1.Application of time series and machine learning models in predicting the trend of sickness absenteeism among primary and secondary school students in Shanghai
WANG Zhengzhong, ZHANG Zhe, ZHOU Xinyi, YUAN Linlin, ZHAI Yani, SUN Lijing, LUO Chunyan
Chinese Journal of School Health 2025;46(3):426-430
		                        		
		                        			Objective:
		                        			To analyze the temporal variation patterns of sickness absenteeism among primary and secondary school students in Shanghai, so as to explore models suitable for predicting peaks and intensity of absenteeism rates.
		                        		
		                        			Methods:
		                        			The seasonal and trend decomposition using loess (STL) method was used to analyze the seasonal and long term trend changes in sickness absenteeism among primary and secondary school students from September 1 in 2010 to June 30 in 2018, in Shanghai. A hierarchical clustering method based on Dynamic Time Warping (DTW) was employed to classify absenteeism symptoms with similar temporal patterns. Based on historical data, the study constructed and evaluated different time series algorithms and machine learning models to optimize the accuracy of predicting the trend of sickness absenteeism.
		                        		
		                        			Results:
		                        			During the research period, the average new absenteeism rate due to illness was 16.86 per 10 000 person day for every academic year, and the trend of sickness absenteeism exhibited both seasonality and a long term upward trend, reaching its highest point in the 2017 academic year (22.47 per  10 000  person day). The symptoms of absenteeism were divided into three categories: high incidence in winter and spring (respiratory symptoms, fever and general discomfort, etc.), high incidence in summer (eye symptoms, nosebleeds, etc.) and those without obvious seasonality (skin symptoms, accidental injuries, etc.).The constructed time series models effectively predicted the trend of absenteeism due to illness, although the accuracy of predicting peak intensity was relatively low. Among them, the multi layer perceptron (MLP) model performed the best, with an root mean squared error (RMSE) of 8.96 and an mean absolute error (MAE) of 4.37, reducing 36.51% and 39.02% compared to the baseline model.
		                        		
		                        			Conclusion
		                        			Time series models and machine learning algorithms could effectively predict the trend of sickness absenteeism, and corresponding prevention and control measures can be taken for absenteeism caused by different symptoms during peak periods.
		                        		
		                        		
		                        		
		                        	
2.Metanephric stromal tumor in children with BRAF V600E gene mutation: a case report and literature review
Shuting MAO ; Dao WANG ; Bai LI ; Shanshan LIU ; Linlin WEI ; Shufang SU ; Yan XU ; Ya′nan MA ; Ge ZHOU ; Yufeng LIU
Chinese Journal of Applied Clinical Pediatrics 2024;39(4):306-310
		                        		
		                        			
		                        			The clinical data of one child with metanephric stromal tumor (MST) and BRAF V600E gene mutation admitted to the First Affiliated Hospital of Zhengzhou University in June 2022 was analyzed retrospectively.Literature was reviewed.The patient, a 2-year-old girl, was diagnosed with a tumor in the left abdomen.The maximum diameter of the tumor was 10.5 cm.A radical nephrectomy was performed on the left kidney, and postoperative pathology revealed MST.Microscopically, the tumor had no envelope and exhibited expansive growth.The tumor cells were fusiform or stellate, and nuclear division was visible in the cell-rich region.Dysplastic blood vessels were seen inside the tumor.The tumor cells around the blood vessels and invaginated renal tubules were arranged like onion skin.CD34 was detected positive by immunohistochemical staining, and BRAF V600E mutation was also detected positive by fluorescent polymerase chain reaction.A total of 21 relevant case reports were retrieved, including 16 in English and 5 in Chinese.Fifty-eight MST patients, including the one in this report were analyzed.These patients were aged 2 days to 15 years, with a median age of 2 years.Except for 2 patients with unknown sex, the ratio of male to female was about 1.4∶1.0.Most MST patients were asymptomatic, with an average tumor size of 5.3 cm.The tumor cell CD34 showed positive expression in different degrees.Eight patients received the BRAF V600E mutation detection, and the results were all positive.Fifty-eight patients underwent nephrectomy and were followed up for 0-156 months, of which 7 patients were assisted with radiotherapy and chemotherapy.During the follow-up, 1 patient died, and 1 patient had a relapse.MST is a rare benign renal stromal tumor. BRAF V600E mutations are detected in a variety of malignancies.This paper is the first to report MST with BRAF V600E mutation in China and points out the importance of molecular detection of BRAF mutation for accurate diagnosis of MST.
		                        		
		                        		
		                        		
		                        	
3.Association between dietary habits and sleep duration among middle school students in Shanghai
YIN Xiaoya, ZHAI Yani, YUAN Linlin, YAN Qiong, ZHOU Xinyi, LUO Chunyan, SUN Lijing
Chinese Journal of School Health 2024;45(8):1140-1143
		                        		
		                        			Objective:
		                        			To explore the association between dietary behaviors and sleep duration among middle school students in Shanghai, so as to provide reference for interventions targeting insufficient sleep.
		                        		
		                        			Methods:
		                        			From May to June 2021, a stratified cluster random sampling method was employed to select a sample of 10-17yearold middle school students for monitoring their healthrisk behaviors. A total of 5 538 valid questionnaires were collected. The survey included items such as daily sleep duration, weekly consumption of sugary beverages, freshly squeezed fruit juice, fresh fruits, fresh vegetables, fried foods, milk and yogurt, breakfast habits, and frequency of eating outside. Statistical analysis was conducted using Chisquare test, Wilcoxon ranksum test, and multivariable Logistic regression model.
		                        		
		                        			Results:
		                        			About 73.7% of middle school students reported insufficient sleep in Shanghai. There was a positive correlation between the average daily consumption of fresh fruits and breakfast consumption with sleep duration. In other words, a higher frequency of consuming fresh fruits (OR=1.29) and eating breakfast (OR=1.07) were associated with a higher likelihood of sufficient sleep. Conversely, there was a negative correlation between the frequency of consuming desserts (OR=0.78) and fried foods (OR=0.88) and sleep duration (P<0.05).
		                        		
		                        			Conclusions
		                        			Increasing the consumption of fresh fruits and maintaining regular breakfast habits while reducing the intake of fried foods can contribute to achieving sufficient sleep among middle school students. When implementing interventions to improve sleep among middle school students, promoting healthy and balanced diets can be considered as one of the intervention strategies.
		                        		
		                        		
		                        		
		                        	
4.Effect of LncRNA OIP5-AS1 on Phenotypic Transformation of IOSE80 in Ovarian Epithelium
Linlin SONG ; Huanran MENG ; Lina ZHOU ; Rui LIU ; Lijun YIN
Chinese Journal of Modern Applied Pharmacy 2024;41(5):649-656
		                        		
		                        			OBJECTIVE 
		                        			To explore the phenotypic changes and possible mechanisms of lncRNA OIP5-AS1 on the proliferation, migration, apoptosis, invasion and cycle of ovarian epithelial cells IOSE80.
METHODS 
The clinical data of patients were collected from TCGA database and GEO database. After R package analysis, the differential expression of OIP5-AS1 was visualized in the volcanic map. The correlation between survival rate and OIP5-AS1 was analyzed by Kaplan-Meier. The IOSE80 cell model of OIP5-AS1 over expression and silencing was constructed with lentivirus vector. The expression of OIP5-AS1 was verified by RT-qPCR. Cell proliferation was detected by CCK-8. Invasion was detected by Transwell. Cell migration was detected by scratch test. Cell cycle and apoptosis were detected by flow cytometry. Western blotting was used to detect the expression of E-cadherin and N-cadherin, as well as the expression of cyclin-dependent kinase(CDK) and cyclin-G-related kinase(GAK).
RESULTS 
RT-qPCR results showed that IOSE80 cell lines over expressing and silencing OIP5-AS1 were successfully constructed. CCK-8 results showed that overexpressing OIP5-AS1 promoted the proliferation of IOSE80 cells. Scratch test results showed that overexpressing OIP5-AS1 promoted the migration of IOSE80 cells. Transwell results showed that overexpressing OIP5-AS1 would increase the invasiveness of IOSE80 cells. Flow cytometry results showed that overexpression of OIP5-AS1 weakened the apoptosis of IOSE80 cells and promoted the progress of cell cycle. Western blotting results showed that overexpression of OIP5-AS1 downregulated the expression of E-cadherin and upregulated the expression of N-cadherin, while overexpression of OIP5-AS1 increased the expression of CDK and GAK proteins.
CONCLUSION 
LncRNA OIP5-AS1 further interferes with the regulation of IOSE80 cell cycle by up regulating the expression of CDK and GAK, and then indirectly regulates the malignant phenotype of ovarian epithelial cells.
		                        		
		                        		
		                        		
		                        	
5.Application value of CT radiomics in differentiating malignant and benign sub-centimeter solid pulmonary nodules
Jianing LIU ; Linlin QI ; Jiaqi CHEN ; Fenglan LI ; Shulei CUI ; Sainan CHENG ; Yawen WANG ; Zhen ZHOU ; Jianwei WANG
Chinese Journal of Radiological Health 2024;33(3):340-345
		                        		
		                        			
		                        			Objective To investigate the application efficiency and potential of CT radiomics in differentiating malignant and benign sub-centimeter solid pulmonary nodules. Methods A retrospective study was performed on the sub-centimeter ( ≤ 10 mm) solid pulmonary nodules detected by enhanced CT in our hospital from March 2020 to January 2023. Malignancy was confirmed by surgical pathology, and benignity was confirmed by surgical pathology or follow-up. Lesions were manually segmented and radiomic features were extracted. The feature dimension was reduced via feature correlation analysis and least absolute shrinkage and selection operator (LASSO). The 5-fold cross validation was used to validate the model. Support vector machine, logistic regression, linear classification support vector machine, gradient boosting, and random forest models were established for CT radiomics. Receiver operating characteristic curves were drawn. Delong test was used to compare the diagnostic performance of the five classifiers. The optimal model was selected and compared to radiologists with medium and high seniority. Results A total of 303 nodules, 136 of which were malignant, were examined. Radiomics models were established after feature extraction and selection. On test set, the areas under the receiver operating characteristic curves of support vector machine, logistic regression, linear classification support vector machine, random forest, and gradient boosting models were 0.922 (95%CI: 0.893, 0.950), 0.910 (95%CI: 0.878, 0.942), 0.905 (95%CI: 0.872, 0.938), 0.899 (95%CI: 0.865, 0.933), and 0.896 (95%CI: 0.862, 0.930), respectively. Delong test indicated no significant differences in the performance of the five radiomics models, and the support vector machine model showed the highest accuracy and F1 score. The support vector machine model showed significantly higher diagnostic accuracy as compared to radiologists (83.8% vs. 55.4%, P < 0.001). Conclusion The radiomics models achieved high diagnostic efficiency and may help to reduce the uncertainty in diagnosis of malignant and benign sub-centimeter solid nodules by radiologists.
		                        		
		                        		
		                        		
		                        	
6.Optimization and Evaluation of Conditions for Orthotopic Nude Mouse Models of Human Liver Tumor Cells
Yu MENG ; Dongli LIANG ; Linlin ZHENG ; Yuanyuan ZHOU ; Zhaoxia WANG
Laboratory Animal and Comparative Medicine 2024;44(5):511-522
		                        		
		                        			
		                        			Objective The study aims to optimize the conditions for constructing orthotopic nude mouse models of liver cancer by injecting human liver tumor cell lines and to explore appropriate timings for drug administration. Methods Human hepatocellular carcinoma Hep3B and hepatoblastoma HepG2 cell lines, which stably expressing the luciferase reporter gene (LUC), were selected. The linear correlation between the luciferase luminescence intensity and the number of liver tumor cells was analyzed using a Small Animal In Vivo Imaging system to verify the luminescent efficiency of the human liver tumor cells. Different concentrations (8×106, 2.4×107, 7.2×107 cells/mL) and resuspension media (PBS, Matrigel) of human liver tumor cell suspensions HepG2-LUC and Hep3B-LUC were orthotopically inoculated into the liver lobes of 5-week-old female BALB/c nude mice (12 groups, 7 mice each) to construct human liver tumor nude mouse orthotopic cancer models. Every 7 days, the weights of mice were recorded, and the growth of orthotopic tumors was monitored using the Small Animal In Vivo Imaging system. On day 35 post-cell inoculation, mouse livers were dissected, and pathological slices were prepared for HE staining to observe histopathological changes in liver tissues. Results The luminescence intensity of human liver tumor cell lines was positively correlated with the number of cells (R2=0.983 1, R2=0.970 5), indicating their suitability for orthotopic model construction. Successful modeling was achieved in the high-concentration groups of HepG2-LUC, the low-, medium-, and high-concentration groups of HepG2-LUC+Matrigel, the medium- and high-concentration groups of Hep3B-LUC, and the low-, medium-, and high-concentration groups of Hep3B-LUC+Matrigel. For both HepG2-LUC+Matrigel and Hep3B-LUC+Matrigel groups, mice in the high-concentration groups exhibited significantly reduced body weight compared to the low- and medium-concentration groups (both with P<0.05). The luminescence intensity of successfully modeled mice increased exponentially over time (R2>0.950 0), and reached a minimum of 1.0×107 p/(s·cm²·sr) by day 14 post-transplantation. Mice in the low- and medium-concentration groups of HepG2-LUC and the low-concentration group of Hep3B-LUC showed no significant pathological changes, while the other groups exhibited evident liver tumors and hepatocyte lesions. Conclusion For the HepG2-LUC cell line, the recommended injection volume is 50 µL with a cell density of 2.4×107 cells/mL, resuspended with Matrigel, followed by drug administration or prognostic measures on day 7 post-modeling. For the Hep3B-LUC cell line, the recommended injection volume is 50 µL with a cell density of 7.2×107 cells/mL, not resuspended with Matrigel, with administration or prognostic measures on day 14 post-modeling. 
		                        		
		                        		
		                        		
		                        	
7.Correlation between stress and Internet addiction among middle school students in Shanghai
YUAN Linlin, ZHANG Zhe, ZHOU Xinyi, ZHAI Yani, YIN Xiaoya, LI Shuman, SUN Lijing
Chinese Journal of School Health 2024;45(12):1757-1760
		                        		
		                        			Objective:
		                        			To understand the relationship between stress and Internet addiction among middle school students in Shanghai, so as to provide a scientific basis for promoting students  mental health and preventing Internet addiction.
		                        		
		                        			Methods:
		                        			From May to June 2021, a stratified random cluster sampling method was used to select 6 123 middle and high school students in Shanghai for health risk behavior monitoring. Daily Stressors Evaluation Scale for Urban Secondary School Students was used to evaluate students' stress, and the Internet Addiction Test compiled by Young was used to evaluate students  Internet addiction. The correlation between student stress and Internet addiction was analyzed by Kruskal-Wallis  H  test ,  Chi square test and multiple Logistic regression.
		                        		
		                        			Results:
		                        			Total stress score of middle school students in Shanghai was 24 (12, 39), academic stress score was 8 (5, 13), physical and psychological stress score was 6 (2, 10), interpersonal stress score was 5 (1, 9), and family stress score was 4 (1, 8). The detection rate of Internet addiction was 4.7%. Multivariate Logistic regression analysis showed that the risk of Internet addiction among middle school students with high levels of stress was 8.05 times(95% CI =4.59-14.12) that of students with low levels of stress( P <0.05). The risk of Internet addiction among middle school students with high levels of academic stress, physical and psychological stress, interpersonal stress and family stress was 5.98(95% CI =3.69-9.70), 6.92(95% CI =4.03-11.88), 4.85(95% CI =3.11-7.55), and 4.18(95% CI =2.73-6.40) times that of students with low levels of stress, respectively( P <0.05).
		                        		
		                        			Conclusion
		                        			The academic stress, physical and psychological stress, interpersonal stress, and family stress among middle school students can all lead to an increased risk of Internet addiction.
		                        		
		                        		
		                        		
		                        	
8.Research progress on the role of immune cells in IgA nephropathy
Weiran ZHOU ; Xuemei LIU ; Linlin DONG ; Hongxia ZHANG
Chinese Journal of Applied Clinical Pediatrics 2024;39(6):477-480
		                        		
		                        			
		                        			IgA nephropathy is a common primary glomerular disease.Its pathogenesis is currently unclear.As an autoimmune disease, immune response is a key link in the onset of IgA nephropathy.Multiple immune cells are involved in the occurrence and development of IgA nephropathy.The impacts of different cell subpopulations of innate and adaptive immunity can lead to sustained immune damage directly or indirectly.This article elaborates on the role of immune cells in IgA nephropathy from two aspects, namely innate immunity and adaptive immunity, aiming to provide references for further research on IgA nephropathy.
		                        		
		                        		
		                        		
		                        	
9.Correlation between obesity and early vascular aging in middle-aged and young adult health check-up populations
Linlin ZHAO ; Man CUI ; Yapei LI ; Ying LI ; Rujia MIAO ; Jiangang WANG ; Hui ZHOU
Journal of Central South University(Medical Sciences) 2024;49(3):408-416
		                        		
		                        			
		                        			Objective:The obesity rate among middle-aged and young adults in China is increasing annually,and the incidence of cardiovascular diseases is becoming more prevalent in younger populations.However,it has not yet been reported whether obesity is associated with early vascular aging(EVA).This study aims to explore the correlation between obesity and EVA in middle-aged and young adult health check-up populations,providing a reference for the prevention of cardiovascular diseases. Methods:A total of 15 464 middle-aged and young adults aged 18-59 who completed brachial-ankle pulse wave velocity(baPWV)test in the Third Xiangya Hospital of Central South University from January to December 2020 were included.Among them,1 965 individuals with normal blood pressure and no cardiovascular risk factors were selected as the healthy population.The baPWV thresholds for determining EVA in each age group for males and females were calculated based on the baPWV values of the healthy population.The number and percentage of individuals meeting the EVA criteria in the middle-aged and young adult health check-up populations were statistically analyzed by age and gender.The differences in obesity indicators[visceral adiposity index(VAI),body mass index(BMI),waist circumference(WC)]between the EVA and non-EVA groups for males and females were compared.Using EVA as the dependent variable,VAI,BMI,and WC were included as independent variables in a Logistic model to analyze the correlation between each obesity indicator and EVA before and after adjusting for other influencing factors.Furthermore,the correlation between each obesity indicator and EVA in each age group was analyzed. Results:In the health check-up populations,the detection rate of EVA in different age groups was 1.65%-10.92%for males,and 1.16%-10.50%for females,the detection rate of EVA increased with age in both males and females.Except for the 40-<50 age group,the EVA detection rate was higher in males than in females in all other age groups.Regardless of gender,obesity indicators VAI,BMI,and WC were significantly higher in the EVA group than in the non-EVA group(all P<0.01).Before and after adjusting for other influencing factors,VAI and WC were both correlated with EVA(both P<0.05).BMI was a risk factor for EVA before adjusting for other influencing factors(P<0.01),but after adjustment,the correlation between BMI and EVA was not statistically significant(P=0.05).After adjusting for other influencing factors,the correlation between VAI and EVA was statistically significant in the 18-<40 and 50-<60 age groups(both P<0.05),while the correlation between BMI and WC with EVA was not statistically significant(both P>0.05).In the 40-<50 age group,the correlation between VAI and BMI with EVA was not statistically significant(both P>0.05),but the correlation between WC and EVA was statistically significant(P<0.01). Conclusion:VAI is closely related to the occurrence of EVA in middle-aged and young adults aged 18-<40 and 50-<60 years,while WC is closely related to the occurrence of EVA in those aged 40-<50 years.
		                        		
		                        		
		                        		
		                        	
10.Influencing factors of poor anal function after laparoscopic intersphincteric resection for extremely low rectal cancer and to construct a predictive model
Ning HAN ; Xiaodong WANG ; Yingchun LI ; Haihua ZHOU ; Linlin PAN ; Chen YU
Journal of Clinical Surgery 2024;32(8):887-891
		                        		
		                        			
		                        			Objective To analyze the influencing factors of poor anal function after laparoscopic intersphincteric resection(Lap-ISR)for extremely low rectal cancer,and to construct and verify a prediction model based on this model,in order to provide guidance for improving the anal function of patients with extremely low rectal cancer after Lap-ISR.Method A total of 127 patients with extremely low rectal cancer who underwent Lap-ISR in Taizhou People's Hospital from June 2020 to June 2022 were retrospectively selected.Patients were followed up for 12 months after surgery,and postoperative anal function was evaluated by the anal incontinence score(Wexner).According to Wexner score,the patients were divided into good anal function group(106 cases)and poor anal function group(21 cases).The clinical data of patients were collected and the risk factors affecting postoperative poor anal dysfunction were analyzed,and a Nomogram model was constructed to predict the risk of postoperative anal dysfunction in patients after Lap-ISR,and the receiver operating characteristic curve(ROC)was drawn.The area under the curve(AUC)was used to analyze the predictive efficacy of the prediction model for poor anal dysfunction after Lap-ISR.Result The incidence of anal dysfunction after Lap-ISR in patients with extremely low rectal cancer was 16.54%(21/127).Univariate analysis showed that there was no significant difference in gender,age,body mass index,clinical stage,combined underlying diseases,operation time,intraoperative blood loss,anastomosis method,and the distance from the lower edge of the tumor to the dentate line between the two groups(P>0.05).The proportion of tumor diameter≥5 cm,the proportion of neoadjuvant chemotherapy,the distance between anastomosis and anal verge<2 cm,and the proportion of anastomotic leakage in the anal dysfunction group were higher than those in the good anal function group(P<0.05).Cox multivariate regression analysis showed that tumor diameter≥5 cm(OR=5.124),neoadjuvant chemotherapy(OR=5.761)and anastomotic leakage(OR=6.881)were risk factors for postoperative anal function(P<0.05).Wexner score of patients with tumor diameter ≥5 cm was higher than that of patients with tumor diameter<5 cm,Wexner score of patients with neoadjuvant chemotherapy was higher than that of patients without neoadjuvant chemotherapy,and Wexner score of patients with anastomotic leakage was higher than that of patients without anastomotic leakage(P<0.05).Internal validation of Bootstrap method showed that the C-index was 0.785(95%CI:0.692-0.851).The results of ROC curve showed that the sensitivity and specificity of the nomogram model in predicting postoperative poor anal function of patients were 85.70%and 88.70%,respectively,and the AUC was 0.895(95%CI:0.795-0.984).Conclusion Tumor diameter,neoadjuvant chemotherapy and anastomotic leakage are risk factors for poor anal function after Lap-ISR in patients with extremely low rectal cancer.The nomogram risk prediction model based on the above risk factors has a good risk efficiency in evaluating the risk of postoperative anal dysfunction in patients.
		                        		
		                        		
		                        		
		                        	
            

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