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    Featured Topics—Bioactive Natural Products
    Secondary metabolites of the endophytic fungus Aspergillus iizukae RD16 isolated from Cynanchum chinene in the Yellow River Delta
    REN Siqi, ZHANG Xiaoqi, LYU Wenyuan, FANG Zhou, QI Shizhou, MIAO Shuang, GONG Kaikai
    Journal of Shandong University (Health Sciences). 2026, 64(5):  1-9.  doi:10.6040/j.issn.1671-7554.0.2025.0990
    Abstract ( 14 )   PDF (3226KB) ( 9 )   Save
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    Objective To investigate the secondary metabolites and cytotoxic properties of the endophytic fungus Aspergillus iizukae RD16, which was isolated from the plant Cynanchum chinense in the Yellow River Delta. Methods The fermentation products of the Aspergillus iizukae RD16 strain were isolated and purified using silica gel column chromatography, gel filtration chromatography and semi-preparative high performance liquid chromatography. The structures of the compounds were identified using NMR and mass spectrometry data analysis. The CCK-8 assay was used to evaluate the cytotoxic activity of the compounds. Results An endophytic fungus from Cynanchum chinene collected in the Yellow River Delta was identified as A.iizukae RD16. Seven monomeric compounds were isolated and identified in its rice fermentation products: cytochalasin Z17(1), cytochalasin Z16(2), flavichalasine I(3), aspochalasin J(4), isorhodoptiometrin(5), questin(6), and sulochrin(7). Compounds 1-4 belong to the cytochalasins, compounds 5 and 6 are anthraquinones, and compounds 7 is a benzophenone. The cytotoxic effects of all the compounds were tested against five human tumor cell lines using the CCK-8 assay. The results showed that compound 1 exhibited significant inhibitory activity against A549 non-small cell lung cancer cells, with an IC50 value of 2.6 μmol/L. Compound 2 demonstrated potent inhibitory activity against both A549 cells and RKO human colorectal adenocarcinoma cells, with IC50 values of 3.0 μmol/L and 2.8 μmol/L, respectively. Compound 4 exhibited moderate activity against A549 cells, with an IC50 value of 11.3 μmol/L, and an IC50 value of 5.6 μmol/L against RKO cells. Compound 5 displayed strong activity against SW480 cells(IC50 value of 5.8 μmol/L)and moderate activity against A549 cells(IC50 value of 13.4 μmol/L). Compound 6 exhibited IC50 values of 8.5 μmol/L and 3.9 μmol/L against A375 cells and A549 cells, respectively. Conclusion The endophytic fungus Aspergillus iizukae RD16 which is found in the Yellow River Delta produces a variety of secondary metabolites. Among them, Cytochalasins and anthraquinones show potential for the discovery of lead compounds due to their cytotoxic activities.
    Isolation, identification, and activity evaluation of secondary metabolites from a fungus Penicillium camemberti RD-37 derived from saline-alkaline soil of the Yellow River Delta
    LYU Wenyuan, SI Jie, REN Siqi, ZHANG Xiaoqi, FANG Zhou, MIAO Shuang, GONG Kaikai
    Journal of Shandong University (Health Sciences). 2026, 64(5):  10-18.  doi:10.6040/j.issn.1671-7554.0.2025.0931
    Abstract ( 8 )   PDF (1456KB) ( 2 )   Save
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    Objective To analyze the secondary metabolites and biological activities of the fungus Penicillium camemberti RD-37, which was isolated from the saline-alkaline soil of the Yellow River Delta. Methods The fermentation extract of this particular fungal strain was isolated and purified through integrated application of separation techniques, including chemical extraction, thin layer chromatography(TLC), octadecylsilyl column chromatography(ODS), and semi-preparative high performance liquid chromatography(HPLC). The structures of the compounds were determined using spectroscopic techniques such as nuclear magnetic resonance(NMR)and mass spectrometry, combined with a comparison of the literature data. The anti-tumor and anti-inflammatory activities of pure compounds were evaluated using CCK-8 and Griess assays. Results Eleven compounds were isolated and identified from the ethyl acetate extract of the rice fermentation of the fungus Penicillium camemberti RD-37, including 6-(methyl 3-methylbutanoate)-7-hydroxy-5-methoxy-4-methylphthalan-1-one(1), 7-hydroxy-5-methoxy-4-methyl-6-(3-methyl-4-oxopentyl)-phthalan-l-one(2), F01-1358B(3), Methyl mycophenolic acid(4), 6-((2E, 6E)-3,7-dimethyldeca-2, 6-dienyl)-7-hydroxy-5-methoxy-4-methylphtanlan-1-one(5), 5,7-dihydroxy-4-methylisobenzofuran-1(3H)-one(6),(2-hydroxypropan-2-yl)-6-methyl-2,3-dihydrobenzofuran-4-ol(7), Radstrictin K(8), 2,3-dihydro-2-hydroxy-2, 4-dimethyl-5-trans-propenylfuran-3-one(9), Benzoic acid(10), p-methoxybenzoic acid(11). The activity results indicated that compound 4(Methyl mycophenolic acid)exhibited significant cytotoxic activities against both human colorectal adenocarcinoma cells RKO and human ovarian cancer cells A2780 cells, with IC50 values of 7.7 μmol/L and 8.2 μmol/L, respectively.In the LPS-induced inflammation model, at a concentration of 30 μmol/L, compounds 1, 6, 8, 9, 10 and 11 exhibited anti-inflammatory activities in mouse mononuclear macrophages cells RAW264.7, with NO inhibition rates of 45.9%, 54.0%, 62.3%, 96.0%, 59.5%, and 55.8%, respectively. Conclusion The fungus Penicillium camemberti RD-37 has the potential to produce compounds with antitumor and anti-inflammatory activities. Compound 4 exhibits significant inhibitory activity against tumor cells.
    Structures and bioactivities of metabolites of marine fungus Talaromyces sp. UJNMF0655
    LI Zihao, HUANG Shanshan, ZHANG Yan, ZHANG Hua, WANG Chunying, LI Mingyue, XU Xiuli, BAO Jie
    Journal of Shandong University (Health Sciences). 2026, 64(5):  19-28.  doi:10.6040/j.issn.1671-7554.0.2025.1192
    Abstract ( 17 )   PDF (1617KB) ( 3 )   Save
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    Objective To investigate the secondary metabolites and their bioactivities of Talaromyces sp. UJNMF0655, a fungus isolated from the root sediment of the mangrove Avicennia marina(Forssk.)Vierh. Methods The ethyl acetate extract of the target fungus fermentation broth was isolated and purified using various chromatographic techniques, including normal-phase silica gel chromatography, reversed-phase silica gel chromatography, Sephadex gel chromatography, and high-performance liquid chromatography(HPLC). The structures of the isolated compounds were elucidated through comprehensive analysis of their physicochemical properties, spectroscopic data, and comparison with literature reports, while their antimicrobial, neuroprotective, and antioxidant activities were evaluated. Results Nine polyketide compounds were isolated and identified from the secondary metabolites of the marine fungus Talaromyces sp. UJNMF0655: talaroisochromane A(1), talaroisochromane B(2), penicillide(3), paecilin L(4), paecilin E(5), paecilin N(6), paecilin P(7), paecilin F(8), and paecilin A(9). Among these, eight compounds(1-2, 4-9)featured dimeric structures, and compounds 1 and 2 were new natural products. Bioactivity results indicated that compound 9 exhibited certain antibacterial activity against S. aureus, and compound 3, at a concentration of 50 μmol/L, significantly reduced high glucose-induced damage in RSC96 cells. Conclusion The marine fungus Talaromyces sp. UJNMF0655 is capable of producing abundant dimeric metabolites, demonstrating the potential of UJNMF0655 to develop lead compounds with antimicrobial and neuroprotective activities.
    Optimisation of ultrasound-assisted deep eutectic solvent extraction of total flavonoids from Chrysanthemum morifolium using response surface methodology
    WANG Yanping, WANG Yubo, DONG Lin, TANG Na, XU Qingqing, GUO Guangjun, GUO Shijin, YANG Limei, XU Zixian, ZHANG Haotian, ZHANG Wenyong, XU Qianqian
    Journal of Shandong University (Health Sciences). 2026, 64(5):  29-41.  doi:10.6040/j.issn.1671-7554.0.2025.0835
    Abstract ( 14 )   PDF (7727KB) ( 6 )   Save
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    Objective To optimise the ultrasonic-assisted deep eutectic solvent(DES)extraction process for total flavonoids from Chrysanthemum morifolium(Huibaiju)in order to replace the traditional method of extraction using organic solvents, and to explore extraction efficiency enhancement and environmental friendliness. Methods A total of eight DES were synthesized and screened, and the effects of key parameters, such as DES water content, liquid-to-solid ratio, extraction time, temperature, and ultrasonic power were investigated based on total flavonoid yield.The critical parameters were modelled and optimised using Box-Behnken response surface methodology(RSM). The extracts were then purified and evaluated for activity. Results Betaine-urea DES(1∶2 molar ratio, denoted as DES-1)exhibited superior extraction efficiency under the following conditions: 30wt% water content in DES-1; a liquid-to-solid ratio of 30 mL/g; an extraction temperature of 40 ℃; 30 min of ultrasonication, and an ultrasonic power of 320 W(80%). Under these conditions, the total flavonoid yield was 120.31±2.16 mg/g, which is a 25.10% increase on the yield obtained using conventional 60%(v/v)ethanol reflux extraction(96.19 mg/g). Following purification using AB-8 macroporous resin, the total flavonoid purity increased to 35.49%, demonstrating a strong 1,1-diphenyl-2-picrylhydrazyl(DPPH)radical scavenging capacity(IC50=0.64 mg/mL). Conclusion The use of betaine-urea DES coupled with ultrasound-assisted extraction enables the efficient and eco-friendly recovery of total flavonoids from Huibaiju, achieving a yield that is over 25% higher while reducing environmental impact. This strategy provides a sustainable method of extracting natural products.
    Preclinical Medicine
    Role of autophagy in the regulation of APAP liver injury and liver regeneration process
    DONG Ping, SHEN Haitao, QIAO Yaqin, LU Yan
    Journal of Shandong University (Health Sciences). 2026, 64(5):  42-49.  doi:10.6040/j.issn.1671-7554.0.2025.0545
    Abstract ( 21 )   PDF (2265KB) ( 6 )   Save
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    Objective To investigate the role of autophagy in acetaminophen(APAP)-induced liver injury and regene-ration in normal mouse hepatocytes(AML-12)and its potential mechanisms. Methods AML-12 cells were cultured in vitro, and Western blotting was employed to detect the protein expression of microtubule-associated protein 1A/1B light chain 3-II(LC3II)at 0, 1, 4, 12, 24, 48, and 72 hours after APAP treatment. This approach enabled identification of the time points corresponding to significant liver injury and liver regeneration following APAP administration. On one hand, the autophagy agonist rapamycin(RAPA)was administered at the point of hepatic injury, which was divided into control group, RAPA group, APAP 4 h group and APAP 4 h + RAPA group. Western blotting was used to detect protein expressions of LC3II, autophagy-related protein 5(ATG5), sequestosome 1(p62), receptor-interacting protein kinase 1(RIP1), receptor-interacting protein kinase 3(RIP3), glutathione peroxidase 4(GPX4), solute carrier family 7 member 11(SLC7A11)and p53; RT-qPCR was used to detect mRNA levels of tumor necrosis factor-alpha(TNF-α), interleukin-6(IL-6), ferritin heavy chain 1(FTH1), and nuclear receptor coactivator 4(NCOA4); the Fe2+ levels were detected using a ferrous ion assay kit. On the other hand, the autophagy inhibitor chloroquine(CQ)was administered at the point of liver regeneration, with the groups divided into control group, CQ group, APAP 24 h group, and APAP 24 h + CQ group. Western blotting was utilized to detect the protein expressions of LC3II, ATG5, p62, proliferating cell nuclear antigen(PCNA), and Cyclin D1; RT-qPCR was employed to detect the mRNA expressions of Ki-67, yes-associated protein 1(YAP1), and wingless-type MMTV integration site family member 2(Wnt2). Results In terms of injury, compared with the control group, the APAP 4 h group exhibited increased expressions of RIP1, RIP3, and p53 proteins, as well as TNF-α, IL-6, NCOA4 mRNA, and Fe2+(P<0.05), conversely, expressions of LC3II, SLC7A11, and GPX4 proteins, along with FTH1 mRNA, were downregulated(P<0.05); compared with the APAP 4 h group, the APAP 4 h + RAPA group showed increased expressions of LC3II, ATG5, SLC7A11, and GPX4 proteins, as well as FTH1 mRNA(P<0.05), conversely, p62, RIP1, RIP3, and p53 protein expressions, as well as TNF-α, IL-6, NCOA4 mRNA, and Fe2+ levels, were downregulated(P<0.05). In terms of regenerations, compared with the control group, the APAP 24 h group exhibited increased expression of LC3II protein, as well as Ki-67, Wnt2, and YAP1 mRNA(P<0.05), while p62 and PCNA proteins expressions were decreased(P<0.05); compared with the APAP 24 h group, the APAP 24 h + CQ group showed increased expressions of LC3II and p62 proteins(P<0.05), while the expressions of ATG5, PCNA, and Cyclin D1 proteins, as well as Ki-67, Wnt2, and YAP1 mRNA, were decreased(P<0.05). Conclusion Activating autophagy reduces inflammatory responses, programmed necrosis, and ferroptosis, ultimately mitigating APAP-induced liver injury; conversely, inhibiting autophagy may impair the liver regeneration process following APAP-induced liver injury. Autophagy agonists hold promise as novel therapeutic targets for treating APAP-induced liver injury.
    Role and mechanism of matrix Gla protein in fibrotic scar formation after spinal cord injury
    ZHAO Xiangrui, YIN Yongcheng, FANG Yuepeng, YANG Zhijie, NING Bin
    Journal of Shandong University (Health Sciences). 2026, 64(5):  50-60.  doi:10.6040/j.issn.1671-7554.0.2025.0945
    Abstract ( 7 )   PDF (7476KB) ( 1 )   Save
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    Objective To investigate the role and underlying mechanism of the matrix Gla protein(MGP)in fibrous scar formation after spinal cord injury(SCI). Methods Six C57BL/6 mice were randomly assigned to the sham group(n=3)and the spinal cord injury group(n=3). A mouse model of SCI was established. On postoperative day 7, spinal cord tissue was harvested from theepicenter of the lesion of the spinal cord injury group and the anatomically corresponding segments of the sham group for transcriptome sequencing. The differentially expressed gene MGP(|log2FC|>1 and Padj< 0.05)were screened and validated. To investigate the role of MGP, western blotting, RT-qPCR, and immunofluorescence were used to assess the expression of fibrosis markers and the activity of the TGF-β/SMAD signaling pathway in mouse embryonic fibroblasts(MEFs)and primary spinal cord fibroblasts after MGP knockdown. Finally, the inclined plane test and Basso mouse scale(BMS)scores were used to assess the impact of fibroblast-specific MGP knockdown on motor function recovery in mice after SCI. Results The results of transcriptome sequencing showed that the expression of MGP in the spinal cord injury group was higher than in the sham group(P<0.05); During the TGF-β-induced fibrogenesis process, MGP knockdown in MEFs and primary spinal cord fibroblasts significantly reduced the expressions of mRNA and proteins of fibronectin 1, type I collagen, and α-smooth muscle actin, as well as the phosphorylation of SMAD2 and SMAD3, compared to the induced state(P<0.05). The fibroblast-specific suppression of MGP in mice significantly promoted recovery ofmotor function after SCI(P<0.05). Conclusion MGP may modulate fibrous scar formation after SCI by targeting the TGF-β/SMAD signaling pathway.
    Clinical Medicine
    Risk factors and early intervention for postpartum hemorrhage caused by lower uterine segment atony
    LIU Huijun, WU Zhaoting, WANG Yuli, XU Mingyang, LIU Xiao, KANG Yan, WANG Hongmei
    Journal of Shandong University (Health Sciences). 2026, 64(5):  61-66.  doi:10.6040/j.issn.1671-7554.0.2026.0013
    Abstract ( 12 )   PDF (1006KB) ( 5 )   Save
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    Objective To investigate the incidence, risk factors of postpartum hemorrhage caused by lower segment atony(PPH-LSA)after vaginal delivery and the impact of its early identification and intervention on improving adverse postpartum outcomes. Methods Clinical data of all consecutive term singleton vaginal deliveries in two tertiary perinatal centers from July 2020 to June 2025(n=42,253)were retrospectively analyzed. Obstetric characteristics of women with postpartum hemorrhage(PPH, n=1,408)were extracted. The incidence of PPH-LSA was compared between the severe PPH group(≥1,000 mL, n=428)and the mild PPH group(500-1,000 mL, n=980). Binary logistic regression analysis was performed to identify independent risk factors for PPH-LSA. The effects of early intervention(within 30 minutes after placental delivery, n=214)versus late intervention(after 30 minutes after placental delivery, n=53)on postpartum blood loss volume and laparotomy rate were further evaluated. Results A total of 42,253 term singleton vaginal deliveries were included, among whom 1,408 women(3.33%)were diagnosed with PPH. Of these, 267 cases(18.96%)were classified as PPH-LSA. The incidence of PPH-LSA in the severe PPH group(24.53%)was significantly higher than that in the mild PPH group(16.53%)(P<0.001). Binary logistic regression analysis revealed that advanced age(per 5-year increment)(OR=1.245, 95%CI: 1.040-1.491), uterine scar(OR=18.760, 95%CI: 2.155-163.282), macrosomia(OR=1.801, 95%CI: 1.031-3.146), and low-lying placenta(OR=5.426, 95%CI: 1.796-16.389)were independent risk factors for PPH-LSA(P<0.05). Compared with the late intervention group, the early intervention group had significantly lower rates of red blood cell transfusion(19.16% vs. 39.62%), laparotomy(0% vs. 5.66%), and severe blood loss(≥2,000 mL, 1.87% vs. 13.21%)(P<0.05). One case of hysterectomy followed by maternal death occurred in the late intervention group. Conclusion Approximately one-fifth of PPH cases after vaginal delivery are attributed to PPH-LSA. Advanced age, uterine scar, macrosomia, and low-lying placenta are independent risk factors for this condition. Early identification and targeted intervention can significantly reduce the risk of severe adverse maternal outcomes.
    Causality between serum cholesterol concentration and neurogenic bladder risk
    YANG Yufan, LI Yue, XIE Hao, LIN Chunhua
    Journal of Shandong University (Health Sciences). 2026, 64(5):  67-73.  doi:10.6040/j.issn.1671-7554.0.2025.1405
    Abstract ( 13 )   PDF (3666KB) ( 4 )   Save
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    Objective To evaluate the potential causal association between serum cholesterol levels and the risk of neurogenic bladder(NB)using a Mendelian randomization(MR)approach. Methods Summary statistics from publicly available genome-wide association studies were used to identify genetic variants significantly associated with serum cholesterol levels as instrumental variables. Multiple MR methods, including inverse variance weighting, MR-Egger regression, and weighted median, were applied. Analyses were conducted separately in European and East Asian populations to assess the consistency of the findings across different ancestral backgrounds. Results MR analysis in the European population demonstrated a negative association between genetically predicted serum cholesterol levels and NB risk(IVW:OR=0.776, 95%CI: 0.656-0.917, P=0.003). Sensitivity analyses revealed no substantial evidence of horizontal pleiotropy or heterogeneity. The effect direction in the East Asian population was consistent with that in the European population, although not statistically significant. Multivariable MR analysis showed that the negative association between cholesterol and NB remained statistically significant after adjusting for body mass index, physical activity, and type 2 diabetes(OR=0.890, 95%CI: 0.835-0.947, P=0.041). Conclusion Genetically predicted higher cholesterol levels have a protective effect against NB. Cholesterol metabolism pathways may play an important role in the pathophysiology of NB.
    Application of 3D reconstruction combined with CT-guided puncture localization in minimally invasive treatment of pulmonary ground-glass nodules
    LIANG Chen, YAO Lijuan, LYU Longfei, TANG Ze, QIN Da, CUI Youbin,YU Xiaoqi
    Journal of Shandong University (Health Sciences). 2026, 64(5):  74-82.  doi:10.6040/j.issn.1671-7554.0.2025.0895
    Abstract ( 13 )   PDF (5906KB) ( 4 )   Save
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    Objective To compare the therapeutic outcomes of an artificial intelligence(AI)-assisted lung CT three-dimensional reconstruction combined with CT-guided lung nodule fine-needle aspiration biopsy preoperative management model versus a conventional thoracoscopic surgery preoperative management model in the treatment of ground-glass nodules(GGN)via video-assisted thoracic surgery(VATS). Methods Clinical data were collected from 114 patients with GGN undergoing VATS sublobar resection between August 2023 and April 2025. Patients were categorized into four groups based on whether they underwent AI-assisted 3D reconstruction of pulmonary CT and CT-guided lung nodule localization preoperatively: the control group(n=19), the biopsy group(n=25), the 3D reconstruction group(n=16), and the combinaton group(n=54). The control group underwent only preoperative contrast-enhanced lung CT. The biopsy group and 3D reconstruction group additionally underwent CT-guided lung nodule fine-needle aspiration localization or conventional CT 3D reconstruction, respectively. The combination group utilized both AI-assisted lung CT 3D reconstruction and preoperative CT-guided lung nodule fine-needle aspiration localization. The following clinical indicators were collected and compared across the four groups: needle localization success rate, perioperative parameters(surgical approach, surgical duration, intraoperative blood loss, postoperative chest tube retention time, total postoperative drainage volume, length of hospital stay, and hospitalization costs). Results There were no statistically significant differences in general clinical data between the combination group and the control group, the puncture group, or the 3D reconstruction group. The combination group, puncture group, and 3D reconstruction group all demonstrated superior outcomes compared to the control group in six postoperative indicators: anesthesia duration, total drainage volume, drainage tube retention time, surgical duration, intraoperative blood loss, and total surgical cost(P<0.05). The 3D reconstruction group and combination group had shorter hospital stays and smaller lesion resection volumes than the control group(P<0.05), while the combination group had shorter hospital stays and smaller lesion resection volumes than the puncture group(P<0.05). Both the puncture group and combination group had fewer days of postoperative infection than the control group(P<0.05). There was an interaction between 3D reconstruction and needle localization in six indicators: anesthesia duration, total drainage volume, drainage tube retention time, surgical duration, intraoperative blood loss, and total cost. The combination group demonstrated superiority over the puncture group in localization time and patient tolerance scores. Conclusion The preoperative management model combining AI-assisted CT three-dimensional reconstruction with CT-guided needle localization significantly improves perioperative outcomes in VATS sublobar resection, enhances patient quality of life and prognosis, and holds broad clinical application prospects.
    Incidence of early postoperative complications following different capsulotomy methods in hip arthroscopy
    DONG Zihao, LIU Zhe, WANG Hao, YU Chenxi, YANG Guang, FENG Haotian
    Journal of Shandong University (Health Sciences). 2026, 64(5):  83-87.  doi:10.6040/j.issn.1671-7554.0.2025.1270
    Abstract ( 8 )   PDF (974KB) ( 5 )   Save
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    Objective To examine effects of different capsulotomy techniques used in hip arthroscopy on early postoperative complications in patients with femoroacetabular impingement(FAI). Methods A retrospective analysis included 135 patients with FAI treated in Department of Sports Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, between January 2019 and September 2024. Cohort comprised 65 men and 70 women aged 15-60(38.5±8.5)years. All patients presented with combined cam and pincer morphology and underwent hip arthroscopic surgery. An outside-in capsulotomy technique was performed in all cases, including 46 patients in transverse capsulotomy group and 89 in longitudinal capsulotomy group. Intraoperative traction time was recorded. Postoperative complications within 1 year were analysed, together with modified Harris Hip Score(mHHS), International Hip Outcome Tool-12(iHOT-12), and Visual Analogue Scale(VAS)pain scores assessed at follow-up. Results All 135 patients completed postoperative follow-up. Complications occurred in 13 cases overall(9.6%), including a single major complication—fluid extravasation with femoral nerve injury—which arose in transverse capsulotomy group. Of 12 minor complications, comprising transient nerve palsy and iatrogenic injury to cartilage and labrum, 8 occurred in transverse capsulotomy group and 4 in longitudinal capsulotomy group. Overall complication rate was higher in transverse capsulotomy group than in longitudinal capsulotomy group(19.6% vs. 4.5%, P=0.006). Intraoperative traction time was significantly shorter in longitudinal capsulotomy group than in transverse capsulotomy group [(35.3±8.4)min vs.(58.1±18.5)min, P<0.001]. Postoperative mHHS, VAS and iHOT-12 scores improved in both groups compared with preoperative values. Conclusion Longitudinal capsulotomy shows clearer advantages, with significantly shorter traction time and lower rate of early postoperative complications, making it preferred surgical approach for FAI.
    Evaluating the efficacy of large language models in answering questions from parents of children with congenital lens dislocation
    CHEN Yumeng, ZHANG Yue, ZHANG Wulin, YANG Guoxing, XU Yanhui, HAN Aijun, LIU Caijuan, GUO Yuyu, CHEN Zhimin
    Journal of Shandong University (Health Sciences). 2026, 64(5):  88-95.  doi:10.6040/j.issn.1671-7554.0.2025.0262
    Abstract ( 11 )   PDF (1719KB) ( 2 )   Save
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    Objective To evaluate the accuracy, completeness, and emotional supportiveness of domestic open-source large language models(LLMs)in answering common diagnostic and therapeutic questions from parents of children with congenital ectopia lentis(CEL), and to explore the feasibility of using LLMs as intelligent health education assistants for parents of CEL children. Methods A question bank comprising 33 CEL-related diagnosis and treatment questions was constructed. Three senior attending ophthalmologists specializing in cataract independently evaluated the answers generated by three LLMs(Kimi chat, Doubao, and DeepSeek-R1)using a blinded assessment method with Likert scales(1-6 for accuracy, 1-3 for completeness and emotional support). Based on preliminary evaluation results, the best-performing model overall, DeepSeek-R1, was selected for a comprehensive evaluation on the entire question bank. Results Among the three LLMs, DeepSeek-R1 performed the best. The proportions of its answers achieving accuracy(≥5 points), completeness(≥2 points), and emotional support(≥2 points)scores were 78.8%, 87.9%, and 69.7%, respectively. The evaluators recommendation rate for its answers was 75.8%(150/198). Its responses were excellent in areas such as treatment, prognosis, and symptoms, but were slightly weaker in disease diagnosis. The word count of DeepSeek-R1s responses was significantly higher than that of human answers(P<0.05), and the word count showed a positive correlation with completeness scores(rs0.608, P<0.05). The intraclass correlation coefficient among the three raters for all ratings was above 0.700, indicating good reliability. Conclusion DeepSeek-R1 demonstrates high accuracy, completeness, and emotional support in answering CEL-related diagnosis and treatment questions. However, its application in disease diagnosis requires cautious interpretation and should be used under professional guidance.
    Public Health and Preventive Medicine
    Relationship between childhood abuse and frequent nightmares in adults with depressive disorders: mediating effect of somatic symptoms and moderating role of social support
    MA Yihan, YUAN Xinyun, LI Jiani, HAN Xu, DIAO Qidi, WANG Yan, CHU Xu, ZHANG Kun, HU Lei
    Journal of Shandong University (Health Sciences). 2026, 64(5):  96-105.  doi:10.6040/j.issn.1671-7554.0.2025.1388
    Abstract ( 17 )   PDF (1109KB) ( 5 )   Save
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    Objective To investigate the associations among childhood maltreatment, somatic symptoms, and frequent nightmares in adults with depressive disorder, and to examine the moderating role of social support and the influence of key confounding factors. Methods A convenience sample of 264 adult patients diagnosed with depressive disorder was recruited. Participants completed the childhood trauma questionnaire-short form(CTQ-SF), the patient health questionnaire-15(PHQ-15), and the social support rating scale(SSRS). A moderated mediation model was tested using the SPSS 27.0 Process macro. Results Correlation analysis showed that nightmare frequency was positively correlated with somatic symptoms(P<0.001)and childhood maltreatment(P<0.01), whereas social support was negatively correlated with both somatic symptoms(P<0.05)and childhood maltreatment(P<0.001). Somatic symptoms fully mediated the association between childhood maltreatment and nightmare frequency( β=0.008 1, 95%CI: -0.004 8-0.021 0). Social support significantly strengthened the first half of the mediation pathway( β=0.010 4, P=0.010), with the effect of childhood maltreatment on somatic symptoms being greater at high levels of social support compared to medium-low levels. After adjusting for covariates-including sex, psychotropic medication use, and smoking-the moderating effect was attenuated to marginal significance(P=0.041). Female sex, use of sedative-hypnotic medications, and smoking may independently predict either somatic symptoms or nightmare frequency. Conclusion Somatic symptoms fully mediate the relationship between childhood maltreatment and nightmare frequency in adults with depressive disorder. Social support moderates this pathway, although this effect is partially confounded by factors such as sex and medication use. Clinical interventions should particularly target patients with high levels of social support to alleviate somatic symptoms.
    Impact of meteorological factors and PM2.5 and their interaction on mumps in Shandong Province
    QIAO Yingyi, YUE Fang, SHI Xinglong, XU Xinying, LYU Jing, CHENG Chuanlong, ZUO Hui, XU Qing, LI Xiujun
    Journal of Shandong University (Health Sciences). 2026, 64(5):  106-115.  doi:10.6040/j.issn.1671-7554.0.2025.0843
    Abstract ( 15 )   PDF (5989KB) ( 3 )   Save
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    Objective To investigate the effects of meteorological factors and PM2.5 on mumps incidence among children aged 0-14 years in Shandong Province, and analyze their interaction effects to provide evidence for prevention stra-tegies. Methods Described the epidemiological characteristics of mumps cases in Shandong Province from 2015 to 2022 and analyzed the nonlinear effects and lag relationships between meteorological factors and PM2.5with mumps incidence using distributed lag nonlinear models. Relative excess risk due to interaction(RERI)and attributable proportion due to interaction(AP)were calculated to quantitatively evaluate interactions between meteorological factors and PM2.5. Results A total of 38,330 mumps cases among children aged 0-14 years were reported in Shandong Province between 2015 and 2022,accounting for 82.89% of the total population. The average annual incidence during 2015-2019 was 36.28 per 100,000, higher than that of 2020-2022(19.27 per 100,000). The male-to-female ratio was 1.91:1,with students and children in preschools identified as the primary affected populations.Temperature exhibited an S-shaped overall effect on mumps incidence, with the maximum risk occurring at 26 ℃(RR=1.38; 95%CI: 1.20-1.60). Precipitation reached its peak effect at 3 mm with a cumulative lag of 4 weeks(RR=1.31; 95%CI: 1.12-1.52). Wind speed showed its highest impact on incidence at 3.9 m/s(RR=1.41; 95%CI: 1.15-1.73). PM2.5mass concentration demonstrated a dose-dependent relationship with increased mumps risk.Synergistic interactions were observed both between temperature and PM2.5 and between relative humidity and PM2.5 for mumps incidence, with corresponding RERI values of 0.28(95%CI: 0.22-0.34)and 0.19(95%CI: 0.14-0.24), and AP values of 0.27(95%CI: 0.21-0.33)and 0.20(95%CI: 0.15-0.25); conversely, antagonistic effects were identified for wind speed and PM2.5 along with atmospheric pressure and PM2.5, reflected in RERI values of -0.13(95%CI: -0.19 - 0.07)and -0.12(95%CI: -0.19 - 0.06), and AP values of -0.14(95%CI: -0.20 - 0.08)and -0.16(95%CI: -0.24 - 0.07). Conclusions High temperatures, low precipitation, high wind speeds, and elevated PM2.5mass concentrations constitute risk factors for mumps incidence. Synergistic interactions exist between temperature and PM2.5 as well as relative humidity and PM2.5. These findings indicate that health authorities should incorporate meteorological conditions and PM2.5 levels when implementing preventive measures against mumps in schools. Simultaneously, educational institutions and kindergartens should reinforce hygiene education and strengthen supervision of childrens personal hygiene practices in daily prevention efforts.
    Early childhood multi-niche viromes: unclassified phage diversity and host features
    YANG Jing, ZHANG Lei
    Journal of Shandong University (Health Sciences). 2026, 64(5):  116-124.  doi:10.6040/j.issn.1671-7554.0.2025.0579
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    Objective To construct a multi-niche viromic dataset in early childhood and analyze the structural characteristics and bacterial hosts of the viral community at this developmental stage. Methods Integrating publicly available metagenomic data, a virome repository covering the upper respiratory tract, plasma, and feces was established using viral-like particle enrichment and de novo assembly strategies. Combined with multi-dimensional bioinformatics methods such as clustered regularly interspaced short palindromic repeats(CRISPR)comparison and gene sharing networks, taxonomic annotation of phages, prediction of lifestyle, and prediction of bacterial hosts were achieved. Results A virome dataset comprising 14,555 contigs was constructed, including 509 complete viral genomes(completeness ≥90%)and 340 high-quality complete genomes(completeness ≥95%). A total of six eukaryotic virus families and 23 phage families were identified, of which 71.70% of the phages could not be classified into known virus families. Host prediction covered 96.45% of the phage bacterial hosts, associated with 3,283 bacterial species, including probiotics such as Bifidobacterium and Lactobacillus. Conclusion There are a large number of unclassified phages in the early childhood virome, which form a extensive interaction network with intestinal probiotics, suggesting the high diversity, unique structure, and key potential role of the viral community at this developmental stage in shaping the early microecology.