Table of Content

  

10 June 2023
Volume 61 Issue 6

基础医学

Mechanism of FOXM1 in acute exacerbation of asthma induced by respiratory virus infection in mice

BU Meiling, WANG Jinrong, FENG Mei, SUN Lifeng

Journal of Shandong University (Health Sciences). 2023, 61(6):  1-9.  doi:10.6040/j.issn.1671-7554.0.2022.1201

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Objective To investigate the role of FOXM1 in respiratory virus-induced asthmatic attacks in mice. Methods BALB/c female mice(aged 6-8 weeks)were randomly divided into control group, asthma model group, Poly(I:C)group, RCM1+Poly(I:C)group and Poly(I:C)+RCM1 group, with 15 mice in each group. Asthma was induced in mice via nasal administration of house dust mite(HDM)and viral analogue, Poly(I:C). The FOXM1 inhibitor RCM1 was used to investigate the role of FOXM1 in virus-induced asthmatic attacks. The lung tissue and bronchial alveolar lavage fluid(BALF)were collected. The induction of asthma was determined by measuring the airway stenosis index. The expressions of IL-4, IL-13, IFN-γ, FOXM1 and MUC5AC in lung tissue and BALF were detected with real-time PCR(RT-PCR)and ELISA. The cell counts in BALF were determined with flow cytometry. The morphological changes of lung tissue and airway epithelial cells were observed with haematoxylin & eosin(HE)staining. The expressions of FOXM1 and MUC5AC were determined with immunohistochemistry. Results The airway resistance was significantly higher in asthma model group mice than in the control group(P<0.05), and Poly(I:C)administration further increased airway resistance(P<0.05). The IL-4 and IL-13 levels were as follows: control group<asthma model group<Poly(I:C)group(P<0.05). The IFN-γ level was as follows: control model>asthma model group>Poly(I:C)group(P<0.05). The administration of RCM1, before or after the administration of Poly(I:C), reversed the cytokine levels(P<0.05). The levels of FOXM1 and MUC5AC were as follows: control group<asthma model group<Poly(I:C)group(P<0.05). The administration of RCM1 further decreased the expressions of FOXM1 and MUC5AC(P<0.05). The FOXM1 expression was higher, while MUC5AC expression was lower in RCM1+Poly(I:C)group than those observed in Poly(I:C)+RCM1 group(P<0.05). In the lungs of asthmatic mice, the epithelium was thickened, the cells were disorderly arranged, infiltration of the inflammatory cells was observed, and the protein levels of FOXM1 and MUC5AC were high(P<0.05). After administering Poly(I:C), the histological changes were aggravated, and protein expression was further elevated(P<0.05). The administration of RCM1 reversed the histological changes and FOXM1 and MUC5AC levels in RCM1+Poly(I:C)and Poly(I:C)+RCM1 groups(P<0.05). Conclusion Respiratory virus in mice induces airway goblet cell hyperplasia, increases mucus secretion, promotes the expression of the inflammatory cytokines, and increases airway resistance via the FOXM1 pathway and thus leading to asthmatic attacks.

SQSTM1 in Legionella pneumophila infected RAW264.7 cells mechanism of autophagy

ZHENG Ronghui, Li Pan, CAO Xiuqin, HE Ruixia, CHEN Minjia, CHEN Haixia, YANG Zhiwei

Journal of Shandong University (Health Sciences). 2023, 61(6):  10-21.  doi:10.6040/j.issn.1671-7554.0.2023.0167

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Objective To explore the role and mechanism of P62 in the autophagy of RAW264.7 macrophages infected with Legionella pneumophila. Methods RAW264.7 macrophages, KO-P62 cells and OE-P62 cells were infected with Legionella pneumophila at multiplicities of infection(MOI)of 10, 50, and 100; unaffected groups were set as controls. The proliferation of Legionella pneumophila in macrophages was observed with bacterial proliferation assay. After co-culture with Legionella pneumophila for 12 h, the ultrastructure of autophagic vesicles, autophagic lysosomes and related organelles in the RAW264.7 group, KO-P62 group and OE-P62 group were observed with transmission electron microscopy. The changes in the autophagic flow of macrophages were detected with pmCherry-C1-EGFP-LC3 B dual fluorescence indicator system. The expression levels of autophagy-related factors, P62, AMBRA1, LAMP2, Atg5, Beclin1 and LC3 B in each group were detected with Western blotting and RT-qPCR. Results Bacterial proliferation assay detected that the number of Legionella pneumophila in RAW264.7 cells gradually increased over time, but decreased in KO-P62 and OE-P62 cells. Transmission electron microscopy showed that after Legionella pneumophila infected RAW264.7 cells, the autophagosomes and autolysosomes decreased; compared with the RAW264.7 group, the KO-P62 and OE-P62 groups had increased autophagosomes and autolysosomes. The results of pmCherry-C1-EGFP-LC3B dual fluorescence indicator system showed that the autophagic flux decreased in the RAW264.7 group infected with Legionella pneumophila, but increased in KO-P62 and OE-P62 groups. Western blotting and RT-qPCR showed that, compared with the RAW264.7 group, the KO-P62 group had firstly increased and then decreased Beclin1, P62 was basically not expressed, and the levels of LC3II/I, AMBRA1, LAMP2 and Atg5 were significantly increased(P<0.05); the OE-P62 group had firstly decreased and then increased Beclin1, and the levels of P62, AMBRA1, LAMP2, Atg5 and LC3Ⅱ/Ⅰ were significantly increased(P<0.05). Conclusion Knockout and overexpression of P62 can inhibit the proliferation of Legionella pneumophila in RAW264.7 macrophages and promote autophagy. The mechanism may be related to the Atg5-P62-AMBRA1 signaling pathway.

Hydrogen peroxide enhances radiotherapy sensitivity of cervical cancer by regulating autophagy

REN Huixin, ZHENG Maojin, HAN Wencan, WANG Chaoqun, ZHOU Yun, PEI Dongsheng

Journal of Shandong University (Health Sciences). 2023, 61(6):  22-28.  doi:10.6040/j.issn.1671-7554.0.2022.0855

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Objective To investigate whether hydrogen peroxide, represented as H₂O₂, combined with sodium hyaluronate can improve the sensitivity of cervical cancer cells to radiotherapy and to explore the underlying mechanisms. Methods The cells were divided into control group, sodium hyaluronate group, 4 Gy group, sodium hyaluronate+4 Gy group, and the expressions of autophagy related proteins were detected with Western blotting assay. Then, the cells were divided into control group, sodium hyaluronate group, 200 μmol/L H₂O₂ group, 500 μmol/L H₂O₂ group, 700 μmol/L H₂O₂ group and 1 000 μmol/L H₂O₂ group, and CCK8 experiment was used to detect the effect of H₂O₂ on cell viability. The cells were divided into control group and 200 μmol/L H₂O₂ group, and were subjected to 0, 2, 4, 6, 8 Gy radiotherapy, respectively, and the clonogenic assay was performed to assess the radiosensitizing effect of H₂O₂. The cells were divided into control group, 200 μmol/L H₂O₂ group, 4 Gy group and 200 μmol/L H₂O₂+4 Gy group, and the expressions of autophagy-related proteins were measured by Western blotting assay and immunofluorescence assay. Results The expressions of autophagy-related proteins LC3 II and p62 between control group and sodium hyaluronate group was not statistically significant (P>0.05). The expressions of autophagy-related proteins LC3 II and p62 between 4 Gy group and sodium hyaluronate+4 Gy group was not statistically significant(P>0.05). The results of CCK8 experiment showed that the cell proliferation rate was not statistically significant between control group and sodium hyaluronate group before and after radiotherapy(P>0.05); compared with control group, 200 μmol/L H₂O₂ promoted cell proliferation(P<0.05), 500 μmol/L H₂O₂ had no statistically significant effect on cell proliferation(P>0.05), and 700 μmol/L H₂O₂ and 1 000 μmol/L H₂O₂ inhibited cell proliferation(P<0.05). The results of clonogenesis assay showed that H₂O₂ increased the sensitivity of cells to radiotherapy(P<0.05). Western blotting assay and immunofluorescence assay showed that 200 μmol/L H₂O₂ group inhibited autophagy compared with the control group(P<0.05), and the 200 μmol/L H₂O₂+4 Gy group promoted autophagy compared with the 4 Gy group(P<0.05). The expressions of p-AKT and p-mTOR proteins were increased in 200 μmol/L H₂O₂ group compared with control group(P<0.05); while the expressions of p-AKT and p-mTOR were decreased in the 200 μmol/L H₂O₂+4 Gy group compared with 4 Gy group(P<0.05). Conclusion H₂O₂ improves radiosensitivity by regulating AKT/mTOR pathway, and then regulating autophagy.

Distribution and drug resistance changes of pathogenic bacteria in hospitalized elderly inpatients from 2012 to 2021

LIU Na, WANG Nana, JI Bing, DING Xuemei, LIU Yaxin, FANG Xiaoqing, ZHANG Xiaoli

Journal of Shandong University (Health Sciences). 2023, 61(6):  29-40.  doi:10.6040/j.issn.1671-7554.0.2022.1373

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Objective To investigate the distribution of pathogenic bacteria and the trend of drug resistance in hospitalized elderly patients, so as to provide reference for rational clinical use of drugs. Methods Pathogenic bacteria were collected from Jan. 2012 to Dec. 2021 in elderly patients hospitalized in the Affiliated Hospital of Binzhou Medical University. The annual trend of drug resistance rate of major pathogenic bacteria was analyzed with Cochran-Armitage trend test. Results A total of 12 258 pathogenic bacteria were isolated, of which Gram-negative bacteria accounted for 81.7%, and Escherichia coli(19.7%)was the most common; Gram-positive bacteria accounted for 18.3%, the most common being Staphylococcus aureus(5.7%). 22.5% of the pathogenic bacteria were isolated from the intensive care unit and 55.0% from sputum specimens. Resistance rates to carbapenems in Escherichia coli and Klebsiella pneumoniae were below 3%. 10.2% to 21.8% of Pseudomonas aeruginosa were resistant to carbapenems over a 10-year period. Although the resistance rate of Acinetobacter baumannii to carbapenems was generally declining, it was still above 40% in 2021. The detection rate of methicillin-resistant Staphylococcus aureus ranged from 18.8% to 44.7% over the 10-year period, and two vancomycin-resistant strains of Staphylococcus aureus and three vancomycin-resistant strains of Enterococcus faecalis were detected during this period. Conclusion It is recommended that hospitals should continuously monitor pathogenic bacteria for rational use of antibacterial drugs in clinic.

Mechanism of Fugan Huaqian Decoction inhibiting HSC-T6 activation via Wnt/β-catenin signaling pathway

XIAO Zhenghua, SHIYI Shize, YANG Qingwan, LI Tingting, LI Shanshan, ZHONG Yan

Journal of Shandong University (Health Sciences). 2023, 61(6):  41-46.  doi:10.6040/j.issn.1671-7554.0.2023.0283

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Objective To explore the inhibitory effect of Fugan Huaqian Decoction on hepatic stellate cell line HSC-T6. Methods A total of 40 healthy and clean male SD rats were given equivalent amount of Fugan Huaxian Decoction by gavage to prepare drug-containing serum and normal serum. The effects of different drug-containing serum concentrations(5%, 8%, 10%, 15%, 20%)on the proliferation rate of HSC-T6 cells were detected with CCK8 assay to determine the optimal acting concentration. HSC-T6 cells were divided into blank group(15% fetal bovine serum), model group ［transforming growth factor-β1(TGF-β1)+15% normal serum］ and treatment group(TGF-β1+15% medicated serum). Protein and mRNA expressions of Wnt1, β-catenin and Cyclin D1 were detected with Western blotting and q-PCR, respectively. Expression of α-SMA was determined with immunofluorescence staining. Results In the treatment group, the number of cells decreased, the morphology turned round, the volume shrank, and the number of suspension cells increased. CCK8 assay showed that drug-containing serum inhibited TGF-β1-induced proliferation of HSC-T6 cells(P<0.01), and the best effect was observed at 15% and 20% concentration, but there was no significant difference between the two groups(P>0.05). Western blotting and q-PCR showed that compared with the model group, the treatment group had decreased mRNA and protein expressions of Wnt1, β-catenin and Cyclin D1(P<0.01). Immunofluorescence staining showed that the cytoplasmic expression of α-SMA increased in the model group, but decreased in the treatment group. Conclusion Serum containing Fugan Huaqian Decoction can inhibit HSC-T6 activation and proliferation, and decrease the protein and mRNA expressions of Wnt1, β-catenin and Cyclin D1 in activated HSC-T6 cells. Fugan Huaqian Decoction may prevent and treat hepatic fibrosis by inhibiting the activation of Wnt/β-catenin signaling pathway.

临床医学

Cerebrospinal fluid CXCL10: a valuable biomarker for anti-NMDAR encephalitis

LI Xifeng, LI Hongmei

Journal of Shandong University (Health Sciences). 2023, 61(6):  47-52.  doi:10.6040/j.issn.1671-7554.0.2023.0099

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Objective To explore the inflammatory biomarkers related to anti-NMDAR encephalitis so as to provide clinical reference. Methods Serum and cerebrospinal fluid(CSF)samples were collected, including 18 cases with anti-NMDAR encephalitis(anti-NMDAR encephalitis group), 12 cases with anti-leucine rich glioma inactivated 1 protein(LGI1)antibody encephalitis(anti-LGI1 antibody encephalitis group)and 12 cases in the control group. The CSF and serum levels of CXC-motif ligand 10(CXCL10)of all three groups were detected with enzyme linked immunosorbent assay(ELISA). Data obtained were analyzed with SPSS 26.0. The differences in CXCL10 level were analyzed, and the correlation between CXCL10 level and clinical indicators of anti-NMDAR encephalitis was assessed. Results The level of CXCL10 in CSF of anti-NMDAR encephalitis group was significantly higher than that of the control group ［168.29 pg/mL(126.74 pg/mL)vs 82.11 pg/mL(43.61 pg/mL), P=0.003］, and the anti-LGI1 antibody encephalitis group ［168.29 pg/mL(126.74 pg/mL)vs 75.72 pg/mL(83.39 pg/mL), P=0.008］. The CXCL10 level in patients with anti-NMDAR encephalitis was positively correlated with the IgM level(rs=0.630, P=0.007). Conclusion CXCL10 in CSF is a valuable biomarker with specificity for anti-NMDAR encephalitis.

Clinical and imaging characteristics of 12 cases of Birt-Hogg-Dubé syndrome

WANG Pengfei, WU Yuanning, GAO Tingting, XU Guang, XIA Wei, WEN Peng, MA Qingqing, CAO Lili, ZHANG Jintao, LIANG Ziting, XU Changjuan, GAO Mingxia, DONG Liang

Journal of Shandong University (Health Sciences). 2023, 61(6):  53-57.  doi:10.6040/j.issn.1671-7554.0.2022.1267

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Objective To investigate the clinical and imaging characteristics of Birt-Hogg-Dubé(BHD)syndrome. Methods Clinical data of Chinese patients with BHD syndrome diagnosed with whole exon sequencing in Shandong Provincial Qianfoshan Hospital during Feb. 2022 and Aug. 2022 were retrospectively analyzed. The clinical and imaging characteristics were described. Results The 12 Chinese patients with BHD syndrome included 5 males and 7 females, aged from 8 to 66 years. Eight patients had a family history of pneumothorax. The most common clinical manifestations was pulmonary cysts. Eight cases were complicated with pneumothorax, and 1 with characteristic skin changes. In 11 cases, the lung cysts were distributed in bilateral and lower lungs, including 9 cases of massive cysts and 2 cases of moderate cysts. The cysts were mainly distributed along the mediastinum in 1 case, around the mediastinum in 4 cases, and along and around the mediastinum in 6 cases. Conclusion Chinese patients with BHD syndrome are characterized by simple lung involvement. The characteristic pulmonary imaging shows the distribution of air-containing vesicles of varying sizes along the periphery of the lower lung.

Pathological characteristics of 3 cases of acute fibrinous and organizing pneumonia and literature review

YANG Qingchan, WANG Yongmei, WANG Chengzhi

Journal of Shandong University (Health Sciences). 2023, 61(6):  58-64.  doi:10.6040/j.issn.1671-7554.0.2022.1287

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Objective To investigate the clinical symptoms, imaging manifestations, pathological features, treatment and prognosis of acute fibrinous and organizing pneumonia(AFOP)to enhance the diagnosis and treatment of this disease. Methods The clinical data of 3 AFOP patients were collected, and the relevant literature reports were reviewed. Results All of the 3 cases were idiopathic and subacute. Pathological histology showed intra-alveolar fibrin deposition forming eosinophilic fibrin “balls”. All patients had a good clinical response to glucocorticoid therapy. Clinical data of 86 reported AFOP cases including 46 males and 40 females(aged 53.8±15.9 years)were also analyzed. No risk or predisposing factors were observed in 35 cases, while the other 51 cases were secondary AFOP. Autoimmune and hematological diseases were the most common comorbidity. Most common symptoms were dyspnea, cough and fever. Consolidation was the most common imaging pattern, followed by ground-glass opacity and nodules. Most cases were confirmed by minimally invasive procedures including percutaneous lung puncture biopsy or transbronchial lung biopsy. Corticosteroids were the main drug treatment, but the final options depended on the etiology and severity of disease. Conclusion AFOP is a rare noninfectious pulmonary disease with a lack of specificity in clinical presentation and imaging. Pathology has unique histological features, and should be differentiated from other lung injury diseases.

Effects of ultrasound-guided puncture sclerotherapy combined with dienogest in the treatment of ovarian endometriosis cyst

WU Leili, CAI Huali, SUN Desheng, WEI Weixia

Journal of Shandong University (Health Sciences). 2023, 61(6):  65-69.  doi:10.6040/j.issn.1671-7554.0.2023.0136

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Objective To analyze the one-year clinical efficacy of ultrasound-guided puncture sclerotherapy combined with dienogest in the treatment of ovarian endometriotic cyst(OEM)and to explore the impacts on the ovarian reserve function. Methods Clinical data of 20 unmarried OEM patients of childbearing age who underwent ultrasound-guided puncture sclerotherapy combined with dienogest during Jun. 2019 and Dec. 2020 were retrospectively analyzed. The changes in cyst diameter, anti Mullerian hormone(AMH), serum tumor markers CA-125/CA-199 and visual analog scale(VAS)were analyzed. The efficacy and effects on the ovarian reserve function were evaluated with paired t-tests and rank sum tests. Adverse reactions of dienogest were recorded. Results After treatment, the OEM diameter, serum CA-125/CA-199 concentrations and dysmenorrhea VAS score were significantly reduced(P<0.01), while serum AMH level remained unchanged(P>0.01). Irregular vaginal bleeding was the most common complication during long-term dienogest use. A few patients presented with mild weight gain, hair loss, and acnes. No adverse effects on liver and kidney function, coagulation function and mammary gland were observed during follow-up. Conclusion Ultrasound-guided puncture sclerotherapy combined with dienogest can effectively reduce the diameter of cysts in OEM patients, alleviate the menstrual pain and lower serum CA-125/CA-199 levels, with minimal impacts on ovarian reserve function. Dienogest has minimal adverse reactions and can be used for a long-term in the treatment of OEM.

Biomechanical effects of different load-carrying ways on lumbar spine

ZHAO Geng, WANG Lianlei, WANG Hongwei, LIU Xinyu

Journal of Shandong University (Health Sciences). 2023, 61(6):  70-78.  doi:10.6040/j.issn.1671-7554.0.2022.1102

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Objective Based on the musculoskeletal model and the lumbar finite element model, to investigate the effects of different knapsack models on paraspinal muscle contraction and lumbar intervertebral disc stress distribution in the upright state. Methods The unloaded, backpack, shoulder-bag and handbag musculoskeletal models and finite element model were established. Muscle force and joint compression force were calculated in the musculoskeletal model, and input into the lumbar finite element model to analyze the stress distribution on lumbar spine. Results Compared with that in the unloaded model, average muscle force in the backpack, shoulder-bag and handbag model increased by 31.0%, 43.4% and 105.1%, respectively. The muscle force was balanced between right and left in the backpack model; however, it was higher in the loaded side in the shoulder-bag model, and was higher in the unloaded side in the handbag model. The force of multifidus muscle was statistically different in the four loading conditions(P<0.05). The average joint compression force on T12-S1 in the backpack, shoulder-bag and handbag models increased by 37%, 45% and 64%, respectively. The peak stress on the lumbar vertebral bodies in the three models increased by 71.6%, 122.3% and 146.6%, respectively; the peak stress on the annulus fibrosus increased by 155.6%, 183.4% and 195.8%, respectively; the peak stress on the nucleus pulposus increased by 95.2%, 146.9% and 161.5%, respectively. Conclusion The balanced way of load-carrying can reduce the activation of muscles and the burden of lumbar spine, which has a protective effect on the body. When a shoulder-bag or handbag is carried, the trunk keeps balance due to muscle contraction, which increases the stress on intervertebral discs.

Value of enhanced MRI radiomics in predicting the drug-resistant protein PFKFB3 in 135 cases of hepatocellular carcinoma

JIN Xinjuan, ZUO Liping, DENG Zhanhao, LI Anning, YU Dexin

Journal of Shandong University (Health Sciences). 2023, 61(6):  79-86.  doi:10.6040/j.issn.1671-7554.0.2022.1151

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Objective To investigate the correlation between MRI enhancement features, radiomics characteristics and PFKFB3 expression in primary hepatocellular carcinoma(HCC)tissue, and to establish a radiomics prediction model for drug-resistant related proteins of HCC. Methods Information of 135 HCC patients who received preoperative multiphase MRI and surgical resection during Jan. 2015 and Dec. 2020 was retrospectively analyzed. The clinical data(age, gender, history of smoking and drinking, alanine aminotransferase, aspartate transaminase, alpha-fetoprotein, pathologic stage and hepatitis B infection), conventional imaging features(tumor size, capsular, enhancement characteristics in arterial phase, necrosis, portal vein invasion, blood-supply type, hemorrhage, intrahepatic satellite foci and arterial tumor-liver differences in arterial phase), and radiomic features were recorded. The expression of PFKFB3 was detected with immunohistochemistry. The independent predictors were screened with multivariate analysis(P<0.05). The radiomics prediction model was constructed based on the features of the selected training set. The receiver operating characteristic(ROC)curve was drawn. The accuracy of the prediction model was evaluated with the area under the curve(AUC)and verified in the validation set. Results Alanine aminotransferase(OR=0.36, 95%CI:0.16-0.83, P=0.017)and the presence of intrahepatic satellite foci(OR=6.89, 95%CI:1.76-27.03, P=0.006)were independent predictors of positive PFKFB3 expression. The AUC of the MRI radiomics model was 0.99 in the training set and 0.80 in the validation set, with 95%CI of 0.61-1.00, sensitivity of 0.78 and specificity of 0.75. Conclusion The model of enhanced MRI radiomics can predict the expression of PFKFB3 in primary HCC, which can provide important information of tumor drug resistance in the treatment of HCC.

医学心理学

Psychometric evaluation of 14-item and 6-item Freiburg Mindfulness Inventory among patients with gastrointestinal cancer

ZHAO Di, LYU Gaorong, LI Guopeng, ZHANG Yunxue, WANG Weimin, DONG Xiaoling, LI Ping

Journal of Shandong University (Health Sciences). 2023, 61(6):  87-91.  doi:10.6040/j.issn.1671-7554.0.2022.1194

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Objective To test the applicability of the simplified Freiburg Mindfulness Inventory(FMI)in patients with gastrointestinal cancer. Methods Totally 411 patients with gastrointestinal cancer were recruited from Shandong Cancer Hospital, and the 14-item FMI(FMI-14)was simplified based on item analysis and exploratory factor analysis. Mplus 7.4 and SPSS 22.0 were used for data description and analysis. Results A total of 8 items were deleted, and 3 presence items and 3 acceptance items were retained. The Cronbachs α coefficient of the 6-item FMI(FMI-6)was 0.831, and the Guttmans split-half reliability was 0.848. The confirmatory factor model fitted well(χ2/df=1.892, CFI=0.991, TLI=0.982, SRMR=0.029, RMSEA=0.064). The total score of FMI-6 was significantly associated with resilience, illness perception, and perceived stress(r=0.679, r=-0.522, r=-0.571, all P<0.001). Conclusion The 6-item FMI has good psychometric properties, and can be used to evaluate mindfulness level of patients in clinic.

公共卫生与和管理学

A quality of life study based on subjective reports of the cleft lip and palate population in Central China

ZHANG Xinyu, KUANG Wenying, XU Jingyi, YAN Jianan, DING Yuzhe, GUO Yanyu, YUAN Wenjun

Journal of Shandong University (Health Sciences). 2023, 61(6):  92-102.  doi:10.6040/j.issn.1671-7554.0.2023.0228

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Objective To assess the quality of life in the non-syndromic cleft lip and palate population aged 8-29 years and to explore its effects from the patients perspective. Methods A cross-sectional study was conducted using the CLEFT-Q scale to statistically describe the subjectively reported quality of life in 329 patients with non-syndromic cleft lip and palate who visited the Department of Orthodontics I of Stomatology Hospital of Wuhan University during Jun. 2021 and Dec. 2022. The patients were divided into subgroups according to gender, age, number of caregivers, number of siblings, subjective family social status(SSS), and unilateral/bilateral complete cleft lip and palate. The data were analyzed with multiple linear regression using SPSS 26.0 to analyze the factors influencing their quality of life. Results Correlation analysis showed that age had a significant effect on patients satisfaction with appearance(P<0.001); SSS had a significant effect on patients satisfaction with appearance(P<0.001), health related quality of life(HRQoL)(P=0.011), and satisfaction with facial function(P<0.022); there were significant differences in the quality of life in patients of different age groups(P<0.001). Multiple linear regression analysis showed that HRQoL, satisfaction with appearance, satisfaction with facial function, SSS and age had an effect on the quality of life. Conclusion The effects of HRQoL, appearance, facial function, and SSS on quality of life from a subjective perspective in patients with cleft lip and palate aged 8 to 29 years were positively correlated, with quality of life decreasing as patients aged. This is a quality of life study from the subjective perspective of patients with cleft lip and palate in Central China, which has shifted from a unidimensional to a multidimensional approach. In addition, clinicians should actively ask patients about their subjective evaluations on the basis of objective assessment of their condition and efficacy, so as to give targeted intervention plans to improve their quality of life comprehensively.

Evaluation on heat-health risk warning in Jinan based on Baidu heat stroke search index

LIU Jing, CHEN Chen, WANG Yanwen, CUI Liangliang, HAN Dandan, LI Tiantian

Journal of Shandong University (Health Sciences). 2023, 61(6):  103-108.  doi:10.6040/j.issn.1671-7554.0.2022.1124

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Objective To evaluate the sensitivity of the heat-health risk warning(HHRW)model in Jinan based on the heat stroke search index(HSSI), and to provide scientific basis for its popularization and application. Methods The HSSI and meteorological data during summer(June to September)of 2018 to 2020 in Jinan were collected. The association(β value)between the distribution of warning ranks and HSSI was analyzed with generalized linear model, and the occurrence of heat stroke in different warning levels was explored. Results In the HHRW model, the frequency of key concern, yellow, orange and red warning levels were 170, 17, 12 and 5, respectively. The evaluation results of the key concern level showed that, the β value of key concern level and above was 77.4(95%CI: 58.6-96.2). The evaluation results of the warning level showed that, the β value of key concern level and warning level were 69.7(95%CI: 55.0-84.4)and 232.1(95%CI: 207.2-257.1), respectively. The evaluation results of the three-level warning showed that, the β value of yellow, orange and red warning levels were 193.4(95%CI: 164.8-221.9), 254.2(95%CI: 220.6-287.8)and 346.1(95%CI: 296.6-395.6), respectively. The comparison between HHRW and high temperature warning(HTW)of the China Meteorological Administration showed a significant association between HSSI and HHRW, but not between HSSI and HTW. Conclusion There was a good increasing relationship between the distribution of HHRW warning ranks and the occurrence of heat stroke, suggesting that the HHRW model based on death risk is also suitable for heat stroke risk warning during summer.