1.A Review of the Knowledge Discovery Methods Based on Knowledge Graph in the Biomedical Field
Jiayue MEI ; Jia SUN ; Yuefang HOU
Journal of Medical Informatics 2024;45(1):45-51
		                        		
		                        			
		                        			Purpose/Significance To review the knowledge discovery methods based on knowledge graph in the biomedical field,and to provide references for researchers.Methods/Process The paper summarizes the knowledge discovery methods based on knowledge graph by systematically searching and analyzing the relevant literatures,and compares the advantages and disadvantages of various knowl-edge discovery methods.It points out that the limitations and challenges of knowledge discovery methods based on knowledge graph in the biomedical field,and puts forward suggestions and prospects.Result/Conclusion In the future research,it is suggested to improve the in-terpretability of knowledge discovery results,build an effective result evaluation framework,and establish a standardized knowledge dis-covery process with multi-domain experts'collaboration,so as to improve the quality and efficiency of knowledge discovery research.
		                        		
		                        		
		                        		
		                        	
2.Zhuangtongyin Modulates Ferroptosis via the Nrf2-SCL7A11/xCT-Gpx4 Pathway to Im-prove Cerebral Ischemia-reperfusion Injury
Chengyi WANG ; Yuefang CAI ; Zhenqiu NING ; Minzhen DENG ; Jingbo SUN ; Kim Sookja CHUNG ; Yan LI ; Xiao CHENG
Journal of Sun Yat-sen University(Medical Sciences) 2024;45(4):539-548
		                        		
		                        			
		                        			[Objective]To investigate the protective effect of Zhuangtongyin on the Middle Cerebral Artery Occlusion(MCAO)model by modulating ferroptosis through the Nrf2-SCL7A11/xCT-Gpx4 pathway and its underlying mechanism.[Methods]C57BL/6J mice were randomly divided into Sham operation group(Sham),model group(MCAO),low-dose Zhuangtongyin group(ZTY-L),high-dose Zhuangtongyin group(ZTY-H),with 5 mice in each group.The MCAO group was modelled by silica gel embolization,the middle cerebral artery of mice was embolized for 1h,then the silica gel was pulled out and reperfusion was performed after 72 h;and the other operations in the Sham group were the same as those in the MCAO group except that the thread plug was not inserted.The neural function of mice was evaluated by Zea-Longa method.TTC staining was used to evaluate the volume of cerebral infarction.The level of brain injury was evaluated by HE staining and Nissl staining.Prussian blue staining and the expression of iron transport-related carrier receptors TfR1 and DMT1 on mRNA level was detected by qPCR to evaluate the iron ion deposition level in mice brain.The expression of lipid peroxidation-related gene ACSL4 on mRNA level was detected by qPCR,and the content of 4-HNE was detected by ELISA kit to evaluate the lipid peroxidation level of mice brain.The expressions of ferroptosis marker PTGS2 mRNA level was detected by qPCR.The expressions of Nrf2,SCL7A11/xCT,Gpx4 in mice brain tissue were detected by Western-blot and immunofluorescence.[Results]Zhuangtongyin improved the nerve function of mice after MCAO(P<0.05)and the cerebral infarction volume of mice(P<0.05)and alleviate the pathological injury of cerebral cortex cells after MCAO operation.Zhuangtongyin attenuated the accumulation of trivalent iron ions in the brain tissue of mice following MCAO.Additionally,Zhuangtongyin downregulated the expression of TfR1 and DMT1 mRNA(P<0.001),a transporter associated with cellular iron ion uptake,in the brains of post-MCAO mice.Furthermore,Zhuangtongyin reduced levels of lipid peroxidation product 4-HNE(P<0.001)and suppressed ACSL4 mRNA expression in brain tissue post-MCAO(P<0.001).Besides,Zhuangtongyin downregulated the expression of PTGS2 mRNA(P<0.001),in the brains of post-MCAO mice.Zhuangtongyin increased the expression of nrf2 into the nucleus(P<0.001),and increased the expression of xCT and Gpx4 in neurons after MCAO(P<0.001).[Conclusion]Zhuangtongyin can enhance the nerve function and reduce cerebral infarction volume in MCAO/R mice,alleviate the pathological damage of cerebral cortex cells,and modulate the expression of key signaling molecules in the Nrf2-SCL7A11/xCT-Gpx4 pathway.Therefore,it is suggested that the mechanism by which Zhuangtongyin improves MCAO/R injury in mice may involve regulating ferroptosis through the Nrf2-SCL7A11/xCT-GPX4 pathway.
		                        		
		                        		
		                        		
		                        	
3.Analysis of traffic injury and associated risk behaviors among secondary school students in Shanghai City
ZHOU Xinyi, ZHOU Yuefang, SUN Lijing,YUAN Linlin, ZHANG Zhe, ZHAI Yani, LUO Chunyan
Chinese Journal of School Health 2023;44(12):1867-1872
		                        		
		                        			Objective:
		                        			To investigate incidence of traffic injury and its associated factors among secondary school students in Shanghai, so as to provide scientific basis for intervention.
		                        		
		                        			Methods:
		                        			Using the method of multi stage stratified random cluster sampling, an on-the-spot anonymous questionnaire survey was conducted among 19 629 adolescents from 16 districts in Shanghai from May to June 2021. The multivariate Logistic regression was used to analyze possible associated factors.
		                        		
		                        			Results:
		                        			The rate of road traffic injuries among secondary school students in Shanghai was 0.74%, the highest reporting rate among secondary vocational school students (1.35%), followed by junior high school students (0.72%), and the lowest reporting rate of road traffic injuries among senior high school students (0.55%), with statistically significant differences ( χ 2=13.39,  P <0.01). The results of multivariate Logistic regression analysis showed that the junior high school ( OR =0.56, 95% CI =0.35-0.89) or senior high school ( OR = 0.40 , 95% CI =0.24-0.68) and residential school ( OR =0.39, 95% CI =0.18-0.88) were protective factors of road traffic injuries( P <0.05). Male ( OR =1.65, 95% CI =1.14-2.37), unaware of seat belt ( OR =6.38, 95% CI =2.81-14.50), had a cycling chase/fight ( OR =2.33, 95% CI =1.39-3.90), music or phone calls on a bicycle ( OR =2.54, 95% CI =1.72-3.75) were positively correlated with road traffic injury( P <0.05).
		                        		
		                        			Conclusions
		                        			The road traffic injury among secondary school students in Shanghai is related to many factors, and traffic hazards are common among students in all school sections. Targeted measures should be taken to strengthen traffic safety knowledge education and intervention in healthy behaviors among adolescents, in order to reduce the incidence of road traffic injury.
		                        		
		                        		
		                        		
		                        	
4.Correlation between depressive symptoms and sleep quality among middle school students in Shanghai
Lijing SUN ; Yuefang ZHOU ; Zhe ZHANG ; Wenjuan QI ; Yani ZHAI ; Chunyan LUO
Journal of Environmental and Occupational Medicine 2022;39(10):1128-1133
		                        		
		                        			
		                        			Background The correlation between depression and sleep quality is well established in adults, but similar evidence is lacking in adolescents. Objective To study the sleep quality, the positive rate of depressive symptoms, and their correlation among middle school students in Shanghai, so as to provide a basis for providing mental health and sleep management to this group of students. Methods From September to November 2020, using multi-stage stratified cluster random sampling method, a total of 7796 students from 32 middle schools in 16 districts of Shanghai were selected to conduct a questionnaire survey. The questionnaire for middle school students of the 2020 Shanghai Students’ Common Diseases and Health Influencing Factors Surveillance was used to collect students' demographic information, history of smoking, history of drinking, and history of chronic diseases; the Pittsburgh Sleep Quality Index was used to assess sleep quality; and the Center for Epidemiological Studies Depression Scale was used to evaluate depressive symptoms. χ2 test was used to compare qualitative data between groups. Binary logistic regression was used to analyze the correlation between sleep quality and depressive symptoms among middle school students in Shanghai. Results After excluding incomplete questionnaires, a total of 7160 valid questionnaires were collected. The average sleep time of middle school students in Shanghai was (7.54±1.15) h. Among them, 84.8% reported insufficient sleep time < 9 h, and only 15.2% reported sleep time ≥9 h. In addition, 9.2% of the students had poor sleep quality (Pittsburgh Sleep Quality Index ≥8 points). The sleep quality of urban students was worse than that of suburban students. The sleep quality of girls was worse than that of boys. The sleep quality of students in the third grade of middle school was worse than that of students in the first and second grades of middle school. Students with smoking history, drinking history, and chronic disease history had worse sleep quality than those without (P<0.05). The positive rate of depressive symptoms among middle school students in Shanghai was 22.2%, among which 7.0% reported possible depressive symptoms and 15.2% reported definite depressive symptoms. The positive rate of depressive symptoms in female students (26.1%) was higher than that in male students (18.5%); among different grades of middle school, the positive rate of depressive symptoms of the third grade middle school students was the highest (24.1%); the positive rates of depressive symptoms in students with smoking history, drinking history, and chronic disease history were higher than those without; the positive rate of depressive symptoms was higher in students with poor sleep quality (P<0.05). The results of logistic regression analysis indicated that the students with poor sleep quality showed higher risks of reporting depressive symptoms, and the OR (95%CI) was 17.064 (14.024-20.764). Conclusion The positive rates of poor sleep quality and depressive symptoms of middle school students in Shanghai are high, and there is a significant correlation between these two indicators. For students’ mental health and sleep management, more attention should be paid to the quality in addition to the quantity of sleep.
		                        		
		                        		
		                        		
		                        	
5.Exploration and practice of collaborative teaching in anesthesia nursing
Di LIU ; Yang FU ; Wenlin ZHANG ; Lei LI ; Yuan GAO ; Yuhang SUN ; Yuefang SUN ; Ying WANG
Chinese Journal of Medical Education Research 2022;21(8):1113-1116
		                        		
		                        			
		                        			Objective:To explore the effect of collaborative teaching on anesthesia nursing.Methods:A total of 50 anesthesiology nursing undergraduates were randomly selected from the Batch 2018 of Harbin Medical University as experimental group and control group respectively. The two groups completed the teaching tasks in the same teaching hours. The control group was taught by traditional teaching method. The experimental group was jointly taught by the teaching team composed of anesthesia nursing teachers, humanistic medicine teachers and ideological and political teachers. After the completion of teaching, the two groups of students were surveyed by questionnaire to evaluate the teaching effect. SPSS 22.0 was used Fisher's exact probability test.Results:The questionnaire results showed that in the evaluation of collaborative teaching, the evaluation of expanded ideological, political and humanistic knowledge (96.00%, 48/50), strengthened the understanding of theoretical knowledge (88.00%, 44/50), improved doctor-patient communication ability (90.00%, 45/50), improved clinical strain ability (94.00%, 47/50), and improved professional identity (86.00%, 43/50) of the experimental group was significantly higher than that of the control group ( P<0.05). Conclusion:The collaborative teaching method in anesthesiology nursing course can not only strengthen students' mastery of clinical skills, but also cultivate lofty sense of mission and professional spirit, strengthen doctors' benevolent belief, improve medical students' comprehensive quality in an all-round way, and promote the development of new medical education.
		                        		
		                        		
		                        		
		                        	
6.Construction of risk assessment index system of epidemic infectious diseases in primary and middle schools
SUN Lijing, ZHAI Yani, ZHOU Yuefang, ZHANG Zhe, LU Yinhao, LUO Chunyan
Chinese Journal of School Health 2022;43(8):1257-1262
		                        		
		                        			Objective:
		                        			To establish a risk assessment index system for epidemic infectious diseases in primary and secondary schools, for early warning and prevention of school infectious diseases accurately and timely.
		                        		
		                        			Methods:
		                        			Through literature review, the indicators pool was established by consulting relevant experts and referring to practical experience. Then two rounds of expert consultation using the Delphi method were conducted(13 experts of round 1, and 20 experts of round 2). The concentration of expert opinions (the average, the percentage of full marks) and the coordination of expert opinions (the coefficient of variation, the coordination coefficient  W ) were calculated and analyzed. The coordination coefficient  W  was obtained by nonparametric Kendall s  W  test of multiple samples. According to the experts  feedback, necessary addition, reduction and modification of the indicators were carried out to determine the evaluation index system, and the analytic hierarchy process (AHP) was used to calculate the weight of each indicator.
		                        		
		                        			Results:
		                        			The expert authority coefficients of the two rounds of consultation were 0.89 and 0.88, respectively, and the form recovery rate was 100%. The range of the variation coefficient of each three level indicator was 0.07-0.31 and 0.06-0.19, and the coordination coefficient  W  was 0.25 and 0.47, respectively, indicating that the consistency and credibility of expert opinions were good. Finally, the risk assessment index system of infectious diseases in primary and secondary schools was established, which was composed of 5 first level indexes, 23 second level indexes and 86 third level indexes. The AHP was used to calculate the intra level weight of the index. The variation coefficient of five first level indicators of school health management and security system, school health personnel facilities, health monitoring and cognition level, severity and coping measures were 0.09, 0.06, 0.08, 0.12 and  0.06 , respectively, and the weight coefficients were 20.42%, 21.19%, 19.87%, 17.45% and 21.08%, respectively.
		                        		
		                        			Conclusion
		                        			The risk assessment index system of school infectious diseases is applicable to primary and secondary schools. The initiative, coordination and authority of experts in this system are all high. It is of practical guiding significance for the early warning of infectious diseases in primary and secondary schools.
		                        		
		                        		
		                        		
		                        	
7.Investigation on the establishment of health care institutions and the need for personnel capacity improvement in primary and secondary schools in Shanghai
SUN Lijing, LUO Chunyan, ZHANG Zhe, ZHOU Xinyi, ZHOU Yuefang
Chinese Journal of School Health 2022;43(6):937-940
		                        		
		                        			Objective:
		                        			To investigate the establishment of health care institutions and the staffing primary and secondary school health care in Shanghai, and to understand the capacity building needs of health care personnel.
		                        		
		                        			Methods:
		                        			A survey was conducted on all primary and secondary schools in Shanghai from April to August in 2020. The content of the questionnaire covers the establishment of health care institutions, the staffing of school health care centers and the capacity building need of health care personnel.  Chi square test was used to compare the difference of the health care institutions setting and staffing by schools and areas.
		                        		
		                        			Results:
		                        			In 2020, there were 1 847 primary and secondary schools in Shanghai (including branches schools). About 51.4% of primary and secondary schools in Shanghai were equipped with school health care personnel in the ratio of the number of students at least  600∶1 , and the staffing compliance rate of urban schools (59.3%) was higher than that of suburban schools (47.3%)( χ 2=24.27,  P <0.01). All school health care personnel believed that there are currently few opportunities for capacity buliding services from health facilities.
		                        		
		                        			Conclusion
		                        			School health care institutions in Shanghai are well equipped, but the staffing shortage is substantial, with strong need for capacity building.
		                        		
		                        		
		                        		
		                        	
8.Effect of neutrophil-lymphocyte ratio at the initial visit on the survival of children with newly diagnosed medulloblastoma
Lulu WAN ; Wanshui WU ; Shuxu DU ; Hong TANG ; Xiaojun GONG ; Miao LI ; Jin ZHANG ; Siqi REN ; Shuting LI ; Yuan WANG ; Yan LIU ; Wenchao GAO ; Jingjing LIU ; Yuefang WU ; Yanling SUN ; Liming SUN
Chinese Journal of Applied Clinical Pediatrics 2022;37(2):116-120
		                        		
		                        			
		                        			Objective:To explore the effect of neutrophil-lymphocyte ratio (NLR) at the initial visit on the survival of children with newly diagnosed medulloblastoma (MB).Methods:This was a case-control study involving 61 children with newly diagnosed MB at the Department of Pediatrics, Beijing Shijitan Hospital, Capital Medical University from August 2018 to January 2020 .The blood cell counts, lymphocyte subsets and immunoglobulin in the periphe-ral blood were measured to calculate NLR at the initial visit.Based on the cut-off value determined by receiver opera-ting characteristic (ROC) curve, patients were divided into high NLR group (≥ 2.07, n=21) and low NLR group (<2.07, n=40). The progression-free survival (PFS) and overall survival (OS) between 2 groups were analyzed by the Kaplan-Meier method, followed by Log- rank test.The correlation between NLR at the initial visit with clinical characteristics, lymphocyte subsets and immunoglobulin of children with newly diagnosed MB was analyzed.Differences between groups were compared by the Chi- square test, Mann- Whitney U test and independent sample t test. Results:The survival analysis showed that the relapse rate (38.1% vs.10.0%, χ2=6.879, P=0.016) and mortality rate (19.0% vs.0, χ2=8.154, P=0.011) were significantly higher in high NLR group than those of low NLR group.PFS (12 months vs.19 months, χ2=9.775, P=0.002) and OS (19 months vs.20 months, χ2=8.432, P=0.004) were significantly shorter in high NLR group than those of low NLR group.No significant differences in clinical characteristics were detected between groups (all P>0.05). Compared with low NLR group, the percentage of T lymphocyte[(67.93±6.37)% vs.(73.38±8.08)%, t=2.886, df=48.865, P=0.006], T helper cells (Th)[(30.86±5.53)% vs.(34.29±7.44)%, t=2.037, df=51.981, P=0.047], and T suppressor cells (Ts)[(27.39±5.50)% vs.(30.84±6.58)%, t=2.164, df=47.581, P=0.035] were significantly lower in high NLR group.Spearman correlation analysis showed a negative correlation between NLR and T lymphocyte count ( r=-0.303, P=0.018), and Ts lymphocyte count ( r=-0.260, P=0.043). Conclusions:Children with newly diagnosed MB expressing a high level of NLR had a poor prognosis, which may be associated with T lymphocyte and Ts lymphocyte.
		                        		
		                        		
		                        		
		                        	
9.Sleep duration, sleep quality and related factors among primary school students in Shanghai
SUN Lijing, ZHANG Zhe, ZHOU Yuefang, ZHOU Xinyi, LUO Chunyan
Chinese Journal of School Health 2021;42(3):354-357
		                        		
		                        			Objective:
		                        			To investigate the general situation of sleep duration, sleep quality and related risk factors among primary students in Shanghai and to provide evidence for the prevention and control of students sleep health.
		                        		
		                        			Methods:
		                        			By using stratified cluster random  sampling method, 3 410 students from 16 primary schools in four urban areas and four suburb areas of Shanghai were selected to conduct sleep health questionnaire survey and physical examination Chi square test was used for group comparison while binary Logistic regression was used to assess possible factors related with sleep quality.
		                        		
		                        			Results:
		                        			The detection rate of sleep insufficiency (<10 h) among students was 93.0%. The detection rate of poor sleep quality was 66.8% with 67.1% in girls and 66.6% in boys. The top three sleep problems were daytime sleepiness(80.9%), irregular sleep duration (74.1%) and sleep anxiety(59.5%). Multivariate Logistic regression analysis showed that everyday moderate-intensity physical activity (OR=1.51, 95%CI=1.04-2.21) and daily walking activity (more than 10 minutes)(OR=1.27, 95%CI=1.08-1.50) were risk factors of poor sleep quality(P<0.05).
		                        		
		                        			Conclusion
		                        			In Shanghai, the prevalence of sleep insufficiency and poor sleep quality among primary students are high. Sleep health was associated with moderate physical activity and walking activity. Increasing the duration of moderate physical activity and daily walking activity is the very important measures in prevention and control of the sleep problems.
		                        		
		                        		
		                        		
		                        	
10.Relationship between body fat percentage and high blood pressure among junior high school students in Shanghai
YANG Dongling,ZHOU Yuefang,SUN Lijing,QI Wenjuan,QU Shuangxiao,LUO Chunyan,FENG Xiaogang
Chinese Journal of School Health 2021;42(5):746-750
Objective: To investigate the relationship between body fat percentage (BF%) and high blood pressure among adolescents in Shanghai, and to provide basis for early prevention and intervention of cardcovascular diseases. Methods: By using stratified cluster sampling method, a total of 5 148 adolescent students in 16 schools from 16 districts of Shanghai were selected. Questionnaire survey and physical examination were performed. The bioelectrical impedance analysis (BIA) was used to measure body fat percentage. National Blood Pressure Reference for Chinese Han Children was used to define high blood pressure. And T test, chi-square test and Logistici regression were used to assess the relation between BF% with high blood pressure. Results: The prevalence of high blood pressure in 5 148 junior middle school students in Shanghai was 10.98%, with girls (13.13%) higher than boys (8.99%)(χ 2=22.48, P<0.01). The average total body fat percentage of male students was (20.90±10.73)%, which decreased with age (linear trend variance is 10.04, P<0.01). The average total body fat percentage of girls was (25.14±8.03)%, which increased with age (linear trend variance is 69.23, P<0.01). After adjusted for age, diet, exercise and other influencing factors, the prevalence of hypertension showed an increasing trend with the increase of body fat percentage for both boys and girls. The risk of high blood pressure in boys with BF%≥P 90 was 12.43 times higher than that in boys with BF%
Conclusion
		                        			There was a positive correlation between body fat percentage and high blood pressure in adolescents. The prevalence of high blood pressure increased with the increase of body fat percentage, which was more obvious in boys.
		                        		
		                        		
		                        		
		                        	
            

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