Table of Content

  

10 July 2025
Volume 63 Issue 7

Expert consensus on standardization of diagnostic criteria of vectorcardiogram(2025)

Stereoscopic Electrocardiogram Professional Committee of Henan Biomedical Engineering Society, Electrocardiogram Professional Committee of China Medical Education Association, Electrocardiogram Professional Committee of Shandong Association of Traditional Chinese Medicine, Electrocardiogram Physiology and Pacing Specialized Branch of Qingdao Medical Association, Remote Cardiac Professional Committee of National Medical Technology Market Association

Journal of Shandong University (Health Sciences). 2025, 63(7):  1-10.  doi:10.6040/j.issn.1671-7554.0.2024.1373

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With the rapid development of electrocardiography and computer network, as well as the improvement of electrocardiac signal processing techniques in biomedical engineering, the most advanced state-of-the-art three-dimensional electrocardiograph in China, featuring functions such as the automatic diagnosis system of color vector cardiogram, heartbeat encoding, multiple heartbeat superimposition, automatic diagnosis and localization of ventricular ectopic beats, pacemaker pulse detection and marking technology, etc, compensates for the inability of conventional electrocardiograms to provide definite diagnoses for certain arrhythmias, atypical myocardial infarction, myocardial infarction combined with conduction disorders, and other diseases. This not only broadens the clinical application scope of vector cardiogram but also imposes higher demands on the standardization of diagnostic criteria for vector cardiogram in clinical practice. This consensus document aimed to promote the standardization of the diagnostic criteria of vector cardiogram, better facilitate the management of vector cardiogram reports, and lay a solid foundation for the future development of artificial intelligence interpretation of vector cardiogram in China.

Mechanism of luteolin regulating Wnt/β-catenin signal pathway in inflammatory microenvironment to promote chondrogenic differentiation of bone marrow mesenchymal stem cells

ZHAO Canbin, SHAO Jiang, GUAN Donghui, QIN Ying, DING Qiang, GUO Liang, WANG Weiwei, CHEN Wei, YAN Xiaolong, ZENG Ping

Journal of Shandong University (Health Sciences). 2025, 63(7):  11-22.  doi:10.6040/j.issn.1671-7554.0.2025.0047

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Objective To investigate the effect of luteolin on chondrogenic differentiation of bone marrow mesenchymal stem cells(BMSCs)and the Wnt/β-catenin signaling pathway in an inflammatory microenvironment. Methods Network pharmacology was used to screen gene sets regulated by luteolin for chondrogenic differentiation, and a protein-protein interaction(PPI)network was constructed. Gene ontology(GO)and Kyoto encyclopedia of genes and genomes(KEGG)enrichment analyses were performed to screen chondrogenic differentiation-related target genes, which were then subjected to molecular docking with luteolin. The cytotoxicity of luteolin on BMSCs was determined using the cell counting kit-8(CCK8)and cell proliferation assay. Rat BMSCs were divided into control group(caltured with 2 mL chondrogenic differentiation induction medium), model group ［using 2 mL of chondrogenic differentiation induction medium containing 10 ng/mL tumor necrosis factor-α(TNF-α)to construct an inflammatory microenvironment］, low-dose group(5 μmol luteolin intervention based on the model group), and high-dose group(10 μmol luteolin intervention based on the model group). Chondrogenic differentiation was induced in each group to construct micromass cartilage pellets. After embedding and sectioning, histologic staining(Safranin-O/Fast Green, Toluidine Blue, Alcian Blue)was performed. RT-qPCR was used to detect the expression of chondrogenic genes collagen type Ⅱ(COL2), Sry-box transcription factor 9(SOX9), and aggrecan(ACAN), as well as the expression of Wnt/β-catenin signaling pathway proteins including protein kinase A(PKA), cAMP response element-binding protein(CBP), glycogen synthase kinase 3β(GSK3β), β-catenin(β-CATENIN), cellular myelocytomatosis viral oncogene homolog(c-MYC), and Cyclin D1. Western blotting was used to determine the protein expression levels of these signaling molecules. Results A total of 54 target genes regulated by luteolin for chondrogenic differentiation were screened, 53 of which were involved in the construction of the PPI network. The target genes were associated with biological processes, including positive and negative regulation of the Wnt/β-catenin signaling pathway. Luteolin showed good docking with collagen type Ⅱ alpha 1 chain(COL2A1), SOX9 and ACAN. Luteolin at 5 μmol and 10 μmol showed no significant cytotoxicity. Histological staining revealed that the model group had sparser and more disorganized staining in cartilage pellets compared to the control group, which was significantly reversed by luteolin intervention. Compared with the control group, the model group had significantly lower mRNA expression of COL2, SOX9, ACAN, PKA, CBP, β-CATENIN, c-MYC, and Cyclin D1(P<0.05), while GSK3β expression was significantly higher(P<0.05). Protein expression levels of PKA, CBP, β-CATENIN, c-MYC, and Cyclin D1 in the Wnt/β-catenin pathway were significantly decreased(P<0.05), and GSK3β was increased(P<0.05)in the model group, all of which were significantly reversed by luteolin intervention. Conclusion Luteolin promotes chondrogenic differentiation of BMSCs in an inflammatory microenvironment, possibly by activating the Wnt/β-catenin signaling pathway.

B4GALNT4 promotes proliferation, migration and invasion of lung adenocarcinoma cells

HAN Jueming, WANG Hui, WU Qian, ZHENG Huiling, ZHU Lin

Journal of Shandong University (Health Sciences). 2025, 63(7):  23-31.  doi:10.6040/j.issn.1671-7554.0.2024.0768

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Objective To evaluate the role of β-1,4-N-acetyl-galactosaminyltransferases Ⅳ(B4GALNT4)in lung adenocarcinoma. Methods The Cancer Genome Atlas(TCGA)database was used to analysis the expression of B4GALNT4 in lung adenocarcinoma, and the relationship between prognosis and the expression level of this gene was explored. Immunohistochemistry and Western blotting were used to detect the expression of B4GALNT4 in lung adenocarcinoma tissues. The functional experiments involved the knockdown of B4GALNT4 in A549 and H1299 cells using transient transfection with small interfering RNA. Subsequently, the proliferative capacity of these lung adenocarcinoma cells was assessed through CCK-8 and EdU assays. Then, cell scratch assay, transwell migration, and invasion assay were utilized to detect the migration and invasion ability of lung adenocarcinoma cells. Western blotting was conducted to uncover the underlying molecular mechanisms in these processes. Results The TCGA database showed that compared with adjacent tissues, the B4GALNT4 gene had significantly higher levels in lung adenocarcinoma tissues (P<0.05), which was correlated with the poor prognosis of patients(P<0.01). Immunohistochemistry and Western blotting showed that B4GALNT4 protein levels were elevated in lung adenocarcinoma tissues compared to adjacent normal tissues. Furthermore, knockdown of B4GALNT4 in A549 and H1299 cell lines significantly inhibited the proliferation, migration, and invasion abilities of lung adenocarcinoma cells(P<0.05), and the mechanism might be closely related to the PI3K/AKT/mTOR pathway. Conclusion B4GALNT4 might play a role as a pro-oncogene in the development of lung adenocarcinoma, and this role might be mediated by affecting the expression levels of key proteins in the PI3K/AKT/mTOR signaling pathway.

Immunoglobulin E changes and risk factors in asthma children between 2008 and 2019

ZHANG Zheng, WANG Jianwei, YANG Yujuan, ZHANG Yu, SONG Xicheng

Journal of Shandong University (Health Sciences). 2025, 63(7):  32-36.  doi:10.6040/j.issn.1671-7554.0.2024.0574

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Objective To investigate immunoglobulin E(IgE)changes by a cross-sectional analysis between 2008 and 2019 and analyze risk factors for IgE elevation in asthmatic patients. Methods The medical records of 292 children in 2008 and 503 children in 2019 diagnosed with asthma were retrospectively analyzed, and clinical characteristics and IgE levels were compared between the two years. Independent risk factors for total serum IgE elevation were identified by performing multiple linear regression analyses. Results Compared with asthmatic children in 2008, asthmatic children had a significantly higher proportion of allergic sensitization to fungal spores(29.79% vs. 43.74%, χ2=17.45, P<0.001), and a significantly lower proportion of allergic sensitization to tree pollens(33.22% vs. 17.89%, χ2=23.60, P<0.001), house dust mites(HDMs)(53.08% vs. 39.36%, χ2=13.02, P<0.001), and dermatophagoides farina(DF)(54.11% vs. 42.35%, χ2=10.17, P=0.001)in 2019. Meanwhile, the level of total serum IgE was significantly lower in 2019 than that in 2008(184 IU/mL vs. 108 IU/mL, Z=-9.32, P<0.001). The independent risk factors for IgE elevation in 2008 included a history of allergic diseases and allergic sensitization to fungal spores, tree pollens, and DF, and in 2019 included age and allergic sensitization to fungal spores, tree pollens, and HDM. Meanwhile, the standardized regression coefficient of allergic sensitization to dust mites was highest whether in 2008 or 2019 among those of independent risk factors. Conclusion The level of IgE significantly decreased in asthmatic patients over 11 years, which was associated with a decline in the proportion of patients sensitized to dust mites.

Clinical efficacy of modified Hughes flap for reconstruction of large full-thickness defects of the lower eyelid

ZHANG Lei, PAN Ye, LI Jiagen, ZHAO Hong

Journal of Shandong University (Health Sciences). 2025, 63(7):  37-43.  doi:10.6040/j.issn.1671-7554.0.2024.0606

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Objective To evaluate the clinical efficacy of the modified Hughes flap in repairing large full-thickness defects of the lower eyelid. Method A prospective study of 53 patients with large full-thickness defects in the lower eyelid was conducted. The patients were divided into a modified group of 25 patients and a control group of 28 patients according to the surgical method used. In the control group, the lower eyelid was repaired using an upper eyelid tarsus conjunctival flap pedicled with Muller muscle and the conjunctiva combined with a free skin graft. In the modified group, the lower eyelid was repaired using a full-thickness upper eyelid flap pedicled with the levator aponeurosis, Muller muscle and conjunctiva. The area of the lower eyelid defect, reconstruction time, time to pedicle division surgery and complication rates were evaluated. Results No significant difference in defect size was found between the control and the modified group(P>0.05). The reconstruction time of the lower eyelid in the modified group was shorter than that in the control group［(62.1±7.4)min vs.(88.1±8.5)min, P<0.001］. The average follow-up period after surgery was 17.5±9.3 months. The waiting time for second-stage surgery in the improvement group was shorter than that in the control group ［(11.2±3.0)days vs.(21.2±2.5)days, P<0.001］. The degree of lower eyelid retraction in the improved group was lower than that in the control group(Z=-3.176,P=0.001), whereas there was no statistically significant difference in the degree of upper eyelid retraction between the two groups(t=0.351, P=0.727). Two patients(7.1%)in the control group exhibited necrosis, and no instances of wound dehiscence, upper eyelid ptosis, entropion or eversion were observed. Conclusion The modified Hughes flap can effectively repair large full-thickness defects of the lower eyelid with a simple procedure and a short waiting time before pedicle division surgery.

Correlation between 3D craniofacial and upper airway structures and apnea hypopnea index in children

SHEN Wei, JIN Chenxi, LI Na, LI Xiaoxuan, GUO Jing

Journal of Shandong University (Health Sciences). 2025, 63(7):  44-53.  doi:10.6040/j.issn.1671-7554.0.2025.0618

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Objective To investigate craniofacial and upper airway anatomical characteristics in children using cone beam computed tomography(CBCT)and their association with apnea hypopnea index(AHI), aiming to identify key predictive indicators for assessing the severity of obstructive sleep apnea(OSA). Methods A total of 80 pediatric patients who visited the Department of Orthodontics at Ningbo Stomatological Hospital between June 2022 and June 2024 with chief complaints of malocclusion or mouth breathing were consecutively enrolled in the study. The sample included 53 boys and 27 girls with a mean age of 9.36 years. Portable home polysomnography was performed to obtain AHI values, followed by CBCT scans to measure adenoid-to-nasopharynx volume ratio(AV/NPV), maxillary and mandibular width and position, hyoid bone position, and upper airway dimensions. Hierarchical regression analysis was conducted to evaluate the independent predictive value of craniofacial and upper airway variables for AHI after controlling for sex, body mass index(BMI), and adenoid size. Results Spearman correlation analysis showed a significant positive correlation between AV/NPV and AHI(P<0.05). In contrast, mandibular ramus length(Ar-Go), maxillary width(Mx-Mx),mandibular width(Go-Go), minimum axial airway area(MAA), retronasal airway volume(V-RNA), retropalatal airway volume(V-RPA)and retrolingual airway volume(V-RLA)were negatively correlated with AHI(P<0.05). In the hierarchical regression analysis, sex and BMI were entered as control variables in Step 1, accounting for only 0.2% of the variance in AHI(R²=0.002), with the model being non-significant(F_(2,77)=0.067, P=0.935). In Step 2, the addition of AV/NPV significantly improved the model, with an increase in explained variance(ΔR²=0.179). AV/NPV was a significant positive predictor of AHI(β=0.441, P<0.001). In Step 3, CBCT-derived variables significantly associated with AHI were added to the model. This step further increased the explained variance(ΔR2=0.273). Among these, Mx-Mx(β=-0.207, P=0.041),Go-Go(β=-0.263, P=0.018)and MAA(β=-0.346, P<0.001)were identified as independent predictors of AHI. Conclusion Upper airway constriction, maxillary and mandibular deficiency serve as independent risk factors for pediatric OSA. These three-dimensional anatomical variables may provide a theoretical basis for early clinical identification of high-risk children.

Quantitative analysis of disc-condyle movement following arthroscopic disc repositioning operation for ADDWoR

JIN Chenxi, SHEN Wei, LI Na, SUN Jianfeng, YANG Chi, GUO Jing

Journal of Shandong University (Health Sciences). 2025, 63(7):  54-61.  doi:10.6040/j.issn.1671-7554.0.2025.0626

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Objective To assess the location of the disc and the movement characteristics of the disc-condyle following arthroscopic disc repositioning operation(ADRO)for the anterior disc displacement without reduction(ADDWoR). Methods A total of 108 patients were enrolled in Ningbo Stomatology Hospital during Jan. 2021 and Jun. 2024, who were with symptoms/signs of temporomandibular disorders(TMD), or protrusive mouth, mandibular retrusion or deviation as the main complaint. Magnetic resonance imaging(MRI)served as the gold standard for determining disc-condyle relationships. Through a four-step screening process, 31 patients(62 joints)without anterior disc displacement were classified as the normal group. Due to disc-condyle heterogeneity between ADDWoR and anterior disc displacement with reduction(ADDWR), 48 patients(83 ADDWoR joints)underwent an ADRO and comprised the surgical group. Assessments were performed preoperatively(group A₀)and at 1(group A_1M), 3(group A_3M), and 6(group A_6M)months postoperatively, measuring visual analogue scale(VAS)pain scores, disc-condyle angle, disc-condyle mobility, and coronal mesial-lateral displacement. Results (1)The VAS pain score in group A₀ was significantly higher than that in the normal group(P<0.001). The differences in VAS pain scores between the groups A₀, A_1M, A_3M, and A_6M were all statistically significant(P<0.05). (2) In the coronal view, disc displacement was rare in the normal group(lateral shift rate: 9.68%). The discs were invisible in the group A₀. At A_6M, the discs were visualized in 20/83 joints, with lateral shift in 6/20 joints. In the sagittal view, significant differences in the disc-condyle angle existed between the normal group and both the groups A₀/A_6M during closed-mouth and open-mouth positions. Significant differences in open-close movement were also found between the normal group and the groups A₀/A_6M(P<0.001). (3) In the coronal view, the number of visualized discs and laterally shifted discs increased progressively across the postoperative groups. Sagittally, the disc-condyle angle gradually increased over time, though the rate of increase decreased. Statistically significant differences were found in the median disc-condyle angle between group A₀ and groups A_1M, A_3M, and A_6M(P<0.05). The disc-condyle mobility progressively increased in all postoperative groups (P<0.05). (4) Spearman correlation analysis: closed-mouth disc mobility demonstrated a significant negative correlation with the surgical disc position(r_s=-0.486, P<0.001; r_s=-0.550, P<0.001). Conclusion ADRO significantly improved disc position(particularly sagittal reduction)and functional mobility in ADDWoR, concomitant with postoperative pain relief. A surgical disc position between 0° to -30° represents a favorable range for overcorrection to maximize postoperative disc-condyle mobility.

Mid-term efficacy of double-column mobile bearing unicompartmental knee prosthesis in treating anterior-medial knee osteoarthritis

MIAO Zhuang, LIU Peilai

Journal of Shandong University (Health Sciences). 2025, 63(7):  62-67.  doi:10.6040/j.issn.1671-7554.0.2025.0161

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Objective To investigate the mid-term efficacy of double-column mobile-bearing unicompartmental knee prosthesis in the treatment of anterior-medial knee osteoarthritis. Methods A prospective single-arm clinical trial was conducted. From December 2018 to June 2019, 30 patients with anterior-medial knee osteoarthritis undergoing unicompartmental knee arthroplasty using double-column mobile-bearing prosthesis were prospectively enrolled at Qilu Hospital of Shandong University. Follow-up assessments were performed preoperatively and at postoperative intervals: 7 days, 6 weeks, 3 months, 6 months, 1 year and 5 years. Evaluations included Hospital for Special Surgery(HSS)functional scores and radiographic outcomes. Results The HSS scores significantly improved from preoperative(68.03±10.34)to 1-year postoperative(90.52±4.57)and 5-year postoperative(92.03±5.45). Statistically significant differences were observed in total scores and each subscale scores between preoperative and both 1-year and 5-year postoperative timepoints(P<0.05), whereas no significant differences existed between 1-year and 5-year scores(P>0.05). Radiographic assessments demonstrated effective correction of knee varus deformity with satisfactory prosthesis alignment. No severe complications occurred, including bearing dislocation or prosthesis loosening. Conclusion Unicompartmental knee arthroplasty with double-column mobile-bearing prosthesis shows favorable mid-term outcomes for anterior-medial knee osteoarthritis, demonstrating reliable prosthesis safety and efficacy.

Application value of serum STAT5B and NKAIN1 mRNA detection in breast cancer

LIU Baoguo, SONG Xiang, ZHAO Xiaowen, MAO Yali

Journal of Shandong University (Health Sciences). 2025, 63(7):  68-74.  doi:10.6040/j.issn.1671-7554.0.2025.0015

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Objective To explore the value of combined detection of serum signal transducer and activator of transcription 5b(STAT5B)and NKAIN1 mRNA in the diagnosis, differentiation and prognosis evaluation of breast cancer(BC). Methods Eighty patients with pathologically confirmed BC admitted to Liaocheng Peoples Hospital from, 2020 to June 1, 2021 were selected as the BC group, of which 22 cases were in the low-differentiation group, June 1, 25 cases were in the middle-differentiation group, and 33 cases were in the high-differentiation group. The 80 patients with benign breast lesions were the control group. Serum STAT5B mRNA and NKAIN1 mRNA levels were detected by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR). All BC patients were discharged from the hospital for a 3-year follow-up, with 24 cases in the poor prognosis group(local recurrence, distant metastasis, and death)and 56 cases in the good prognosis group. ROC curves were used to analyze the clinical value of the combined detection of serum STAT5B mRNA and NKAIN1 mRNA in the diagnosis of BC as well as in prognostic assessment. SPSS 22.0 software was used for statistical analysis of data. Results Compared with the control group, patients in the BC group had significantly higher levels of estradiol, testosterone, and low-density lipoprotein cholesterol(LDL-C)(P<0.05), and significantly higher levels of STAT5B mRNA and NKAIN1 mRNA in serum(P<0.05). Compared with the low-differentiation group, the serum levels of STAT5B mRNA and NKAIN1 mRNA were significantly lower in the middle-differentiation group and the high-differentiation group patients in that order(P<0.05). The serum levels of STAT5B mRNA and NKAIN1 mRNA were significantly higher in patients in the poor prognosis group compared with those in the good prognosis group(P<0.05). The ROC results showed that the AUC of serum STAT5B mRNA and NKAIN1 mRNA combined to diagnose BC was higher than that of STAT5B mRNA(Z=3.015, P=0.003), NKAIN1 mRNA(Z=2.919, P=0.004)AUC for diagnosis alone. Serum STAT5B mRNA, NKAIN1 mRNA combined predicted prognosis of BC patients with higher AUC than STAT5B mRNA(Z=4.305, P<0.001), NKAIN1 mRNA(Z=3.307, P=0.001)AUC predicted alone. Conclusion The application of serum STAT5B and NKAIN1 mRNA can improve the sensitivity of BC diagnosis and predict the prognosis of BC more accurately, which is important for the diagnosis and prognosis evaluation of BC.

Potentially inappropriate medication of patients with multiple chronic diseases in rural areas of Shandong Province

ZHANG Mingyu, GAO Shijuan, PAN Dongjie, WANG Chunxia, WANG Haipeng, LI Hui

Journal of Shandong University (Health Sciences). 2025, 63(7):  75-81.  doi:10.6040/j.issn.1671-7554.0.2024.1233

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Objective To explore the current status and influencing factors of polypharmacy and potentially inappropriate medication(PIM)among patients with multimorbidity in rural areas, and to compare the differences and applicability of the 2023 Beers Criteria(hereinafter referred to as the "Beers Criteria")and the Chinese Criteria for Potentially Inappropriate Medications in Older Adults(2017 Edition)(hereinafter referred to as the "Chinese Criteria")in PIM evaluation, with the aim of providing evidence for reducing PIM incidence in this population. Methods A multi-stage random sampling method was used to select 531 multimorbid patients from 16 villages in Shandong Province. Medication use was investigated via questionnaire surveys, and PIM was assessed using both the Beers Criteria and the Chinese Criteria. Multivariate Logistic regression was performed to identify risk factors for PIM, and the Kappa test was employed to evaluate consistency between the two criteria. Results According to the Beers Criteria, 390 patients had PIM, while the Chinese Criteria identified 312 cases. Both criteria highlighted high-risk medications such as reserpine, aspirin, and nifedipine. Multivariate Logistic regression revealed that gender and the number of medications were significant influencing factors for PIM(P<0.05). The consistency coefficient(Kappa)between the two criteria was 0.179; however, after incorporating reserpine into the Beers Criteria, the consistency improved to 0.369. Conclusion PIM is prevalent among rural patients with multimorbidity in Shandong Province. We recommend combining both criteria in clinical practice to enhance PIM detection accuracy and establishing a systematic PIM identification framework for traditional Chinese patent medicines.

Status and influencing factors of health check-up services utilisation among middle-aged and elderly populations with hyperglycaemia, dyslipidaemia, and hypertension in China

WANG Ning, HAO Xiumei, NIU Xiang, HUANG Jinming, XU Jingya

Journal of Shandong University (Health Sciences). 2025, 63(7):  82-91.  doi:10.6040/j.issn.1671-7554.0.2025.0116

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Objective By exploring the current situation of the utilisation of health check-up services and its influencing factors among middle-aged and elderly populations with hyperglycaemia, dyslipidaemia and hypertension in China, to provide evidence to optimise the strategy of “co-management of hyperglycaemia, dyslipidaemia and hypertension”, and reform the health service system. Methods According to the fifth round of national survey data conducted by China Health and Retirement Longitudinal Study(CHARLS)in 2020, a total of 8,227 middle-aged and elderly individuals with hyperglycaemia, dyslipidaemia, and hypertension were selected as the study populations. The analysis of the utilisation of health check-up services among these populations was conducted utilising the chi-square test and multivariate logistic regression based on the Anderson model framework. Results Among middle-aged and elderly individuals with hyperglycaemia, dyslipidaemia, and hypertension, utilisation rate of health check-up was 54.13%. The results of multivariate logistic regression analysis showed that: age(≥65 years old: OR=2.024, 95%CI=1.831-2.236, P<0.001), education level(senior high school and above: OR=1.303, 95%CI=1.123-1.511, P<0.001), personal income(have: OR=1.440, 95%CI=1.285-1.614, P<0.001), type of endowment insurance(enterprise employee endowment insurance: OR=0.655, 95%CI=0.516-0.833, P<0.001; urban resident/urban and rural resident endowment insurance: OR=0.633, 95%CI=0.493-0.813, P<0.001; new rural social endowment insurance: OR=0.602, 95%CI=0.466-0.778, P<0.001; other endowment insurance: OR=0.549, 95%CI=0.390-0.772, P<0.001; no endowment insurance: OR=0.473, 95%CI=0.361-0.619, P<0.001), type of medical insurance(new rural cooperative medical insurance/ other medical insurance/ no medical insurance: OR=0.834, 95%CI=0.726-0.959, P=0.011), depression status(yes:OR=0.885, 95%CI=0.804-0.975, P=0.014), number of chronic diseases(2 types: OR=1.158, 95%CI=1.004-1.337, P=0.045; 3 types: OR=1.273,95%CI=1.099-1.475, P=0.001; ≥4 types: OR=1.282, 95%CI=1.117-1.472, P<0.001), social contacts(yes:OR=1.396, 95%CI=1.274-1.530, P<0.001), utilization of inpatient services(yes/demand: OR=1.207, 95%CI:1.080-1.348, P<0.001), alcohol consumption(OR=1.127, 95%CI=1.019-1.246, P=0.020), and smoking behavior(OR=0.761, 95%CI=0.681-0.849, P<0.001)were the primary factors influencing the utilisation of health check-up services. Conclusion The utilization rate of health check-up services among middle-aged and elderly individuals with hyperglycaemia, dyslipidaemia, and hypertension in China requires improvement. It is recommended to implement flexible health check-up subsidies for individuals aged 45-64 years, promote reimbursement of health check-up fees through health insurance, and alleviate the financial burden on impoverished populations. Furthermore, the integration of medical care and prevention should be strengthened, with innovative technologies employed to simplify health check-up processes. The enhancement of policies pertaining to the prevention and control of chronic diseases, in conjunction with health education, is of paramount importance in enhancing residents health literacy and adherence to health management. The development of targeted intervention programmes is imperative for individuals with low income, low educational attainment, and depression status, with the objective of promoting the prevention and management of chronic diseases at an earlier stage and facilitating healthy ageing.

Association between long-term mixed air pollution exposure and the risk of drug-resistant tuberculosis based on three statistical models

WANG Ying, LI Huaichen, LONG Fei, LIU Yi

Journal of Shandong University (Health Sciences). 2025, 63(7):  92-101.  doi:10.6040/j.issn.1671-7554.0.2024.1389

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Objective To study the effects of long-term mixed exposure to five common air pollutants(PM₁₀, PM_2.5, SO₂, NO₂, and O₃)on the incidence of drug-resistant tuberculosis(DR-TB), and to provide a basis for the prevention and treatment of DR-TB. Methods Laboratory test results, clinical indicators and sociodemographic information of 3,369 patients who were first diagnosed DR-TB patients in Shandong Province from 2015 to 2019 were collected. Patients were monitored for exposure to air pollutants during four exposure windows(90, 180, 270 and 360 days before diagnosis). The Logistic regression(LR)model was used to evaluate the impact of a single pollutant. Weighted quantile sum(WQS)and Bayesian kernel machine regression(BKMR)models were applied to examine the joint effects of pollutants, with the BKMR model was used to study the concentration-response(C-R)relationship between pollutants and the risk of DR-TB, as well as the interactions between pollutants. Results The results of LR model showed that the increase of O₃ concentration was associated with the increased risk of IR-TB during the 90 days exposure window(OR=1.008,P=0.02). The results of WQS and BKMR models showed that the mixed exposure to air pollutants reduced the risk of IR-TB and MDR-TB(β2=0.75, P=0.01). The results of the BKMR model showed that NO₂ reduced the risk of IR-TB(90 days: β=-0.12, 95%CI: -0.22~-0.02; 360 days: β=-0.10, 95%CI: -0.19~-0.01)and MDR-TB(90 days: β=-0.10, 95%CI: -0.19~-0.01; 360 days: β=-0.13, 95%CI: -0.22~-0.04), and the association was statistically significant(P<0.05). In addition, the model also showed a non-linear relationship between NO₂ and the risk of DR-TB, as well as interactions with other pollutants under mixed exposure conditions. Conclusion High levels of O₃ exposure can increase the risk of IR-TB; long-term exposure to mixed air pollutants was not associated with the risk of DR-TB. Long-term exposure to mixed air pollutants is not associated with the risk of DR-TB.

Epidemiological and genotyping characteristics of human rhinovirus among influenza-like illness in children in Jinan from March 2019 to February 2024

DING Xiaoman, LYU Yan, SUN Jiawen, ZHAO Baotian, QI Na, JIAO Haitao

Journal of Shandong University (Health Sciences). 2025, 63(7):  102-108.  doi:10.6040/j.issn.1671-7554.0.2024.1011

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Objective To investigate the prevalence characters and genotypes of human rhinovirus(HRV)among influenza-like illness(ILI)in children in Jinan from March 2019 to February 2024, and to provide prevention and control strategies for HRV infection in children. Methods The nasopharyngeal swab samples from ILI in children aged 0 to 14 years were collected weekly in a childrens hospital in Jinan. Multi-pathogen nucleic acid detection was conducted by real-time fluorescence quantitative polymerase chain reaction(RT-PCR). Some nucleic acid positive samples of HRV were used in amplification and sequencing of the VP4/VP2 gene segments. A phylogenetic tree was constructed and homology analysis was performed. Results Respiratory pathogens were positive in 645 of 1,200 specimens, accounting for 53.75%. HRV had the 2nd highest detection rate after influenza virus at 7.67%(92/1,200), of which the positive rates of male and female cases were 8.02%(57/711)and 7.16%(35/489), respectively, with no statistically significant difference(χ2=0.001,P>0.05). The age distribution of the preschool(3 to <6 years old)age group was the highest(8.90%), and the difference in the positive rates of various age groups was not statistically significant(χ2=1.92,P>0.05). The positive rates of HRV in different monitoring years and seasons were statistically significant(χ2=18.67,P=0.001; χ2=35.88,P<0.001). The VP4/VP2 region sequences of the 28 HRV strains were compared with the reference strain and analyzed, and two genotypes(including 21 serotypes)were involved, with HRV A group as the main group, followed by HRV C group, and HRV B group genotypes were not detected. Conclusion From March 2019 to February 2024, the HRV positivity rate among children with ILI in Jinan City was similar in age distribution and different in seasonal distribution. The prevalence of HRV was only briefly suppressed and then rapidly rebounded. In addition, HRV A was predominant, followed by HRV C and multiple serotypes were involved in Jinan during this period.

The relationship between perceived supervisory social support types with work engagement among clinical nursing teachers based on latent profile analysis

SUN Xiangjie, YIN Haiyan, LIU Chunlan, ZHAO Fenge

Journal of Shandong University (Health Sciences). 2025, 63(7):  109-115.  doi:10.6040/j.issn.1671-7554.0.2024.1404

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Objective To provide a theoretical basis for optimizing their work engagement by exploring the latent profiles and characteristics of perceived supervisory social support among clinical nursing teachers, and analysising the relationship between different profiles of perceived supervisory social support with work engagement. Methods Convenience sampling method was used to select clinical nursing teachers from five tertiary teaching hospitals in Shandong Province as participants. General information questionnaire, the Perceived Supervisory Social Support Scale, and the Work Engagement Scale were used to conduct the survey. Latent profile analysis was employed to identify potential profile of clinical nursing teachers perceived supervisory social support. One way ANOVA and multifactor linear regression were applied to examine the relationship between these profiles and work engagement. Results Among 421 clinical nursing teachers surveyed, 406 valid questionnaires were collected. Latent profile analysis revealed 3 profiles of perceived supervisory social support: supervisor-low support group(26%), partner-moderate support group(39%)and coach-high support group(35%). Three profiles scores of work engagement were ranked as follows: coach-high support group>partner-moderate support group > supervisor-low support group. Different profiles were predictors of work engagement(P<0.05). Conclusion Clinical nursing teachers exhibit heterogeneity in perceived supervisory social support, with the supervisor-low support group demonstrating the lowest work engagement, which should be emphasized.

Research on the optimization of the “Sports-medicine-nursing care integration” policy in Shandong Province from the perspective of policy tools

HAN Shuang, TIAN Xiaowei, ZHANG Xinyu, KONG Yang

Journal of Shandong University (Health Sciences). 2025, 63(7):  116-124.  doi:10.6040/j.issn.1671-7554.0.2024.1340

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Objective To provide feasible suggestions for the “Sports-medicine-nursing care integration” policy optimization by analyzing the characteristics and deficiencies of the content of policy texts. Methods A two-dimensional analysis framework was constructed based on policy tools and implementing entities. Content analysis was used to analyze 19 policy documents by univariate quantification and bivariate cross Analysis, and expert scoring was conducted. The sequence diagram method was employed to rank the value contribution of implementing entities, and the results were compared with the two-dimensional cross-analysis. Results The analysis from the dimension of the policy tools showed that environmental tools accounted for 50.17%, supply-side tools for 36.88%, and demand-side tools for 12.94%; the analysis from the dimension of implementing entities indicated that government involvement made up 31.27%, medical-care entities 23.40%, social entities 19.91%, sports entities 16.87%, and educational entities 8.55%; the ranking of the importance of the value contribution of implementing subjects was: medical-care entities > sports entities > government entities > social entities > educational entities, with the weight proportions being 30%, 29%, 21%, 13% and 7%, respectively. By comparing with the results of the two-dimensional cross-analysis, it could be seen that the correlation between the government entities, medical-care entities, and social entities and policy tools was relatively good, while the correlation between sports entities and educational entities and policy tools was poor, especially for sports entities. Conclusion The current policies exhibit imbalances in policy tool usage, uneven distribution of implementing entities, and poor interaction between policy tools and entities. This suggests the necessity of optimizing the institutional framework for policy instrument application and fortifying the linkage mechanisms between heterogeneous actors, in order to drive the high-quality evolution of the “Sports-medicine-nursing care integration” model.