Table of Content

  

10 April 2023
Volume 61 Issue 4

基础医学

ACE2 gene protects against renal ischemia-reperfusion injury by regulating the Nrf2/HO-1 signaling pathway

ZHANG Jiaying, SU Rongyun, WANG Yinghui, WANG Honggang, LIU Gang

Journal of Shandong University (Health Sciences). 2023, 61(4):  1-9.  doi:10.6040/j.issn.1671-7554.0.2022.1226

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Objective To investigate the effects of angiotensin-converting enzyme 2(ACE2)on the oxidative stress, inflammation, apoptosis and the nuclear factor E2-related factor 2(Nrf2)/ heme oxygenase 1(HO-1)signaling pathway in renal tubular epithelial cells(HK-2)induced by hypoxia/reoxygenation(H/R). Methods HK-2 cells were transfected with ACE2 lentivirus, and divided into the control group, H/R group, H/R-NC group, and H/R-ACE2 group. After H/R treatment, cell viability was measured with CCK-8 assay; the levels of inflammatory factors including interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)were measured with ELISA and RT-PCR; superoxide dismutase(SOD)and malondialdehyde(MDA)levels were measured with colorimetric assay; protein levels of Caspase-3, Bcl-2, Bax, Nrf2, and HO-1 were measured with Western blotting. After ML385 and SnPPIX were used to inhibit the Nrf2/HO-1 pathway, changes in the expressions of Caspase-3, Bcl-2, Bax, Nrf2 and HO-1 were detected with Western blotting, and changes in SOD and MDA levels were detected with colorimetry. Results Compared with the control group, the H/R group showed lower cell viability(t=7.58, P<0.001), higher expression levels of MDA, IL-1β, IL-6, TNF-α, Caspase-3 and Bax(t_MDA=11.08, P_MDA<0.001; t_PCR-IL-6=5.82, P_PCR-IL6<0.001; t_PCR-TNF-α=7.69, P_PCR-TNF-α<0.001; t_PCR-IL-1β=4.80, P_PCR-IL-1β=0.001; t_ELISA-IL-6=34.11, P_ELISA-IL-6<0.001; t_ELISA-TNF-α=14.12, P_ELISA-TNF-α<0.001; t_ELISA-IL-1β=9.63, P_ELISA-IL-1β<0.001; t_Caspase-3=2.73, P_Caspase-3=0.026; t_Bax=27.75, P_Bax<0.001), but lower levels of SOD, Bcl-2 and ACE2(t_SOD=7.74, P_SOD<0.001; t_Bcl-2=75.49, P_Bcl-2<0.001; t_ACE2=11.41, P_ACE2<0.001). Compared with the H/R group, the H/R-ACE2 group had higher cell viability(t=3.61, P=0.002), lower levels of MDA, IL-1β, IL-6, TNF-α, Caspase-3 and Bax(t_MDA=6.15, P_MDA<0.001; t_PCR-IL-6=3.34, P_PCR-IL6=0.006; t_PCR-TNF-α=3.65, P_PCR-TNF-α=0.007; t_PCR-IL-1β=4.06, P_PCR-IL-1β=0.004; t_ELISA-IL-6=14.62, P_ELISA-IL-6<0.001; t_ELISA-TNF-α=10.42, P_ELISA-TNF-α<0.001; t_ELISA-IL-1β=8.65, P_ELISA-IL-1β<0.001; t_Caspase-3=3.74, P_Caspase-3=0.006; t_Bax=30.52, P_Bax<0.001), higher levels of SOD, Bcl-2, ACE2, Nrf2, and HO-1(t_SOD=3.58, P_SOD=0.007; t_Bcl-2=63.86, P_Bcl-2<0.001; t_ACE2=58.72, P_ACE2<0.001; t_Nrf2=44.55, P_Nrf2<0.001; t_HO-1=14.19, P_HO-1<0.001). However, ML385 and SnPPIX inhibited the protective effects of ACE2 gene overexpression on HK-2 cells under H/R(F_Bax=11.02, P_Bax=0.003; F_Bcl-2=21.48, P_Bcl-2<0.001; F_Caspase-3=20.80, P_Caspase-3<0.001; F_SOD=133.49, P_SOD<0.001; F_MDA=14.06, P_MDA=0.001). Conclusion ACE2 inhibits the oxidative stress, regulates inflammation, and ameliorates apoptosis in HK-2 cells under H/R, and the Nrf2/HO-1 signaling pathway may play an important role in this progress.

Secondary metabolites of edible birds nest prepared by different stewing temperatures

WANG Zhifan/sup>1, LIN Xiaoxian, YIN Jialu, WANG Dongliang, WANG Shuqi

Journal of Shandong University (Health Sciences). 2023, 61(4):  10-17.  doi:10.6040/j.issn.1671-7554.0.2022.0705

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Objective To investigate the differential markers of secondary metabolites in edible birds nest products at different stewing temperatures. Methods Edible birds nest and edible birds nest products prepared at different temperatures were analyzed with UPLC-MS technology and multivariate statistical analysis to assess the chemical composition differences of secondary metabolites and to screen the characteristic compounds of the differences. Results Primary positive and negative ion mode mass spectrometry detected 10,687 ions, and the Compound Discoverer 3.0 software identified 30 chemical components in finished products, including more than 10 active components. The results of principal component analysis(PCA)showed that there was little difference in secondary metabolites in finished edible birds nest products with different processing temperature. Therefore, the orthogonal partial least squares discriminant analysis(OPLS-DA)method was used to screen the differential compounds between the high and low temperature stewing groups. The results showed that the contents of 6 compounds were different, and the contents of some compounds decreased after high temperature stewing, but increased during low temperature stewing(P<0.05). Conclusion The 6 compounds can be used as differential compounds in different stewing methods, and can be used to guide the process control of stewing degree of edible birds nest products.

临床医学

The cg20657709 site methylation in the early detection of lung adenocarcinoma

LIU Shibiao, ZHANG Shujun, LI Peilong, DU Lutao, WANG Chuanxin

Journal of Shandong University (Health Sciences). 2023, 61(4):  18-25.  doi:10.6040/j.issn.1671-7554.0.2022.1418

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Objective To investigate the clinical value of cg20657709 site methylation in the early detection of lung adenocarcinoma(LUAD). Methods The genome-wide DNA methylation profiling of peripheral blood mononuclear cells(PBMCs)and candidate differentially methylated position(DMP)were obtained from 30 LUAD patients and 45 healthy controls using Illumina Infinium MethylationEPIC BeadChip detection. Furthermore, the candidate DMP was validated in 35 LUAD patients and 30 healthy controls by pyrosequencing. Finally, multiple target region methylation enrichment sequencing was performed to evaluate the diagnostic value of DMP in the detection of lung adenocarcinoma in situ(AIS)in a cohort of 50 lung AIS patients and 50 healthy controls. Results Illumina Infinium MethylationEPIC BeadChip detection results showed that LUAD patients had specific genome-wide DNA methylation profiling based on PBMCs. The methylation levels of LUAD patients and healthy controls were significantly different. Initially, 1,345 DMPs were screened with the standard of∣Δβ∣≥0.06 and adjusted P<0.05. After multi-step screening, cg20657709 was determined as the candidate site. The cg20657709 site methylation was significantly higher in LUAD patients than in healthy controls (Δβ=0.097, adjusted P=0.004). Pyrosequencing results showed that cg20657709 site could clearly discriminate LUAD patients from healthy controls(AUC=0.946, sensitivity=91.4%, specificity=90.0%, cut-off value=66.91). Multiple target region methylation enrichment sequencing results showed cg20657709 site had good value in the detection of lung AIS(AUC=0.787, sensitivity=86.0%, specificity=64.0%, cut-off value=0.746 5). Conclusion Compared with healthy controls, LUAD patients have significantly higher cg20657709 site methylation, which is an important marker in the early detection of LUAD.

Association of NAMPT with pathological features and immune infiltration of hepatocellular carcinoma using database information

CHANG Qing, LIU Jia, QU Ailin, YANG Yongmei

Journal of Shandong University (Health Sciences). 2023, 61(4):  26-36.  doi:10.6040/j.issn.1671-7554.0.2022.0913

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Objective To analyze the expression profile of nicotinamide phosphoribosyltransferase(NAMPT)in hepatocellular carcinoma(HCC), and to explore the relationship between NAMPT expression and immune infiltration and clinicopathological features. Methods The expression profile of NAMPT in HCC was obtained from TIMER database. Based on UALCAN database, the correlation between NAMPT and alpha fetal protein(AFP)level was analyzed. Hepatocellular carcinoma transcriptome RNA-seq dataset was downloaded from TCGA-LIHC, and the mRNA expressions of NAMPT and immune-related molecules were extracted. The number of immune components, matrix components and the abundance of immune cell infiltration and the differences in the expression of immune-related molecules between high-NAMPT and low-NAMPT groups were evaluated using the estimation algorithm and the single sample gene set enrichment analysis(ssGSEA), respectively. Differences of above variables were compared. The relevance between NAMPT and immune cell infiltration was analyzed. Results TIMER database showed that the expression of NAMPT in HCC was lower than that in adjacent tissues(P<0.05). UALCAN database revealed that there was a negative low correlation between NAMPT expression and serum AFP level (r=-0.464, P<0.05). There were significant differences in stromal cell proportion, immune cell proportion and tumor cell purity(P<0.05)between high-NAMPT and low-NAMPT groups. ssGSEA analysis identified the infiltration levels of 20 immune cells were higher in the high-NAMPT group(P<0.05). The expressions of immune-related genes including NKG2D, CD40, FAS, ELANE,PDL1 and PDL2 were significantly different between the two groups(P<0.05). TIMER database showed NAMPT had a low positive correlation with macrophages(r=0.125, P=0.021), neutrophils(r=0.284, P<0.001), and dendritic cells(r=0.131, P=0.016), but a low negative correlation with tumor purity(r=-0.137, P=0.011). Conclusion NAMPT expression is correlated with clinicopathological features, and can reflect the status of immune microenvironment in HCC patients. Our study may provide a new clue for identifying the beneficiaries of HCC immunotherapy.

Risk factors of pulmonary complications after radical gastrectomy in 443 cases

MU Yanxi, LI Jinzhou, CHEN Kang, LIANG Hongying, YAO Yalong, WANG Wenjie, CHEN Xiao

Journal of Shandong University (Health Sciences). 2023, 61(4):  37-41.  doi:10.6040/j.issn.1671-7554.0.2022.0917

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Objective To explore the risk factors of postoperative pulmonary complications(PPCs)after radical gastrectomy for gastric cancer, and to provide individualized preventative and treatment plans. Methods Clinical data of 443 patients with gastric cancer during Jan. 2019 and Mar. 2021 were retrospectively analyzed. The clinicopathological features were statistically analyzed, and the risk factors of PPCs were determined with binary Logistic regression. Results The incidence of PPCs was 18.1%(80/443), that of pulmonary infection and pleural effusion were 12.4%(55/443)and 11.7%(52/443), respectively. People with PPCs needed longer hospital stay than those without. Logistic regression analysis showed that age ≥60 years (OR=0.424, 95%CI: 0.241-0.746), diabetes mellitus(OR=0.318, 95%CI: 0.146-0.693), per minute maximum ventilatory volume(MVV)(%)<85%(OR=0.509, 95%CI: 0.297-0.874), intraoperative blood loss ≥200 mL(OR=0.496, 95%CI: 0.276-0.797)and postoperative anastomotic complications(OR=4.038, 95%CI: 1.250-13.049)were independent risk factors for PPCs. Conclusion Gastric cancer patients with age ≥60 years, diabetes history, MVV(%)<85%, intraoperative blood loss ≥200 mL, and postoperative anastomotic complications have a high risk for PPCs.

Long-term efficacy of total parathyroidectomy with trace parathyroid tissue autotransplantation in the treatment of 109 cases of renal secondary hyperparathyroidism

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

Journal of Shandong University (Health Sciences). 2023, 61(4):  42-48.  doi:10.6040/j.issn.1671-7554.0.2022.1417

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Objective To analyze the long-term efficacy of total parathyroidectomy with trace parathyroid tissue autotransplantation(tPTx+AT)for patients with renal secondary hyperparathyroidism(SHPT)undergoing continuous hemodialysis. Methods Clinical data of 109 SHPT patients who underwent tPTx+AT during Jan. 2011 and Dec. 2015 were retrospectively analyzed. The changes of intact parathyroid hormone(iPTH), serum calcium and serum phosphorus before and after operation(1 week, 1 year, 3 years, 6 years)were collected. The long-term quality of life before and after operation(3 years, 6 years)were evaluated with the MOS 36-Item Short-Form Health Survey(SF-36). Results The success rate of operation was 87.16%(95/109). During the follow-up, 8 patients were lost; 14 patients died, including 7 deaths within 3 years and 7 within 3-6 years; 87 completed the follow-up for 6 years. The levels of iPTH, serum calcium and phosphorus significantly decreased after operation, and the score of quality of life significantly increased(P<0.05). The 3-year recurrence rate and mortality rate were 4.60%(4/87)and 6.93%(7/101), respectively, while the 6-year recurrence rate and mortality rate were 12.50%(10/80)and 13.86%(14/101), respectively. The incidence of persistent hyperparathyroidism(PHPT)and permanent hypoparathyroidism was 6.93%(7/101)and 1.98%(2/101), respectively. Nine patients with persistent or recurrent hyperparathyroidism underwent a second surgery. Conclusions tPTx+AT is safe and effective in the treatment of SHPT, with a high success rate of operation. It can significantly reduce the level of parathyroid hormone(PTH), improve calcium and phosphorus metabolism, enhance patients quality of life, and maintain a low long-term recurrence rate and mortality rate.

Prognostic value of CCR gene in clear cell renal cell carcinoma based on database

HU Liyong, ZHONG Hao, FANG Juanjuan, GUO Wei, ZHANG Yulu, FAN Yidong

Journal of Shandong University (Health Sciences). 2023, 61(4):  49-55.  doi:10.6040/j.issn.1671-7554.0.2022.1015

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Objective To explore the prognostic value of CC chemokine receptor(CCR)gene family in patients with clear cell renal cell carcinoma(ccRCC)based on database. Methods The gene expression data were downloaded from The Cancer Genome Atlas(TCGA)and analyzed to screen the differentially expressed genes of CCR family in normal tissues and ccRCC tissues. The prognostic model was constructed with COX regression analysis, and relevant functional analysis was carried out. Results Transcriptome data of 539 ccRCC tissues and 72 normal tissues were downloaded from the TCGA database, and 11 differentially expressed CCR genes were screened out. Two CCR genes(CCR3 and CCR10)associated with ccRCC prognosis were obtained, and the prognostic model was constructed. According to the median risk score of the model, the training set samples were divided into high risk group(n=184)and low risk group(n=197). Kaplan-Meier analysis showed that the overall survival rate of low-risk group was significantly higher than that of high-risk group(P<0.001). Conclusion The prognostic model of CCR gene constructed in this study can effectively evaluate the prognosis of ccRCC patients and guide the individualized treatment.

Pregnancy outcomes of frozen embryo transfer in 112 patients of endometrial hyperplasia and early-stage endometrial cancer after fertility preserving treatment

QI Dan, ZHANG Xi, YU Qian, CUI Linlin, YAN Lei

Journal of Shandong University (Health Sciences). 2023, 61(4):  56-63.  doi:10.6040/j.issn.1671-7554.0.2023.0032

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Objective To investigate the effects of endometrial preparation protocol in frozen embryo transfer(FET)on pregnancy outcomes after fertility preserving treatment of complex hyperplasia/atypical hyperplasia/early-stage endometrial cancer(CH/AEH/EEC). Methods Clinical data of 179 FET cycles of 112 patients with CH/AEH/EEC, who underwent in vitro fertilization or intracytoplasmic single sperm injection(IVF/ICSI)during Jan. 2015 and Dec. 2020 were retrospectively analyzed. The patients were divided into four groups according to endometrial preparation protocols: natural cycle(group 1, n=29), stimulated cycle(group 2, n=38), hormone replacement treatment(group 3, n=89), and down-regulation in combination with hormone replacement therapy(group 4, n=23). Clinical characteristics and IVF/ICSI outcomes were assessed. The influencing factors of live birth rate were determined with binary Logistic regression analysis. Results Compared with groups 2, 3 and 4, group 1 had higher live birth rate per transfer cycle(34.2% vs. 31.0% vs. 31.5% vs. 30.4%), higher live birth rate(46.7% vs. 31.8% vs. 34.8% vs. 22.2%), higher clinical pregnancy rate per transfer cycle(52.6% vs. 37.9% vs. 49.4% vs. 43.5%), higher biochemical pregnancy rate per transfer cycle(65.8% vs. 44.8% vs. 64.0% vs. 47.8%), and lower miscarriage rate per transfer cycle(18.2% vs. 35.0% vs. 36.4% vs. 30.0%), but the differences were not statistically significant(P>0.05). Multivariate regression analysis showed that higher TSH level led to lower live birth rate per transfer cycle(OR=1.461, 95%CI=0.002-2.130), and increased number of retrieved oocytes led to higher live birth rate per transfer cycle(OR=0.903, 95%CI=0.833-0.980). The other potential confounders such as endometrium preparation protocol for FET had no significant correlation with the live birth rate per transfer cycle(P>0.05). Conclusion The endometrial preparation with FET shows no difference in terms of live birth rate, clinical pregnancy rate, biochemical pregnancy rate, and abortion rate of patients after fertility preserving treatment of CH/AEH/EEC. The endometrial preparation with FET should be selected individually so that patients have better endometrial transformation and achieve clinical pregnancy faster.

Two male CCRs carriers with assisted pregnancy and literature review

JIN Chenxi, WANG Yufeng, ZHANG Qian, LI Jing, LI Hongchang, YAN Junhao

Journal of Shandong University (Health Sciences). 2023, 61(4):  64-70.  doi:10.6040/j.issn.1671-7554.0.2022.1274

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Objective To explore the appropriate means of assisted pregnancy in male complex chromosome rearrangements(CCRs)carriers. Methods Two male CCRs carriers underwent next-generation sequencing(NGS)based preimplantation genetic testing for structural rearrangement(PGT-SR). One of the couples underwent carrier screening to select non-carrier euploidy embryos. Results The two CCRs carrier couples were assisted in pregnancy by PGT-SR(one of them underwent carrier screening at the same time), obtained transferable embryos, and finally gave birth to healthy offspring. The embryo euploidy rate of the two carriers was 8.82%(3/34). Conclusion PGT-SR can effectively help CCRs carriers screen out transplantable euploidy embryos. Carrier screening technology can help carriers to select non-carrier euploidy embryos and block the progeny transmission of chromosomal genetic diseases.

Clinical analysis of 936 cases of tracheobronchial foreign body in children

ZHOU Jiamin, QIU Jingjing, CHEN Xiumei, SONG Xicheng, SUN Yan

Journal of Shandong University (Health Sciences). 2023, 61(4):  71-76.  doi:10.6040/j.issn.1671-7554.0.2022.1286

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Objective To analyze the differences in clinical characteristics, imaging examination results, surgical treatments and postoperative complications of tracheobronchial foreign body in children in different periods, and to explore the advances of clinical diagnosis and treatment. Methods A total of 936 children with tracheobronchial foreign body hospitalized in the Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University during June 2010 and May 2022 were enrolled. According to the admission time, they were divided into early group(admitted during June 2010 and May 2016, n=526)and late group(admitted during June 2016 and May 2022, n=410). The patients age, gender, type of foreign body, visit time, detection rate of chest X ray/CT scanning, surgical treatment rate, correct diagnostic rate of chest X-ray/CT scanning, incarceration site of foreign body, change of location of foreign body and postoperative complications were compared between the two groups. Results There were no significant differences between the two groups in patients age, gender, type of foreign body, visit time, detection rate of chest X-ray/CT scanning, surgical treatment rate, correct diagnostic rate of chest X-ray/CT scanning, and change of location of foreign body(P>0.05). There were statistically significant differences in the incarceration site of foreign body and postoperative complications(P=0.04, P=0.01). Multivariate binary Logistic regression analysis showed that in the late group, the incarceration site of foreign body in the left upper bronchus decreased by 0.178 times compared with that in the early group, and incidence of pneumonia decreased by 0.423 times. Conclusion Tracheobronchial foreign body in children is common, acute and severe. Timely treatment, correct diagnosis, early surgery and success rate of first-stage operation are key to avoid postoperative complications.

Preparation and application of an enzyme-linked immunoassay kit for SARS-CoV-2 neutralizing antibody

GAO Lihe, REN Jingjing, LI Yan, LI Qiang, MA Wanshan, LI Huanjie, CHEN Zhen,OU Lanxiang, ZHANG Shaoming, ZHU Zhiwei, DING Xinglong, LI Hongxia, WANG Yan, ZHANG Zhongfa, WANG Yunshan

Journal of Shandong University (Health Sciences). 2023, 61(4):  77-85.  doi:10.6040/j.issn.1671-7554.0.2022.0859

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Objective To develop an enzyme-linked immunosorbent assay kit for the detection of SARS-CoV-2 neutralizing antibody, and to analyze its clinical value in monitoring the efficacy of COVID-19 vaccine. Methods After the receptor binding domain(RBD)of SARS-CoV-2 virus S protein and human angiotensin-converting enzyme 2(ACE2)were expressed and purified, RBD was conjugated with horseradish peroxidase(HRP)and ACE2 was conjugated with biotin(Bio)to prepare a SARS-CoV-2 neutralizing antibody detection kit. The serum samples of 15 volunteers injected with COVID-19 vaccine were collected to analyze the level of neutralizing antibody produced. Results The positive rate of SARS-CoV-2 neutralizing antibody was 0.00% before vaccination. On the 11th to 15th day after the first, second and third doses of COVID-19 vaccine injection, the positive rate of SARS-CoV-2 neutralizing antibody was 13.33%, 93.33% and 100.00%. On the 180th to 190th day after the second dose, the positive rate of neutralizing antibody reduced to 33.33%. The performance test showed the kit’s detection limit was 0.06 μg/mL, the coefficient of variation(CV)in the batch was <5%, CV between the batches was <10%, and the linear detection range was 0.030-3.125 μg/mL. Furthermore, the validation value for the analytical sensitivity was 0.040 μg/mL, which was highly consistent with the results of microcellular neutralization assay. Conclusion The enzyme-linked immunosorbent assay kit for SARS-CoV-2 neutralizing antibody has good performance, and the detection method is fast, convenient, and easy to operate, which can be used to evaluate the protective effects of the vaccines.

公共卫生与管理学

A Lung cancer risk prediction model based on Bayesian network uncertainty inference

ZHONG Lu, XUE Fuzhong

Journal of Shandong University (Health Sciences). 2023, 61(4):  86-94.  doi:10.6040/j.issn.1671-7554.0.2022.0927

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Objective To predict the risk of lung cancer in individuals with missing covariates by combining a Bayesian network with a Cox model. Methods Data were obtained from the UK Biobank. Predictors associated with lung cancer were screened with univariate Cox regression analysis. Based on the predictors identified, the individual risk prediction model of lung cancer was established. The identification and calibration of the model were determined to evaluate its predictive performance. Results The prediction model had good identification and calibration ability, and the AUC of the training and validation cohorts were 0.854(95%CI: 0.836-0.870)and 0.885(95%CI: 0.871-0.897), respectively. Conclusion A lung cancer risk prediction model based on Bayesian network and Cox model was constructed. The model has good identification and calibration ability, and can effectively predict the high-risk population of lung caner. Combined model provides an effective risk prediction method in the presence of missing predictors, which can provide theoretical reference for the prevention and control of lung cancer.

Exploring the environmental influencing factors of lung cancer incidence based on geographically and temporally weighted regression model

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

Journal of Shandong University (Health Sciences). 2023, 61(4):  95-102.  doi:10.6040/j.issn.1671-7554.0.2022.0919

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Objective To analyze the spatial and temporal distribution of lung cancer incidence in Zibo City, and to explore the environmental influencing factors of lung cancer incidence based on geographically and temporally weighted regression(GTWR)model. Methods The incidence data of lung cancer in Zibo City from 2015 to 2019 were collected, and the spatio-temporal epidemiological characteristics were described. GTWR model was used to explore the relationship between lung cancer incidence and environmental factors, and the fitting effect was compared with the traditional model. Results The incidence of lung cancer in Zibo City showed an increasing trend from 2015 to 2019, with an average annual incidence of 67.43/100,000. The spatial distribution of lung cancer incidence was clustered in Zibo City, with low incidence in the central region and high incidence in the surrounding and southern regions. GTWR model results showed that environmental factors in different spatial locations had different effects on lung cancer incidence. Economic development level might affect the relationship between air pollution and lung cancer incidence, and the influence of air pollution on lung cancer incidence was stronger in areas with low economic development level. Compared with traditional model, GTWR model had better fitting effect. Conclusion There is a spatial and temporal correlation between lung cancer incidence and environmental factors in Zibo City. Local medical resources should be allocated rationally. Besides paying attention to the areas with serious air pollution, lung cancer prevention and treatment should also be carried out in the areas with low economic development level to improve the local medical service level.

MaxEnt modeling to analyze influencing factors of severe fever with thrombocytopenia syndrome and predict the potential distribution in Shandong Province

HAN Luyi, TIAN Xueying, GAO Qi, SHE Kaili, CAO Yunxian, WEI Shushu, Ding Shujun, LI Xiujun

Journal of Shandong University (Health Sciences). 2023, 61(4):  103-110.  doi:10.6040/j.issn.1671-7554.0.2022.1106

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Objective To explore the appropriate environmental factors for the incidence of severe fever with thrombocytopenia syndrome(SFTS)in Shandong Province and to predict the potential high-risk areas, so as to provide scientific basis for the prevention and control of SFTS. Methods Based on the data of confirmed SFTS cases and environmental factors in Shandong Province from 2016 to 2019, MaxEnt model was trained to analyze the influencing factors of SFTS, and to predict the high-risk areas of SFTS from 2017 to 2020. Results From 2016 to 2020, 2,548 cases of SFTS were reported in Shandong Province, and 14 environmental factors were found to affect the distribution of SFTS to varying degrees, including slope, which contributed the most, and meteorological factors such as average sunshine duration, annual accumulated precipitation, annual relative humidity and annual average wind speed. The receiver operating characteristic(ROC)curve showed that the prediction effects of MaxEnt model was good, with the area under the curve(AUC)being 0.862, 0.842, 0.830, 0.832, and 0.814, respectively. The potential high-risk areas predicted by the model was around the Jiaodong Peninsula and central region of Shandong Province. Conclusion The high-risk areas of SFTS in Shandong Province are relatively stable. SFTS tends to occur in flat slope areas around gentle slopes, and is affected by meteorological factors. Comprehensive measures should be taken to prevent and control SFTS.

Short-term effects of diurnal temperature range on hospital admissions for coronary heart disease in Zibo City

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

Journal of Shandong University (Health Sciences). 2023, 61(4):  111-118.  doi:10.6040/j.issn.1671-7554.0.2022.1215

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Objective To investigate the impacts of diurnal temperature range(DTR)on the daily hospital admissions for coronary heart disease in Zibo City. Methods Daily hospital admission data of coronary heart disease, meteorological data and air pollutant data in Zibo from 2015 to 2019 were analyzed. After influencing factors such as long-term trend, meteorological factors and holiday effects were adjusted, generalized additive model was used to test the effects of DTR on daily hospital admissions for coronary heart disease. Subgroup analysis was performed by age and gender to identify the vulnerable population. Results A total of 21,105 coronary heart disease admissions were reported. DTR significantly increased the number of coronary heart disease admissions, with the maximum Lag effect of 1.053(95%CI: 1.026-1.081)at Lag1 day and the maximum cumulative lag effect of 1.076(95%CI: 1.016-1.139)at Lag04. Subgroup analysis showed no significant differences in the effects of DTR between different gender and age groups. Conclusion Large DTR increases the risk of coronary heart disease admission. Departments responsible should carry out health education on DTR and coronary heart disease, improve the accuracy of weather forecast, and guide people to take good personal protection to reduce the influence of DTR.