Table of Content

  

10 September 2020
Volume 58 Issue 9

Follicle protection and antioxidant effect of quercetin on the cryopreservation of ewe ovarian tissues

YANG Lukai, JIANG Ligang, CUI Yanting, LIU Jin, HAN Yilong, CHEN Chao, DENG Xiaohui

Journal of Shandong University (Health Sciences). 2020, 1(9):  1-7.  doi:10.6040/j.issn.1671-7554.0.2020.0655

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Objective To investigate the effect of quercetin in cryoprotectant on the activity of follicles after cryopreservation of ovarian tissues. Methods Cortical pieces of 36 sexually mature ewe ovaries were randomly assigned to fresh control(CON)group, vitrification(VIT)group, vitrification with low, medium and high concentration(1, 5, 10 μmol/L)of quercetin(VWQ1, VWQ2, VWQ3)groups. The cortical pieces were rewarmed and cultured after vitrification to measure the estrogen levels, count the number of follicles and observe the morphological changes. The proliferating cell nucleus antigen of ovarian tissues was analyzed with immunohistochemistry. Tissue apoptosis was detected with TUNEL, and antioxidant capacity of ovarian tissues was determined with immunohistochemistry and visible light colorimetry. Results The proportion of morphological normal follicles was the highest while the number of apoptotic cells was the lowest in CON group(84.1%, P<0.001; 13.92±3.88, P<0.001). Compared with the VIT group, the VWQ1 group had higher rate of morphological normal follicles(76.5% vs 71.7%, P=0.035), fewer number of apoptotic cells(50.96±24.28 vs 73.44±35.47, P=0.017), and higher expressions of manganese superoxide dismutase(SOD-2)and catalase(CAT)［0.54(0.53, 0.55)vs 0.32(0.29, 0.51), P<0.001; 5.60±1.49 vs 3.48±1.21, P=0.008］. The VWQ3 group had the lowest rate of morphological normal follicles(61.2%, P<0.001), but the largest number of apoptotic cells(127.12±42.46, P<0.001). Conclusion Low concentration of quercetin in cryoprotection can reduce the oxidative damage on ovarian tissues and thus preserve the follicular activity, but excessively high concentration of quercetin can be harmful.

Effects of PPARγ agonist rosiglitazone on the differentiation of beige adipocytes in 24 obese individuals

LI Han, FU Tingting, ZHANG Lei, YAN Bing, SUN Tao, GUO Feng, YIN Xiao

Journal of Shandong University (Health Sciences). 2020, 1(9):  8-13.  doi:10.6040/j.issn.1671-7554.0.2020.0266

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Objective To investigate the effects of peroxisome proliferators-activated receptor γ(PPARγ)agonist, rosiglitazone, on the browning process of white adipose tissues from obese patients, so as to provide possible treatment for obesity. Methods The subcutaneous white adipose tissues were collected from 24 obese patients who underwent selective operation. The adipose-derived stem cells(ADSCs)were isolated and induced to differentiate into mature adipocytes, which were then divided into control group, Rosi-1 group(1 μmol/L rosiglitazone), and Rosi-2 group(2 μmol/L rosiglitazone). The expressions of uncoupling protein 1(UCP1)and beige adipocytespecific thermogenic genes were detected with Western blotting and real time qRT-PCR. Lipolysis was analyzed using colorimetric assay. Results With rosiglitazone treatment, the adipocytes in Rosi-1 and Rosi-2 groups exhibited multi-nodular lipid droplets, higher expression of UCP1(t=23.12, P<0.01; t=7.35, P<0.01), and higher expressions of beige adipocyte specific thermogenic genes, including UCP1(t=2.63, P=0.03; t=9.86, P<0.01), PPARγ(t=2.8, P=0.02; t=11.06, P<0.01)and PRDM16(t=2.65, P=0.02; t=12.85, P<0.01). Rosi-1 group(t=2.76, P=0.02)and Rosi-2 group(t=5.83, P<0.01)showed increased lipolysis compared with control group. Conclusion PPARγ agonists can enhance the differentiation of beige adipocytes in white adipose tissues in obese patients and induce the browning process of white adipose tissues. The development of PPARγ agonists which have effects on adipose tissues may provide new path for the treatment of obesity.

Perioperative observation and postoperative risk factors of severe hypocalcemia after parathyroidectomy: a report of 303 cases

ZHANG Hongbin, ZHAO Hanhui, WANG Suxia, ZHOU Peng, HE Qingqing, WANG Yanqun, DING Weiping, LIU Gang

Journal of Shandong University (Health Sciences). 2020, 1(9):  14-20.  doi:10.6040/j.issn.1671-7554.0.2020.090

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Objective To investigate the perioperative safety and efficacy of parathyroidectomy(PTX)in the treatment of refractory secondary hyperparathyroidism(SHPT)and risk factors of postoperative severe hypocalcemia. Methods Atotal of 303 patients with refractory SHPT who underwent PTX in the 960th Hospital of the PLA Joint Logistics Support Force during Nov. 2010 and Dec. 2018 were involved. The preoperative and postoperative blood parathyroid hormone(iPTH), serum calcium, phosphorus and alkaline phosphatase were collected and statistically analyzed, and the postoperative complications and prognosis were observed. Univariate and multivariate analyses were performed for patients with severe hypocalcemia to determine the risk factors. Results A total of 1 216 parathyroid glands were resected in the 303 cases. The cure rate and success rate were both 99%. Symptoms of bone pain and itching were relieved in 284 cases on the day of operation, and in 19 cases 1 week after operation. On day-1 after operation, iPTH ［25.65(16.00, 43.20)pg/mL］, serum phosphorus ［1.43(1.01, 1.94)mmol/L］ and serum calcium ［2.04(1.76, 2.29)mmol/L］ were significantly lower than those before operation(P<0.001). Hypocalcemia occurred in 171 cases(56.44%)after operation, severe hypocalcemia in 106 cases(34.98%), subcutaneous hemorrhage and hematoma in 10 cases(3.3%), hypotension shock in 2 cases(0.6%), subcutaneous emphysema in 1 case(0.3%), and acute cerebral infarction in 1 case(0.3%). All patients recovered after symptomatic treatment. Univariate analysis showed that age, preoperative serum calcium, alkaline phosphatase and iPTH were significantly different(P<0.05). Multivariate analysis showed that age, preoperative serum calcium and iPTH were independent risk factors of severe hypocalcemia. Conclusion PTX is a safe and effective treatment for uremic refractory SHPT. Patients with low preoperative serum calcium, young age and high iPTH are prone to develop severe hypocalcemia after operation.

Application of CT venography in the diagnosis and treatment of recurrent lower extremity varicose veins

WU Mengtao, WU Peng, YANG Yanfei, TANG Dianjun, MIAO Xiangling, LI Fandong

Journal of Shandong University (Health Sciences). 2020, 1(9):  21-26.  doi:10.6040/j.issn.1671-7554.0.2020.0756

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Objective To explore the application of computed tomography venography(CTV)in the diagnosis and treatment of recurrent lower extremity varicose veins. Methods The clinical data of 91 patients(91 limbs)with recurrent lower extremity varicose veins treated in our hospital during Jan. 2014 and Dec. 2019 were analyzed. The CTV data were collected and three-dimensional models were reconstructed. The causes of recurrence were analyzed with reference to the cross-sectional images and three-dimensional models, and the culprit veins causing recurrence were accurately located by previewing visualized surgeries. Individualized treatment plans were developed with the help of color Doppler ultrasound. The application value of CTV in the diagnosis and treatment of recurrent lower extremity varicose veins was evaluated based on curative effects and follow-up results. Results The cross-sectional images and three-dimensional models of CTV could identify the cause of recurrence and clearly display the culprit veins and adjacent tissues. After individualized surgeries, the varicose veins disappeared and ulcers healed in 21(13.5-31.0)days. During the follow-up of 5 to 60［average 18(11-27)］ months, no varicose veins or ulcers recurred. The diameter of the iliac vein and number of valves measured by CTV were significantly smaller than those measured by color Doppler ultrasound(P<0.001), but the number of perforating veins was significantly larger(P<0.001). Conclusion CTV can help to clearly determine the cause of recurrence of varicose veins in lower extremities, accurately locate the culprit veins, and provide intraoperative road map information. It has clinical value that color Doppler cannot replace.

Association of serum leptin with induced sputum eosinophils in 92 asthmatic patients

LIU Xiaofei, LIANG Ying, ZHANG Congxi, WANG Juan, PAN Yun, XU Jiawei, CHANG Chun, DONG Liang

Journal of Shandong University (Health Sciences). 2020, 1(9):  27-33.  doi:10.6040/j.issn.1671-7554.0.2020.0552

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Objective To determine whether serum leptin is related to airway and blood eosinophils in patients with asthma. Methods A cross-sectional study was conducted in 124 subjects, 92 of whom suffered from asthma including 46 overweight and 46 non-overweight and 32 of whom were healthy controls. Serum leptin levels were measured in all subjects, and induced sputum eosinophil and neutrophil percentages were determined in 57 asthmatic subjects. The differences among the three groups were evaluated by non-parametric test, correlation analysis and ordinal Logistic regression. Results Compared with healthy contrls, the serum leptin levels in asthmatic patients had no statistical difference. Overweight asthmatic subjects had significantly higher leptin levels than non-overweight asthmatic subjects, 17.7(11.1, 27.4)vs 10.2(7.8, 14.9)ng/mL, z=3.577, P<0.001. In subjects with asthma, leptin levels were positively correlated to the percentage of induced sputum eosinophils(r=0.285, P=0.031), but were not related to the percentage of induced sputum neutrophils and blood eosinophils. After adjustment for blood eosinophil level, serum IgE level, allergic rhinitis and usage of inhaled corticosteroids, multivariate ordinal Logistic regression analysis showed that serum leptin levels remained independently and positively related to the percentage of induced sputum eosinophils(OR=1.091, 95%CI:1.004-1.186, P=0.039). The correlation between serum leptin level and induced sputum eosinophils was statistically significant in non-overweight asthmatic subjects(r=0.496, P=0.005), while it was not statistically significant in overweight asthmatic subjects(r=0.094, P=0.640). Conclusion Compared with non-overweight asthmatic patients, serum leptin levels are significantly elevated in overweight asthmatic patients. Serum leptin is positively correlated to increased airway eosinophils in asthmatic patients.

Expression of CPLX2 and its in vitro effects on the proliferation migration and invasion of hepatocellular carcinoma cells

SUN Yifeng, GAO Yu, LIANG Yongyuan, GAO Yang

Journal of Shandong University (Health Sciences). 2020, 1(9):  34-39.  doi:10.6040/j.issn.1671-7554.0.2020.0748

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Objective To investigate the expression of Complexin 2(CPLX2)in human hepatocellular carcinoma(HCC)and its effects on the proliferation and invasion of Huh7 cells. Methods The mRNA and protein expressions of CPLX2 in 30 HCC tissues and adjacent tissues were detected with RT-qPCR and Western blotting. Two CPLX2 small interfering RNA(siRNA)were transfected into Huh7 cells mediated by Lipofectamine 2000. The transfection efficiency of siRNA was confirmed by RT-qPCR and Western blotting. The cells were divided into 4 groups: blank group, siRNA control group, CPLX2 siRNA group 1 and CPLX2 siRNA group 2. The cell proliferation and migration were determined with methyl thiazol tetrazolium(MTT)and Transwell assay. The siRNA interference effects and cell invasion were analyzed with group t test. The cell proliferation in each group was compared with two-way ANOVA. Results The expression of CLPX2 was higher in HCC tissues than in adjacent tissues ［(22.69±14.78) vs(4.03±2.65), t=5.941, P<0.001］. The mRNA expression of CPLX2 was(0.34±0.02)in CPLX2 siRNA group 1 and(0.48±0.01)in CPLX2 siRNA group 2, which was lower than that in the siRNA control group(0.88±0.02)and blank group(1.00±0.05), and the difference was statistically significant(P<0.05), showing good siRNA interference effects. MTT assay confirmed the cell proliferation was lower in CPLX2 siRNA groups 1 and 2 than in the control group(P<0.001)and blank group(P<0.001). Transwell migration showed the number of penetrating cells in each detection field was(37.0±2.0)in CPLX2 siRNA group 1 and(46.3±2.5)in CPLX2 siRNA group 2, which was lower than that in the blank group(88.0±2.0)and siRNA control group(77.0±4.4). Transwell invasion showed the number of penetrating cells was(29.7±2.5)in CPLX2 siRNA group 1 and(41.0±2.6)in CPLX2 siRNA group 2, which was lower than that in the blank group(74.7±3.1)and siRNA control group(68.7±1.5), and the difference was statistically significant(P<0.001). Conclusion CPLX2 is highly expressed in HCC tissues and knockdown of CPLX2 can inhibit the proliferation and migration of Huh7 cells, indicating that CPLX2 may play an important role in HCC tumorigenesis and progression.

Clinical analysis of laparoscopy assisted small incision of umbilicus in the treatment of Meckels diverticulum in children

LIU Chao, YAN Dong, LI Xiang, ZHANG Lei, LI Yan

Journal of Shandong University (Health Sciences). 2020, 1(9):  40-44.  doi:10.6040/j.issn.1671-7554.0.2020.152

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Objective To explore the clinical feasibility and safety of laparoscopy assisted small incision of umbilicus in the treatment of Meckels diverticulum in children. Methods The clinical data of 32 children with Meckels diverticulum during Dec. 2013 and Jun. 2019 were retrospectively analyzed, including general information, symptoms and signs, results of auxiliary examinations, operation and postoperative complications. Results Of the 32 cases, 21 were male and 11 were female, with an average age of(4.2±2.9)years. All patients came to see doctors due to various symptoms, including hematochezia in 20 cases, diverticulitis in 4 cases and intestinal obstruction in 8 cases. Laparoscopy assisted small incision of umbilicus was performed in all cases. The average operation time was(42.8±11.3)minutes, and average hospital stay was(7.8±1.9)days. All cases were diagnosed as Meckels diverticulum by pathological examination. Long-term follow-up showed no infection of incision, incision hernia or other complications. The incision was concealed with good cosmetic effects. Conclusion Meckels diverticulum in children has various clinical manifestations, and active surgical exploration should be performed in suspected cases. Laparoscopy assisted small incision of umbilicus is a safe and effective treatment, with concealed incision and good cosmetic effects.

Identification of FKBP11 expression in clear cell renal cell carcinoma using bioinformatics analysis

LI Yinglin, SONG Daoqing, XU Zhonghua

Journal of Shandong University (Health Sciences). 2020, 1(9):  45-51.  doi:10.6040/j.issn.1671-7554.0.2020.0367

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Objective To explore the expression of FK506 binding protein 11(FKBP11)in clear cell renal cell carcinoma(ccRCC), and to analyze its correlation with the clinicopathological features of ccRCC. Methods Based on Ualcan, GEPIA and HPA databases, the mRNA and protein expressions of FKBP11 in ccRCC, their correlation with the clinicopathological features of ccRCC, and their effects on the prognosis of patients were analyzed. Results The mRNA expression of FKBP11 was higher in ccRCC tissues than in normal kidney tissues. Analysis of Ualcan database showed differences in FKBP11 expression between normal kidney tissues and Grade 1(P=5.78E-051), Grade 2(P=1.62E-12), Grade 3(P=1.11E-16)and Grade 4(P=1.63E-12)ccRCC. The expression differences between normal and ccA and ccB subtypes were both P=1.62E-12. There were differences between normal and N0(P<1E-12)and N1(P=8.26E-05)subtypes in TNM staging. With higher ccRCC pathological grading, the expression of FKBP11 was up-regulated and related to the progression of ccRCC. However, there were no differences among different age, sex and race groups(P>0.05). There was difference in the overall survival rate between patients with high and low expressions of FKBP11(P<0.01). Conclusion Bioinformatics analysis indicated that FKBP11 was highly expressed in ccRCC, and there were differences in FKBP11 expressions among different stages, pathological grades and subtypes of ccRCC. Poorer pathological grades and stages of ccRCC showed higher expression of FKBP11, and high expression of FKBP11 indicated poorer prognosis.

Application of CT three-dimensional reconstruction modified R.E.N.A.L. score in 50 cases of laparoscopic partial nephrectomy

GAO Pei, MAO Changlin, CHEN Feng, HE Wei, GUAN Yong,LYU Jiaju, LI Shanjun, DING Sentai

Journal of Shandong University (Health Sciences). 2020, 1(9):  52-57.  doi:10.6040/j.issn.1671-7554.0.2020.0703

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Objective To explore the application value of the modified R.E.N.A.L.(radius, exophytic/endophytic, nearness, anterior/posterior, location)scoring system based on CT three-dimensional(3D)reconstruction technology in laparoscopic partial nephrectomy(LPN)for renal cell carcinoma(RCC). Methods A total of 50 patients undergoing LPN for stage T1 RCC in the Department of Urology of Shandong Provincial Hospital during Sep. 2018 and Nov. 2019 were enrolled. CT 3D reconstruction was performed in all patients before surgery, who were evaluated with the conventional R.E.N.A.L. score and modified R.E.N.A.L. score, respectively. The results were compared with the actual surgery. The correlation between the modified R.E.N.A.L. score and operation time, hospitalization days, intraoperative warm ischemia time(WIT), postoperative hemoglobin reduction, serum creatinine and blood urea nitrogen was analyzed with Spearman’s rank correlation analysis. Results There was a significant positive correlation between the modified R.E.N.A.L score and operation time, WIT, and hemoglobin reduction(r_s=0.570, 0.802, 0.903, P<0.001). The specificity, sensitivity and Yoden index of the modified R.E.N.A.L. score were significantly better than those of the conventional R.E.N.A.L. score. Conclusion The CT 3D reconstruction modified R.E.N.A.L. scoring system is more accurate than conventional R.E.N.A.L. scoring system in evaluating the surgical difficulty, and it can predict the perioperative indicators.

Correlation between interleukin-18 single nucleotide polymorphism and susceptibility of laryngeal squamous cell carcinoma: a report of 73 cases

MENG Zhaotun, LI Qin, SUN Hui, WU Xinfang, SUN Wenkai, GAO Wei

Journal of Shandong University (Health Sciences). 2020, 1(9):  58-63.  doi:10.6040/j.issn.1671-7554.0.2020.137

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Objective To investigate the correlation between interleukin-18(IL-18)and promotors -137G/C and -607C/A gene polymorphisms and the susceptibility of laryngeal squamous cell carcinoma(LSCC)in a Chinese Han population in Shandong Province. Methods A total of 73 LSCC patients(case group)treated at Linyi Peoples Hospital during May 2017 and Oct. 2019 and 73 healthy controls were enrolled. The clinical information and peripheral venous blood samples(2 mL)were collected. The whole blood DNA was extracted, and gene sequencing and SNP genotyping 山 东 大 学 学 报 (医 学 版)58卷9期 -孟朝暾,等.白细胞介素18单核苷酸多态性与73例喉鳞状细胞癌易感性的关联性 \=-were conducted. The quantitative data were analyzed with Students-t test, and the qualitative data were analyzed with Pearson χ² test or Fisher exact test. The control group was analyzed with chi-square goodness of fit test to verify whether it was in accordance with the Hardy-Weinberg equilibrium law. The correlation between two SNP loci and risk factors(age, smoking, drinking)with LSCC risk was determined with binary Logistic regression analysis. Results The case group had higher genotype frequency of GC at -137G/C(34.2% vs 19.2%, P=0.040), but there was no significant difference in the genotype frequency at -607C/A between the two groups(P>0.05). Smoking and drinking increased the risk of LSCC(OR=5.710; 3.116). After the risk factors of genotype, age, smoking and drinking history were adjusted, the OR of LSCC risk in smokers and -137G/C carriers were 4.967(95%CI=2.185-11.289, P<0.001)and 2.971(95%CI=1.243-7.101, P=0.014), respectively. Conclusion Our findings suggest that IL-18 promoter -137G/C polymorphism is correlated with an increased risk of LSCC.

Analysis of CLCNKB gene mutation in two families with Bartter syndrome

HU Sicui, SUN Qing, WANG Yibing, SUN Lili, SUI Yanxi, LI Tang

Journal of Shandong University (Health Sciences). 2020, 1(9):  64-70.  doi:10.6040/j.issn.1671-7554.0.2020.0574

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Objective To explore the clinical characteristics of Bartter syndrome(BS)in children and analyze the characteristics of CLCNKB gene mutation. Methods The clinical data of two unrelated BS family probands and their family members were analyzed. The peripheral blood DNA was extracted with column method. Primers were designed for the coding region of exons of BS-related mutant genes and then amplified. The PCR products were sequenced and compared with the normal sequences in NCBI by BLAST to identify possible gene mutations. Large fragment deletions were detected with multiple ligation probe amplification technique. Results Laboratory tests of both probands showed hypokalemia, alkalosis, hyperreninemia and hyperaldosteroneemia. Large fragment homozygous deletions of exons 1-3, 5-6, 8, 10-11, 13-15 and 17-19 of CLCNKB were detected in pedigree 1, which were inherited from parents. Large fragment deletions of exons 1-3, 5-6, 8, 10-11, 13-15 and 17-19 of CLCNKB and c.1881delC(p.Thr628fs)compound heterozygous mutation were identified in pedigree 2, which were inherited from parents. Conclusion c.1881delC(p.Thr628fs)is a frameshift mutation, which has not been reported at home and abroad. CLCNKB gene mutation is the cause of the two BS families, and the diagnosis is type III classic BS. BS can be clinically identified with molecular genetics to improve the diagnosis rate and to implement timely treatment.

Prediction of the prognosis of 312 cirrhosis patients using the joint models and database

XIAO Yufei, FENG Jianing, WANG Xiaoxuan, MAO Qian, SHI Fuyan, WANG Suzhen

Journal of Shandong University (Health Sciences). 2020, 1(9):  71-76.  doi:10.6040/j.issn.1671-7554.0.2020.0555

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Objective To explore the dynamic prediction efficiency of longitudinal survival data after slope term of longitudinal monitoring variables was added on the standard joint model. Methods Based on the dataset of primary biliary cirrhosis(PBC2)in the R 3.6.2 software of JM package, a standard joint model and a time-varying slope parameterized joint model were constructed, whose fitting results were analyzed. Their prediction efficiency on the survival rate of cirrhosis patients were compared and the individual survival rate was predicted. Results The standard joint model showed that with each unit of log(serBilir)increased longitudinally, the risk of death increased by 3.852 0 times(95%CI: 3.152 5-4.706 3). The time-varying slope parameterized joint model showed that with each unit of log(serBilir)increased longitudinally, the risk of death increased by 3.135 2 times(95%CI: 2.433 2-4.039 8). If the slope of the longitudinal trajectory increased by one unit, the risk of death increased by 17.431 9 times(95%CI: 2.399 6-126.633 9). The slope of log(serBilir)longitudinal trajectory was highly correlated with the risk of death(P<0.000 1). Both models were more accurate in predicting the 4-year survival rate than predicting the 2-year survival rate. The area under the ROC curve(AUC)of the time-varying slope parameterized joint model(0.714 2-0.831 1)was smaller than that of the standard joint model(0.645 0-0.836 1), and the prediction performance was more stable. The time-varying slope parameterized joint model predicted the 4-year survival rate was 0.850 3(95%CI: 0.481 0-0.963 9)for 1 randomized patient. Conclusion Both the standard joint model and time-varying slope parameterized joint model can be used to analyze the correlation between longitudinal monitoring indexes and survival outcomes in longitudinal survival data. The time-varying slope parameterized joint model not only has the function of the standard joint model, but also takes into account the influence of the trajectory slope of longitudinal monitoring variables on survival outcomes. Therefore, it has higher prediction efficiency than the standard joint model.

Association between restless legs syndrome and suicidal behaviors among adolescents

AN Di, WANG Xinting, LIU Zhenzhen, JIA Cunxian

Journal of Shandong University (Health Sciences). 2020, 1(9):  77-82.  doi:10.6040/j.issn.1671-7554.0.2020.0366

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Objective To explore the association between restless legs syndrome(RLS)and suicidal behaviors in a large sample of Chinese adolescents. Methods A total of 11 831 adolescents were included in the analysis. The 7-11 graders were sampled from 5 middle schools and 3 high schools in 3 counties of Shandong Province, China. A self-administrated structured questionnaire was used to collect information about demographics, RLS, suicidal behaviors, depression and insomnia. Logistic regression analyses were performed to examine the association between RLS and suicidal behaviors. Results Of the 11 831 participants, the average age was(14.97±1.46)years and 49.1% were girls. The prevalence of suicidal behaviors(33.3% vs 21.6%, P<0.05), suicidal ideation(29.7% vs 19.5%, P<0.05), suicide plan(15.2% vs 9.0%, P<0.05)and suicide attempt(7.0% vs 3.6%, P<0.05)were higher in adolescents with RLS than in those without. Multivariate Logistic regressions showed that RLS was associated with suicidal behaviors(OR=1.36, 95%CI=1.18-1.57), suicidal ideation(OR=1.25, 95%CI=1.08-1.46), suicide plan(OR=1.26, 95%CI=1.04-1.52), and suicide attempt(OR=1.35, 95%CI=1.03-1.76). Conclusion RLS is associated with suicidal behaviors among adolescents.

A study on self-reported health-adjusted life expectancy of adults in Shandong Province, 2018

LU Zilong, FU Zhentao, DU Enqing, XU Chunxiao, ZHANG Jiyu, CHU Jie, ZHANG Bingyin, WU Bingyi, GUO Xiaolei

Journal of Shandong University (Health Sciences). 2020, 1(9):  83-88.  doi:10.6040/j.issn.1671-7554.0.2020.0118

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Objective To investigate the level and distribution of health-adjusted life expectancy(HALE)among adults in Shandong Province, so as to provide references for the rational distribution of health resources and decision-making. Methods A self-reported health survey was conducted among 10 927 adult residents in 17 counties(cities or districts)of Shandong Province with a multi-stage cluster random sampling method. The data collected were adjusted with HOPIT model. The HALE was calculated with Sullivans method. Results The severity-weighted prevalence of disability increased significantly after the adjustment with HOPIT model, and was higher in women than in men. The average life expectancy(LE)and HALE of residents aged ≥20 were 59.78 and 39.02 years, respectively. The ratio of HALE/LE was 65.27%, which decreased with age. The LE, HALE and ratio of HALE/LE among male residents were 56.98 years, 38.90 years and 68.28%, respectively, whereas those among female residents were 61.98 years, 39.26 years and 63.34%, respectively. In all age groups, the LE and HALE were higher in female residents than in male residents, but the ratio of HALE/LE was lower. Conclusion The HALE of female is higher than male, and the HALE of elder residents is low. Close attention should be paid to gender and age in health care services.

Health financing fairness of households in three regions of Shandong Province

FAN Jiayin, ZHAO Di, GUO Lei, JIA Liying

Journal of Shandong University (Health Sciences). 2020, 1(9):  89-94.  doi:10.6040/j.issn.1671-7554.0.2020.0680

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Objective To explore the differences in health financing fairness of households and the influencing factors in the context of medical insurance integration, and to put forward relevant recommendations. Methods Urban and rural households in Qihe, Jiyang, and Jimo of Shandong Province were interviewed, and the health financing fairness was evaluated with the Theil index, Gini coefficient, concentration coefficient and Kakwani index. The influencing factors were determined with single-factor chi-square test and multivariate ordered Logistic regression analysis. Results There was a gap in health financing fairness between urban and rural households in the three regions, and urban households had higher health financing fairness than rural households(Kakwani index: 0.32 vs 0.20). Region, gender, age, marital status, educational level and work status were the influencing factors. Conclusion The medical insurance integration can narrow the urban-rural gap and unify medical benefits, so this policy can be further deepened to ensure the fairness of health financing.

Influence of compensation mechanism reform on the hospitalization expenses of a county-level public hospital in Shandong Province

JIANG Xiaofeng, YAO Jingjing, ZHU Dawei, HE Ping, SHI Xuefeng, MENG Qingyue

Journal of Shandong University (Health Sciences). 2020, 1(9):  95-102.  doi:10.6040/j.issn.1671-7554.0.2020.0581

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Objective To analyze the impact of compensation mechanism reform on the per-visit inpatient services in a county-level public hospital in Shandong Province, and offer evidence for further development and adjustment of the reform. Methods Interrupted time series segmented regression model was used to analyze the instant change which took place on October 1, 2014 and trend of per-visit inpatient expense, hospital stay and surgical rate, based on data of diabetes, pneumonia, appendicitis and lumbar discherniation collected from a county-level public hospital in Shandong Province. Results After the reform, there were statistically significant in the changes of inpatient drug expense and medical service expense in this hospital; there were no statistical significance in the changes of per-visit inpatient expense, medical consumables expense and diagnosis expense; there were no statistical significance in the changes of hospital stay and surgical rate. Conclusion Although compensation mechanism reform reduces the per-visit inpatient drug expense, the trend of rising inpatient expense and other indicators have not been effectively controlled.