Journal of Shandong University (Health Sciences)

Laboratory influencing factors of recurrent implantation failure

ZHANG Chaofan, ZHAO Mingpeng, LIU Jie, SHI Yuhua

Journal of Shandong University (Health Sciences). 2024, 62(1): 1-6. doi:10.6040/j.issn.1671-7554.0.2023.0918

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Objective To investigate the effects of laboratory factors on patients with recurrent implantation failure(RIF). Methods Clinical data of 57 cases of RIF in vitro fertilization or intracytoplasmic sperm injection(IVF/ICSI)during 2017 and 2021 were retrospectively analyzed. After the failure of the 3rd embryo transfer, patients who were pregnant after the 4th or 5th embryo transfer were divided into the pregnant group(group A, n=24)and non-pregnant group(group B, n=33). The laboratory and clinical factors of the two groups were compared with independent sample t test, rank sum test and Logistic regression. Results There was statistically significant difference in the number of embryos transferred between groups A and B(1.67±0.48 vs. 1.36±0.49, P=0.024). However, there were no significant differences in baseline data, clinical factors, and embryo scores(P>0.05); there were no significant differences in the transfer of embryos at different developmental stages(cleavage embryo, blastocyst), ovum insemination methods(IVF/ICSI), and the cumulative number of available embryos(P>0.05). Further analysis of the number of transplants from the first to the last cycle indicated that transfer of two blastocysts helped improve the pregnancy outcomes. Conclusion For patients with RIF, transfer of two embryos will improve the success rate of pregnancy.

Composition and drug resistance of pathogenic bacteria in human eye infection in Shandong Province between 2017 and 2022

YU Shujuan, WANG Shifu, YANG Shangmin, LIU Guohua

Journal of Shandong University (Health Sciences). 2024, 62(1): 7-14. doi:10.6040/j.issn.1671-7554.0.2023.0807

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Serum infectious indicators of patients before dental implant surgery in a stomatological hospital

JIANG Lili, CHEN Peng, ZHANG Xiaorong, XU Xinyang, MENG Qiuyu, QI Dong, SONG Youwen, WANG Dongxue

Journal of Shandong University (Health Sciences). 2024, 62(1): 15-20. doi:10.6040/j.issn.1671-7554.0.2023.0587

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Objective To explore the prevalence of serum infectious indicators of implant patients, including hepatitis B surface antigen(HBsAg), hepatitis C virus antibody(Anti-HCV), treponema pallidum antibody(Anti-TP)and human immunodeficiency virus antibody(Anti-HIV). Methods A retrospective analysis was conducted on the data of 5,896 patients who underwent dental implantion surgery and completed preoperative serum infectivity test in a stomatological hospital during Jan. 2017 and Dec. 2022, and the differences in general data such as gender and age were compared. Results Among the 4 serum infectious indicators in 5,896 patients, 197 were positive, with an overall positive detection rate of 3.34%(197/5 896). The positive detection rate of HBsAg, Anti-HCV and Anti-TP were 2.75%(162/5 896), 0.24%(14/5 896)and 0.36%(21/5 896), respectively(χ2=214.747, P<0.001). No Anti-HIV positive individual was identified. The differences in HBsAg positive detection rate among different age groups were statistically significant(χ2=8.074, P=0.018). Conclusion There is a certain positive detection rate of preoperative serum infectious indicators in dental implant patients. Its recommended that dental personnel strictly implement pre-examination and triage, strengthen the implementation of hospital infection prevention and control measures, increase the screening of serum infectious indicators. Meanwhile, the health managernent department should strengthen publicity and education on the knowledge of infectious diseases such as vaccination to reduce the risk of cross infection of blood borne pathogens.

Exploring colorectal cancer related genes and their functions based on GEO

JING Kai, XU Zhiwei, LI Leping

Journal of Shandong University (Health Sciences). 2024, 62(1): 21-30. doi:10.6040/j.issn.1671-7554.0.2023.1090

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Objective To explore the differential expression genes(DEGs)in colorectal cancer(CRC)using bioinformatic analysis in combination with the Gene Expression Omnibus(GEO)database. Methods The gene expression data of tumor tissue and normal tissue of CRC patients were obtained from the GEO database. The DEGs were screened using GEO2R, which then underwent GO enrichment analysis using the David database to identify the molecular functions, cellular components and biological processes. The signaling pathways of the DEGs were obtained from the KEGG to construct protein interaction network. Topological analysis of key nodes in the network was performed using Cytoscape software to screen out key genes in the pathogenesis of CRC. Results Through bioinformatic analysis of the GSE21510 dataset, a total of 664 DEGs were screened, including 234 upregulated and 430 downregulated genes, which were mainly involved in the biological processes, such as cell division, positive and negative regulation of RNA polymerase II promoter transcription, as well as in the composition of cellular components, such as the nucleus, cytoplasm, cytosol, plasma, and cell membrane, and in processes such as the expression and realization of molecular functions of protein-binding, ATP-binding, and so on. Protein network analysis identified the upregulated genes, including CDK1, CCNB1, TOP2A, AURKA, UBE2C, BUB1, CHEK1, RRM2, MYC, and TPX2, and the downregulated genes, including SLC26A3, CLCA4, GUCA2A, MS4A12, ZG16, GUCA2B, CLCA1, AQP8, MT1E and MT1G. Survival analysis showed that the low expression of the key gene CCNB1 was significantly correlated with poor prognosis of CRC patients(logrank P<0.01). Moreover, CCNB1 was significantly correlated with tumor pathological stage(P<0.01). Conclusion The screened key genes may become markers or potential targets for the diagnosis or treatment of CRC, which provide theoretical reference for the research on the pathogenesis and treatment of CRC.

Predication and bioinformatics analysis of preeclampsia-related Siglec-6 core genes

QIN Jinjin, CAO Chenyuan, XING Jiejie, AN Yan, HUANG Yuxiang

Journal of Shandong University (Health Sciences). 2024, 62(1): 31-37. doi:10.6040/j.issn.1671-7554.0.2023.0799

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Objective To investigate the core pathogenesis genes of preeclampsia through high throughput bioinformatics analysis. Methods Two microarray datasets of preeclampsia coding genes from Gene Expression Omnibus(GEO)were selected for bioinformatics analysis. The datasets were homogenized and corrected with R language, and then the up-regulated and down-regulated differentially expressed genes were selected, which were then analyzed with gene ontology enrichment, Kyoto Encyclopedia of Genes and Genomes(KEGG)signal pathway enrichment, protein interaction network analysis and core gene calculation analysis to identify the most relevant pathogenesis genes and signal pathways of preeclampsia. Five placentas of preeclampsia patients and normal pregnant women were randomly selected for real-time quantitative PCR to verify the core genes. Results A total of 38 up-regulated and 20 down-regulated genes were screened from the microarray GSE43942 and GSE66273. After homogenization of all data, gene ontology analysis showed that biological function was enriched in positive regulation of follicle-stimulating hormone secretion, molecular composition was enriched in extracellular region, and cell component was enriched in hormone activity. KEGG signaling pathway was enriched in the Peptide hormone metabolism pathway. The protein interaction network showed that there were 58 points and 30 lines among all differentially expressed genes. The cytohubba analysis identified Siglec-6 as the core gene of preeclampsia. The real-time quantitative PCR showed that the expression of Siglec-6 in the placental tissue of preeclampsia pregnant women was 2.85 times that of normal pregnant women, which was consistent with the results of bioinformatics analysis. Conclusion Siglec-6 could be used as a potential diagnostic and therapeutic marker for preeclampsia.

Construction of a machine learning-based tongue diagnosis model for gastrointestinal diseases

ZHANG Jinghui, WANG Juan, ZHAO Yujie, DUAN Miao, LIU Yiran, LIN Minjuan, QIAO Xu, LI Zhen, ZUO Xiuli

Journal of Shandong University (Health Sciences). 2024, 62(1): 38-47. doi:10.6040/j.issn.1671-7554.0.2023.0435

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Objective To construct a machine learning(ML)-based tongue diagnostic model for the diagnosis of gastrointestinal diseases so as to realize the non-invasive auxiliary diagnosis of common gastrointestinal diseases in a more convenient and faster way. Methods Tongue images of 948 subjects who underwent electronic endoscopy were prospectively collected. After quality screening, 3,140 images that met the application criteria were finally obtained to constitute the tongue image data set, which underwent preprocessing, feature extraction and pattern recognition. On the basis of traditional machine learning methods, a method to realize information fusion in terms of feature fusion and decision fusion was proposed, and a tongue diagnosis model of gastrointestinal diseases was constructed. Results The area under the curve(AUC)of the model was 0.808, which was higher than that of the single handcrafted feature(AUC=0.769)and deep feature(AUC=0.779)models. Sample enhancement using the BSFCM hybrid sampling method improved the models performance for Helicobacter pylori(H. pylori) infection(AUC=0.816), bile reflux(AUC=0.829), reflux esophagitis(AUC=0.800), gastric erosion(AUC=0.833)and duodenal erosion(AUC=0.818). Conclusion The intelligent tongue diagnostic model based on ML constructed in this study shows a high degree of differentiation for a variety of gastrointestinal diseases, and may provide a new and valuable idea and method for the diagnosis and screening of gastrointestinal diseases.

Development of a nomogram model for individualized prediction of the risk of nosocomial infection after heart valve replacement in elderly patients

SONG Tiantian, LI Zuokun, WANG Shuhui

Journal of Shandong University (Health Sciences). 2024, 62(1): 48-56. doi:10.6040/j.issn.1671-7554.0.2023.0965

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Objective To develop a nomogram model for individualized prediction of the risk of nosocomial infection after heart valve replacement in the elderly patients, so as to provide a basis for the early screening of the high-risk population and the formulating of targeted prevention strategies. Methods The clinical data of 334 elderly patients who underwent heart valve replacement surgery in Qilu Hospital of Shandong University during Jan. 1, 2020 and Dec. 31, 2021 were retrospectively collected, including 176 males and 158 females, aged 60-81 years, with an average of(65.86±4.34)years. The independent risk factors for nosocomial infection were identified with Lasso regression and multivariate Logistic regression, based on which, a nomogram model for individualized prediction of risk was constructed. The internal validation of the model was tested with Bootstrap self-sampling method(n=1,000). The predictive performance of the model was tested with C-index, area under the receiver operating characteristic(ROC)curve, calibration curve or decision curve. Results A total of 91 nosocomial infection occurred, with an incidence of 27.25%. Heart failure, stress hyperglycemia, indignant gastric tube, pulmonary hypertension, left ventricular ejection fraction(LVEF)and American Society of Anesthesiologists(ASA)were independent risk factors for nosocomial infection. Based on the above variables, a nomogram model was constructed, whose C-index after correction was 0.80. The calibration curve showed that the model could accurately predict the risk of nosocomial infection. The clinical decision curve showed good net benefit. Conclusion The nomogram model for the prediction of nosocomial infection risk in the elderly patients after heart valve replacement has good differentiation, calibration and clinical effectiveness, which can help to screen the high-risk group and formulate targeted intervention strategies, so as to reduce the incidence of nosocomial infection.

Early clinical application of “single-surgeon double-incision method” in video-assisted thoracoscopic surgery in the treatment of the children with extralobar sequestration

LYU Longfei, LI Jiru, ZHAI Yunpeng, ZHAO Huashan, GUO Rui, XU Hongxiu, HUANG Sai, ZHANG Shisong

Journal of Shandong University (Health Sciences). 2024, 62(1): 57-62. doi:10.6040/j.issn.1671-7554.0.2023.0995

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Objective To summarize the operation process of “single-surgeon double-incision method” in video-assisted thoracoscopic surgery in the treatment of the children with extralobar sequestration, and to evaluate the feasibility and safety of this operation. Methods The clinical data of 45 patients operated on by the same surgeon in the Childrens Hospital Affiliated to Shandong University during Jan. 2020 and Aug. 2023 were retrospectively collected. According to different surgical methods, the patients were divided into double-incision group(n=15, 11 males and 4 females, aged 4 to 19 months)and three-incision group(n=30, 21 males and 9 females, aged 3 to 59 months). The operation time, intraoperative blood loss, hospital stay, hospital costs and incidence of postoperative complications were compared with rank-sum test, t test and Fisher exact test. Results All operations were successfully completed, without conversion to open surgery. The double-incision group had lower hospital costs(31,165 vs. 35,555 Yuan, t=-6.093, P<0.001), shorter operation time(40 vs. 45 min, z=-2.322, P=0.020), shorter hospital stay(5 vs. 6 d, z=-3.519, P<0.001), and shorter length of chest wall incision(1.0 vs. 1.6 cm, z=-5.489, P<0.001). There were no significant differences in the amount of intraoperative blood loss and incidence of postoperative complications between the two groups. Conclusion Single-surgeon double-incision method is simple, safe and feasible in minimally invasive video-assisted thoracoscopic surgery in the treatment of the children with extralobar sequestration, which reduces the operation time, hospital stay, length of chest wall incision, and hospital costs. It is in line with the concept of enhanced recovery after surgery, and worthy of promotion and application in clinical practice.

Domestic extracorporeal membrane oxygenation in the treatment of cardiogenic shock and acute respiratory failure: a report of 8 cases and literature review

LI Ruijian, ZHANG Jianbo, BIAN Yuan, LIU Shuqin, LIU Yanwei

Journal of Shandong University (Health Sciences). 2024, 62(1): 63-70. doi:10.6040/j.issn.1671-7554.0.2023.0694

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Objective To analyze the safety and efficacy of domestic extracorporeal membrane oxygenation(HX-ECMO)for patients with cardiogenic shock and acute respiratory failure. Methods In the Department of Emergency, Qilu Hospital, Shandong University, HX-ECMO was used for the treatment of 8 patients with cardiogenic shock and(or)acute respiratory failure during December 2022 and March 2023. The efficacy of treatment was prospectively analyzed. Results After treatment, all indexes were improved, as sufficient circulatory and oxygenation support were provided to patients through artificial heart pump and membrane lung, which created conditions for the recovery of organ function. Compared with conventional treatment, ECMO improved the success rate of acute respiratory and circulatory failure. During the study, HX-ECMO operated stably and performed well. Conclusion Domestic HX-ECMO can effectively improve the success rate of patients with cardiogenic shock and acute respiratory failure, which can provide support for the application of ECMO.

Five cases of hiatal hernia complicated with pneumonia during painless gastroscopy and literature review

CHEN Wenjun, SONG Lijun, WANG Junjuan

Journal of Shandong University (Health Sciences). 2024, 62(1): 71-75. doi:10.6040/j.issn.1671-7554.0.2023.0565

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Objective To investigate the treatment and prevention measures of hiatal hernia complicated with pneumonia during painless gastroscopy. Methods A total of 5 patients with hiatus hernia complicated with pneumonia undergoing painless gastroscopy during Nov. 2021 and Feb. 2023 were involved. The clinical characteristics, diagnosis and treatment were analyzed, and relevant literature was reviewed. Results Residual fluid in the esophagus was found in 4 out of 5 patients during the insertion of the gastroscope; all 5 patients had fever, cough, excessive phlegm and chills. The total number of white blood cells or the proportion of neutrophils were increased in all patients. CT showed that all patients had left lung pneumonia. Four patients were given oxygen inhalation and intravenous dexamethasone during gastroscopy; four patients were given levofloxacin, and one was given ceftizoxime sodium for anti-infection. The body temperature of all patients returned to normal within 48 hours; re-examination of lung CT suggested lesion absorption in 4 patients; CT follow-up of the other patient revealed a thick-walled cavity in the left lung, which disappeared after prolonged anti-infective therapy. Conclusion Pneumonia is a serious complication in patients with hiatal hernia during painless gastroscopy. Due attention should be paid and active prevention measures should be adopted.

Hormones combined with methimazole in the treatment of thyroid crisis with hepatitis B and liver failure: a case report

SONG Xiaoyu, LI Qian, WANG Lulu, WANG Xin, DONG Zhenhua, PANG Shuguang

Journal of Shandong University (Health Sciences). 2024, 62(1): 76-81. doi:10.6040/j.issn.1671-7554.0.2023.0852

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Objective To explore the clinical basis of drug effectiveness and safety in the treatment of hyperthyroidism complicated with liver damage, especially in cases of thyroid crisis with hepatitis B and liver failure. Methods A case of hepatic failure complicated with hyperthyroidism with uncontrolled chronic hepatitis B was reported. The course of treatment was described, including hepatoprotective, enzyme-lowering treatment, artificial liver blood purification, antiviral therapy, and glucocorticoid combined with methimazole therapy after thyroid crisis. Results At admission, the patients alanine aminotransferase(ALT)was 534.6 U/L, aspartate aminotransferase(AST)was 597.3 U/L, international normalized ratio(INR)was 1.92, and prothrombin activity(PTA)was 30.7%. After hepatoprotective, enzyme-lowering treatment, the INR was 1.94, and PTA was 30.1%. At this time, thyroid crisis occurred, which was dealt with glucocorticoid and methimazole along with antiviral therapy. After treatment, the ALT was 73.3 U/L, AST was 58.2 U/L, INR was 1.26, and PTA was 70.9%. Conclusion For liver failure caused by hyperthyroidism, the use of methimazole is not contraindicated, since treatment of the primary disease of hyperthyroidism is more effective than supportive treatment of liver protection. In case of thyroid crisis complicated with hepatitis B and liver failure, glucocorticoid can effectively improve hyperthyroidism and liver injury along with antiviral therapy.

Horizontally impacted maxillary central incisor: 1 case report and literature review

HAO Xinyu, XIONG Shijiang

Journal of Shandong University (Health Sciences). 2024, 62(1): 82-88. doi:10.6040/j.issn.1671-7554.0.2023.0890

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Objective To investigate the etiology, diagnosis and treatment of a case of horizontally impacted maxillary central incisor and review relevant literature, so as to provide reference for the clinical treatment of such disease. Methods The data of cone beam computer tomography(CBCT), facial and intraoral photographs of the patient were retrospectively analyzed. Relevant literature in CNKI, VIP, Wanfang and PubMed databases were reviewed. Results The main manifestation included unerupted permanent central incisor, deciduous tooth retention, space loss, and inclination of adjacent teeth in mixed dentition. CBCT revealed crown labial growth, immature roots, curved roots with an approximate angle of 65° to the crown. After treatment, the impacted incisor moved into alignment, without external root resorption, sensitivity to percussion, mobility, or sensitivity to thermal stimuli. Conclusion It is an effective way to fix horizontally impacted maxillary central incisor with removable orthodontic appliances and sectional fixed orthodontic appliances, which can improve the preservation rate of affected teeth.

Effects of occupational stress on quality of life among nurses: a moderated mediation model

ZHU Hongting, REN Minmin, WANG Hui, SUN Xiangjie, FENG Danjun

Journal of Shandong University (Health Sciences). 2024, 62(1): 89-94. doi:10.6040/j.issn.1671-7554.0.2023.0972

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Objective To explore the relationship between occupational stress and quality of life of nurses, the mediating effects of psychological distress on the relationship between occupational stress and quality of life, as well as the moderating effects of neuroticism in the relationship between occupational stress, psychological distress and quality of life. Methods Totally 459 nurses were surveyed with questionnaires of 8-Item Short Form, Occupational Role Questionnaire, Psychological Distress Scale and the neuroticism subscale of the Big Five Personality Scale. The mediating effects were verified with PROCESS. Results The occupational stress was positively correlated with psychological distress (r=0.513, P<0.01), but negatively related with quality of life(r=-0.409, P<0.01). Psychological distress played a significant mediating role in the relationship between occupational stress and quality of life. In addition, neuroticism had a moderating effect on the relationship between occupational stress, psychological distress and quality of life. Conclusion Occupational stress can reduce the quality of life of nurses directly or indirectly through increased psychological distress. In addition, high level of neuroticism exacerbates the negative effects of occupational stress on psychological distress and quality of life.

Heavy metal pollution status and dietary exposure risk of marketed vegetables in Yantai City

TANG Yuying, WANG Baozhen, XIAO Peirui, ZHAI Yuting, WANG Kebo, CHEN Chen, CHU Zunhua

Journal of Shandong University (Health Sciences). 2024, 62(1): 95-101. doi:10.6040/j.issn.1671-7554.0.2023.0660

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Objective To investigate the status of heavy metal pollution in vegetable samples in Yantai City, and to assess the dietary exposure risk. Methods According to the national standards, the contents of lead, cadmium, mercury, and arsenic in vegetables were measured and analyzed with the pollution index. The risk of dietary exposure was assessed with the target hazard coefficient(THQ)and total target hazard coefficient(TTHQ). Results The four heavy metals were detected in vegetables to varying degrees. The average contents of lead, cadmium, mercury, and arsenic were 0.014 2, 0.002 8, 0.000 4 and 0.007 1 mg/kg, respectively. The detection rate of cadmium was the highest, accounting for 35.36%. Of the 758 vegetable samples, 2 leek samples had excessive lead, and the over-standard rate was 0.26%. The pollution index and comprehensive pollution index of the four heavy metals were lower than 0.7. Of all samples, bulb vegetables were the most polluted but still at a safe level. The THQ and TTHQ of the four heavy metals for adults and children were less than 1. Conclusion The overall level of heavy metals in vegetables in Yantai City is relatively low. Eating vegetables poses no significant health risk to the human body.

Mediators or confounders: should obesity be adjusted to estimate the effects of trihalomethanes on thyroid function

FAN Jiaxu, CHENG Fang, QIAO Junpeng, FEI Haicheng, CHEN Xueyu, ZHAO Yun, JIA Hongying

Journal of Shandong University (Health Sciences). 2024, 62(1): 102-110. doi:10.6040/j.issn.1671-7554.0.2023.0983

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Objective To explore whether obesity plays a confounding or mediating role in the effects of trihalomethanes on thyroid function. Methods The cross-sectional data were obtained from the NHANES database. The continuous and categorical variables were compared with weighted rank sum test and χ2 tests, respectively. Variables with skewed distribution were subjected to natural ln transformation; THM was classified according to the quartile distribution of ln transformed concentration; directed acyclic graphs(DAGs)and Logistic regression were introduced to explore the potential role of body mass index(BMI)in the causal pathway of THM exposure and thyroid function. Results There was no significant effect on the association between THM exposure and thyroid function before and after additional adjustment for BMI as a categorical variable; however, when stratified analyses were performed based on obesity, THM was a risk factor for elevated TSH levels in obese patients. Conclusion Considering collider bias, the potential heterogeneity observed in stratified analyses of obesity needs to be interpreted with caution, as well as the need for additional analyses of obesity as a confounder and/or mediator in THM studies.

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