Table of Content

  

10 February 2023
Volume 61 Issue 2

基础医学

Effects of Lipin1 on neuronal metabolomics in high glucose environment

HUANG Shan, LOU Nengjun, HAN Xiaolin, LIANG Zhonghao, HUA Mengyu, ZHUANG Xianghua, CHEN Shihong

Journal of Shandong University (Health Sciences). 2023, 61(2):  1-8.  doi:10.6040/j.issn.1671-7554.0.2022.1442

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Objective To investigate the effects of phosphatidic acid phosphatase(Lipin1)on the metabolomics of PC12 cells in high glucose environment. Methods PC12 cells infected with lentivirus were constructed. PC12 cells infected with empty capsid lentivirus(WT group)and underexpression Lipin1 lentivirus(D-WT group)were incubated with 25 mmol/L glucose. PC12 cells infected with empty capsid lentivirus(HG group)and overexpression Lipin1 lentivirus(G-HG group)were incubated with 100 mmol/L glucose. The expression of Lipin1 was determined with Western blotting after 48 h(n≥6). WT group, HG group and G-HG group were treated for 48h and the cells were collected and subjected to LC-MS/MS to compare the metabolomic differences(n=6). Results The Lipin1 expression was significantly higher in the WT group than in D-WT and HG groups(P<0.05), significantly higher in G-HG group than in HG group(P<0.01). When the screening criteria for differential metabolites were VIP>1, P<0.05, fold change(FC)>1.5 or <0.65, glutamic acid significantly decreased in HG group than in WT group; diacylglycerol(DAG)and 2-arachidacylglycerol(2-AG)significantly increased in G-HG group than in HG group. Cognitive-related pathway after high glucose incubation and regulation of Lipin1 involved the retrograde endocannabinoid signaling(ECS), glutamatergic synapse, long term enhancement(LTP)and long term inhibition(LTD). Conclusion Decreased glutamic acid in high glucose environment may explain the pathogenesis of diabetic encephalopathy. Overexpression of Lipin1 can improve neuro-related metabolites DAG and 2-AG and related pathway ECS to alleviate cognitive impairment. Lipin1 may be one of the key therapeutic targets for diabetic encephalopathy.

Effects of β-estradiol on the proliferation of cervical cancer Hela cells

LIU Meng, HOU Congzhe, MA Huanyu, ZHANG Zhen, ZHAO Xinrui, ZHANG Ping, ZHU Lin

Journal of Shandong University (Health Sciences). 2023, 61(2):  9-15.  doi:10.6040/j.issn.1671-7554.0.2022.0807

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Objective To investigate the effects of different concentrations of β-estradiol(E₂)on the proliferation of Hela cells in cervical cancer and the mechanism. Methods Hela cells cultured in vitro were divided into control, low concentration and high concentration groups. The effects of E₂ on the proliferation were detected with CCK8 assay and cell clone formation assay. The effects of E₂ on the apoptosis, cell cycle and migration were detected with flow cytometry and Transwell assay, respectively. In the control and high concentration groups, the mRNA expressions of HPV18 E6, E7, p21, p53, CDK2 and Rb were detected with qRT-PCR; the protein expressions of p21, p53, CDK2, Rb and Rb phosphorylation(pRb)were detected with Western blotting. Results Compared with the control and low concentration groups, the high concentration group had reduced cell growth rate(P<0.001), inhibited cell cloning(P=0.013)and prolonged G0/G1 phase(P<0.001). High concentration of E₂ reduced the mRNA expressions of HPV18 E6/E7(P=0.049, P=0.043), downregulated the mRNA and protein expressions of CDK2 and Rb(P_{CDK2 mRNA}=0.035, P_{Rb mRNA}=0.003, P_{CDK2 protein}=0.009, P_{Rb protein}=0.008), upregulated the mRNA and protein expressions of p21 and p53(P_{p21 mRNA}=0.042, P_{p53 mRNA}=0.035, P_{p21 protein}=0.039, P_{p53 protein}=0.043), and downregulated pRb(P<0.001). Conclusion High concentration of E₂ inhibits the proliferation of Hela cells. The mechanism might be related to the inhibition of HPV18 E6/E7 oncogene, promotion of the protein expressions of p53 and p21, and regulation of cell cycle protein(CDK2, Rb)levels, thus affecting the normal cell cycle.

Effects of Helicobacter pylori infection on glycolysis of gastric cancer cells

WANG Zan, XU Xiaohan, ZHANG Yu, QU Yemin, WANG Mingyi, CHEN Ai

Journal of Shandong University (Health Sciences). 2023, 61(2):  16-24.  doi:10.6040/j.issn.1671-7554.0.2022.0965

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Objective To explore the effects of Helicobacter pylori(H. pylori)on glycolysis metabolism of gastric cancer cells and the molecular mechanism. Methods After the glucose consumption rate and lactate production of gastric mucosal epithelial cells GES-1 and gastric cancer cells including MKN28, AGS, HGC27, MGC803, MKN45 and NCI-N87 were detected, GES-1, MKN28 and AGS were identified as the follow-up research objects. Untreated GES-1, MKN28 and AGS were set as controls, while they were co-cultured with H. pylori(H. pylori-HVS, H. pylori-26695, H. pylori-△cagA)to establish acute and chronic cell models. Glucose consumption, lactate production and glucose uptake were measured in all cell models. The protein levels of key enzymes in glucose metabolism were detected with Western blotting. Results Compared with normal gastric mucosal GES-1 cells, the gastric cancer cells(AGS, HGC27, MGC803, MKN45, NCI-N87)had significantly up-regulated glycolysis(P<0.001). Compared with the controls, the acute models had unchanged glucose uptake and lactate production(P>0.05), while chronic models had significantly increased glucose uptake and lactate production(P<0.001). The expression level of M2 isoform of pyruvate kinase(PKM2)was significantly up-regulated in the acute models, while that of M1 isoform of pyruvate kinase(PKM1)was down-regulated. Conclusion Chronic H. pylori infection can up-regulate glycolysis in gastric cancer cells, and the molecular mechanism may be related to PKM2, suggesting that PKM2 may be the target of H. pylori-mediated metabolic changes in gastric cancer.

Effects of KLHL15 gene on the testis and liver of male mice

LIU Xiaohan, SHI Hui, ZHAO Zhenjun

Journal of Shandong University (Health Sciences). 2023, 61(2):  25-30.  doi:10.6040/j.issn.1671-7554.0.2022.1324

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Objective To explore the effects of KLHL15 gene deletion on the structure and function of testis and liver in male mice. Methods The structure and function of testis and liver tissues of wild type(WT)and KLHL15 knockout type(KLHL15^-/^-)male mice were compared. The measurement indexes included: (1) Fertility: number of offspring, sperm vitality and sperm quality; (2) Anatomy: the mass and organ index of testis and liver were compared between WT and KLHL15^-/^- mice in similar growth conditions; (3) Histopathology: the effects of KLHL15 gene deletion on the structure of liver and testis were observed with HE staining; (4) Liver function: apoptosis of liver tissue was detected with Tunel; liver differential proteins were enriched and analyzed with TMT labeled quantitative proteomics. Results (1) Fertility: compared with WT mice, KLHL15^-/^- mice had decreased total sperm count, increased number of immobile sperm(IM), decreased average curve velocity(VCL)and average path velocity(VAP)(P=0.010, P=0.020). (2) Anatomy: compared with WT mice, KLHL15^-/^- mice had decreased mass of liver and testis(P<0.001, P=0.026), and decreased organ index(P<0.001); (3) Histopathology: the lumen of the convoluted seminiferous tubules of KLHL15^-/^- mice testis became larger, many spermatogenic cells were lost, the epithelial structure became thinner, and the number of sperm decreased; the liver cells were disorderly and the hepatic sinusoids were dilated; (4) Liver function: Tunel results showed more apoptotic cells in the liver of KLHL15^-/^- mice; enrichment analysis showed that deletion of KLHL15 gene affected the composition of mitochondria, various organelle membranes in the liver, reactions involved by peroxisomes and the metabolism of various amino acids. Conclusion Deletion of KLHL15 gene can destroy the structure of testis and reduce the sperm vitality and sperm quality of male mice, leading to reduced fertility. It can also cause structural damage to the liver of mice and affect the metabolic function of the liver.

临床医学

Clinical characteristics and misdiagnosis of CSF1R-related leukoencephalopathy

ZHANG Yu, DONG Qiwei, SONG Yiming, DU Yifeng, HAN Xiaojuan

Journal of Shandong University (Health Sciences). 2023, 61(2):  31-35.  doi:10.6040/j.issn.1671-7554.0.2022.1142

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Objective To improve clinicians understanding of colony-stimulating factor 1 receptor(CSF1R)-related leukoencephalopathy by summarizing the clinical manifestations, imaging features and misdiagnosis. Methods The literatures in PubMed and CNKI databases from January 1, 2011 to June 30, 2022 were searched, and all case reports of CSF1R-related leukoencephalopathy confirmed by genetic testing were screened. Results A total of 121 cases were involved, including 58 males(47.93%)and 63 females(52.07%). The age of onset ranged from 20 to 70 years(mean 42.12 years). The most common clinical manifestations were cognitive impairments in 112 cases(92.56%), psychological and behavioral abnormalities in 86 cases(71.07%), pyramidal tract injuries in 76 cases(62.81%), and Parkinson-like symptoms in 65 cases(53.72%). Brain MRI was performed in 120 patients and white matter damages were observed in 119(99.17%). Brain CT scanning was performed in 36 patients and 23(63.89%)had calcifications. During treatment, 48 patients were misdiagnosed with other diseases. Conclusion CSF1R-related leukoencephalopathy has various and complex clinical manifestations. For middle-aged patients, it manifests with cognitive impairments, psychological and behavioral abnormalities, pyramidal tract injuries or Parkinson-like symptoms accompanied with white matter lesions and calcifications. Genetic testing is conducive for the diagnosis.

Early remodeling of the proximal aorta after Castor single-branched stent-graft implantation for acute type B aortic dissection

WANG Zhenhua, SONG Han,WEI Duoliang, LI Bowen, XU Kai, FANG Changcun, ZHAO Xin

Journal of Shandong University (Health Sciences). 2023, 61(2):  36-42.  doi:10.6040/j.issn.1671-7554.0.2022.0854

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Objective To evaluate the early remodeling of proximal aorta after Castor single-branched stent-graft implantation for acute type B aortic dissection. Methods Clinical data of 22 patients with acute type B aortic dissection who underwent Castor single-branched stent-graft implantation due to unfavorable proximal landing zone during Jan. 2018 and Dec. 2021 were collected, including the demographic characteristics, surgical details, postoperative complications and follow-up results. Three-dimensional imaging created by computed tomography angiography was used to measure parameters such as angulation, cross-sectional area(CSA), length and tortuosity. The geometric parameters of the proximal aorta before operation and 3 months after operation were compared. Results After operation, the angle between aortic arch and ascending aorta, descending aorta and left subclavian artery increased(P<0.001), the cross-sectional areas of ascending aorta and the proximal aortic arch decreased(P<0.05), the cross-sectional areas of total thoracic aorta and false lumen decreased(P<0.001), the cross-sectional areas of the true lumen increased(P<0.001), and the length of aortic arch increased(P<0.05). There were no significant differences in the other aortic parameters(P>0.05). Conclusion Castor single-branched stent-graft has a good geometric remodeling effect on the proximal aorta after the treatment of acute type B aortic dissection, which provides a safe and effective treatment for patients with unfavorable proximal landing zone.

Scraping method improves the extraction of primary endothelial cells from human saphenous vein

YU Ruiming, BING Weidong, LIU Chunxiao, MENG Xiangbin, BI Yanwen

Journal of Shandong University (Health Sciences). 2023, 61(2):  43-48.  doi:10.6040/j.issn.1671-7554.0.2022.0805

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Objective To improve the extraction method of primary endothelial cells from human saphenous vein and to provide a cell model for the study of vein graft failure after coronary artery bypass grafting. Methods Endothelial cells were extracted from abandoned human saphenous vein by enzymatic digestion and scraping(scraping the vascular intima after enzymatic digestion for further enzymatic digestion). The extracted endothelial cells were cultured in the endothelial cell culture medium containing 10% fetal bovine serum +1% endothelial cell growth supplement +100 U/mL penicillin +100 mg/mL streptomycin. The morphology and adhesion of endothelial cells were observed under an inverted microscope. The specific antigen was identified with immune fluorescence assay of von Will brand Factor(vWF). The purity was detected with flow cytometry of CD31. The activity of endothelial cells was determined with the cell growth curve plotted on different observation days. Results Under the inverted microscope, endothelial cells converged on the wall and arrayed in a typical cobblestone shape. Immune fluorescence assay confirmed the positive expression of vWF. The results of flow cytometry showed that 99.9% and 89.2% of cultured cells in the enzymatic group and scraping group were positive for CD31. Data of the cell growth curve demonstrated that there was no significant difference in endothelial cell activity between the two groups(P=0.057). Endothelial cells from both groups were able to transmit to the 7th-8th generation. Conclusion Based on the traditional enzymatic digestion method, adding the scraping and re-digestion step can extract more primary human saphenous vein endothelial cells.

A clinical analysis of radiofrequency catheter ablation of tachyarrhythmia in 972 children in a single center

YANG Xiaofei, HAN Bo, JIANG Diandong, LYU Jianli,YI Yingchun, ZHANG Jianjun, ZHAO Lijian, WANG Jing, WANG Yan, YUAN Hui

Journal of Shandong University (Health Sciences). 2023, 61(2):  49-56.  doi:10.6040/j.issn.1671-7554.0.2022.0857

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Objective To investigate the efficacy and safety of radiofrequency catheter ablation(RFCA)for children with tachyarrhythmia of various types. Methods A total of 972 patients with tachyarrhythmia who underwent electrophysiological study and RFCA during Aug. 2000 and Aug. 2021 were selected, including 580 males and 392 females, median age 10 years, median body weight 38 kg. The immediate success rate of the procedure, recurrence rate and complications were summarized. The ablation efficacy in children with congenital heart disease(CHD)and cardiomyopathy, the overall procedure time, fluoroscopy time and success rate in different periods were analyzed. Results Among the 972 patients, 6 were complicated with dilated cardiomyopathy, 5 with tachycardia cardiomyopathy, 1 with arrhythmogenic right ventricular cardiomyopathy, and 25 with CHD, mostly atrial septal defects. Atrioventricular reentrant tachycardia(AVRT)was observed in 444(45.68%)patients, atrioventricular nodal reentrant tachycardia(AVNRT)in 221(22.74%)patients, ventricular tachycardia/premature ventricular contraction(VT/PVC)in 232(23.87%)patients, atrial tachycardia(AT)in 62(6.38%)patients, and atrial flutter(AF)in 9(0.92%)patients. The mechanism of tachycardia could not be determined in 4(0.41%)patients. Totally 938 children underwent RFCA.The immediate success rate was 99.04%, and recurrence rate was 6.89%. The mean procedure duration was 100(70-120)min, and the mean fluoroscopy time was 3.30(0.50-9.41)min. The 437 AVRT patients had an immediate success rate of 98.86%,and a recurrence rate of 6.48%. The 219 AVNRT patients had an immediate success rate of 100%, and a recurrence rate of 5.02%. The 225 VT/PVC patients had an immediate success rate of 99.11%, and a recurrence rate of 8.97%. The 49 AT patients had an immediate success rate of 97.96%, and a recurrence rate of 10.42%. The 8 AF patients had an immediate success rate of 87.50%, with no recurrence. Major complications occurred in 10(1.07%)patients, including left pneumothorax in 5 cases, complete left bundle branch block in 1 case, Ⅱ° atrioventricular block in 1 case, thrombus in 1 case, pericardial effusion in 1 case and pleural effusion in 1 case. Compared with children with normal cardiac structure and function, children with CHD and cardiomyopathy had the same immediate success rate but significantly higher recurrence rate(P<0.05). There was no significant difference in the immediate success rate between the early stage(2000—2010)and late stage(2011—2021)(P>0.05). However, as the technology matured, the recurrence rate and the radiation exposure time were significantly reduced(P<0.05). Conclusion RFCA is safe and effective for children with tachyarrhythmia, with high success rate and low recurrence and complication rates.

Patterns and risk factors of cervical lymph node metastasis in 934 cases of papillary thyroid microcarcinoma

SHAO Changxiu, HE Qingqing, ZHUANG Xiaoxuan, LI Xiaolei, ZHOU Peng, YUE Tao, GAO Yuan, XU Jing, LI Chenyu, GUO Haonan, ZHUANG Dayong

Journal of Shandong University (Health Sciences). 2023, 61(2):  57-64.  doi:10.6040/j.issn.1671-7554.0.2022.1004

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Objective To explore the patterns and risk factors of cervical lymph nodes metastasis(LNM)of papillary thyroid microcarcinoma(PTMC), in order to provide clinical evidences for reasonable and standardized surgical procedures. Methods Pathological data of 934 PTMC patients who underwent lateral lymph node dissection during Jan. 2019 and Dec. 2021 were retrospectively analyzed. The cervical LNM data were collected. The relationship between cervical LNM and different clinical characteristics and risk factors of LNM were analyzed. Results Among the 934 patients, the rate of central and/or lateral LNM was 50.64%(473/934); the rates of central and lateral LNM were 47.86%(447/934)and 20.77%(194/934), respectively. Among the 447 patients with central LNM, 168(37.58%)also had lateral LNM. The rate of lateral LNM without central LNM was 2.78%(26/934). Chi-square analysis showed that male, tumor diameter larger than 0.55 cm, extracapsular invasion, bilateral cancer, and multifocality were related to higher rate of cervical LNM, central LNM and lateral LNM(P<0.05); patients without Hashimotos thyroiditis had higher rate of cervical LNM and central LNM(P<0.05); patients of specific pathological types had higher rate of cervical LNM and lateral LNM(P<0.05). The binary multivariate Logistic regression analysis showed that male, tumor diameter larger than 0.55 cm, bilateral cancer, and without Hashimotos thyroiditis were independent risk factors of cervical LNM and central LNM; tumor diameter larger than 0.55 cm, extracapsular invasion, and specific pathological subtypes were independent risk factors of lateral LNM. For PTMC patients with single foci, the rate of lateral LNM was higher when the tumor was located in the upper pole of glands and isthmus than in the middle and lower. Conclusion PTMC patients with high probability of central LNM should receive regular central lymph node dissection. For patients with tumor diameter larger than 0.55cm, extracapsular invasion, specific pathological subtypes, and tumor located in the upper pole or isthmus, there is an increased risk of lateral LNM, and lateral lymph node dissection can be considered.

A case of non-tuberous sclerosis complex with giant angiomyolipoma of both kidneys treated with simultaneous resection and literature review

MA Chenbang, GAO Pei, CHANG Yao, MAO Changlin, CHEN Feng, ZHU Kejia, GUAN Yong, LI Shanjun, DING Sentai

Journal of Shandong University (Health Sciences). 2023, 61(2):  65-71.  doi:10.6040/j.issn.1671-7554.0.2022.0352

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Objective To explore the accurate diagnosis and the safety and prognosis of simultaneous resection of giant angiomyolipoma of both kidneys. Methods Clinical data of a patient with giant angiomyolipoma of both kidneys were retrospectively analyzed. The 18-year-old female patient with body mass index(BMI)of 20.96 kg/m² was admitted due to “palpable abdominal mass for 2 weeks”. Preoperative enhanced CT showed giant angiomyolipoma of both kidneys. Three-dimensional reconstruction of CT further clarified the tumor location, blood supply and other information. Results After exclusion of relevant contrain dications, bilateral resection was performed simultaneously with midline abdominal incision under general anesthesia. There were multiple angiomyolipomas around the kidneys. After dissociation, they were resected successfully. Routine pathological results indicated(bilateral)angiomyolipomas. During the 10-day postoperative hospitalization, no bleeding, renal failure or urinary leakage occurred. During the 12-month follow-up, no metastasis or recurrence was observed. Conclusion In addition to clinical symptoms and signs, gene detection, imaging reconstruction and other accurate diagnosis are necessary to formulate the surgical plan. Simultaneous resection of bilateral giant angiomyolipomas through one incision is safe and feasible.

Relationship between carotid artery stenosis and white matter structural topological properties in the elderly

WANG Shaohu, MU Xin, XU Chengfei, ZHAO Yingxin, ZHANG Hua

Journal of Shandong University (Health Sciences). 2023, 61(2):  72-77.  doi:10.6040/j.issn.1671-7554.0.2022.1184

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Objective To explore the relationship between carotid artery stenosis and white matter structural topological properties in the elderly. Methods According to the North American Symptomatic Carotid Endarterectomy Test(NASCET), 101 elderly people with carotid artery stenosis were divided into mild(n=35), moderate(n=34)and severe(n=32)stenosis groups. The white matter structure network was constructed with deterministic fiber tracking technology. Based on graph theory analysis, the differences among the topological attributes of white matter structure network in the three groups were analyzed. The relationship between the degree of carotid stenosis and topological attributes of white matter structure network was analyzed with multivariate linear regression. Results The local efficiency(Eloc)of severe stenosis group was lower than that of mild and moderate stenosis groups(both P<0.001), and the length of the shortest path(Lp)was greater than that of the other two group(P<0.001, P=0.016). The cluster coefficient(Cp)of moderate and severe stenosis groups was lower than that of mild stenosis group(P=0.009, P<0.001). The small world attribute(σ)of severe stenosis group was lower than that of mild stenosis group(P=0.01). The results of multivariate linear regression showed that the degree of carotid stenosis was negatively related to Eloc, Cp and σ(Eloc: moderate stenosis group β=-0.026, P=0.002, severe stenosis group β=-0.060, P<0.001; Cp: moderate stenosis group β=-0.018, P=0.007, severe stenosis group β=-0.031, P<0.001; σ: moderate stenosis group β=-0.195, P=0.026, severe stenosis group β=-0.301, P=0.001), but positively correlated with Lp(severe stenosis group β=0.346, P=0.007). Conclusion Carotid artery stenosis in the elderly is associated with the topological properties of the white matter structure network, so active prevention and treatment measures should be taken for this population to delay the progression of white matter injury.

Effects of circular RNA hsa_circ_0008591 on tumor biological behavior of breast cancer cells

DONG Xiangjun, LI Juan, KONG Xue, LI Peilong, ZHAO Wenjing, LIANG Yiran, WANG Lili, DU Lutao, WANG Chuanxin

Journal of Shandong University (Health Sciences). 2023, 61(2):  78-87.  doi:10.6040/j.issn.1671-7554.0.2022.1273

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Objective To investigate the expression of circular RNA(circRNA)hsa_circ_0008591 and its effects on the biological behavior of breast cancer(BC)cells. Methods The differentially expressed circRNAs in BC tissues were screened using high-throughput circRNA microarray, and hsa_circ_0008591 was selected as a candidate, which was characterized by Sanger sequencing and ribonuclease R(RNaseR)treatment. Quantitative real-time PCR(qRT-PCR)was performed to detect the expression of hsa_circ_0008591 in BC tissues and cells. Furthermore, BC cells were transfected with plasmid or small interfering RNA(siRNA)and the effects of hsa_circ_0008591 on cell proliferation were detected with real-time cellular analysis(RTCA), cell counting kit-8(CCK-8)assay, 5-ethynyl-2'-deoxyuridine(EdU)assay, and colony formation assay. The interacting microRNAs(miRNAs)and proteins were predicted by databases such as TargetScan, and function enrichment analysis were performed. A regulatory network of ceRNA was constructed with Cytoscape software. Results Hsa_circ_0008591 was significantly downregulated in BC tissues(P=0.007 6). Compared with normal breast epithelial cells, six BC cell lines had a lower expression of hsa_circ_0008591(P<0.001). In vitro functional experiments showed that overexpression of hsa_circ_0008591 inhibited the proliferation of MDA-MB-231(P_RTCA<0.001, P_EdU=0.000 6, P_colony=0.001 0)and MCF-7 cells(P_RTCA<0.001, P_EdU=0.001 7, P_colony<0.001), while the knockdown of hsa_circ_0008591 promoted the proliferation of SK-BR-3 cells(P_RTCA<0.001, P_EdU<0.001, P_colony=0.003 4). The downstream targets, gene ontology(GO)analysis, and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment indicated that hsa_circ_0008591 inhibited the progression of BC through ceRNA mechanism or interaction with RNA-binding protein(RBP). Conclusion Circular RNA hsa_circ_0008591 can inhibit the proliferation of BC cells and is expected to be an effective intervention target for the treatment of BC.

Diagnostic value of extracellular volume fraction in 62 cases of different pathological types of lung cancer

YANG Yongqing, ZHAO Peng, WANG Yu, MA Wenjing, TIAN Mimi, CHENG Yani, ZU Lu, LIN Xiangtao

Journal of Shandong University (Health Sciences). 2023, 61(2):  88-94.  doi:10.6040/j.issn.1671-7554.0.2022.0528

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Objective To evaluate the differential diagnostic value of extracellular volume fraction(ECV)in the different pathological types of lung cancer. Methods Sixty-two patients with lung cancer were performed T1 mapping sequence in this prospective study. Areas of interest were delineated on T1 mapping images. The T1 value of lesions and aortic blood pool were measured in the T1 mapping images before and after enhancement. Hematocrit was collected to calculate the ECV. One-way ANOVA was used to compare the differences among the different pathological types of lung cancer. The receiver operating characteristic curve was constructed to analyze its diagnostic value. The sensitivity,specificity and accuracy were calculated. Results A total of 62 patients were included, including 13 cases of small cell lung cancer and 49 cases of non-small cell lung cancer(including 33 cases of adenocarcinoma and 16 cases of squamous cell carcinoma). The mean ECV of small cell lung cancer and non-small cell lung cancer were(13.79±5.93)% and(27.17±6.59)%, respectively. The ECV value of non-small cell lung cancer was higher than small cell lung cancer, and the cut-off value was 18.97%. The sensitivity, specificity and accuracy were 89.8%, 92.3%, and 90.3%, respectively. The average ECV values of adenocarcinoma and squamous cell carcinoma were(24.21±4.92)% and(33.28±5.32)%, respectively, and the difference was statistically significant(P<0.001). The ECV value of carcinoma was higher than adenocarcinoma, the cut-off value was 29.11%, and the sensitivity, specificity and accuracy were 84.8%, 81.2% and 83.7%, respectively. Conclusion ECV can quantitatively analyze the tissue characteristics of lung cancer, and identify the pathological type of lung cancer, with good sensitivity, specificity and accuracy.

Diagnostic value of multi-modal ultrasound in 70 cases of BI-RADS category 4 breast lesions

XU Shuaiya, LUO Fangqiong, BA Chenxi, ZHANG Xinru, MA Zhe

Journal of Shandong University (Health Sciences). 2023, 61(2):  95-101.  doi:10.6040/j.issn.1671-7554.0.2022.1214

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Objective To explore the diagnostic value of multi-modal ultrasound in Breast Imaging Reporting and Data System(BI-RADS)category 4 breast lesions. Methods A total of 70 BI-RADS category 4 lesions in 63 patients who underwent needle biopsy or resection of breast lesions were selected, including 40 benign lesions(benign group)and 30 malignant lesions(malignant group). The general clinical features, preoperative ultrasound diagnosis, and postoperative pathologic results were reviewed. Results There were no significant differences in nodule shape, orientation, internal echogenicity, margin, boundary, posterior echo attenuation and calcification between benign and malignant breast lesions(P>0.05). However, significant differences were observed in hyperechoic halos and Adler flow grades(P<0.05). The maximum value of shear wave velocity(SWVmax), elasticity imaging/B-mode ratio(EI/B), and strain ratio(SR)were higher in the malignant group than in the benign group, with significant differences(P<0.05). The area under the receiver operating characteristic curve(AUC)for SWVmax was 0.94, and the optimal cutoff value, diagnostic sensitivity and specificity were 2.85 m/s, 86.7% and 95.0%, respectively. The AUC for EI/B was 0.92, and the optimal cutoff value, and diagnostic sensitivity and specificity were 1.01, 96.7% and 82.5%, respectively. The AUC for SR was 0.78, and the optimal cutoff value, diagnostic sensitivity and specificity were 7.86, 76.7% and 72.5%, respectively. Multivariate binary Logistic analysis showed that the OR of SWVmax and EI/B of the malignant group were 12.97(P<0.05)and 1.51(P<0.05), respectively. Conclusion Reasonable application of multi-modal ultrasound is able to effectively identify benign and malignant BI-RADS category 4 breast lesions and reduce unnecessary needle biopsies.

医学心理学

Latent profile analysis of burnout and its relation with work characteristics among CDC staff

JIANG Lili, WU Liuliu, XU Xinyang, ZHANG Xiaorong, CAO Fenglin, XIN Yuheng

Journal of Shandong University (Health Sciences). 2023, 61(2):  102-109.  doi:10.6040/j.issn.1671-7554.0.2022.0664

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Objective To identify different categories of job burnout among staff of Center for Disease Control and Prevention(CDC)based on latent profile analysis, and to explore the independent effects between dimensions of the work characteristics and latent categories of job burnout. Methods A total of 943 staff were surveyed with the Chinese Version of the Maslach Burnout Inventory-General Survey(MBI-GS), Work Characteristics Inventory, and a self-administered general questionnaire. Job burnout subtypes were identified with latent profile analysis, and the independent effects between dimensions of the work characteristics and subtypes of job burnout were analyzed with multivariable Logistic regression. Results The CDC staff burnout could be classified into 3 subtypes: low job burnout(Ⅰ, 54.7%), high job burnout(Ⅱ, 24.1%), and insufficient accomplishment job burnout(Ⅲ, 21.2%). Multivariable Logistic regression showed that high job feedback and high work significance were independent protective factors for high job burnout(OR=0.561; OR=0.612). High workload, high work demands on individual control and emotion expression were independent risk factors for high job burnout(OR=1.693; OR=1.770). High job autonomy was an independent risk factor for insufficient accomplishment job burnout(OR=1.810). High work demands on individual control and emotion expression was an independent protective factor for insufficient accomplishment job burnout (OR=0.582). Conclusion Three subtypes of job burnout are identified among CDC staff, and there are independent effects between different dimensions of the work characteristics and categories of job burnout.

公共卫生与管理学

Effects of chlorogenic acid on the structure and allergenicity of shrimp tropomyosin

QU Xin, LYU Xiaojing, CHAI Qing, JU Guangxiu, WANG Shuhui

Journal of Shandong University (Health Sciences). 2023, 61(2):  110-116.  doi:10.6040/j.issn.1671-7554.0.2022.0673

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Objective To investigate the effects of chlorogenic acid(CA)on the structure and allergenicity of shrimp tropomyosin(TM), so as to reduce the sensitization of shrimp allergen and provide theoretical reference for controlling the risk of shrimp allergy. Methods Changes in the structure of covalently bound complexes between CA and TM were analyzed with polyacrylamide gel electrophoresis, intrinsic fluorescence, circular dichroism chromatography, and changes in the potential allergenicity was analyzed with ELISA and KU812 cells. Results The band moved slightly upward and molecular weight increased with higher CA concentration after different concentrations of CA interacted with shrimp TM. After 2.0 mg/mL CA covalently bound to TM, the content of free amino groups, available lysine, surface hydrophobicity, intrinsic fluorescence intensity, α-helix, IgE binding capacity of TM, β-hexosidase, and histamine decreased by 46.01%, 32.10%, 36.36%, 68.49%, 41.12%, 32.56%, 37.70% and 23.46%, respectively. Interleukin-4 and interleukin-13 also showed a downward trend. Conclusion Covalent binding of CA can alter the structure of TM, thereby reducing its allergenicity.

Effects of extreme temperature on non-accidental death and years of life lost in Zibo City

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

Journal of Shandong University (Health Sciences). 2023, 61(2):  117-124.  doi:10.6040/j.issn.1671-7554.0.2022.0886

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Objective To investigate the effects of extreme temperature on non-accidental death counts and years of life lost(YLL), so as to provide scientific evidence for disease prevention and control and health decision-making. Methods The daily non-accidental death and meteorological data of Zibo City from 2015 to 2019 were collected and collated, and daily YLL were calculated. The lag effects of extreme low temperature and extreme high temperature, which were defined as the 2.5(-4.2 ℃)and 97.5 percentile(29.1 ℃)of the mean daily temperature distribution on non-accidental death counts and YLL were analyzed by using distributed lag nonlinear model(DLNM), and vulnerable groups were identified. Results A total of 144,310 non-accidental death counts were reported in Zibo City during the study period, and the YLL was 1,886,493 years. The effects of extreme low temperature on non-accidental death had a lag time, and the single and cumulative lag effects peaked at days 4 and 21 after exposure, with relative risk(RR)of death being 1.05(95%CI: 1.04-1.07)and 1.23(95%CI: 1.10-1.39), and the changes of YLL being 56.51(95%CI: 37.92-75.11)and 259.55(95%CI: 116.45-402.65)years, respectively. The effects of extreme high temperature were more short-term, and the single and cumulative lag effects peaked at days 0 and 7 after exposure, with RR of death being 1.19(95%CI: 1.15-1.24)and 1.45(95%CI: 1.34-1.57), and the changes of YLL being 137.34(95%CI: 93.37-181.30)and 265.90(95%CI: 175.05-356.74)years, respectively. Men and young people(<65 years)were more sensitive to extreme low temperature, and women and the elderly(≥65 years)were more sensitive to extreme high temperature. Conclusion Extreme temperature can increase the risk and YLL of non-accidental death for local residents. Extreme high temperature has a stronger effect on population, and women and people aged ≥65 years are more susceptible to it. It is necessary to strengthen the ability of extreme weather forecast and early warning and the propaganda of relevant health knowledge, and implement targeted public health intervention strategies for vulnerable populations.