Journal of Shandong University (Health Sciences)

In vivo anti-aging effect of poria cocos three active ingredients on caenorhabditis elegans

YU Yunan, WANG Ping, DAI Junyi, LIU Junfeng, ZAN Junfeng

Journal of Shandong University (Health Sciences). 2025, 63(6): 1-10. doi:10.6040/j.issn.1671-7554.0.2024.1116

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Objective To explore the anti-aging potential of Poria cocos by investigating the effects of its three active ingredients on the life-span and stress ability in Caenorhabditis elegans(C. elegans) and potential mechanisms. Methods Water-soluble polysaccharides, acidic polysaccharides, and triterpenes were extracted from Poria cocos using a solvent extraction method. The effects of these three active ingredients on the lifespan, stress resistance, reproduction ability, and locomotion of C. elegans, as well as their impact on the levels of ROS and lipofuscin, were evaluated. The expression of aging-related genes was determined using qRT-PCR. Results Compared with the control group, water-soluble polysaccharides at 500 μg/mL, acidic polysaccharides at 62.5 μg/mL, and triterpenes from Poria cocos at 500 μg/mL prolonged the lifespan of C. elegans by 12.72%, 15.07% and 12.55%, and enhanced the antioxidant stress resistance(P<0.05), respectively. Acidic polysaccharides and triterpenes increased their survival rates under heat stress and ultraviolet stress and reduced the levels of ROS in the C. elegans, with statistically significant differences(P<0.05). Meanwhile, these three active ingredients significantly reduced lipofuscin levels in C. elegans(P<0.05), and did not affect the egg-laying capacity and motility(P>0.05). The three active ingredients from Poria cocos upregulated the expression of daf-16 and ctl-2 mRNA, while downregulating the expression of daf-2 and age-1 mRNA, thereby extending the lifespan of C. elegans. Conclusion The three active ingredients of Poria cocos exhibited antioxidant and anti-aging effects in C. elegans. The mechanism may be related to regulating the expression of aging-related genes in the insulin/IGF-like signaling pathway.

Comparison of osteogenic induction methods for human valve interstitial cells in vitro

XING Kai, ZHENG Qiang, SUN Jinshu, LIU Xiaolin, WANG Zhengjun

Journal of Shandong University (Health Sciences). 2025, 63(6): 11-18. doi:10.6040/j.issn.1671-7554.0.2024.0701

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Objective To explore the effects of different osteogenic induction methods on the osteogenic differentiation and calcification of human valvular interstitial cells(hVICs). Methods Five commonly used in vitro osteogenic induction methods for valvular interstitial cells were selected from the literature: (1) 2 mmol/L inorganic phosphate+50 μg/mL vitamin C(2 mmol/L Pi + VC); (2) 2.6 mmol/L inorganic phosphate(2.6 mmol/L Pi); (3) 2.5 mmol/L inorganic phosphate+2.7 mmol/L calcium chloride+50 μg/mL vitamin C(2.5 mmol/L Pi + Ca + VC); (4) 10 mmol/L β-glycerophosphate+10 nmol/L dexamethasone+8 mmol/L calcium chloride+4 μg/mL vitamin D3(β-GP+DXM+Ca+VD3); (5) 10 mmol/L β-glycerophosphate+10 nmol/L dexamethasone+50 μg/mL vitamin C(β-GP+DXM+VC). Alizarin red staining, RT-qPCR and Western blotting were used to assess calcium deposition and the expression of osteogenic markers, respectively. Results By comparing the calcium deposition areas on day 4, 7, 10, and 14 induced by five different induction methods, it was found that there was almost no calcification within the first 10 days with 2 mmol/L Pi+VC, β-GP+DXM+Ca+VD3, and β-GP+DXM+VC. In contrast, significant calcification appeared on day 7 with 2.6 mmol/L Pi, 2.5 mmol/L Pi+Ca+VC showed significant calcification on day 4 and almost all calcification on day 7. On day 14, except for the relatively low calcification with 2 mmol/L Pi+VC, all other methods showed significant calcification. Osteogenic marker detection indicated that alkaline phosphatase was significantly upregulated on day 7 with 2 mmol/L Pi+VC, 2.6 mmol/L Pi, and β-GP+DXM+VC(P<0.05), while osteopontin showed significant upregulation on day 7 in all methods(P<0.001). Subsequently, calcium induction was performed with pairwise combinations of the three components in 2.5 mmol/L Pi+Ca+VC. It was found that the calcium deposition areas were significantly larger with Pi+Ca and Pi+Ca+VC on day 7 compared to Pi+VC and Ca+VC, but ALP expression was significantly lower in Pi+Ca and Pi+Ca+VC, suggesting that this calcium deposition might be due to the reaction between inorganic phosphate and calcium chloride forming calcium phosphate precipitates. Conclusion The optimal effect of inducing osteogenic differentiation in hVICs was achieved with 2.6 mmol/L Pi and β-GP+DXM+VC.

Efficacy and mechanism of ginkgo leaf tablets combined with trimetazidine in the treatment of elderly patients with chronic heart failure

JIA Kui, LI Zhiguo, CHENG Cuiting, LI Zhijuan, LIU Ruiqing

Journal of Shandong University (Health Sciences). 2025, 63(6): 19-26. doi:10.6040/j.issn.1671-7554.0.2024.1088

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Objective To investigate the clinical efficacy of ginkgo leaf tablets combined with trimetazidine in the treatment of elderly patients with chronic heart failure(CHF)and its impact on the mRNA expression of transforming growth factor-β1(TGF-β1)/Smad3 signaling pathway molecules in peripheral blood mononuclear cells(PBMCs). Methods Ninety-six elderly patients with CHF were selected from January 2021 to October 2023 and randomly assigned to a combination group, a trimetazidine group, and a ginkgo leaf tablet group, with 32 patients in each group. The clinical efficacy, cardiac function indicators(including cardiac index, left ventricular ejection fraction, left ventri-cular end-systolic diameter, and left ventricular end-diastolic diameter), levels of heart failure-related biomarkers(amino-terminal pro-B-type natriuretic peptide, soluble stromal derived factor 2, angiotensin II), and mRNA relative expression levels of key molecules in the TGF-β1/Smad3 pathway(TGF-β1, Smad2, Smad3, Smad7)in PBMCs were compared among the three groups, and the occurrence of adverse reactions was recorded. Results The cardiac index and left ventricular ejection fraction in the combination group were higher than those in the trimetazidine group and ginkgo leaf tablet group, and the trimetazidine group had higher values than the ginkgo leaf tablet group, with statistically significant differences(P<0.05). The left ventricular end-systolic diameter and left ventricular end-diastolic diameter in the combination group were lower than those in the trimetazidine group and ginkgo leaf tablet group, and the trimetazidine group had lower values than the ginkgo leaf tablet group, with statistically significant differences(P<0.05). The levels of amino-terminal pro-brain natriuretic peptide, soluble stromal derived factor 2, and angiotensin II in the combination group were lower than those in the trimetazidine group and ginkgo leaf tablet group, and the trimetazidine group had lower values than the ginkgo leaf tablet group, with statistically significant differences(P<0.05). The relative mRNA expression levels of TGF-β1, Smad2, and Smad3 in PBMCs from the combination group were lower than those in the trimetazidine group and ginkgo leaf tablet group; the relative mRNA expression level of Smad7 was higher than that in the trimetazidine group and ginkgo leaf tablet group, with statistically significant differences(P<0.05). There was no statistically significant difference in the incidence of adverse reactions among the three groups(P>0.05). Conclusions The combination of Ginkgo leaf tablets and trimetazidine can significantly improve cardiac function and alleviate myocardial damage in elderly patients with CHF. The mechanism is related to the inhibition of the TGF-β1/Smad3 signaling pathway, providing a new strategy for the integrated traditional Chinese and Western medicine treatment of CHF.

Effect of herpesvirus infection on clinical prognosis and respiratory microbiota in patients with severe pneumonia

GE Xue, ZHAO Hongyan

Journal of Shandong University (Health Sciences). 2025, 63(6): 27-37. doi:10.6040/j.issn.1671-7554.0.2024.1059

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Objective To investigate the effect of herpesvirus infection on the clinical prognosis and the microbiota of the lower respiratory tract in patients with severe pneumonia. Methods According to the results of metagenomic next-generation sequencing(mNGS), 114 patients with severe pneumonia hospitalized in ICU were divided into herpesvirus-positive group and herpesvirus-negative group. The basic demographic and clinical characteristics were collected. Differences between the two sets of information were compared using the independent samples t test, Mann-Whitney U test, and χ2 test. Cox regression model was used to analyze the factors affecting prognosis. Kaplan-Meier method was used to conduct the survival analysis, and the Log-Rank test was applied to compare survival curves. Histograms and heat maps were generated to illustrate the differences in the lower respiratory tract microbiota between the two groups. Results The acute physiololgy and chronic health evaluation(APACHE II)score of the herpesvirus-positive group was higher than that of the negative group, and the difference was statistically significant(Z=-2.260, P=0.024). There were no significant differences in other clinical characteristics. Herpesvirus infection was an independent risk factor affecting the clinical prognosis of patients with severe pneumonia. The 30-day mortality rate of the herpesvirus-positive group was higher than that of the herpesvirus-negative group(44.64 % vs. 27.57 %, χ2=4.040, P=0.044), with a statistically significant difference. The 30-day mortality rate of herpes simplex virus-1(HSV-1),Epstein-Barr virus(EBV)and cytomegalovirus(CMV)positive groups were higher than that of the corresponding herpesvirus-negative groups, with a statistically significant difference(χ2=3.982, P=0.046; χ2=4.991, P=0.025; χ2=6.791, P=0.009). There were observable differences in the distribution of microbial flora between the herpesvirus-positive and herpesvirus-negative groups, with a distinct predominance of certain species in each group. The herpesvirus-positive group showed a higher likelihood of co-occurrence with pathogens such as Corynebacterium striatum, Legionella pneumophila, Aspergillus and Pneumocystis japonicus. Conclusion Herpesvirus infection is an independent risk factor for the clinical prognosis of patients with severe pneumonia, and is closely associated with the 30-day mortality of patients with severe pneumonia, particularly the presence of HSV-1, EBV, and CMV, which correlate with increased 30-day mortality rates. Furthermore, patients with severe pneumonia who were positive for herpesviruses tend to have a higher presence of conditional pathogenic bacteria in their respiratory tracts, suggesting that herpesviruses may influence disease prognosis by altering the microbiota.

Analysis of the characteristics of bronchial dilation test in children with FeNO elevation during asthma exacerbation

CAO Luofei, WANG Shanshan, WANG Jinrong, JIANG Heyun, MIAO Yu, MA Guangzeng

Journal of Shandong University (Health Sciences). 2025, 63(6): 38-44. doi:10.6040/j.issn.1671-7554.0.2025.0347

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Objective To analyze the improvement of pulmonary function indices after the bronchial dilation test(BDT)in children with asthma at different levels of fractional concentration of exhaled nitric oxide(FeNO). Methods This study included children with asthma exacerbation aged 5-12 who visited the Pediatric Respiratory Clinic of Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2022 to December 2023. They were divided into the normal FeNO group and the high FeNO group based on their fractional concentration of FeNO results. Then the pulmonary function indices between the two groups of children were compared, as well as the improvement rate of pulmonary function indices after BDT, and the correlation between FeNO and pulmonary function indices and their improvement rate was analyzed. Results A total of 268 children with asthma exacerbations were included, of whom 211(78.74%)had elevated FeNO. The median values of forced expiratory volume in one second(FEV₁), forced expiratory volume in one second to forced vital capacity ratio(FEV₁/FVC), peak expiratory flow(PEF), forced expiratory flow at 50% vital capacity(FEF₅₀), forced expiratory flow at 75% vital capacity(FEF₇₅)and maximum midexpiratory flow(MMEF)were not significantly different between the two groups(P>0.05). The median improvement rates of FEV₁, FEF₅₀ and MMEF in the high FeNO group were higher than those in the normal FeNO group(P<0.05). The proportion of children with positive FEF₅₀, FEF₇₅, and MMEF improvement rates in the high FeNO group was significantly higher than that in the normal FeNO group(P<0.05). FeNO was weakly negatively correlated with FEV₁, FEV₁/FVC(P<0.05); FeNO was positively correlated with FEV1, PEF, FEF₅₀ and MMEF improvement rate after BDT(P< 0.05). Conclusion Most children with asthma during the exacerbation period have elevated levels of FeNO, indicating that type II inflammation is the main cause of childhood asthma exacerbation. The improvement of BDT in children with exacerbation of asthma with elevated FeNO is significantly increased, especially characterized by the improvement of small airway function. FeNO is positively correlated with bronchial dilation test improvement rates in FEV₁, FEF₅₀, and MMEF.

Predictive value of intratumoral and peritumoral DCE-MRI imaging histology for progression-free survival in patients with cervical cancer

WANG Lei, CHANG Xiao, WANG Zimeng, LI Jiaojiao, CUI Shujun, YANG Fei, ZHU Yuexiang

Journal of Shandong University (Health Sciences). 2025, 63(6): 45-54. doi:10.6040/j.issn.1671-7554.0.2024.0958

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Objective To explore the predictive value of intratumoral and peritumoral radiomics in different ranges for progression-free survival(PFS)in patients with locally advanced cervical cancer undergoing concurrent chemotherapy(CCRT). Methods A total of 135 patients with cervical cancer were retrospectively selected, including 32 patients with progression and 103 patients without progression. They were divided into the training set and the validation set in a 7∶ 3 ratio. On the basis of the second phase images of dynanic contrast-enhanced magnetic resonance imaging(DCE-MRI), three-dimensional volume of interest(VOI)delimitations were performed in the 3, 5, and 7 mm areas within and around the tumor. Radiomics features were extracted and dimensionally reduced, respectively. The selected characteristics were used to construct combined intratumoral, peritumoral, and intratumoral-peritumoral radiomic models to compare predictive efficacy. Clinical models were constructed by retaining statistically significant clinical characteristics. A comprehensive model was jointly established based on the best radiomic features of area under curve(AUC)and the screened clinical features. The predictive ability of the model was evaluated using AUC and the consistency index(C-index). The models with the highest AUC and C-index values were used to evaluate the calibration curve, decision curve analysis(DCA)and Kaplan-Meier survival curve. Results The intratumoral + 5 mm peritumoral model showed better predictive efficacy than other radiomic models, with an AUC of 0.852, Compared to the clinical and radiomic models, the comprehensive model showed the best predictive efficacy, with AUCs of 0.766, 0.852, and 0.872, respectively. Through the calibration curve and DCA analysis, the comprehensive model had a high degree of calibration and a large clinical net benefit. The Kaplan-Meier survival curve could distinguish between high-risk patients and low-risk patients with disease progression. Conclusion The combined intratumoral and peritumoral radiomic characteristics based on DCE-MRI can be used as an effective indicator for evaluating PFS in patients with locally advanced cervical cancer undergoing CCRT. Among them, the intratumoral + 5 mm peritumoral model shows higher predictive ability, and the comprehensive model incorporating clinical parameters has better efficacy.

Development and validation of a postpartum stress urinary incontinence risk prediction model based on machine learning

WANG Liyun, GAO Tianqin, LIU Yujia, CHEN Qing, CHEN Liu, SHA Kaihui

Journal of Shandong University (Health Sciences). 2025, 63(6): 55-66. doi:10.6040/j.issn.1671-7554.0.2024.1431

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Objective To develop risk prediction models for postpartum stress urinary incontinence(PPSUI)using five machine learning algorithms based on the latest PPSUI definition, identify the optimal model, and evaluate its clinical applicability. Methods This study adopted a prospective design and included 1,208 postpartum women. Data were collected from questionnaires and electronic medical records, and the dataset was randomly divided into a training set and a test set in an 8∶2 ratio. Feature selection was performed using univariate analysis and the random forest algorithm. Five PPSUI prediction models were developed based on Logistic regression, decision tree, random forest, support vector machine, and extreme gradient boosting(XGBoost), with hyperparameter optimization conducted through grid search. Model training and validation were performed using the bootstrap method and ten-fold cross-validation to enhance stability and generalizability. The models were comprehensively evaluated in terms of classification performance, clinical applicability, and predictive reliability to identify the optimal prediction model. Results XGBoost was identified as the optimal prediction model, achieving the highest AUC in the test set(AUC=0.993, 95%CI: 0.985-0.998, P<0.01). Decision curve analysis showed that XGBoost provided the highest net benefit within the intermediate threshold range, while the calibration curve was closest to the ideal state, indicating superior predictive reliability and significant clinical applicability. Conclusion XGBoost is suitable for early screening and risk assessment of high-risk PPSUI populations, providing a scientific basis for precision medicine and postpartum health management.

Causal association of antidiabetic drugs with female malignant tumours: a two-sample Mendelian randomisation study

WANG Xuemei, YANG Hao, SONG Yang, CHENG Shichao, ZHANG Tingting, WANG Yanchun

Journal of Shandong University (Health Sciences). 2025, 63(6): 67-77. doi:10.6040/j.issn.1671-7554.0.2024.1155

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Objective To investigate the causal associations between antidiabetic medications(exogenous insulin, metformin, rosiglitazone, and gliclazide)and the risk of malignant tumours in women using Mendelian randomisation. Methods Summary-level data from genome-wide association studies(GWAS)in the IEU OpenGWAS project were analyzed. Exposures included four antidiabetic drugs(insulin, metformin, rosiglitazone, and gliclazide), with female malignant tumours as the outcome. Two-sample Mendelian randomisation analyses were conducted using inverse variance weighting(IVW, primary method), MR-Egger regression, and weighted median approaches. Heterogeneity was assessed via IVW and MR-Egger, pleiotropy was evaluated using MR-Egger intercepts, and leave-one-out sensitivity analysis tested result robustness. Results This study showed a positive causal association between insulin treatment and the risk of ovarian cancer(OR=1.08,95%CI: 1.03-1.14; P=0.004), a negative causal association with the risk of cervical cancer(OR=6.14×10^-11,95%CI: 2.00×10^-19-1.88×10^-2; P=0.018), endometrial cancer(OR=1.86×10^-3,95%CI: 6.47×10^-6-0.533; P=0.029), breast cancer(OR=4.83×10^-4;95%CI: 2.02×10^-6-0.116; P=0.006), and HER(+)breast cancer subtype(OR=2.4×10^-4;95%CI: 1.64×10^-7-0.351; P=0.025), and a negative causal association between metformin treatment and human epidermal growth factor receptor(HER)(+)breast cancer subtypes(OR=2.14×10^-2;95%CI: 1.36×10^-3-0.337; P=0.006). No horizontal pleiotropy was found in any of the above studies. Conclusion Exogenous insulin increases ovarian cancer risk but reduces risks of cervical, endometrial, breast, and HER(+)breast cancers. Metformin lowers HER+ breast cancer risk.

Value of a combined model based on ATM gene methylation of peripheral blood mononuclear cells in the early diagnosis of pancreatic cancer

ZHU Yongcai, XIE Yan, QI Qiuchen, LI Peilong, WANG Chuanxin, DU Lutao

Journal of Shandong University (Health Sciences). 2025, 63(6): 78-88. doi:10.6040/j.issn.1671-7554.0.2024.1427

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Objective To provide a new approach for the early diagnosis of pancreatic cancer by establishing and validating a combined diagnostic model for pancreatic cancer based on the methylation of the ataxia telangiectasia mutated(ATM)gene and clinical test indicators using the random forest algorithm. Methods Retrospectively, 118 specimens of peripheral blood mononuclear cells(PBMCs)from pancreatic cancer patients(pancreatic cancer group)and 73 specimens from healthy controls(healthy control group)were collected and their clinical test results were recorded. They were divided into discovery set, training set and validation set. In the discovery set, 935K methylation chip was used to analyze the differentially methylated points(DMPs)of PBMCs samples from both groups. In the training set and validation set samples, pyrosequencing was used to validate the candidate DMPs. In the training set, random forest algorithm was used for variable selection and to construct a combined diagnostic model. The diagnostic efficacy of the model in pancreatic cancer at different stages and in patients with negative carbohydrate antigen 19-9(CA19-9)was evaluated in the validation set using the receiver operating characteristic(ROC)curve. Results The results of the DNA methylation beadchip indicated that, with the screening condition of |Δβ|≥0.1 and P<0.01, 132 differentially methylated points(DMPs)were obtained. Among them, the methylation level of the ATM gene DMPs in PBMCs of the pancreatic cancer group was significantly higher than that of the healthy control group, and it could distinguish the pancreatic cancer group from the healthy control group(AUC=0.871, P<0.001). The pyrosequencing results further indicated that the ATM gene DMPs in PBMCs of the pancreatic cancer group was in a high-methylation level. Based on the variable selection of the random forest algorithm, three variables, ATM gene DMP, CA19-9, and albumin(ALB), were obtained. In the training set and validation set, the expression level of CA19-9 was significantly increased in the pancreatic cancer group(P<0.001), and the expression level of ALB was significantly decreased(P<0.001). Using the expression levels of the above three variables as features, the combined diagnostic model("AmCA")constructed by random forest in the training set had an AUC of 0.992(95%CI: 0.952-1.000)for pancreatic cancer diagnosis. The AUC of the model in the validation set was 0.982(95%CI: 0.895-1.000), which was superior to the AUC value of CA19-9 alone(0.840, 95%CI: 0.705-0.930); the model had good diagnostic efficacy for early-stage pancreatic cancer, with AUC values of 1.000(95%CI: 0.863-1.000)and 0.979(95%CI: 0.840-1.000)for stage I and stage II pancreatic cancer, respectively. The AUC of the model for diagnosing CA19-9-negative pancreatic cancer patients was 0.751(95%CI: 0.639-0.843), with a sensitivity of 52.2% and a specificity of 98.1%. Conclusion The ATM gene is hypermethylated in PBMCs of pancreatic cancer patients. Characterized by ATM hypermethylation,high CA19-9 and low ALB levels,the combined diagnostic model built with the random forest algorithm holds great clinical value for early pancreatic cancer diagnosis,and can make up for the diagnostic deficiency of the conventional biomarker CA19-9.

Diagnostic value of blood cell count-related biomarkers in predicting 28-day mortality in acute-on-chronic hepatitis b liver failure

JIA Ruoxi, LYU Li, LIU Hanyun, WU Yinping, LI Fengcai, ZHAO Zehua, WANG Kai, FAN Yuchen

Journal of Shandong University (Health Sciences). 2025, 63(6): 89-99. doi:10.6040/j.issn.1671-7554.0.2024.1354

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Objective To investigate the diagnostic value of blood cell count-related biomarkers in predicting 28-day morality in patients with acute-on-chronic hepatitis B liver failure(ACHBLF). Methods A total of 261 patients with ACHBLF were retrospectively included from January 2010 to July 2024. Univariate and multivariate Logistic regression analyses were performed to identify the risk factors, which were further evaluated by machine learning using XGBoost algorithm. The receiver operating characteristic(ROC)curve was analyzed to evaluate the prognostic accuracy and the calibration curve was used to evaluate the calibration. Furthermore, Kaplan-Meier survival analysis was performed to evaluate the performance of the model in diagnosing the 28-day mortality. Results There were 99(37.93%)patients who died within 28 days. Univariate Logistic regression analysis identified age, albumin, serum sodium, eosinophil ratio, eosinophil count, prothrombin activity(PTA), international normalized ratio(INR), total bilirubin(TBIL), model for end-stage liver disease(MELD)score,(neutrophil+monocyte)/lymphocyte ratio(NmLR), systemic inflammatory response index(SIRI), and neutrophil/platelet ratio(NPR)as risk factors. Multivariate Logistic regression analysis showed that SIRI(OR=1.15,95%CI:1.03-1.29,P=0.011)and MELD score(OR=1.23,95%CI:1.14-1.31,P<0.001)were independent risk factors for 28-day mortality. XGBoost algorithm showed that the SHAP values of SIRI and MELD score were 0.278 and 0.839, respectively. The area under the ROC curve(AUC)of SIRI was 0.693(95%CI: 0.628-0.758)with a specificity of 0.469 and a sensitivity of 0.828. In addition, the combination of SIRI and MELD score showed an AUC of 0.807(95%CI: 0.753-0.861)with a specificity of 0.722 and a sensitivity of 0.727. The calibration curve showed that the predicted probability was consistent with the actual probability. Kaplan-Meier analysis showed that patients with a combined diagnostic score above the cut-off value of 1.9 had a worse survival than those with a combined diagnostic score below 1.9(P=0.012). In ACHBLF patients diagnosed by Chinese criteria, the combination of SIRI and MELD score showed an AUC of 0.749(95%CI: 0.677-0.820)with a specificity of 0.677 and a sensitivity of 0.733, validating the performance of the combined model in predicting 28-day prognosis. Conclusion SIRI combined with MELD score has good diagnostic value for predicting 28-days mortality in ACHBLF.

Influence of physiological indicators on parathyroid gland function

LIU Kailin, GUO Ying, WANG Zhihao, GENG Chong, WANG Nana

Journal of Shandong University (Health Sciences). 2025, 63(6): 100-106. doi:10.6040/j.issn.1671-7554.0.2025.0216

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Objective To analyze the influence of various basic physiological indicators on parathyroid hormone(PTH)levels and explore their roles in the regulation of PTH metabolism. Methods A retrospective analysis was conducted on the clinical data of 1,391 hospitalized patients from October 2023 to October 2024. Spearman correlation analysis and stepwise multiple linear regression were employed to identify the major determinants of serum PTH levels. Additionally, data from 2,034 and 311 patients between January 2022 and November 2024 were retrospectively analyzed to investigate the impact of seasonal variation on PTH and 25-hydroxyvitamin D ［25(OH)D］ levels, respectively. Results Multiple linear regression analysis indicated that BMI(β=0.157, P<0.001), albumin(ALB)(β=0.095, P=0.001), and free fatty acids(FFA)(β=0.177, P<0.001)were positively associated with serum PTH levels, whereas retinol-binding protein(RBP)(β=-0.056, P=0.048)and Ca²⁺(β=-0.309, P<0.001)were negatively associated with PTH levels. Additionally, serum PTH and 25(OH)D levels exhibited seasonal variations, with PTH levels being lower in March and from August to September, peaking in May. Meanwhile, 25(OH)D levels remained higher from July to October. No significant gender differences in PTH levels were observed. Conclusion Serum PTH levels are positively correlated with BMI, ALB, and FFA, and negatively correlated with RBP and Ca²⁺. In addition, gender differences have no effect on PTH levels. PTH levels exhibit an overall inverse trend with 25(OH)D levels, suggesting that metabolic factors and seasonal variations may play an important role in the regulation of PTH.

Evaluation of operational management effectiveness in a tertiary general hospital in Shandong Province based on entropy weight technique for order preference by similarity to an ideal solution method

CAI Zhiqing, DONG Shiju, LI Naikun, CUI Xuedan, WANG Jianwei, WANG Heng

Journal of Shandong University (Health Sciences). 2025, 63(6): 107-116. doi:10.6040/j.issn.1671-7554.0.2025.0354

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Objective To evaluate the operational management effectiveness of a tertiary general hospital in Shandong Province and provide reference for promoting the high-quality development of public hospitals. Methods Based on the literature analysis method the evaluation index system for the high-quality development of clinical departments was constructed in a tertiary general hospital. Combined with the monthly operation data of a tertiary general hospital in Shandong Province from January to December 2023, entropy weight TOPSIS analysis was used to conduct a comprehensive evaluation of the high-quality development of clinical departments, and the C_i value was used to judge the operational efficacy of the hospital. Results A total of 3 primary indicators and 28 secondary indicators were included in this study. The results of the entropy weight TOPSIS analysis showed that the C_i value had increased significantly from 0.435 in April 2023 to 0.534 in October, while the C_i value in November and December showed a slightly decreasing trend. The results of the sub dimensional evaluation showed that the hospitals secondary indicators under the service capacity, quality and safety, and operational efficiency(except for the progressively decreasing category of indicators)showed a significant upward trend. Conclusion The overall trend of high-quality development of clinical departments in this hospital is favorable, especially in service capacity, quality and safety and operational efficiency.

Application of low molecular weight heparin in reproductive field

WAN Wenjing, GAO Shanshan

Journal of Shandong University (Health Sciences). 2025, 63(6): 117-124. doi:10.6040/j.issn.1671-7554.0.2024.0727

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Low molecular weight heparin(LMWH)is the most commonly used heparin anticoagulant, which is relatively safe for mother and fetus. At present, LMWH has been widely used in assisted reproduction, and clinical studies have reported its efficacy in preventing thrombosis, increasing embryo implantation rates, reducing the risk of spontaneous abortion, etc. However, the dosage and level of evidence are not clear. This review summarized the relevant studies on the clinical application of LMWH in assisted reproduction, in order to provide relevant reference information for the reasonable application of LMWH in clinic, and to provide ideas for the clinical and basic research of LMWH in the field of assisted reproduction.

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