Table of Content

  

10 January 2020
Volume 58 Issue 1

Effects of recombinant human endostatin combined with recombinant human interferon γ on mouse Lewis lung cancer xenografts

XU Pengfei, ZHU Ling, WAN Yunyan, YAO Zhouhong, LI Dezhi, WANG Cong, ZHAI Congcong, LI Wen, LIN Dianjie

Journal of Shandong University (Health Sciences). 2020, 58(1):  1-5.  doi:10.6040/j.issn.1671-7554.0.2019.1037

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Objective To investigate the effects of recombinant human endostatin(Endostatin)combined with recombinant human interferon γ(IFNγ)on Lewis lung cancer xenografts in mice. Methods Mice models of Lewis lung cancer xenografts were established and divided into control group, Endostatin group, IFNγ group, and Endostatin+IFNγ group, with 10 mice in each group. The control group was given phosphate buffered saline, Endostatin group was given 15 mg/(kg·d)endostatin, IFNγ group was given 750 IU/(kg·d)IFNγ, and Endostatin+IFNγ group was given 15 mg/(kg·d)endostatin and 750 IU/(kg·d)IFNγ. After 14 days of treatment, the longest and shortest diameters of tumor were measured to calculate tumor volume. The expressions of microvessel density, vascular endothelial growth factor(VEGF)and hypoxic inducible factor-1 α(HIF-1α)were detected with immunohisto chemistry. The expressions of VEGF and HIF-1α were determined with real-time quantitative RT-PCR. Results Compared with the control group, Endostatin, IFNγ and Endostatin+IFNγ groups showed obvious tumor inhibition(P<0.001), and Endostatin+IFNγ group had the most significant tumor inhibition effect(P<0.001). The microvessel density in Endostatin, IFNγ and 山 东 大 学 学 报 (医 学 版)58卷1期 -徐鹏飞,等.重组人血管内皮抑素联合重组人干扰素γ对小鼠Lewis肺癌移植瘤的作用 \=-Endostatin+IFNγ groups all significantly decreased(all P<0.001), and Endostatin+IFNγ group had the lowest density compared with Endostatin and IFNγ groups(P<0.001). The expression of VEGF in Endostatin, IFNγ and Endostatin+IFNγ groups all significantly decreased(P<0.001), while the expression of HIF-1α significantly increased(P<0.001), and the change in Endostatin+IFNγ group was the most significant(P<0.001). Conclusion Combination therapy of endostatin and IFNγ caneffectively inhibits tumor angiogenesis and tumor growth.

A metabonomic study on mTOR pathway regulating radiosensitivity of ECA109 cells

ZHANG Hairong, ZHANG Xiaohong, WANG Chaoqun

Journal of Shandong University (Health Sciences). 2020, 58(1):  6-12.  doi:10.6040/j.issn.1671-7554.0.2019.940

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Objective To explore the effects of mammalian target of rapamycin(mTOR)pathway on radiotherapy-induced autophagy, to search for the small molecular metabolites related to radiosensitivity and their regulatory pathways. Methods ECA109 cells were divided into three groups: control group, radiotherapy group and radiotherapy plus MHY1485 group. The mTOR, Beclin-1 and LC3-II/I were detected with Western blotting, and cell viability 24h after treatment was determined with CCK8 method. The cell culture medium of radiotherapy group(n=6)and radiotherapy plus MHY1485 group(n=6)were collected and analyzed with liquid chromatography-mass spectrometry(LC-MS). The differences in metabolites between the two groups were analyzed with PLS-DA and OPLS-DA. Results Radiotherapy induced autophagy by inhibiting mTOR pathway, and MHY1485 activated mTOR to antagonize autophagy and inhibited proliferation of tumor cells. Compared with the radiotherapy group, the radiotherapy plus MHY1485 group had upregulated expressions of betaine aldehyde, creatine, stearic acid, ornithine, L-cystine and L-proline(P<0.001), but downregulated expressions of citrulline, niacin, glucose 6-phosphate, L-valine, thymine, betaine, L-arginine, L-leucine, L-tryptophan and pyridoxine(P<0.001). Conclusion Radiotherapy can inhibit mTOR-induced autophagy, which 山 东 大 学 学 报 (医 学 版)58卷1期 -章海容,等. 哺乳动物雷帕霉素靶蛋白通路调控ECA109细胞放疗敏感性的代谢组学 \=-can be resisted by the activation of mTOR, so as to inhibit the proliferation of ECA109 cells and enhance the radiosensitivity. As metabolites in the radiotherapy group are different from those in radiotherapy plus MHY1485 group, metabolites and their pathways related to radiosensitivity can be detected with LC-MS technology.

Effects of intranasal infusion of IFN-γ on Th17/Treg cells in peripheral blood of rats with allergic rhinitis

ZHANG Meiling, SUN Hui, SUN Wenkai, MENG Zhaotun, WU Xinfang, GAO Wei, LI Qin

Journal of Shandong University (Health Sciences). 2020, 58(1):  13-19.  doi:10.6040/j.issn.1671-7554.0.2019.339

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Objective To investigate the effects of interferon gamma(IFN-γ)on T helper cell 17(Th17)and regulatory T cell(Treg)(Th17/Treg)in peripheral blood of rats with allergic rhinitis(AR). Methods A total of 40 Wistar male rats were randomly divided into 4 groups: control group, sensitized group, triamcinolone acetonide group, and IFN-γ group. The control group was injected with saline intraperitoneally, and had ultra-pure water nasal drops. The other 3 groups were injected with ovalbumin(OVA)and aluminium hydroxide and had OVA nasal instillation to establish AR models. After that, the sensitized group was treated with 50 μL phosphate buffer(PBS), triamcinolone acetonide group was treated with 3.5 μg triamcinolone acetonide, and IFN-γ group was treated with 1 μg IFN-γ nasal drops on either nostril. The proportions of Th17 cells and Treg cells in peripheral blood were measured with flow cytometry within 24 hours after the last administration, and levels of interleukin-17 A(IL-17A)and transforming growth factor(TGF-β1)were detected with quantitative enzyme-linked immunosorbent assay(ELISA)within 1 week. The nasal mucosa was observed with hematoxylin-eosin(HE)staining. Results Compared with control group ［(0.213 4±0.149 5)%］, the percentage of Th17 cells in sensitized group ［(4.975 7±1.503 9)%］, triamcinolone acetonide group ［(1.169 3±0.386 1)%］ and IFN-γ group ［(1.532 0±0.526 5)%］ increased in varying degrees(F=51.532, P<0.05), with no statistical difference between the triamcinolone acetonide group and IFN-γ group(P>0.05), but with differences among the other groups(P<0.05). Compared with control group ［(22.939 3±2.099 5)%］, the proportion of Treg cells in sensitized group ［(8.223 2±2.1888)%］, triamcinolone acetonide group ［(14.087 5±1.369 6)%］ and IFN-γ group ［(16.614 3±1.621 7)%］ decreased in varying degrees(F=97.107, P<0.05), with no difference between the triamcinolone acetonide group and IFN-γ group(P>0.05), but with differences among the other groups(P<0.008 3). Compared with control group ［(5.076 9±1.435 6)pg/mL］, the concentration of IL-17A in sensitized group ［(34.900 5±11.670 8)pg/mL］, triamcinolone acetonide group ［(9.733 8±1.828 9)pg/mL］, and IFN-γ group ［(10.524 6±2.118 0)pg/mL］ increased(F=27.173, P<0.05), with no difference between the triamcinolone acetonide group and IFN-γ group(P>0.05), but with differences among the other groups(P<0.05). Compared with the control group ［(431.881 6±67.326 2)pg/mL］, the concentration of TGF-β1 in sensitization group ［(173.886 2±41.708 2)pg/mL］, triamcinolone acetonide group ［(246.053 3±13.841 2)pg/mL］ and IFN-γ group ［(290.012 7±22.885 6)pg/mL］ decreased(F=36.623, P<0.05), with no differences among the groups(P<0.05). Compared with control group, the nasal mucosa of sensitized group was thicker and more edematous, with infiltration of a large number of inflammatory cells, disordered cell arrangement, goblet cell proliferation and almost invisible cilia. The nasal mucosa of triamcinolone acetonide group was thinner, edema was improved, inflammatory cells were significantly reduced and cilia slightly grew. The nasal mucosa of IFN-γ group was thinner than that of sensitized group, edema was improved, only a few inflammatory cells were found and the cilia slightly grew. Conclusion The percentages of Th17 and Treg cells in peripheral blood of AR rats were abnormal, accompanied by abnormal expression of IL-17A and TGF-β1. IFN-γ may play a therapeutic role in AR by decreasing the proportion of Th17 cells and level of IL-17A, while increasing the proportion of Treg cells and level of TGF-β1.

Value of blood routine data in distinguishing myelodysplastic syndrome and acute myeloid leukemia

DAI Xiaoyu, LU Yuan, WANG Zhiheng, LI Mingzhuo, SI Shucheng, LI Jiqing, JING Ming, XUE Fuzhong

Journal of Shandong University (Health Sciences). 2020, 58(1):  20-25.  doi:10.6040/j.issn.1671-7554.0.2019.1009

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Objective To establish a model to identify myelodysplastic syndrome(MDS)and acute myeloid leukemia(AML)based on blood routine data. Methods The data of 1 681 patients from Shandong Multi-Center Health Medical Big Data Platform were randomly divided into the training set(70%)and testing set(30%). MDS and AML were identified with random forest model. The discriminatory ability of the model was determined with the area under the receiver operating characteristic curve(AUC)and the stability of the model was tested with ten-fold cross validation. Results Both of the random forest model and support vector machine model were able to identify MDS and AML, but the former had better performance. It showed the estimated AUC for male was 0.874(95%CI: 0.815-0.932), sensitivity was 81.1%, and specificity was 81.9%; the estimated AUC for female was 0.831(95%CI: 0.752-0.911), sensitivity was 77.8%, and specificity was 74.3%. The ten-fold cross validation showed the estimated AUC was 0.884(95%CI: 0.854-0.913)for male and 0.842(95%CI: 0.802-0.883)for female. Conclusion The discriminant model is capable of identifying MDS and AML based on blood routine data.

Effects of mechanical thrombus aspiration and catheter-directed thrombolysis on venous function in 87 cases of acute central deep venous thrombosis of lower extremity

SUN Xinguo, CHEN Kunhao, HU Zhang, DENG Xiaojun, DUAN Shijiao, XIE Weihua, YAN Qiong, ZHANG Hongwen

Journal of Shandong University (Health Sciences). 2020, 58(1):  26-30.  doi:10.6040/j.issn.1671-7554.0.2019.969

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Objective To explore the effects of mechanical thrombus aspiration and catheter-directed thrombolysis(CDT)on venous function of acute central deep venous thrombosis(DVT). Methods A total of 87 patients with acute central DVT treated during Jan. 2015 and Jan. 2017 were selected, including 45 males and 42 females. The patients were divided into 2 groups: mechanical group(n=39, thrombus aspiration with big catheter or sheath, supplemented with small dose of urokinase after operation), and CDT group(n=48). The effective internal diameter of superficial femoral vein(SFV), time of blood regurgitation of the first valve in SFV, reflux distance, and incidence of post-discharge postthrombotic syndrome(PTS)were compared 6 months, 1 year and 2 years after treatment. Results There 山 东 大 学 学 报 (医 学 版)58卷1期 -孙鑫国,等. 机械性血栓抽吸和置管溶栓对87例急性中央型下肢深静脉血栓静脉功能的影响 \=-was significant difference in the diameter of SFV between the two groups(Ftreatment=10 197.500, P<0.001), the differences 6 months, 1 year and 2 years were statistically significant(F_time=442.770, P<0.001), and there was a synergistic interaction effect between the treatment method and time(F_{treatment×time}=317.749, P<0.001). There was significant difference in valvular regurgitation time between the two groups(F_treatment=14 529.193, P<0.001), the differences 6 months, 1 year and 2 years were significant(F_time=670.189, P<0.001), and there was a synergistic interaction effect between treatment method and time(F_{treatment×time}=501.604, P<0.001). There was significant difference in reflux distance between the two groups(F_treatment=4 842.897, P<0.001), the differences 6 months, 1 year and 2 years were significant(F_time=413.343, P<0.001), and there was a synergistic interaction effect between the treatment method and time(F_{treatment×time}=313.582, P<0.001). The incidence of PTS was ［35.42%(17/48)］ in CDT group, and ［15.40%(6/39)］ in the mechanical group, with statistical difference(χ2=106.350, P<0.001). Conclusion Mechanical thrombus aspiration can expand the cavity of SFV in the early stage, reduce the time and distance of blood reflux at the valve, reduce the incidence of long-term PTS, and better protect the venous function compared with CDT.

Application of mixed reality technique in the resection of benign lateral skull base tumor

XU Ling, SUN Yan, CHEN Liang, WANG Xiwen

Journal of Shandong University (Health Sciences). 2020, 58(1):  31-38.  doi:10.6040/j.issn.1671-7554.0.2019.1139

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Objective To explore the application value of mixed reality technique in the resection of benign lateral skull base tumor. Methods The clinical data of 19 patients with benign lateral skull base tumor during Mar. 2017 and Oct. 2018 were retrospectively analyzed. The patients were divided into group A(n=8)and B(n=11). In group A, before operation, 3D image fusion technique was applied to reconstruct anatomical structure, mixed reality technique was used to formulate operation scheme, and surgeons communicated fully with patients and their families. During operation, mixed reality technique was used to guide the resection of tumors. In group B, no mixed reality technique was applied before or during operation. The time needed from skin incision to tumor exposure, tumor removal rate, postoperative hospital stay, incidence of complications and patients satisfaction rate were compared between the two groups. Results There were no significant differences in tumor removal rate, hospital stay and incidence of complications between the two groups(P>0.05). However, group A had shorter time from skin incision to tumor exposure(P=0.003)and higher patients satisfaction rate(P=0.005)than group B. Conclusion Pre- and intra-operative use of mixed reality technique in the resection of benign lateral skull base tumor can significantly shorten the time from the initial incision to tumor exposure, facilitate doctor-patient communication and improve patients satisfaction, which is worthy of clinical promotion.

Risk factors of malignant transformation trend of 53 cases of endometrial polyps

LIU Ya, WANG Yafen, ZHU Lin, ZHANG Ping, MA Demei

Journal of Shandong University (Health Sciences). 2020, 58(1):  39-42.  doi:10.6040/j.issn.1671-7554.0.2019.555

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Objective To explore the hysteroscopic features of endometrial polyps and the diagnostic value. Methods The study collected the clinical information of 567 patients during Aug. 2012 and Jan. 2019 who were diagnosed with ultrasound and hysteroscopy as endometrial polyps, and then received biopsy or resection of polyps under hysteroscopy. According to the pathological results, the patients were divided into two groups, 514 cases in the benign group and 53 caes in the malignant and pre-malignant group. The characteristics of endometrial polyps under hysteroscopy, the patients’ age, pregnancy history and ultrasound results were analyzed. Results The malignant and pre-malignant group were more likely to be menopausal and have symptoms of abnormal uterine bleeding than the benign group(47.16% vs 21.79%, P<0.001; 92.45% vs 70.82%, P<0.001). Surface vascular hyperplasia was the risk factor of malignant transformation of polyps, whose incidence was higher in the malignant and pre-malignant group than in the benign group(60.37% vs 9.33%, P<0.001). Multivariate binary Logistic regression analysis showed that surface vascular hyperplasia(OR=14.73, 95%CI:7.88-27.53), abnormal uterine bleeding(OR=5.05, 95%CI:1.79-14.24)and menopause(OR=3.21, 95%CI:1.80-5.72)were risk factors of polyp malignant transformation, and surface vascular hyperplasia had the highest risk. Conclusion Due attention should be paid to menopause, abnormal uterine bleeding and surface vascular hyperplasia as they are risk factors of malignant transformation of endometrial polyps.

High live birth rate in women with hypogonadotropic hypogonadism after treatment of in vitro fertilization

FENG Zhenhua, LI Yuanmei, CUI Wenjuan, SI Rui, SHENG Yan, ZHAO Han

Journal of Shandong University (Health Sciences). 2020, 58(1):  43-48.  doi:10.6040/j.issn.1671-7554.0.2019.810

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Objective To evaluate the outcomes of in vitro fertilization and embryo transfer(IVF-ET)in women with hypogonadotropic hypogonadism(HH). Methods The retrospective study involved 79 women with HH(HH group)who received first cycle IVF-ET during Mar. 2013 and Jan. 2017 in Center for Reproductive Medicline, Shandoug University, and 270 controls(control group)with matched age, body mass index(BMI), and normal ovarian reserve who received IVF-ET due to oviduct diseases. The outcomes of IVF-ET were compared between the two groups. Results There were no statistical differences in clinical pregnancy rate, live birth rate of fresh or frozen embryo transfer and cumulative pregnancy rate between the two groups. The early abortion rate of fresh embryo transfer(8.82% vs 10.66%), rate of ectopic pregnancy(0% vs 1.4%)and early abortion rate of frozen embryo transfer(0% vs 6.98%)were lower in HH group than in control group although no statistical significance was obtained due to limited number of samples. The HH group had more dosage of gonadotropin(Gn)［(4 163.61±1 798.98)IU vs(1872.55±759.19)IU, P<0.001］and longer Gn stimulation duration ［(14.28±2.80)d vs(11.11±1.90)d, P<0.001］ than the control group. After we adjusted the total dosage and medication time of Gn, serum HCG and other related factors, we obtained similar results. Conclusion Women with hypophysical dysfunction will get expected high live birth rate and cumulative pregnancy rate 山 东 大 学 学 报 (医 学 版)58卷1期 -冯振花,等.79例低促性腺激素性腺功能减退患者体外受精-胚胎移植结局分析 \=-after IVF-ET/FET treatment. Their clinical outcomes are comparable to those of young patients with good ovarian function.

Impact of body mass index on pregnancy outcomes in artificial insemination by husband

SONG Haixia,YUAN Caixia,FAN Lingling

Journal of Shandong University (Health Sciences). 2020, 58(1):  49-53.  doi:10.6040/j.issn.1671-7554.0.2019.973

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Objective To explore the impact of body mass index(BMI)on pregnancy outcomes of artificial insemination by husband(AIH)in letrozole plus human menopausal gonadotropin(HMG)ovulation cycle. Methods The clinical data of 325 patients who received AIH with letrozole plus HMG ovulation cycle were retrospectively analyzed. According to BMI, the patients were divided into obese group(BMI≥25 kg/m², n=133)and control group(BMI<25 kg/m², n=192). The clinical baseline parameters and pregnancy outcomes of the two groups were compared, including age, infertility time, basal hormones, antral follicol count(AFC), days and dosage of gonadotropin(Gn), and pregnancy outcomes. In the obese group, 68 patients had polycystic ovary syndrome(PCOS)and 65 had not, while in the control group, 83 had PCOS and 109 had not. The correlation between PCOS and pregnancy outcomes was analyzed. Results The obese group had longer days and higher dosage of Gn than the control group(P<0.05), but lower biochemical pregnancy rate(23.3% vs 29.2%,P=0.242), and there was no significant difference after prolactin(PRL)and PCOS were adjusted(OR=0.671, 95%CI:0.399-1.13). The obese group had lower clinical pregnancy rate than the control group(17.3% vs 26.6%, P=0.052), but there was significant difference after PRL and PCOS were adjusted 山 东 大 学 学 报 (医 学 版)58卷1期 -宋海霞,等.体质量指数对夫精人工授精妊娠结局的影响 \=-(OR=0.528, 95%CI:0.301-0.928). The obese group had lower live birth rate than the control group(10.5% vs 24.5%, P=0.002), and there was significant difference after PRL and PCOS were adjusted(OR=0.331, 95%CI:0.172-0.637). The obese group had higher abortion rate than the control group(12.8% vs 4.7%, P=0.011), and there was significant difference after PRL and PCOS were adjusted(OR=2.82, 95%CI:1.2-6.627). Conclusion In AIH with letrozole plus HMG ovulation cycle, obese patients may acquire lower live birth rate than non-obese patients. Obese women with or without PCOS should control BMI by means of diet, sports or drug treatment to improve pregnancy rate.

Expression of microRNA519D and matrix metalloproteinase2 in placenta tissues of pre-eclampsia and its significance

ZHANG Weiyue, LI Yaguang, LIU Enling, WANG Weijie, WEI Jingwen, JING Nan

Journal of Shandong University (Health Sciences). 2020, 58(1):  54-59.  doi:10.6040/j.issn.1671-7554.0.2019.1049

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Objective To investigate the expressions of microRNA519D(miR-519d)and matrix metalloproteinase2(MMP2)in placental tissues of patients with pre-eclampsia(PE). Methods A total of 71 pregnant women in Tangshan Gongren Hospital from Nov. 2018 to May 2019 were divided into PE patients(PE group, n=16), severe PE patients(severe PE group, n=20), and normal pregnant women(control group, n=35). The expression levels of miR-519d and MMP2 were detected by real-time quantitative PCR, immunohistochemistry and Western blotting methods. Results The expression levels of miR-519d in placental tissues of control group, PE group and severe PE group were 0.992±0.092, 1.550±0.119, and 2.698±0.278, respectively, and there was statistical difference on the whole(F=638.245,P<0.001). The expression levels of miR-519d between each group were statistically different(PE group vs control group, T=18.226, P<0.001; severe PE group vs control group, T=26.588, P<0.001; PE group vs severe PE 山 东 大 学 学 报 (医 学 版)58卷1期 -张炜悦,等.microRNA519D与基质金属蛋白酶2在36例子痫前期患者胎盘组织中的表达及意义 \=- group, T=16.636, P<0.001). The expression levels of MMP2 in placental tissues of control group, PE group and severe PE group were 0.844±0.047, 0.458±0.039, and 0.273±0.012, respectively, and there was statistical difference on the whole (F=1 552.203,P<0.001). The expression levels of miR-519d between each group were statistically different(PE group vs control group, T=28.823, P<0.001; severe PE group vs control group, T=68.189, P<0.001; PE group vs severe PE group, T=18.442, P<0.001). MMP2 and miR-519d expressions exhibited a negative correlation(r=-0.907, P<0.001). Conclusion The expression of miR-519d in placental tissue of PE patients is increased, while the expression of MMP2 is decreased with the exacerbation of PE. MMP2 and miR-519d may participate in the pathogenesis of PE.

Antiretrovial treatment effect and related factors of patients with human immunodeficiency virus infection and hepatitis B virus co-infection in Shandong Province

LIU Cuixiao, ZHU Xiaoyan, ZHANG Na, HUANG Pengxiang, WANG Guoyong, KANG Dianmin

Journal of Shandong University (Health Sciences). 2020, 58(1):  60-66.  doi:10.6040/j.issn.1671-7554.0.2019.1166

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Objective To investigate the treatment effect and its related factors among human immunodeficiency virus(HIV)/ acquired immunodeficiency syndrome(AIDS)patients with or without HBV co-infection in Shandong Province. Methods Data of 500 HIV/AIDS patients were collected from the Shandong AIDS Antiviral Treatment Database during 2015 and 2017. The patients were divided into the HIV infection group(n=168)and the HIV/HBV co-infection group(n=332), aged(35.41±10.24)and(34.75±9.22)years, respectively. The basic situation of patients were analyzed, and the changes of related indicators after treatment for 12 months were compared. Logistic regression model was used to analyze the related factors of the antiretroviral therapy effect. Results Most of patients were male, unmarried, 山 东 大 学 学 报 (医 学 版)58卷1期 -刘翠晓,等.山东省单纯艾滋病病毒感染与合并乙型肝炎病毒感染者抗病毒治疗效果及相关因素 \=-and infected by sexual transmission. After treatment for 12 months, the median of CD4⁺ T lymphocyte increased from 315.5/μL to 439.0/μL in HIV infection group, and from 349.5/μL to 491.0/μL in HIV/HBV co-infection group. The proportion of immunological failure was 16.3% in the HIV infection group and 44.6% in the HIV/HBV co-infection group. The proportion of virological failure was 7.5% in the HIV infection group and 13.1% in the HIV/HBV co-infection group. Multivariate Logistic analysis of treatment outcomes showed that immunological failure was associated with HBV co-infection(OR=1.619, 95%CI: 1.061-2.469), 35-44 years old (OR=2.695, 95%CI: 1.145-6.345)and older than 45 years old (OR=3.101, 95%CI: 1.291-7.450). The occurrence of virological failure was associated with HBV co-infection(OR=2.156, 95%CI: 1.142-4.070)and clinical stage III or IV (OR=2.443, 95%CI: 1.102-5.416). Conclusion The treatment effect of patients with HIV/HBV co-infection is not as good as that with HIV simple infection. Screening and effective management of HBV in HIV/AIDS patients should be strengthened. Choosing the suitable treatment drug for different people is crucial and can improve the effectiveness of antiviral treatment.

Influencing factors of lymphatic leakage after laparoscopic radical cystectomy: an analysis of 160 cases

ZHANG Zhaopeng, XING Naidong, ZHANG Xiang, YAN Lei, XU Zhonghua

Journal of Shandong University (Health Sciences). 2020, 58(1):  67-72.  doi:10.6040/j.issn.1671-7554.0.2019.1307

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Objective To investigate the factors leading to lymphatic leakage after laparoscopic radical cystectomy(LRC), and to explore their roles in the prevention and treatment of postoperative lymphatic leakage. Methods The clinical data of 160 patients who underwent LRC at the Urology Department of Qilu Hospital of Shandong University from Jan. 2015 to Jan. 2019 were retrospectively analyzed and relevant literature was reviewed. The patients were divided into leakage group and non-leakage group. Patients age, lymph node dissection range, number of lymph nodes, number of positive lymph nodes, whether the lymphatic tissues were clapped with Hemolock after dissection, preoperative and postoperative hemoglobin(HGB), postoperative albumin(ALB)were collected to analyze factors associated with postoperative lymphatic leakage. Results Lymphatic leakage was detected in 44(27.5%)patients. One-way t-test and χ2 test showed the number of positive lymph nodes and whether lymphatic tissues were clamped with Hemolock after dissection were associated with occurrence of lymphatic leakage, and the latter could significantly reduce incidence of lymphatic leakage(t=2.477, χ2=41.215, P<0.05). Logistic regression analysis showed lymphatic leakage was associated with whether lymphatic tissues were clamped with Hemolock after dissection(OR=18.482, 95%CI:6.872-49.709, 山 东 大 学 学 报 (医 学 版)58卷1期 -张照鹏,等.160例腹腔镜根治性膀胱切除术后淋巴漏的影响因素分析 \=-P<0.001). All patients were cured after conservative treatment including fasting and unobstructed drainage. Conclusion The number of positive lymph nodes and whether lymphatic tissues are clamped with Hemolock after dissection are high risk factors of postoperative lymphatic leakage. Conservative treatment and adequate drainage can achieve satisfactory results. Skillful grasp of operation skills, clamping after lymph node dissection, good knowledge of anatomy and careful operation can prevent occurrence of lymphatic leakage.

Diagnosis and treatment of matanephric adenoma: a single center experience

LEI Kunyang, WANG Xu, MA Ming, SUN Ting

Journal of Shandong University (Health Sciences). 2020, 58(1):  73-76.  doi:10.6040/j.issn.1671-7554.0.2019.1160

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Objective To explore the clinical manifestations, imaging features, pathological features, treatment and prognosis of metanephric adenoma(MA)in order to improve the diagnosis and treatment of MA. Methods The clinical data of 9 MA patients confirmed by pathology in The First Affiliated Hospital of Nanchang University from May 2011 to January 2019 were analyzed retrospectively, and their clinical manifestations, imaging characteristics, histological and immunohistochemical characteristics, treatment methods and prognosis were summarized, analyzed and discussed. Results A total of 9 MA patients were enroued in this study, including 1 case of low back pain, 2 cases of low back discomfort, 1 case of low back pain complicated with polycythemia, and the other 5 cases were found by physical examination. The tumors were located on the left side in 5 cases and on the right side in 4 cases. The mean diameter of the tumors was 4.3(1.7-6.7)cm. Laparoscopic partial nephrectomy(LPN)was performed in 7 cases and laparoscopic radical nephrectomy(LRN)in 2 cases. All cases were pathologically diagnosed as MA. The mean follow-up time was 43(5-97)months, and there were no recurrence or metastasis in all cases. Conclusion MA is a rare renal tumor. Its clinical manifestations and imaging features are helpful for diagnosis, but the diagnosis mainly depends on pathology. The prognosis of MA is generally good, but regular follow-up is needed.

Efficacy of high flow nasal cannulae therapy for acute cardiogenic pulmonary edema

ZHANG Guoying, WANG Jing, WANG Chuanxia, ZHANG Xuan, CHI Xiangyu, LI Qing

Journal of Shandong University (Health Sciences). 2020, 58(1):  77-80.  doi:10.6040/j.issn.1671-7554.0.2019.1313

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Objective To explore the clinical efficacy of high flow nasal cannulae(HFNC)therapy for patients with cardiogenic pulmonary edema. Methods A total of 14 patients with cardiogenic pulmonary edema treated with HFNC therapy during ist Oct. 2018 and ist Aug. 2019 were selected as the treatment group, and another 12 patients with cardiogenic pulmonary edema who received routine oxygen therapy during the same period served as the control group. The respiratory rate, blood oxygen saturation, comfort and other indicators of the two groups were compared. Results All patients in the treatment group achieved effective clinical control, pulmonary edema was effectively treated, symptoms and signs were improved, and oxygenation indexes were increased (P=0.048). Compared with control group, treatment group had lower 0.5 h, 1 h and 12 h respiratory rate; lower 0.5 h, 1 h, 6 h, 12 h and 24 h heart rate; and lower 1 h mMRC. Conclusion HFNC therapy is effective in the treatment of cardiogenic pulmonary edema.

Clinical features of 9 cases of cryptogenic organizing pneumonia and literature review

WANG Huasheng, OU Renjie, WANG Mo, BAI Longzhen,LI Yingjie, SUN Chao, WANG Yongmei

Journal of Shandong University (Health Sciences). 2020, 58(1):  81-86.  doi:10.6040/j.issn.1671-7554.0.2019.764

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Objective To summarize cryptogenic orgenizing pneumonia(COP)s clinical and radiographic features. Methods Nine cases COP were reviewed. Their clinical presentation, radiographic and pathology features were analyzed. Results Cough(66.7%)and chest tightness(55.6%)were the most common symptoms in those patients. CRP and ESR were increased distinctly. Chest CT was characterized by bilateral or unilateral patchy or dffuse con-solidation(55.6%), and migration was its characteristic radiographic feature. In pathological staining, the alveoli and bronchioles were filled with loose fibroblast connective tissue thrombus, which was round or dumbbell-shaped. COP was sen-sitive to corticosteroid therapy, and had a good outcome. Conclusion COP has its own radiographic characteristics and sensitive to corticosteroid treatment. Attention should be paid to the disease to avoid misdiagnosis and mistreatment.

Small intestinal neuroendocrine tumors: report of 2 cases and literature review

XIA Dandan, WANG Huiyu, XU Junying, LIU Chaoying, WANG Runjie

Journal of Shandong University (Health Sciences). 2020, 58(1):  87-90.  doi:10.6040/j.issn.1671-7554.0.2019.913

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Objective To explore the epidemiology, pathogenesis, clinical manifestation, imaging selection, pathological characteristics and treatment of small intestinal neuroendocrine tumors(SI-NETs), and to analyze the biological behavior and prognosis. Methods The clinicopathological data of 2 cases of SI-NETs were reviewed. Results The pathogenesis of SI-NETs remained unclear, mainly due to genetic factors. The malignant degree of SI-NETs was low, and there was no early specific clinical manifestation. The onset of the disease was late, and patients generally had poor prognosis. Conclusion Further study of the molecular mechanism and prognostic biomarkers of SI-NETs can provide information for the choice of optimal treatment strategy, and is of great significance for the early diagnosis, treatment and prognosis.

Gastric cancer complicated with mild hemophilia and postoperative hemorrhage: a report of one case

WANG Yajie, WEN Bei, SHI Haoyu, SHANG Liang, DONG Kangdi, LI Leping

Journal of Shandong University (Health Sciences). 2020, 58(1):  91-93.  doi:10.6040/j.issn.1671-7554.0.2019.1228

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Objective The purpose of this paper is to explore the perioperative management of gastric cancer complicated with hemophilia. Methods The clinical characteristics, diagnosis and treatment of postoperative hemorrhage in a patient with gastric cancer and mild hemophilia A were retrospectively analyzed, and relevant literatures were reviewed. Results The patients condition was discussed by multi-disciplinary experts. Blood examination revealed decreased activity of coagulation factor Ⅷ and confirmed mild hemophilia A. The patient stopped bleeding after transfusion of recombinant coagulation factor Ⅷ. Conclusion For gastric cancer patients complicated with hemophilia, alternative therapy is very important. The first choice is recombinant FⅧ, and duration of alternative therapy should be appropriately prolonged according to the type of operation and degree of injury. Patients should be registered in the hemophilia center for long-term follow-up.

Relationship among activity of daily life, social support and loneliness in rural elderly: mediating effects of general self-efficacy

JING Xiang, WANG Yali, LU Lu, XIA Yu, JIAO Anan, LI Yaozu, XU Lingzhong

Journal of Shandong University (Health Sciences). 2020, 58(1):  94-99.  doi:10.6040/j.issn.1671-7554.0.2019.1035

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Objective To explore the mediating effects of general self-efficacy in the relationship among activity of daily life, social support and loneliness in rural elderly. Methods Objects were chosen with multi-stage stratified random sampling and surveyed with Activity of Daily Living Scale(ADL), Loneliness Scale(ULS-6), General Self-efficacy Scale(GSES)and a self-developed questionnaire. Data were analyzed with SPSS 24.0 and AMOS 21.0. Results Spearman rank correlation analysis showed that activity of daily life and social support were negatively correlated with general self-efficacy(r=-0.265, r_D1=-0.206, r_D2=-0.221, P<0.001), but positively correlated with loneliness(r=0.142, r_D1=0.173, r_D2=0.187, P<0.001); general self-efficacy was negatively correlated with loneliness(r=-0.240, P<0.001). The mediating effect model showed that general self-efficacy had a significant mediating effect on activity of daily life and loneliness(95%CI:0.029-0.047), and the proportion of mediating effect was 33.33%; general self-efficacy had a significant mediating effect on social support and loneliness(95%CI: 0.034-0.054), and the proportion of 山 东 大 学 学 报 (医 学 版)58卷1期 -景翔,等.农村老年人日常活动能力、社会支持与孤独感的关系:一般自我效能的中介作用 \=-mediating effect was 14.81%. Conclusion General self-efficacy has mediating effects on activity of daily life, social support and loneliness among rural elderly.

Relationship between parenting styles and non-suicidal self-injury in senior students: the moderating role of gender

MAO Cui, LI Yuanyuan, LI Ping

Journal of Shandong University (Health Sciences). 2020, 58(1):  100-105.  doi:10.6040/j.issn.1671-7554.0.2019.1012

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Objective To investigate the occurrence of non-suicidal self-injury(NSSI)among senior high school students and the moderating role of gender between parenting styles and NSSI. Methods A total of 641 grade two students(male 308, female 333, aged 15-18)were surveyed with general demographic information questionnaire, adolescent self-injury questionnaire and parental bonding instrument(PBI). Results The detection rate of NSSI was 32.1%, which was 30.2% among male and 33.9% among female students(P>0.05). There were differences between male and female students in 5 behavior patterns, 1 behavior cause and 1 external stimulus event of NSSI(P<0.05). Logistic stratified stepwise regression showed that paternal care(OR=0.926)was a protective factor for NSSI; gender moderated the relationship between maternal control and NSSI; maternal control(OR=1.102)was a risk factor for NSSI among female students. Conclusion The occurrence of NSSI is common and the behavior patterns are diverse in grade two students. Gender plays a moderating role in the relationship between parenting styles and NSSI.

Analysis of mental health status and influencing factors of female infertility patients

FAN Antong, TIAN Qing, LI Xinyang, ZHAO Xinping, LIU Hongqing

Journal of Shandong University (Health Sciences). 2020, 58(1):  106-111.  doi:10.6040/j.issn.1671-7554.0.2019.820

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Objective To investigate the mental health status and influencing factors of female infertile patients. Methods A total of 320 females were selected with simple random sampling from infertile outpatients and surveyed with Symptom Checklist 90(SCL-90)and a self-made questionnaire. The influencing factors of mental health status were analyzed with multivariate Logistic regression. Results Altogether 273 valid questionnaires were collected and the effective rate was 85.31%. Two independent sample t-test showed statistical differences in the number of positive items, interpersonal sensitivity factor score, anxiety factor score, hostility factor score, terror factor score, paranoid factor score and psychiatric factor score between patients and norms(P<0.05). Single factor analysis indicated that education level, actual treatment cost, first year of consultation, number of outpatient treatment, duration of treatment, treatment of in vitro fertilization(IVF), type of infertility, husband-wife relationship, and mother-in-law and daughter-in-law relationship could influence mental health(P<0.05). Binary Logistic regression analysis showed that number of outpatient 山 东 大 学 学 报 (医 学 版)58卷1期 -樊安彤,等.女性不孕症患者心理健康状况及其影响因素分析 \=-treatment(OR=1.63)and primary infertility(OR=2.50)were risk factors of mental health, while harmonious husband-wife relationship(OR=0.30)was a protective factor. Conclusion The mental health status of female infertile patients is lower than that of normal adults. The main influencing factors of mental health include number of outpatient treatment, type of infertility and husband-wife relationship.

Seasonal characteristics of influenza incidence in Shandong Province from 2010 to 2018

XIU Jingwei, LI Wangchen, CUI Qingxia, WU Bingyi, WANG Zaixiang

Journal of Shandong University (Health Sciences). 2020, 58(1):  112-117.  doi:10.6040/j.issn.1671-7554.0.2019.584

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Objective To analyze the seasonal characteristics of influenza incidence in Shandong Province from January 2010 to December 2018, and to provide scientific basis for the formulation of influenza prevention and control measures. Methods The monthly report data of influenza epidemic in Shandong Province from 2010 to 2018 were sorted out by the concentration, circular distribution and seasonal index methods. Results The number of influenza cases in Shandong Province was on the rise from 2010 to 2018(χ2=21 625, P<0.001), and the annuary epidemic concentration value was 0.56, 0.33, 0.33, 0.37, 0.48, 0.34, 0.48, 0.53 and 0.62, respectively. The peak date of influenza incidence was January 14 in each year, and the peak period was from November 28 to March 1. The difference of the peak dates in different years was statistically significant(F=347.13, P<0.001). Seasonal indices of different months varied with the maximum being 253% in January and the minimum being 27% in June. Conclusion The influenza incidence in Shandong Province has seasonal characteristics, which suggests that prevention and control measures should be taken at the peak of the epidemic.