT scans were performed before treatment and 3 months after retention. The data obtained were analyzed with Dolphin 11.8. Skeletal expansion, tipping of the anchored teeth, and buccal alveolar thickness and height were measured before and after treatment. Results The skeletal expansion increased significantly after treatment in both groups. There were significant increases in the width of midpalatal suture, nasal cavity, nasal floor, and zygomaticomaxillary suture(P<0.05). Change of nasal cavity width in maxillary first molar area in MARPE group was more significant than that in SARPE group(P<0.05), but there were no significant differences in other changes between the two groups(P>0.05). Both SARPE and MARPE resulted in tipping of the anchored teeth(P<0.05). The differences of the buccal alveolar height and thickness were not statistically significant between the two 山 东 大 学 学 报 (医 学 版)56卷12期 -王晓雅,等.成人手术辅助快速扩弓与种植钉辅助快速扩弓效率的对比 \=-groups(P>0.05). Conclusion Both SARPE and MARPE are effective treatment modalities for the correction of maxillary transverse deficiency in adults through separation of the midpalatal suture while MARPE shows certain superiority.

Significance of ultrasonography and MRI in the prenatal diagnosis of cleft lip and palate

TIAN Mimi, XIAO Lianxiang, JIAN Nan, ZHAO Hui, WEI Xinhong, SHI Yan, LI Guan, ZHANG Shuai, LIN Xiangtao

Journal of Shandong University (Health Sciences). 2018, 56(12):  62-67.  doi:10.6040/j.issn.1671-7554.0.2018.632

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Objective To evaluate the accuracy of ultrasound(US)and magnetic resonance imaging(MRI)in the diagnosis of fetal cleft lip and palate. Methods Pregnant women suspected of fetal facial malformations or unable to clearly display normal maxillofacial anatomy were enrolled in the prospective blinded case-control study. The US and MRI images were reviewed in a blinded fashion by experienced radiologists without knowledge of indications or prior imaging findings. The prenatal US and MRI diagnosis were compared with the postnatal results. Receiver operating characteristic curve(ROC)analysis of data by SPSS 20.0 software was conducted to compare the diagnostic efficiency of 山 东 大 学 学 报 (医 学 版)56卷12期 -田迷迷,等.超声和MRI对胎儿唇腭裂的诊断价值 \=-US and MRI. Diagnostic confidence was divided into four levels. Results All of the 47 fetuses had craniofacial anomaly, including isolated cleft lip in 23 cases, unilateral cleft lip and alveolus in 1 case, cleft lip and palate in 19 cases, and isolated cleft palate in 4 cases. The accuracy, sensitivity and specificity of both US and MRI in the diagnosis of cleft lip were 100%. The accuracy of US and MRI in the detection of cleft palate was 93.6% vs 48.9%. The AUC of US and MRI was 0.954 vs 0.704 for the detection of cleft lip and palate(P<0.05). The diagnostic confidence of MRI in the diagnosis or exclusion of cleft lip and palate was higher than that of US(91.5% vs 44.7%). Conclusion MRI is superior to US in the diagnosis of cleft lip and palate, which can serve as an auxiliary diagnostic method, especially when US is unable to confirm the presence of complicated cleft palate.

Effects of body mass index and renal subcutaneous depth on the results of virtual touch tissue imaging quantification in renal transplant patients

SHENG Xuan, WANG Yonge, GUO Dan, LAN Meng, FAN Fengjing, DING Hongyu

Journal of Shandong University (Health Sciences). 2018, 56(12):  68-72.  doi:10.6040/j.issn.1671-7554.0.2018.722

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Objective Effects of the BMI and the subcutaneous depth of the transplanted kidney on results of virtual touch tissue imaging quantification(VTIQ)were studied by analyzing the quality control pattern images in VTIQ of patients with different somatotypes. Methods A total of 119 patients undergoing renal transplantation and postoperatively reexaminated as normal were selected from November 2017 to May 2018 in Qianfoshan Hospital Affiliated to Shandong University. Firstly, the height and weight of the patients were measured and the body mass index(BMI)value was calculated. Then the region of interest(ROI)was selected from the transplanted kidney cortex to measure the distance from the surface of the transplanted kidney to the body surface which was defined as a subcutaneous depth of the transplanted kidney. Finally, VTIQ was used to obtain the image in quality control mode and the images were divided into grades A, B and C according to the quality. Patients BMI and grades of images quality were recorded as BMI group, subcutaneous depths of transplanted kidneys and grades of images quality were recorded as Depth group, and the datas of two groups were statistically analyzed. Results The image quality of VTIQ quality control mode of transplanted kidney was different between the patients with different BMI and the different subcutaneous depth of the transplanted kidney(P<0.05). 山 东 大 学 学 报 (医 学 版)56卷12期 -盛璇,等.移植肾患者体质量指数与移植肾皮下深度对声触诊组织量化成像结果的影响 \=-ROC curves of two groups showed that AUC(BMI group)was greater than AUC(Depth group), the cut-off value between grades B and C was 23.99, the sensitivity was 0.800, and the specificity was 0.731. Conclusion The images quality of the VTIQ quality control model of transplanted kidney is related to the BMI and subcutaneous depth of the transplanted kidney. The greater the BMI or subcutaneous depth are, the worse the quality of the transplanted kidney quality control images is, that means the lower accuracy of the measured VTIQ results. Compared with the subcutaneous depth of transplanted kidney, the BMI of patient has a higher accuracy in the evalution of VTIQ results.

Fat-containing ganglioneuroma: imaging features and clinicopathological correlation

ZHANG Lihong, LI Xian, WANG Linsheng, LI Honglei, LI Lei

Journal of Shandong University (Health Sciences). 2018, 56(12):  73-78.  doi:10.6040/j.issn.1671-7554.0.2018.280

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Objective To summarize the imaging features of fat-containing ganglioneuroma(FCG). Methods The imaging manifestations of 9 cases of FCG confirmed pathologically were reviewed. All cases received unenhanced and enhanced CT scanning, 4 of whom underwent unenhanced and enhanced MRI scanning. Results The ganglioneuromas were singular in all of the 9 cases, including 4 in the posterior mediastinum, 4 in the retroperitonium and 1 in the right adrenal gland. They all presented well-defined fat-containing heterogeneous masses on unenhanced CT images, and the CT values of fatty portion ranged from -120.7 to -43.4 HU. The fat was focalized around the mass in 6 cases, and diffused as patches or nodules in the other 3 cases. The intratumoral fat was verified by fat-suppressed T₁WI and/or T₂WI. The neural portions presenting soft-tissue density showed slightly low signals on T₁WI and slightly high signals on T₂WI, 山 东 大 学 学 报 (医 学 版)56卷12期 -张丽红,等.含脂肪节细胞神经瘤的影像学表现与病理对照 \=-which were slightly(n=5), moderately(n=2), and obviously(n=2)enhanced on enhanced CT, and slightly(n=3)and obviously(n=1)enhanced on enhanced MRI. All of the abdominal masses presented gradual enhancement on enhanced triphase CT and/or MRI scan. Conclusion Fat rarely occurs in ganglioneuromas. CT measurement and fat-suppression sequence of MRI can confirm its occurrence. CT and/or enhanced MRI scanning of the predilection location help to improve the diagnosis of FCG.

Depression, anxiety and irritability and their related factors in patients with breast pain

YU Lixiang, ZHUO Yingjie, LIU Liyuan, WANG Fei, ZHOU Fei, XIANG Yujuan, HUANG Shuya, ZHENG Chao, FU Qinye, GAO Dezong, LI Liang, MA Zhongbing, ZHANG Qiang, YU Zhigang

Journal of Shandong University (Health Sciences). 2018, 56(12):  79-85.  doi:10.6040/j.issn.1671-7554.0.2018.837

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Objective To investigate the level of depression, anxiety and irritability, and their related factors in patients with breast pain. Methods Totally 2 731 breast pain patients were recruited from the breast clinics of 12 hospitals in China from May 2015 to December 2016. The basic information and clinical examination data were collected. Irritability, depression and anxiety scale(IDA)was used to measure their mental status. Results Of breast pain patients, 22.8% had four psychological emotional problems; 18.8%, 20.2% and 19.4% had respective three, two and one psychological emotional problems. The score of depression, anxiety and outward irritability of IDA gradually increased with the increase of pain degree(F=6.7-26.7, P<0.05). Multivariate analysis showed that high pain scores, low education level, low income level, smoking history and drinking history were important factors influencing emotional problems in patients with breast pain(all P<0.05). Conclusion Patients with breast pain have a higher incidence of depression, anxiety, inward and outward irritability. Pain is related to the occurrence of depression and anxiety in patients with breast pain.

Mediating effect of emotion regulation on relationship between mindfulness and clinical communication ability of nursing students

ZHANG Xuan, LI Jiahuan, WANG Ying, CHAI Rong, YANG Bei, CAO Fenglin

Journal of Shandong University (Health Sciences). 2018, 56(12):  86-91.  doi:10.6040/j.issn.1671-7554.0.2018.415

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Objective To investigate the clinical communication ability of nursing students and to explore the mediating effect of emotion regulation on relationship between mindfulness and clinical communication ability. Methods A total of 294 nursing students in a tertiary hospital in Jinan City were surveyed with the Five Facet Mindfulness Questionnaire, Emotion Regulation Questionnaire and Clinical Communication Ability Questionnaire. SPSS 21.0 and Amos 21.0 were used for statistical analysis. Results The total clinical communication ability score was 82.13±8.55, which was of medium level. Mindfulness was positively correlated with cognitive reassessment(r=0.254, P<0.001), communication ability(r=0.268, P<0.001), and cognitive reassessment was positively correlated with clinical communication ability(r=0.219, P<0.001). The mediating effect model and Bootstrap test showed that the mindfulness could indirectly influence the clinical communication ability through cognitive reassessment［χ2/df=1.748, RMSEA=0.051, GFI=0.985, AGFI=0.961, CFI=0.990, TLI=0.981, PNFI=0.521; Bootstrap 95% CI:(0.012-0.079, P<0.001)］. Conclusion As a way of emotion regulation, cognitive reassessment plays a mediating role in the mindfulness and clinical communication ability of nursing students.

Association between platelet count and metabolic syndrome based on a prospective cohort study

MA Xiaotian, GU Jianhua, WANG Li, XUE Fuzhong, LIU Yanxun

Journal of Shandong University (Health Sciences). 2018, 56(12):  92-97.  doi:10.6040/j.issn.1671-7554.0.2018.411

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Objective To explore the correlation between platelet count and metabolic syndrome. Methods Our cohort was based on a “Multi-center Health Management Cohort”. People who did at least two health examinations, didnt have missing value in important variables, and were free of metabolic syndrome at baseline were selected into the prospective cohort. The study subjects were divided into four groups according to the baseline platelet count quartile, and the incidence density of each group was compared. The characteristics of each variable were described in the four groups at baseline. The Cox proportional regression model was used in this study, where we adjusted age, gender, BMI, hyperglycemia, hypertension and dysplasia gradually, to explore whether the platelet count was still a risk factor for metabolic syndrome before and after adjustment of confounding factors. Results There were 14 173 individuals who were aged 21-60 in this cohort. The total follow-up time was 41 014.8 person-year. The average follow-up time was 2.89 years. A total of 1 611 people were diagnosed as having metabolic syndrome. The incidence density of this cohort was 39.28/1 000 person-year. The platelet counts were always statistically significant in model 1(single factor analysis), 山 东 大 学 学 报 (医 学 版)56卷12期 -马晓天,等.血小板计数与代谢综合征关联性的前瞻性队列研究 \=-model 2(adjusted for age and gender)and model 3(adjusted for age, gender, BMI, hyperglycemia, hypertension and dysplasia), with similar HR values. Q2 didnt have a statistical difference with Q1 in model 1, while Q3 and Q4 had. In model 2 and model 3, Q2-Q4 all had statistical significance when compared to Q1, and their HR values increased from Q2 to Q4. It showed that with the increase of platelet count, the risk of metabolic synthesis increased. Conclusion Elevated platelet count is an independent risk factor for metabolic syndrome.

Epidemiological and clinical analysis of 74 cases of severe fever with thrombocytopenia syndrome in Shandong Province, China from 2014 to 2015

SUN Luyan, ZHANG Xiuzhen, LIU Kuihua, YANG Bo, WU Anzhao, YUAN Chengmin

Journal of Shandong University (Health Sciences). 2018, 56(12):  98-102.  doi:10.6040/j.issn.1671-7554.0.2018.412

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Objective To summarize and analyze the epidemiological features and clinical characteristics of severe fever with thrombocytopenia syndrome(SFTS). Methods The clinical data of 74 patients with SFTS in Shandong Province were collected and retrospectively analyzed. They accepted treatment in Jinan Infectious Disease Hospital from 2014 to 2015. The data included epidemiology, clinical symptoms, signs and related laboratory tests. Results The disease occurred mostly in the elderly farmers living in hilly areas. Some patients had tick bites history. The clinical manifestations included fever, systemic symptoms and digestive system symptoms, and some severe patients also had pneumonia, gastrointestinal bleeding and multiple organ damage, etc. After antiviral and symptomatic treatments, 46 cases were cured; 12 died during hospitalization; and 16 gave up treatment and left hospital voluntarily,and among them 13 died during follow-up. Conclusion SFTS progresses rapidly and has a high fatality rate. It is necessary to strengthen the awareness of disease prevention,and early diagnosis and treatment are the most important measures.

Application of multiple seasonal autoregressive integrated moving average model in the prediction of viral hepatitis A

LI Xinyang, LI Sujuan, LIU Xiaodi, FAN Antong, YAN Ping, LIU Hongqing

Journal of Shandong University (Health Sciences). 2018, 56(12):  103-108.  doi:10.6040/j.issn.1671-7554.0.2018.551

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Objective To establish a multiple seasonal autoregressive integrated moving average(ARIMA)model, predict the national incidence of hepatitis A, and provide decision-making basis for the prevention and control of hepatitis A. Methods Based on the monthly data of the National Hepatitis A Report from Jan. 2011 to Dec. 2016, the multiple seasonal model of ARIMA was established, whose predictive effect was evaluated with the number of cases from Jan. to Dec. 2017. Results The parameters were below: unseasonal moving=0.282, seasonal moving=0.530, Akaike information criterion(AIC)=815.710, and Schwarz Bayesian criterion(SBC)=819.865. The significance test of the optimal model showed that P<0.05, the model residual white noise test showed that χ2=6.83, 12.38, 15.12 and 18.28 for 6, 12, 18 and 24 orders(P>0.05), and there were no significant differences. Based on the above parameters, ARIMA(0, 1, 1)(0, 1, 1)₁₂ model was established, and the formula of the model was ∇∇₁₂x_t=(1-0.282B)(1-0.530B12)ε_t. Conclusion The ARIMA(0, 1, 1)(0, 1, 1)₁₂ model can fit the incidence trend of hepatitis A. It can be used to predict the incidence and to provide a scientific basis for the prevention and control of hepatitis A in China.