1.Platelet Metabolomics Analysis in Rats of Coronary Heart Disease with Blood Stasis Syndrome by Overexpression of Fibrinogen
Manli ZHOU ; Jiale ZHU ; Liping WANG ; Weixiong JIAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(6):230-237
ObjectiveTo analyze the metabolomic characteristics of platelets in fibrinogen(FIB) overexpression rats of coronary heart disease with blood stasis syndrome(CHD-BSS), explore potential biomarkers, and investigate the mechanism of FIB overexpression on CHD-BSS. MethodsSD rats were randomly divided into BSS group and BSS+FIB overexpression group(BSS+FIB group), with 10 rats in each group. Both the BSS+FIB group and the BSS group were fed a high-fat diet combined with oral administration of vitamin D3 and subcutaneous injection of isoproterenol, but rats in the BSS+FIB group were overexpressed with FIB during the initial modeling stage by transfection with adeno-associated virus(AAV). The overexpression level of FIB in rat liver and plasma samples was detected by enzyme-linked immunosorbent assay(ELISA) and real-time fluorescence quantitative polymerase chain reaction(Real time PCR), as well as the expression level of liver FIB A(FGA) mRNA. The characteristics of metabolites in rat platelet samples were analyzed by ultra-high performance liquid chromatography-quadrupole-electrostatic field orbital trap high-resolution mass spectrometry(UPLC-Q-Exactive Orbitrap-MS), and the differential metabolites between groups were screened by principal component analysis(PCA) and orthogonal partial least squares-discriminant analysis(OPLS-DA), and the enriched pathways were analyzed. The accuracy of potential biomarkers in the diagnosis of CHD-BSS was evaluated by receiver operating characteristic(ROC) curve. The expression of autophagy related proteins phosphorylated adenosine monophosphate(AMP) activated protein kinase(p-AMPK)/AMPK, phosphorylated mammalian target of rapamycin(p-mTOR)/mTOR, microtubule-associated protein 1 light chain 3(LC3) Ⅱ/Ⅰ and p62 in platelets were detected by Western blot. ResultsCompared with the BSS group, the expression levels of FIB in liver and plasma samples of the BSS+FIB group were significantly increased(P<0.05, P<0.01), and the expression level of FIB mRNA in the liver was remarkably increased(P<0.01), indicating successful overexpression of FIB. Platelet metabolomics results showed significant differences in metabolic profiles between the BSS+FIB group and the BSS group, and a total of 25 significantly enriched metabolic pathways and 8 metabolites involved in these metabolic pathways, among which uric acid, guanosine and ribose 1-phosphate levels were up-regulated, while adenosine diphosphate(ADP), AMP, guanosine diphosphate(GDP), adenylosuccinate and norepinephrine levels were down-regulated. The diagnostic ability analysis of differential metabolites showed that all 8 differential metabolites had good diagnostic ability, with an area under the curve(AUC)>0.85. Western blot results showed that compared with the BSS group, the expression levels of p-mTOR/mTOR and p62 proteins in platelets of the BSS+FIB group was significantly reduced(P<0.01), while the expression levels of p-AMPK/AMPK and LC3Ⅱ/Ⅰ proteins were increased, but the difference was not statistically significant. ConclusionOverexpression of FIB can change the metabolic characteristics of CHD-BSS rat model, involving multiple aspects such as vascular endothelial injury, platelet activation and myocardial function damage. Among them, overexpression of FIB may enhance the occurrence of platelet autophagy, thereby inducing platelet activation and promoting thrombus formation.
2.Analysis of risk factors for post-prematurity respiratory disease in very preterm infants
You YOU ; Jingwen LYU ; Lin ZHOU ; Liping WANG ; Jufeng ZHANG ; Li WANG ; Yongjun ZHANG ; Hongping XIA
Chinese Journal of Pediatrics 2025;63(1):50-54
Objective:To investigate the risk factors associated with post-prematurity respiratory disease (PPRD) in very preterm infants.Methods:A prospective cohort study was conducted, enrolling 369 very preterm infants who were admitted to the neonatal intensive care unit of Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, within one week of birth from January 2019 to June 2023. Data on maternal and infant clinical characteristics, neonatal morbidities, and treatments during hospitalization were collected. The very preterm infants were divided into 2 groups based on whether they developed PPRD. Continuous variables were compared using Mann-Whitney U test, while categorical variables were compared using χ2 tests or continuity correction χ2 test. Multivariate Logistic regression analysis was used to identify the independent risk factors for PPRD in very preterm infants. Results:Among the 369 very preterm infants, 217 cases(58.8%) were male, with a gestational age of 30 (28, 31) weeks at birth and a birth weight of 1 320 (1 085, 1 590) g. Of these, 116 cases (31.4%) developed PPRD, while 253 cases (68.6%) did not. The very preterm infants in the PPRD group had a lower gestational age and lower birth weight (both, P<0.001). The PPRD group also had a higher proportion of males, lower Apgar scores at the 1 th minute after birth and the 5 th minutes after birth, a higher rate of born via cesarean delivery, and a higher incidence of bronchopulmonary dysplasia, more pulmonary surfactant treatment, longer durations of mechanical ventilation, longer total oxygen therapy, and lower Z-score for weight at discharge (all P<0.05). Multivariate Logistic regression analysis showed that gestational age ( OR=0.85, 95% CI 0.73-0.99, P=0.037), born via cesarean delivery ( OR=2.23, 95% CI 1.21-4.10, P=0.010), a duration of mechanical ventilation ≥7 days ( OR=2.51, 95% CI 1.43-4.39, P=0.001), and a Z-score for weight at discharge ( OR=0.82, 95% CI 0.67-0.99, P=0.040) were all independent risk factors for PPRD in very preterm infants. Conclusion:Very preterm infants with a small gestational age, born via cesarean section, mechanical ventilation ≥7 days, and a low Z-score for weight at discharge should be closely monitored for PPRD, and provided with standardized respiratory management after discharge.
3.Establishment of a method for detecting the potency of recombinant human coagulation factor Ⅶa for injection
Rong WU ; Liping WANG ; Jinye LANG ; Yue ZHU ; Jing ZHOU ; Xun LIU ; Jing NI ; Shunbo ZHOU ; Yaling DING
Chinese Journal of Blood Transfusion 2025;38(3):415-420
[Objective] To establish a method for detecting the potency of recombinant human coagulation factor Ⅶa for injection. [Methods] By adding the sample and factor Ⅶ deficient plasma to the sample cup and activating the reaction with prothrombin time assay reagent (PT reagent), the coagulation time of the sample was determined by the change in magnetic bead swing amplitude in the sample cup. The logarithm of coagulation time was inversely proportional to the logarithm of human factor Ⅶa potency. [Results] Under the experimental conditions, the specificity of the methodology was evaluated through spiked recovery, and the recovery rates ranged from 90.0% to 110.0%. Within the range from 0.125 to 1.000 IU/mL, there was a good linear response between the potency and coagulation time of the standard and sample, with correlation coefficients r>0.99. As for the accuracy and repeatability, the recovery rates of various concentrations detected in the stock solution were 101.0%, 100.0% and 112.0%, respectively, with RSD values of 2.6%, 4.0% and 0.0%, respectively. The recovery rates of various concentrations in finished product testing were 104.0%, 94.7% and 112.0%, respectively, with RSD values of 1.9%, 2.4% and 0.0%, respectively. As for the intermediate precision, the RSD were 4.5% and 3.7%, respectively. After treated with sample diluent, the sample was tested at room temperature for 6 hours and still exhibited relatively stable biological activity. [Conclusion] This detection method is accurate, stable, easy to operate and highly automated, and is suitable for detecting the potency of recombinant human coagulation factor Ⅶa for Injection.
4.Mechanism of Fibrinogen Overexpression in Influencing Coronary Heart Disease with Syndrome of Blood Stasis in Rats Based on Mitochondrial Quality Control System
Manli ZHOU ; Liping WANG ; Weixiong JIAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(10):149-158
ObjectiveTo study the effect and mechanism of fibrinogen (Fib) overexpression on mitochondrial quality control system in the rat model of coronary heart disease with the syndrome of blood stasis. MethodsForty male SD rats were randomly assigned into normal, model, Fib, and empty vector (AAV) groups, with 10 rats in each group. The model, Fib, and AAV groups were fed with a high-fat diet adaptively and administrated with 3×106 U·kg-1 vitamin D3 powder by gavage after 7 days and 2×106 U·kg-1 vitamin D3 solution after 14 days. After being fed with a high-fat diet for 7 weeks, rats in each group received subcutaneous injection of isoproterenol (5 mg·kg-1) for 3 days. During the modeling period, rats in the normal group were fed with ordinary feed without any special treatment. The changes in blood lipid and hemorheological indexes of rats in each group were measured. The aorta tissue was stained with hematoxylin-eosin (HE), and the standard lead Ⅱ electrocardiograms (ECGs) of rats in each group were recorded. Enzyme-linked immunosorbent assay (ELISA) and real-time PCR were employed to verify the overexpression levels of Fib in the liver and plasma. Western blotting was employed to determine the protein levels of mitofusin 2 (Mfn2), optic atrophy protein 1 (OPA1), dynamin-related protein 1 (Drp1), phosphorylated adenosine monophosphate-activated protein kinase (p-AMPK)/adenosine monophosphate-activated protein kinase (AMPK), peroxisome proliferator-activated receptor γ-coactivator-1α (PGC-1α), PTEN-induced putative kinase 1, and Parkin. Real-time PCR was employed to determine the mRNA levels of AMPK and PGC-1α in the myocardial tissue. The changes in levels of adenosine triphosphate (ATP) and adenosine monophosphate (AMP) in the myocardial tissue were determined by ELISA. ResultsCompared with the normal group, the other three groups showed elevated levels of total cholesterol and low-density lipoprotein cholesterol (P<0.01) and no significant changes in levels of triglyceride and high-density lipoprotein cholesterol. Compared with the model group, the Fib and AAV groups showed risen levels of total cholesterol (P<0.05, P<0.01). Compared with the normal group, the model and Fib groups presented increases in low shear viscosity and middle shear viscosity (P<0.05, P<0.01), and the Fib group showcased an increase in high shear viscosity (P<0.01). Compared with the model group, the Fib group showed increases in low shear viscosity, middle shear viscosity, and high shear viscosity (P<0.05, P<0.01). Compared with the Fib group, the AAV group demonstrated decreases in low shear viscosity, middle shear viscosity, and high shear viscosity (P<0.05, P<0.01). The normal group had an complete aortic structure with well arrangement of elastic fibers. In the model group, the vascular wall became thickened and the intima was rough with inflammatory infiltration. In the Fib group, the intima calcification formed a cavity structure and the intima was abnormally proliferated, while in the AAV group, the intima smooth muscle was slightly proliferated with local calcification. The ECG of the normal group indicated sinus rhythm, and that of the model group presented ST segment oblique elevation (>0.1 mV). The ECG of the Fib group presented characteristic ST segment arch back elevation with T-wave towering, and that of the AAV group presented ST segment oblique elevation. Compared with the normal group, the model and Fib groups showed elevations in levels of liver Fib, plasma Fib, and liver Fibα mRNA (P<0.01), and the AAV group had risen levels of Fib and Fibα mRNA (P<0.01). Compared with the model group, the Fib group presented risen levels of liver Fib and Fibα mRNA (P<0.01). Compared with the Fib group, the AAV group presented decreases in levels of liver Fib, plasma Fib, and liver Fibα mRNA (P<0.01). Compared with the normal group, the other three groups had down-regulated protein and mRNA levels of Mfn2, OPA1, PINK1, Parkin, p-AMPK/AMPK, and PGC-1α (P<0.05, P<0.01) and up-regulated protein levels of Drp1 (P<0.01). Compared with those in the model group, the mRNA and protein levels of Mfn2, OPA1, PINK1, Parkin, p-AMPK/AMPK, and PGC-1α were all down-regulated (P<0.05, P<0.01) and the protein level of Drp1 was up-regulated (P<0.01) in the Fib group. Compared with the Fib group, the AAV group showed differences in protein levels of OPA1, PGC-1α, Parkin, and Drp1 (P<0.05, P<0.01) and an increasing trend in the mRNA levels of AMPK and PGC-1α with no significant difference. Compared with the normal group, the other three groups had elevated levels of ATP in the myocardial tissue (P<0.01). Compared with the model group, the Fib group showed elevated levels of ATP and AMP (P<0.01). Compared with the Fib group, the AAV group exhibited lowered levels of ATP and AMP (P<0.01). ConclusionFib can achieve the overexpression effect in the rat model of coronary heart disease with the syndrome of blood stasis. At the same time, the overexpression of Fib can induce the damage of the mitochondrial quality control system in the myocardial tissue, inhibit mitochondrial dynamics and mitochondrial biosynthesis, and down-regulate mitochondrial autophagy, thereby aggravating myocardial injury in the rat model.
5.Effects of di(2-ethylhexyl) phthalate on glucose homeostasis in rats due to impaired autophagy flux of islet β cells mediated by oxidative stress
Hongyang ZHOU ; Yuting HU ; Xue CHEN ; Yunqiang ZHOU ; Liping LI ; Ling LI ; Herong LIU
Journal of Environmental and Occupational Medicine 2025;42(6):674-683
Background Di(2-ethylhexyl) phthalate (DEHP) is the most prevalent environmental endocrine disruptor among phthalate acid esters (PAEs) worldwide. Previous studies have indicated that exposure to DEHP may disrupt glucose metabolism. Objective To investigate the impact of DEHP on glucose homeostasis in rats, focusing on oxidative stress-induced impairment of autophagy in islet β cells. Methods Forty male SD rats were randomly assigned to four groups, receiving DEHP doses of 0, 187, 375, and 750 mg·kg−1 for 12 weeks. Oral glucose tolerance (OGTT) and insulin tolerance tests (ITT) were conducted 24 h after the final exposure. Pancreatic microstructural alterations were assessed using hematoxylin and eosin (HE) staining and transmission electron microscopy (TEM). Commercial ELISA kits were employed to quantify the levels of insulin, adenosine triphosphate (ATP), and adenosine monophosphate (AMP) in rat serum, as well as the protein expression level of activated caspase-3 in pancreatic tissue. Additionally, commercial microplate kits were utilized to measure the concentration of reduced glutathione (GSH) in serum, the activity of superoxide dismutase (SOD) using water-soluble tetrazolium salt-1, the content of malondialdehyde (MDA) by thiobarbituric acid method, and the level of reactive oxygen species (ROS) in pancreatic tissue by chemical fluorescence method. Reverse transcription polymerase chain reaction (RT-PCR) was used to measure sequestosome1 (SQSTM1/p62), Beclin1, microtubule-associated protein 1 light chain 3 (LC3), and cysteinyl aspartate specific proteinase-8 (Caspase-8) mRNA levels. Western blot analysis was applied to detect the protein relative expression levels of p62, Beclin-1, LC3-I, LC3 II, AMPK, p-AMPK, mTOR, p-mTOR, ULK1, and Caspase-8. Results Compared to the 0 mg·kg−1 DEHP group, the 750 mg·kg−1 DEHP group exhibited a significant increase in fasting blood glucose levels at 2, 4, 6, and 12 weeks (P<0.05). The OGTT showed that, following high-glucose gavage, the 187 mg·kg−1 DEHP group had elevated blood glucose at 30 min (P<0.05), the 375 mg·kg−1 DEHP group showed increased glucose levels at 15, 30, and 180 min (P<0.05), and the 750 mg·kg−1 DEHP group exhibited elevated levels at 15, 30, 60, and 180 min (P<0.05). The 375 and 750 mg·kg−1 DEHP groups demonstrated significantly increased OGTT area under the curve (AUC) values (P<0.05). In contrast, ITT results indicated no significant differences in blood glucose levels or AUC among the DEHP exposure groups at all time points (P>0.05). Compared to the 0 mg·kg−1 DEHP group, the 750 mg·kg−1 DEHP group exhibited significantly higher HOMA-IR levels and markedly lower HOMA-ISI values (P<0.05). HE and TEM showed that in each DEHP exposure group, the number of islet cells decreased, the islet area reduced, and chromatin condensation occurred. The endocrine granules in the cytoplasm of islet β cells decreased, and there were varying degrees of widening of the nuclear membrane gap, flattening and expansion of the Golgi complex, and expansion of the endoplasmic reticulum. Ribosome separation was observed, and autophagosomes were visible. In the 375 and 750 mg·kg−1 DEHP groups, the mitochondria were deformed to varying degrees, and some cristae structures disappeared, presenting vacuolization. Moreover, the chromatin condensation in the nuclei was more severe in the 750 mg·kg−1 DEHP group. The serum SOD activity was significantly elevated in the 750 mg·kg−1 DEHP group (P<0.05). Both the 375 mg·kg−1 and 750 mg·kg−1 DEHP groups exhibited a significant increase in the relative ROS content in pancreatic tissue (P<0.05). In DEHP-treated groups, the MDA content increased (P<0.05), while the GSH content decreased (P<0.05). Additionally, in the 750 mg·kg−1 DEHP group, the AMP/ATP ratio in serum was significantly raised (P<0.05), and the expression of cleaved Caspase-3 protein in pancreatic tissue was also significantly increased (P<0.05). The relative mRNA levels of p62, Beclin-1, LC3, and Caspase-8 in the pancreatic tissue of rats exposed to DEHP were significantly elevated (P<0.05). The relative expression levels of p-AMPK/AMPK, p-ULK1/ULK1, and Beclin-1 proteins in the DEHP-treated groups were significantly increased (P<0.05). In the 375 mg·kg−1 and 750 mg·kg−1 DEHP treatment groups, the relative expression levels of p62, LC3 II/LC1, and Caspase-8 proteins were significantly increased (P<0.05), while the relative expression level of p-mTOR/mTOR was significantly decreased (P<0.05). Conclusion DEHP can disrupt glucose homeostasis by inducing oxidative stress, which subsequently activates autophagy via the ROS/AMPK/ULK1 pathway, impairing autophagic flux and promoting apoptosis of islet β cells, ultimately decreasing their function and number.
6.Incidence of pulmonary tuberculosis and its influencing factors in Hubei Province based on the geographically weighted regression model
Xingxing LU ; Xun LIU ; Fan WANG ; Jianjun YE ; Yu ZHANG ; Chengfeng YANG ; Liping ZHOU ; Hongxing WANG ; Wenqian ZHOU
Journal of Public Health and Preventive Medicine 2025;36(5):28-31
Objective To study the spatial distribution of the incidence of pulmonary tuberculosis in Hubei Province and its influencing factors, so as to improve the theoretical basis for scientific development of tuberculosis prevention and control measures in the future. Methods The data of reported incidence of tuberculosis and related influencing factors in various counties and districts of Hubei Province in 2020 were collected. Global Moran's I index, hotspot analysis and geographically weighted regression (GWR) model analysis were used to calculate the spatial autocorrelation of the incidence of tuberculosis, and to analyze the influencing factors affecting the incidence rate of tuberculosis. Results There were obvious regional differences in the space distribution of the incidence rate of tuberculosis. Hot spot analysis showed positive spatial correlation and obvious clustering. The GWR model (AICc=784.251) in this study had higher AICc value compared to the ordinary least squares regression (OLS) model (AICc=804.2585). The GWR model showed that the increase in the proportion of the population aged 65 and above and the proportion of the ethnic minority population had a significant promoting effect on the increase of the incidence rate of tuberculosis, and there was significant spatial heterogeneity. The effect of PM2.5 concentration on the incidence rate of pulmonary tuberculosis varied in different regions, and the degree of effect was also different. Conclusion The proportion of people aged 65 and above and the proportion of ethnic minorities may significantly influence the incidence of pulmonary tuberculosis. The effect of PM2.5 concentration varies in different regions, so targeted measures should be formulated according to the situation in different regions.
7.Incidence of pulmonary tuberculosis and its influencing factors in Hubei Province based on the geographically weighted regression model
Xingxing LU ; Xun LIU ; Fan WANG ; Jianjun YE ; Yu ZHANG ; Chengfeng YANG ; Liping ZHOU ; Hongxing WANG ; Wenqian ZHOU
Journal of Public Health and Preventive Medicine 2025;36(5):28-31
Objective To study the spatial distribution of the incidence of pulmonary tuberculosis in Hubei Province and its influencing factors, so as to improve the theoretical basis for scientific development of tuberculosis prevention and control measures in the future. Methods The data of reported incidence of tuberculosis and related influencing factors in various counties and districts of Hubei Province in 2020 were collected. Global Moran's I index, hotspot analysis and geographically weighted regression (GWR) model analysis were used to calculate the spatial autocorrelation of the incidence of tuberculosis, and to analyze the influencing factors affecting the incidence rate of tuberculosis. Results There were obvious regional differences in the space distribution of the incidence rate of tuberculosis. Hot spot analysis showed positive spatial correlation and obvious clustering. The GWR model (AICc=784.251) in this study had higher AICc value compared to the ordinary least squares regression (OLS) model (AICc=804.2585). The GWR model showed that the increase in the proportion of the population aged 65 and above and the proportion of the ethnic minority population had a significant promoting effect on the increase of the incidence rate of tuberculosis, and there was significant spatial heterogeneity. The effect of PM2.5 concentration on the incidence rate of pulmonary tuberculosis varied in different regions, and the degree of effect was also different. Conclusion The proportion of people aged 65 and above and the proportion of ethnic minorities may significantly influence the incidence of pulmonary tuberculosis. The effect of PM2.5 concentration varies in different regions, so targeted measures should be formulated according to the situation in different regions.
8.Ancient Literature Analysis and Modern Clinical Application of Famous Classical Formula Huagaisan
Qiaonan CHEN ; Canyu SU ; Chen WANG ; Liping ZHANG ; Wei ZHOU ; Conghui WANG ; Xien LOU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(5):35-45
ObjectiveTo sort out the historical evolution, prescription evolution and modern clinical application of Huagaisan. MethodHuagaisan and its synonym Huagaitang are used as keywords to search the databases of Traditional Chinese Medicine Think Tank, Chinese Medical Dictionary, Airusheng Chinese Medical Database and China National Knowledge Infrastructure(CNKI). According to the inclusion and exclusion criteria, we obtained the information of ancient books and modern clinical research literature related to Huagaisan, and systematically reviewed and analyzed the historical origin, prescription composition, preparation method, dosage, efficacy, medicinal material origin, processing method and modern clinical application of Huagaisan. ResultA total of 198 pieces of ancient book information were included, involving 93 ancient Chinese medicine books. Huagaisan was composed of fried Perillae Fructus, red Poria, fried Mori Cortex, Citri Eoxcarpium Rubrum, stir-fried Armeniacae Semen Amarum, Ephedrae Herba and fried Glycyrrhizae Radix et Rhizoma, which had the efficacy of promoting the lungs and relieving epidemiological symptoms, expelling phlegm and relieving cough, and treating cough with wind-cold bundled epidemiological symptoms and stagnation of phlegm and Qi. The preparation method was suggested as boiling powder, crushing the seven herbs into coarse particles, the dosage of each drug was fried Perillae Fructus of 1.27 g, red Poria of 1.27 g, fried Mori Cortex of 1.27 g, Citri Eoxcarpium Rubrum of 1.27 g, stir-fried Armeniacae Semen Amarum of 1.27 g, Ephedrae Herba of 1.27 g and fried Glycyrrhizae Radix et Rhizoma of 0.64 g, taking 8.26 g when decocting, adding 300 mL of water, decocting to 210 mL, removing the dregs, and taking it warmly after meals. Twenty-one clinical research papers were included to analyze the modern clinical application of Huagaisan, which was mainly used in the treatment of respiratory diseases such as pneumonia, asthma, bronchitis and so on. ConclusionThis paper has verified and summarized the key information of the famous classical formula Huagaisan, which can provide a detailed reference basis for the development and clinical application of its compound preparation.
9.Retrospective analysis on the effect of prevention and treatment of senile pulmonary tuberculosis in Hubei Province
Qi PI ; Jianjun YE ; Liping ZHOU ; Mengxian ZHANG ; Yeqing TONG ; Yu ZHANG ; Xingxing LU ; Chengfeng YANG
Journal of Public Health and Preventive Medicine 2024;35(2):44-47
Objective To retrospectively analyze the prevention and control effect and epidemic characteristics of elderly tuberculosis in Hubei Province from 2016 to 2020, and to provide a scientific basis for the prevention and treatment of elderly tuberculosis in Hubei Province. Methods The data on tuberculosis patients aged 60 and above who registered their current address in Hubei Province from 2016 to 2020 were collected and analyzed. The registration rates and composition ratios were analyzed using χ2 test and χ2 test for trend. Results A total of 135 976 tuberculosis patients were reported in Hubei from 2016 to 2020. The annual average registration rate of elderly tuberculosis among the elderly registered residence population (referring to the registration rate of elderly registered residence population aged 60 and above as the denominator, and tuberculosis patients aged 60 and above as the numerator) was 263.51/100 000. The highest rate was 300.02/100,000 in 2017, and the lowest was 188.19/100,000 in 2020 (χ2=70,227.603, P<0.001). In terms of composition, the average annual proportion of tuberculosis patients in the 60-70 years old group was 59.60%, which decreased year by year (χ2trend=40.448,P<0.001 ). The average annual proportion of males was 73.35%, which was significantly higher than that of females (26.65%). The average annual proportion of farmers was 62.03%. From the perspective of case management, the annual average proportion of major epidemic online reports was 85.17%. The classification of cases was mainly based on clinical diagnosis, accounting for 48.33% annually and showing a decreasing trend year by year (χ2trend=740.911, P<0.001). The proportion of confirmed cases was 25.08%, which showed an increasing trend (χ2trend=380.557, P<0.001). From 2016 to 2019, the delay rate of diagnosis and treatment of elder tuberculosis patients was 49.42% (67 876/135 967), and the delay rate decreased year by year (χ2trend=323.764, P<0.001). Conclusion The elderly population with pulmonary tuberculosis in Hubei Province shows a downward trend. It is necessary to focus on the efforts of designated hospitals to proactively identify cases, increase the proportion of confirmed cases, maintain a high tracking in place, reduce medical delays, and ensure the effectiveness of tuberculosis prevention and treatment for the elderly.
10.Establishment of a risk prediction model for poly victimization among rural left behind children
LUO Yandong, CHANG Ping, ZHOU Jiajun, CAO Zicheng, LI Liping
Chinese Journal of School Health 2024;45(4):575-580
Objective:
To construct a risk prediction model for poly victimization (PV) among rural left behind middle and high school students in Chaoshan, and to evaluate the prediction effect of the model, so as to provide scientific basis for early identification and prevention of PV among students.
Methods:
A questionnaire survey was conducted among 1 005 left behind students, selected from 7 middle and high schools in rural areas of Shantou City and Jieyang City by a stratified random cluster sampling method from January 2020 to September 2021, for the personal, family, external environmental factors, psychological factors (mental resilience, coping approaches, self esteem and social support) and PV situations. R software and Logistic regression were used to screen predictor variables to build a risk prediction model, and the area under the ROC curve (area under the curve, AUC), accuracy, precision, recall, F1 value and calibration curve were used to evaluate the model s effect.
Results:
The incidence rate of PV among left behind middle and high school students was 23.38%. The results of Logistic regression analysis showed that physical illness or disability ( β =1.02), grade retention during the past year ( β =1.31), having no close partner ( β =1.00), self harm intention (seldom: β = 0.58 , occasionally: β =0.79), negative peer behavior ( β =0.90), family member smoking ( β =0.59), criminal offenses of parents ( β =1.04), witnessing school bullying ( β =0.78), house moving ( β =0.58), using venting ( β =0.34) and the coping style of patience ( β =0.28) were positively correlated with PV among left behind children in Chaoshan area, and family support in psychological flexibility ( β =-0.31) was negatively correlated with PV ( P <0.05). A nomogram prediction model was constructed for the meaningful variables included in the multivariate analysis, and the prediction model AUC was 0.88, the accuracy was 82.00 %, the precision was 77.78%, and the F1 value was 43.75%. The calibration plot fitted well, and the model had good discrimination and calibration.
Conclusion
The risk prediction model for left behind middle and high school students with PV has good predictive performance and is helpful for schools and communities to early identify high risk middle and high school students with PV.


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