D3 In Group Research Articles

D3 Lymph Node Dissection Improves Survival Outcomes in Patients With cT2 Colorectal Non-well-differentiated Adenocarcinoma.

The extent of lymphadenectomy appropriate for patients with cT2 colorectal cancer (CRC) remains controversial. This study was conducted to compare the survival outcomes of patients with cT2 CRC after D3 or D2 lymph node dissection (LND). Qualifying subjects (N=590) had undergone radical colorectal resections for cT2 CRC and were grouped according to tumor histological type as either well-differentiated (WDA) or non-well-differentiated (nWDA) adenocarcinoma. Each group was further stratified into D3 or D2 LND according to the extent of lymph node dissection. Propensity score matching (PSM) was applied to balance potential confounding factors, and identify independent prognostic risk factors using Cox regression analysis. Primary outcome measures were overall survival (OS), cancer-specific survival, (CSS) and relapse-free survival rate (RFS). Prior to PSM, OS and CSS differed significantly (p=0.001 and p=0.021, respectively) for D3 and D2 LND subsets in the nWDA group. Estimated hazard ratios (HRs) for OS and CSS were 3 [95% confidence interval (CI)=1.3-6.8; p=0.0084] and 3.2 (95%CI=1-10; p=0.047), respectively, in the D3 LND subset. After matching, significant differences in OS (p=0.007) and CSS (p=0.012) were also observed, with corresponding estimated HRs of 4 (95%CI=1.2-14; p=0.028) and 16 (95%CI=1.2-220; p=0.034). In the WDA group, D2 and D3 LND procedures displayed similar favorable prognoses before and after matching. Postoperative complications emerged as independent risk factors for prognosis in the WDA group of patients with cT2 CRC. D3 LND improved survival outcomes in patients with non-well-differentiated cT2 CRC. In patients with well-differentiated cT2 adenocarcinoma, D3 LND was preferred to reduce perioperative complications.

Vitamin D Level in Children with Acute and Relapsing Demyelinating Disorders of the Nervous System

Background Vitamin D has recently gained increased attention owing to its immunomodulatory role. Epidemiological evidence demonstrates that deficiency of Vitamin D is a relevant risk for acute acquired immune-mediated inflammatory demyelinating diseases in childhood, such as Multiple sclerosis (MS). Exact mechanism remains widely unexplored. Aim to measure the serum level vitamin D-25(OH) in pediatric patients diagnosed with acquired central and peripheral demyelinating diseases, and to compare these to levels found in healthy age and gender matched controls. Patients and Methods Twenty children (patients’ group) diagnosed with acute demyelinating diseases (Acute Disseminated Encephalomyelitis (ADEM, n = 7), Acute Necrotizing Encephalopathy of Childhood (ANEC, n = 3), Autoimmune Encephalitis (AE, n = 3), Transverse Myelitis (TM, n = 3), Guillain-Barre syndrome (GBS, n = 4)) and 40 healthy age and gender matched children (control group), were enrolled in the study. All patients were subject to full history, examination and measurement of serum levels of 25 (OH) vitamin D3 in both cases and control group. Results The mean level of vitamin D in cases was 4.4 ± 11.14 ng/ml, and it was deficient in 75% of the cases and insufficient in 15% of cases. The mean vitamin d level in cases was significantly lower than that in controls (27.18 ± 7.8 ng/ml). Conclusion Serum levels of 25 (OH) Vitamin D3 in pediatric acute acquired demyelinating diseases of the nervous system are significantly lower than levels in healthy controls, raising a possibility that vitamin D deficiency may be a risk factor for the development of various autoimmune neurological diseases.

Clinical and immunological analysis of the effectiveness of local application of vitamin D<sub>3</sub> in experimental colitis

The pathogenesis of inflammatory bowel diseases has not been fully studied, and the therapies used have side effects that limit their use.The purpose of this study is to conduct a clinical and immunological analysis of the effectiveness of vitamin D3 in the original rectal suppositories in experimental colitis (EC).EC was modeled with oxazolone. Original suppositories with vitamin D3 in group 3 and 5-ASA in group 4 were used per rectum. The clinic was evaluated on the Disease activity index scale. The expression of MPO and TNFa, the content of neutrophils, lymphocytes, eosinophils, histiocytes, plasmocytes, fibroblasts, ulcerative defect, tissue damage index were determined in the focus of colon injury. The study was carried out on days 2, 4 and 6.With EC, DAI increases for the entire day, MPO and TNFa increase in the lesion, ulcerative defect isfixed, neutrophil-lymphocytic infiltration increases, and TDI increases. When comparing the morphometric parameters of the alteration zone in EC under the conditions of vitamin D3 use, in contrast to the use of 5-ASA, a decrease in the number of lymphocytes, an increase in fibroblasts was revealed on day 2, a decrease in the number of plasmocytes and an increase in fibroblasts on day 4, an increase in the number of histiocytes and fibroblasts on day 6. The diameter of the ulcerative defect and the TDI index have no significant differences between the compared groups. When comparing the effectiveness of vitamin D3, in contrast to the use of 5-ASA, the MPO content is higher on day 6; the TNFa content is higher on day 4.In EC, the effects of using rectal suppositories with vitamin D3 on clinical signs, the size of the ulcerative defect, the content of MPO and TNFa in the lesion are comparable to the effects of using rectal suppositories with 50 mg of 5-ASA; more pronounced with respect to the dynamics of the cellular composition of the lesion of the colon.

Differences and Clinical Significance of Serum 25-Hydroxyvitamin D3 and Vasohibin-1 (VASH-1) Levels in Patients with Diabetic Nephropathy and Different Renal Injuries.

We investigate the relationship between the changes of serum 25-hydroxyvitamin D3 (25(OH)D3) and vasohibin-1 (VASH-1) and renal function injury in patients with type 2 diabetic nephropathy. In this study, 143 patients with diabetic nephropathy (DN) were selected as DN group, and 80 patients with type 2 diabetes mellitus were selected as T2DM group. The serum 25 (OH) D3, VASH-1, blood glucose index, inflammation index and renal function index were compared between the two groups. According to the urinary microalbumin/creatinine ratio (UACR), the DN group was divided into microalbuminuria group (UACR range≥30.0mg/g and <300.0mg/g) and macroalbuminuria group (UACR≥300.0mg/g) for stratified comparison. The correlation between 25-hydroxyvitamin D3, VASH-1 and inflammation index and renal function index was analyzed by simple linear correlation analysis. The level of 25 (OH) D3 in DN group was significantly lower than that in T2DM group (P<0.05). The levels of VASH-1, CysC, BUN, Scr, 24h urine protein, serum CRP, TGF-β1, TNF-α and IL-6 in DN group were higher than those in T2DM group (P<0.05). The level of 25 (OH) D3 in DN patients with massive proteinuria was significantly lower than that in DN patients with microalbuminuria. The level of VASH-1 in DN patients with massive proteinuria was higher than that in DN patients with microalbuminuria (P<0.05). There was a negative correlation between 25 (OH) D3 and CysC, BUN, Scr, 24h urine protein, CRP, TGF-β1, TNF-α, IL-6 in patients with DN (P<0.05). VASH-1 was positively correlated with Scr, 24h urinary protein, CRP, TGF-β1, TNF-α and IL-6 in patients with DN (P<0.05). The level of serum 25 (OH) D3 in DN patients was considerably decreased, and the level of VASH-1 was increased, which was related to the degree of renal function injury and inflammatory response.

Effect of Cadmium on Oxidative Stress Indices and Vitamin D Concentrations in Children

Heavy metal poisoning can have serious health consequences, including damage to the brain, kidneys, and other organs. Cadmium is a toxic heavy metal that can accumulate in the body over time and the exposure to this element has been linked to a variety of adverse health effects. Cadmium toxicity can lead to an imbalance in the cellular redox state and be a source of oxidative stress. On the molecular level, cadmium ions negatively affect cellular metabolism, including the disruption of energy production, protein synthesis, and DNA damage. The study has been carried out on a group of 140 school-age children (8 to 14 years old) inhabiting the industrialized areas of Upper Silesia. The study population was divided into two sub-groups based on the median concentration of cadmium in blood (0.27 µg/L): Low-CdB and High-CdB. Measured traits comprised blood cadmium levels (CdB) as well as a blood count and selected oxidative stress markers. This research study aimed to demonstrate a correlation between the impact of exposure to elevated cadmium concentrations in a population of children and certain markers of oxidative stress, and 25-OH vitamin D3 concentration. A negative correlation has been found between cadmium concentration and 25-OH vitamin D3 level, protein sulfhydryl groups content in blood serum, glutathione reductase activity, and lipofuscin and malondialdehyde levels in erythrocytes. The concentration of 25-OH vitamin D3 in the High-CdB group was decreased by 23%. The oxidative stress indices can be considered a valuable indicator of early Cd-toxicity effects to be included in the routinely-applied cadmium exposure monitoring parameters, allowing the evaluation of stress intensity to the cell metabolism.

Correlation analysis of serum CTRP3 and PGC-1α expression with traumatic fracture healing

To investigate the relationship between serum C1q/tumor necrosis factor-related protein-3(CTRP3) and peroxisome proliferator-activated receptor γ coactivator-1α(PGC-1α) on predictive value of expression level on fracture healing. From January 2019 to January 2020, 80 patients with traumatic tibial plateau fractures were treated by internal fixation with support plates through the posterior approach of the knee joint. The patients were followed up for 12 months. According to the criteria for delayed fracture healing, the patients were divided into two groups:54 patients in fracture healing group included 24 males and 30 females, aged 29 to 75 years old with an average of (52.36±13.17) years;In the delayed healing group, there were 26 cases, 13 males and 13 females, aged from 29 to 75 with an average od (53.82±13.52) years. The serum levels of CTRP3, PGC-1αand 25 hydroxyvitamin D3[25(OH)D3] in patients with traumatic fracture were detected by enzyme-linked immunosorbent assay(ELISA);Blood phosphorus and calcium levels were measured by automatic biochemical analyzer, and the product of calcium and phosphorus was calculated;Pearson's method was used to analyze the correlation between serum CTRP3, PGC-1αand bone biochemical indexes in patients with delayed union one week after operation;The predictive value of serum levels of CTRP3 and PGC-1αon traumatic fracture healing was analyzed by receiver operating characteristic curve(ROC curve). PGC-1α, calcium phosphorus product and 25(OH)D3 in the fracture healing group were higher than those in the delayed healing group at 1 and 4 weeks after operation(P<0.05). Serum CTRP3 was positively correlated with PGC-1α(r=0.637, P<0.05) and positively correlated with calcium phosphorus product and 25(OH)D3(P<0.05). The areas under the curve(AUC) of serum ctrp3 and PGC-1α levels in predicting traumatic fracture healing were 0.845 and 0.855, respectively. The cutoff values were 188.678 pg/ml and 2.697 ng/ml, respectively. The specificity was 96.2% and 80.8%, and the sensitivity was 53.7% and 77.8%;The predicted AUC was 0.904, the specificity was 88.5%, and the sensitivity was 81.5%. The serum levels of CTRP3 and PGC-1 in patients with delayed union of traumatic fracture at 1 and 4 weeks after operation α The expression level is of certain reference value to predict the fracture healing status of patients.

Lifestyle Improvements and Vitamin D Supplementation Play an Important Role in the Prevention of Childhood Diabetes.

Objective This study was to investigate the characteristics of insulin secretion and the 25-hydroxyvitamin D3 (25(OH)D3) levels in children with obesity. Methods A retrospective analysis was conducted among children who underwent health checkups in the pediatric healthcare department of our hospital from January 2018 to January 2021, and they were divided into a normal group and an obese group according to their BMI. The insulin secretion and the 25(OH)D3 levels of the two groups of children were compared. A total of 721 children were included in the study, including 591 in the normal group and 130 in the obese group, with an obesity rate of 18.03%. Results The blood glucose of the normal group was 4.55 ± 1.75 mmol/L, and the 2 h PG was 7.51 ± 2.11 mmol/L; in the obesity group, they were 6.03 ± 2.16 mmol/L and 8.92 ± 3.24 mmol/L, respectively. The FPG and 2 h PG in the obese group were significantly higher than those in the normal group (all P < 0.05). The incidence of IFG/IGT in the normal group was 5.24% (31/591), and the incidence of DM was 3.71% (22/591); the incidence of IFG/IGT in the obese group was 14.62% (19/130), and the incidence of DM was 13.08% (17/130). The incidences of IFG/IGT and DM in the obese group were significantly higher than those in the normal group (P < 0.05). The FINS of the children in the normal group was 18.46 ± 3.15 μU/mL, and the HOMA-IR was 2.64 ± 0.62; the above indicators in the obese group were 19.11 ± 4.72 μU/mL and 3.01 ± 0.83, respectively. The FINS and HOMA-IR in the obese group were significantly higher than those in the normal group (P < 0.05). The serum 25(OH)D3 level in the normal group was 28.15 ± 5.27 ng/mL, of which 556 cases were normal in 25(OH)D3 and 35 cases were deficient in 25(OH)D3. The serum 25(OH)D3 level in the obese group was 24.35 ± 4.51 ng/mL, of which 112 cases were normal in 25(OH)D3 and 18 cases were deficient in 25(OH)D3. The level of serum 25(OH)D3 in the normal group was significantly higher than that in the normal group, and the ratio of 25(OH)D3 deficiency was significantly lower than that in the normal group (P < 0.05). Conclusions The blood glucose level of childhood obesity was significantly increased, the incidence of abnormal glucose metabolism and diabetes was significantly increased, and the level of 25(OH) vitamin D3 was significantly decreased. Lifestyle improvements and vitamin D supplementation play an important role in the prevention of childhood diabetes. Because the major causes of childhood obesity are excessive caloric intake and lack of exercise, the most effective and direct measures to prevent obesity are a reasonable lifestyle, reasonable eating habits, and moderate exercise. Although genetics are critical, there is no reliable way to eliminate obesity genes in the human body. Therefore, the role of obesity genes is required to be ultimately eliminated by reduced caloric intake and increased physical activity.

Vitamin D status in children with a psychiatric diagnosis, autism spectrum disorders, or internalizing disorders.

Background and objectiveMultiple studies suggest that children with Autism Spectrum Disorders (ASD) have significantly lower vitamin D3 levels than typically developing children. However, whether vitamin D3 deficiency is more common in children with ASD than in children with other psychiatric disorders remains unclear. This study was conducted to explore the prevalence of vitamin D3 in children with a psychiatric diagnosis including children with ASD or with internalizing disorders (mood and anxiety disorders). In addition, this study investigated the potential associations between vitamin D3 and Body Mass Index (BMI).Materials and methodsClinical data, including BMI and vitamin D3 levels, of 93 children (6–18 years; n = 47; 51% female) with ASD (n = 58) and internalizing disorders (n = 37) were retrospectively analyzed.ResultsIn the overall sample, the prevalence of vitamin D3 deficiency (<50 nmol/L) was 77.4%. Additionally, 75.9% of the children with ASD and 79.5% with internalizing disorders had vitamin D3 deficiency. BMI was inversely related to vitamin D3 in the total group (p = 0.016). The multiple regression model for the total group significantly predicted vitamin D3 (p = 0.022). Age contributed significantly to the prediction. Stratified for sex and primary diagnosis, multiple regression models showed that for boys with ASD, higher BMI levels were associated with lower vitamin D3 levels (p = 0.031); in boys with internalizing disorders and in girls, no relation was found between BMI and vitamin D3 levels.ConclusionIn this this cross-sectional, explorative study high rates of vitamin D3 deficiency in children with different psychiatric disorders were found. The results showed an inverse relation between BMI and vitamin D3 levels in the total group. Vitamin D3 deficiency was particularly common in boys with ASD and obesity. Lifestyle factors may contribute to the association between high BMI and low vitamin D3 levels in boys with ASD. Vitamin D3 deficiency is common in patients with psychiatric disorders and it is highly recommended to increase clinicians’ awareness of this common and remediable risk factor.

Mediation Effects of IL-1β and IL-18 on the Association Between Vitamin D Levels and Mild Cognitive Impairment Among Chinese Older Adults: A Case-Control Study in Taiyuan, China.

ObjectiveMild cognitive impairment (MCI) is a common, chronic, and complex disease in the elderly, which is often influenced by a variety of factors that include nutrition and inflammation. This study was undertaken to evaluate the mediation effects of inflammation on the association between vitamin D levels and MCI.MethodsWe explored the associations of inflammation and cognitive impairment related to 25(OH)D3 deficiency among 360 older people from the communities in China. Demographic characteristics, lifestyle, and health status were investigated by questionnaire, cognitive function was detected by MoCA, and plasma 25(OH)D3, interleukin-1β (IL-1β), and interleukin-18 (IL-18) were measured by ELISA. Spearman’s correlation analysis and logistic regression analysis were used to analyze the relationship among 25(OH)D3, IL-1β, and IL-18 in the MCI group and the control group and further to analyze the relationship between 25(OH)D3 and inflammatory factors in the MCI group. Finally, mediation analysis was performed to evaluate whether inflammation mediated the effect of 25(OH)D3 deficiency on cognitive impairment.ResultsThere were lower plasma 25(OH)D3 concentration and higher IL-1β and IL-18 levels in the MCI group compared with the controls. The levels of 25(OH)D3 were positively correlated with the MoCA scores and scores of different domains; the levels of IL-1β and IL-18 were negatively correlated with them (p < 0.05). In multivariate logistic analysis, there were significant associations among 25(OH)D3, IL-1β, IL-18, and MCI after adjusted. Further analysis revealed the significant association between the subjects with VD deficiency and the highest quartile of IL-18 in MCI (OR = 4.066), not with IL-1β after adjusting the confounding variables in MCI group. Ultimately, mediation analysis suggested that IL-1β and IL-18 could explain 25.4 and 17.5% of effect of the risk of cognitive impairment related to 25(OH)D3 deficiency.ConclusionOur findings suggested that 25(OH)D3 deficiency could increase the risk of cognitive impairment by a mechanism partly involving inflammation. Therefore, vitamin D supplementation may improve or delay the decline in cognitive function caused by inflammation in the elderly.

Timing theory continuous nursing, resistance training: Rehabilitation and mental health of caregivers and stroke patients with traumatic fractures.

BACKGROUNDStroke is the leading cause of adult lifelong disability worldwide. A stroke is an acute cerebrovascular disease with a variety of causes and corresponding clinical symptoms. Around 75% of surviving stroke patients experience impaired nerve function, and some suffer from traumatic fractures, which can lead to special care needs. AIMTo determine the effect of timing theory continuous care, with resistance training, on the rehabilitation and mental health of caregivers and stroke patients with traumatic fractures. METHODSBetween January 2017 to March 2021, we selected 100 hospital admissions with post-stroke hemiplegia complicated with a traumatic fracture. Two participant groups were created: (1) Control group: given resistance training; and (2) Observation group: given timing theory continuous care combined with resistance training. The degree of satisfaction and differences in bone and phosphorus metabolism indexes between the two groups were compared. The self-perceived burden scale (SPBS) and caregiver burden questionnaire were used to evaluate the psychological health of patients and caregivers. The Harris hip function score, ability of daily living (ADL) scale, and global quality of life questionnaire (GQOL-74) were used to evaluate hip function, ability of daily living, and quality of life.RESULTSData were collected prior to and after intervention. Alkaline phosphatase (ALP), osteocalcin, and vitamin D3 in the observation group and control group increased after intervention (P < 0.05), and carboxy-terminal peptide of type I collagen β Special sequence (β-CTX) decreased (P < 0.05). ALP and osteocalcin in the observation group were higher than in the control group (P < 0.05). There was no significant difference in β-CTX and vitamin D3 between the two groups (P > 0.05). The SPBS score of the observation group was lower and the ADL score was higher than the control group. The burden score was lower and the Harris hip function and GQOL-74 scores were higher than that of the control group (P < 0.05). The observation group’s satisfaction rating was 94.00%, which was higher than the rating from the control group (P < 0.05).CONCLUSIONTiming theory continuous nursing with resistance training can reduce hip dysfunction in stroke patients with a traumatic fracture and enhance quality of life and mental health of patients and caregivers.

The low level of vitamin D3 among Type 1 Diabetes Mellitus (T1DM) children at Saiful Anwar General Hospital, Malang, Indonesia

Background: The Type 1 Diabetes Melitus (T1DM) is a disease which is occurred because of autoimmune destruction in pancreas islet (insulin-producing ß cells). A Failure mechanism of immunoregulator causes inflammatory process in the islets and continue to damage the pancreatic β cell. Vitamin D deficiency may increase the risk of autoimmune diseases including type 1 diabetes mellitus. The aim of this study was to know the level of vitamin D in type 1 diabetes mellitus.&#x0D; Methods: An observational analytic cross-sectional design was conducted among 40 T1DM subjects and 40 healthy controls aged between 10-18-year-old. They were not having local or systemic infection, nor liver and kidney disorders. Vitamin D levels were measured by the ELISA method (ng/ ml). Subjects’ data were collected and processed by 2007 Microsoft Excel software, then analyzed with SPSS version 16.0 for Windows.&#x0D; Results: Most of respondents in T1DM group were female (57.5%) and 15.94±1.00 years old for average age but not statistically significant compared with control group (p&gt;0.05). There was a significant different of the mean level of vitamin D3 in the T1DM group (10.41 + 2,20 ng/ml) compared with control group (18.41 + 1.41 ng/ml) (p&lt;0,05).&#x0D; Conclusion: The level of vitamin D (25 (OH) D3) in the T1 DM group were significantly lower compared to the control group&#x0D;

Evaluation of analgesic effect, joint function recovery and safety of meloxicam in knee osteoarthritis patients who receive total knee arthroplasty: A randomized, controlled, double-blind study.

Meloxicam is commonly administrated to control postoperative pain in orthopedic surgery, while its efficacy in total knee arthroplasty (TKA) is not clear. Therefore, this study aimed to explore the postoperative analgesic effect and tolerance of meloxicam in knee osteoarthritis (OA) patients undergoing TKA.Totally, 128 knee OA patients scheduled for TKA were enrolled in this randomized, controlled, double-blind study, then randomized into meloxicam group (N = 65) and control group (N = 63) as 1:1 ratio. Patients took meloxicam or placebo from 4 hours (h) to 72 h after TKA. Patients were followed up at 6 h, 12 h, day (D)1, D2, D3, D7, month (M)1, and M3.Pain visual analog scale score at rest was decreased in meloxicam group at 12 h, D1 and D3 compared to control group; pain visual analog scale score at flexion was reduced in meloxicam group at 6 h, 12 h, D1, D2, and D3 compared to control group. Additional and total consumption of patient-controlled analgesia were both attenuated in meloxicam group compared to control group. Furthermore, patient satisfaction score was higher on D1, D2, D3 in meloxicam group compared to control group. However, no difference of hospital for special surgery knee score score at M1 or M3 was found between the 2 groups. Moreover, the occurrence of adverse events was similar between the 2 groups.Meloxicam displays good effect on controlling postoperative pain and improving patient satisfaction, while does not affect long-term knee function recovery or safety profile in knee OA patients undergoing TKA.

Does vitamin D3 supplementation improve medial joint space narrowing in patients with osteoarthritis knee

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Although vitamin D3 levels are known to improve pain and knee function in patients with knee OA, no clear evidence is available regarding relation between improvement in medial joint space with improvement in vitamin D3 levels. The aim of this study was to evaluate effectiveness of vitamin D3 supplements in improving joint space in the patients with OA knee.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods: &lt;/strong&gt;100 patients with OA Knee who fulfilled inclusion criteria and consented to participate were enrolled for study. Patients of OA Knee were blinded and randomized to receive either tablet vitamin D3 or identical placebo tablet. Vitamin D3 Tab was administered in a dose of 60000U/week for 3 months in 12 doses while placebo tablets with identical dosing schedule were used for control group. The patients who received vitamin D3 tablets were allocated to case group while those receiving identical placebo tablets were grouped as controls. The vitamin D3 levels and medial joint space were assessed at baseline, 3 mo, 6mo and 1 year in both the groups.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; In two groups of patients of OA knee of 50 patients each vitamin D3 supplementation increased levels of vitamin D3 in case group. While no significant improvement in joint space narrowing was noted with vitamin D3 supplementation in case group. Also no significant correlation was observed between vitamin D3 levels and medial joint space narrowing.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;There was no improvement in medial knee joint space with vitamin D3 supplementation.&lt;/p&gt;

Changes in bone mineral density, 25-hydroxyvitamin D3 and inflammatory factors in patients with hyperthyroidism.

The present study aimed to evaluate changes in bone mineral density, 25-hydroxyvitamin D3 [25-(OH)D3] and inflammatory factors in patients with hyperthyroidism, in order to determine the correlations with the pathogenesis of hyperthyroidism. A total of 55 patients with hyperthyroidism (observation group) and 53 healthy patients (control group) enrolled at Weifang People's Hospital from March 2017 to February 2018 were randomly enrolled. The thyroid function, bone mineral density, 25-(OH)D3 and inflammatory factors were measured and compared between the two groups. The measurement data are presented as mean ± standard deviation (SD), and Student t-test was performed for the comparison between two groups. Chi-square test was used for enumeration data regarding sex. Pearson correlation analysis was performed for two-variable analysis on L1, 25-(OH)D3, interleukin (IL)-2, IL-6 with FT3, respectively. In regards to the results, no difference in sex, age and body mass index (BMI) between the two groups were found but the thyroid function was markedly enhanced in the observation group compared to the control group. Bone mineral density index and 25-(OH)D3 in the observation group were significantly lower than those in the control group (P<0.05). There were significant differences in the inflammatory factors between the two groups (P<0.05). The L1, 25-(OH)D3 and IL-2 levels were significantly negatively correlated with thyroid function index and free triiodothyronine (FT3) while a statistically positive correlation was found between IL-6 and FT3 (P<0.05). In conclusion, abnormal levels of bone mineral density, 25-(OH)D3 and inflammatory factors are observed in patients with hyperthyroidism, and there are correlations between L1, 25-(OH)D3, IL-2, IL-6 and FT3 in the pathogenesis of hyperthyroidism, which provides new insight for the diagnosis of hyperthyroidism.

The correlation between neonatal vitamin D levels and the risk of childhood asthma attacks.

BackgroundTo explore the correlation between neonatal vitamin D levels and the risk of asthma in children aged 3–9 years.MethodsA total of 1,534 subjects were selected, and clinical and laboratory test data of all subjects were collected at birth, including 25-hydroxyvitamin D3 [25(OH)D3] levels, gender, season of birth, birth weight; whether delivery was premature, cesarean section, or primipara; and parental details including maternal age, ethnicity, level of education, history of smoking, and history of maternal or paternal asthma. The level of 25(OH)D3 was used as a continuous variable to analyze its correlation with the risk of asthma using the Cox proportional regression model. In addition, subjects were divided into four groups according to their 25(OH)D3 quartiles, and the first quantile group was used as a reference to analyze the risk of asthma in the other groups. Further subgroup analysis was conducted according to the patients’ gender and birth season.ResultsAmong the 1,534 subjects included, there were 107 cases in the asthma-affected group and 1,427 cases in the normal control group. Compared with the control group, the level of 25(OH)D3 in the asthma group was significantly lower (P=0.03), the mother’s education level was lower (P=0.002), but the preterm birth rate, cesarean section rate, and parental asthma prevalence rate were significantly higher (all P<0.05). When the neonatal 25(OH)D3 was divided into quartiles to perform a categorical variable analysis, we found that compared with the first quantile (Q1, 0.0–25.1 mmol/L), the risk of asthma in Q4 was reduced by 50% (HR=0.50, 95% CI: 0.38-0.76). The second quantile group (Q2) and the third quantile group (Q3) showed no significant difference in the risk of disease compared with Q1 but showed a trend of decreasing risk as the quantile group increased (the trend P values were both <0.05). This correlation was still valid when a stratified analysis was made based on gender and birth season.ConclusionsThere is a significant correlation between a reduced vitamin D level in newborns and the subsequent risk of asthma in children aged 3–9 years. Moreover, the level of vitamin D is an independent risk factor for childhood asthma.

Correlation between serum 25-(OH)D3 level and immune imbalance of Th1/Th2 cytokines in patients with Hashimoto's thyroiditis and its effect on autophagy of human Hashimoto thyroid cells.

The study aimed to determine the relationship between serum 25-(OH)D3 and Th1/Th2 cytokine immune imbalance, and the effect of 25-(OH)D3 on the autophagy of human Hashimoto thyroid cells. Western blot analysis was used to detect the expression levels of microtubule-associated protein 1 light chain 3 (LC3) and autophagy-associated protein mammalian target protein of rapamycin (mTOR) in thyroid tissues of 20 Hashimoto's thyroiditis (HT) patients and normal tissues of 20 benign thyroid adenomas. Nthy-ori3-1 cells (normal cells of human thyroid follicular epithelium) were treated with different concentrations of 25-(OH)D3 for 24 h. The expression of LC3, mTOR and caspase-3 protein in the cells was detected by western blot analysis. The apoptosis and proliferation levels were detected by flow cytometry and MTT assay, respectively. The levels of FT3, FT4 and IL-10 in the HT group were lower than those in the healthy control group. The serum levels of 25-(OH)D3, TPOAb and TGAb in the HT group were lower than those in the healthy control group. Serum 25-(OH)D3 level in the HT group was negatively correlated with IL-2 and IFN-γ, and positively correlated with IL-4. In Hashimoto's thyroiditis tissues, the expression of mTOR was higher while the expression of LC3B-II was lower than that of normal thyroid tissue. With the increase in 25-(OH)D3 concentration, the expression level of mTOR increased, the expression level of LC3B-II decreased and the apoptosis rate was significantly increased. The cell proliferation rate decreased with the increase in 25-(OH)D3 concentration. The serum 25-(OH)D3 level in HT hypothyroidism patients was significantly lower than that of the control group. Thus, 25-(OH)D3 may be involved in the disease progression by upregulating the levels of Th1 cytokines and downregulating the levels of Th2 cytokines. 25-(OH)D3 can inhibit autophagy of thyroid cells, induce apoptosis and participate in the pathogenesis of Hashimoto's thyroiditis.

Effect of Cluster Nursing Mode Combined with Blood Pressure Regulation on Surgical Tolerance of Patients with Esophageal Cancer and Hypertension

Objective: To explore the effect of the cluster nursing mode combined with blood pressure regulation on the surgical tolerance of patients with esophageal cancer and hypertension. Methods: The clinical data of 86 patients with esophageal cancer and hypertension treated in our hospital (February 2016–February 2017) were retrospectively analyzed. The patients were randomly split into research group and reference group, with 43 cases in each group. The reference group received routine nursing, while the research group received cluster nursing combined with blood pressure regulation. The SBP, DBP and heart rates at D1 (at admission), D2 (2 h before surgery) and D3 (2 h after surgery) were compared between the two groups. In addition, the surgical tolerance, ESCA scores at 1 month after discharge, personality and behavior characteristics before and after intervention, and incidence of postoperative complications were also compared between the two groups. Results: With no obvious difference in SBP, DBP and heart rates at D1 between the two groups (P > 0.05), the SBP, DBP and heart rates at D2 and D3 in the research group were obviously lower compared with the reference group (P < 0.001). With no obvious difference in the number of patients with surgical tolerance of Grades I, II and III after intervention between two groups (P > 0.05), the number of patients with surgical tolerance of Grade IV in the research group was significantly higher than that in the reference group (P < 0.05). The scores of self-concept, self-care skills, self-care responsibility and health knowledge in the research group at 1 month after discharge were obviously higher compared with the reference group (P < 0.001). The scores of EPQ-L (lie), EPQ-P (psychoticism) and EPQ-N (neurosism) after intervention in both groups were obviously lower compared with those before intervention (P < 0.001), and the scores of EPQ-L, EPQ-P and EPQ-N after intervention in the research group were significantly lower than those in the reference group (P < 0.001). The total incidence of postoperative complications in the research group was significantly lower compared with the reference group (P < 0.05). Conclusion: Cluster nursing combined with blood pressure regulation can significantly improve the surgical tolerance of patients with esophageal cancer and hypertension and enhance the self-care ability after surgery, with obvious therapeutic effect, which is worthy of promotion and application.

The Level of Bone Metabolism Indexes in Patients with Chronic Obstructive Pulmonary Disease and Its Clinical Significance

To determine the level of bone metabolism indexes in patients with chronic obstructive pulmonary disease and its clinical significance. A total of 164 patients with chronic obstructive pulmonary disease admitted to the outpatient and inpatient departments of our hospital from April 2019 to April 2020 were selected as the study objects. Patients were divided into acute exacerbation group (n=78) and remission group (n=52) according to relevant criteria in chronic obstructive pulmonary disease. There was no significant difference in gender, age, body mass index and other general data among the three groups (p>0.05), showing comparability. The bone mineral density of femoral neck, lumbar spine and Ward’s triangle in the three groups had statistical significance (p<0.05). The bone metabolism indexes of beta-isomerized C-terminal telopeptides, procollagen type I N propeptide and osteocalcin in the acute exacerbation group were significantly higher than those in the remission group, the levels of 25-hydroxyvitamin D3 in the acute exacerbation group were lower than those in the remission group and the differences had statistical significance (p<0.05). Pearson correlation analysis showed that bone mineral density of chronic obstructive pulmonary disease patients was negatively correlated with beta-isomerized C-terminal telopeptides, procollagen type I N propeptide, osteocalcin and positively correlated with 25-hydroxyvitamin D3 (p<0.05). According to Pearson correlation analysis, there was a positive correlation between bone mineral density and 25-hydroxyvitamin D3 in patients with chronic obstructive pulmonary disease (p<0.05), which was consistent. In conclusion, chronic obstructive pulmonary disease secondary osteoporosis is a high conversion type and bone mineral density and bone metabolism marker levels can effectively predict chronic obstructive pulmonary disease secondary osteoporosis.

The influence and clinical significance of proteasome inhibitor on serum bone metabolite markers in patients with myeloma bone disease

Objective: To investigate the influence and clinical significance of proteasome inhibitor on serum bone metabolite markers including tartrate-resistant acid phosphatase 5b isoenzyme (TRACP-5b), type I collagen carboxy terminal peptide β(β-CTX), type I procollagen amino terminal prolongation peptide (PINP) and vitamin D3 in patients with myeloma bone disease (MBD). Methods: From April 2015 to June 2018, 68 patients with newly diagnosed MBD who admitted to our hospital were treated with proteasome inhibitor-based regimen. Serum concentration of TRACP-5b、β-CTX、PINP and vitamin D3 were measured before treatment and after 4 and 8 cycles of chemotherapy, and imaging changes were observed. Results: After 4 and 8 cycles of chemotherapy, serum levels of TRACP-5b, β-CTX and vitamin D3 were decreased significantly (P<0.05). The serum concentration of PINP was (78.1±44.9) ng/L before chemotherapy, while after 4 cycles, it turned to (94.5±56.1) ng/L without significant difference (t=-1.871, P=0.063). Moreover, it increased to (173.3±80.5) ng/L after 8 cycles of chemotherapy with significant difference (t=-8.272, P<0.001). The proportion of imaging classification ≥3 among all patients was 66.2%, and it decreased to 60.3% after 4 cycles of chemotherapy without significant difference (χ(2)=0.569, P=0.477). The proportion of imaging classification ≥3 after 8 cycles of chemotherapy decreased to 44.5%, which was significantly lower than that before treatment (χ(2)=6.260, P=0.012). After 8 cycles of chemotherapy, 63 patients were evaluable, of which 50 were effective and 13 were ineffective. Serum concentration of PINP in the effective group was higher than that in the ineffective group ((190.7±78.5) ng/L vs (106.5±47.3) ng/L,t=5.762, P<0.001), and the serum concentration of vitamin D3 in the effective group was lower than that in the ineffective group ((11.7±4.8) μg/L vs (15.6±5.5) μg/L, t=-2.478, P=0.016). The proportion of patients with more than grade 3 bone disease of the effective group was also significantly lower than that of the ineffective group (38.0% vs 69.2%, χ(2)=4.076, P=0.044). There was no significant difference in the serum concentration of TRACP-5b and β-CTX between two groups. Conclusion: After treatment with the proteasome inhibitor -based regimen, the serum concentrations of TRACP-5b, β-CTX and vitamin D3, which reflect osteoclast activity in MBD patients were decreased, the serum concentration of PINP indicating osteoblast activity was increased, and the grade of imaging of bone disease was decreased.

Serum vitamin D levels of atopic dermatitis in adolescents and its clinical significance

Objective To investigate the relationship between the serum level of vitamin D and severity of atopic dermatitis (AD) in adolescents. Methods From March 2016 to February 2017, 102 adolescents with AD(AD group) and 100 healthy adolescents(control group) were selected.The distribution and serum levels of vitamin D in the two groups were compared.According to SCORing atopic dermatitis (SCORAD) score, AD patients were divided into mild group, moderate group and severe group.The levels of 25-(OH)D3, total IgE (TIgE) and peripheral blood eosinophil cells percentage(EOS%) were detected in the three groups. Results There was no statistically significant difference in the proportion of patients with vitamin D deficiency, insufficiency and sufficiency between the AD group and control group(χ2=2.718, P=0.257). The serum level of 25(OH)D3 in the AD group was lower than that in the control group[(18.43±3.73)μg/L vs.(19.47±3.27)μg/L, t=2.112, P=0.036]. The mean values of vitamin D deficiency, insufficiency and sufficiency in the AD group were (11.11±1.65)μg/L, (17.49±1.69)μg/L, (21.73±1.17)μg/L, respectively, which in the control group were (12.86±1.47)μg/L, (17.55±1.34)μg/L, (22.05±1.32)μg/L, respectively.The level of vitamin D deficiency in the AD group was significantly lower than that in the control group (t=2.588, P=0.017), but there were no statistically significant differences in vitamin D insufficiency and sufficiency between the AD group and control group.In 102 AD patients, 40 cases were mild, 29 cases were moderate and 33 cases were severe.The levels of 25-(OH)D3, TIgE and peripheral blood EOS% had statistically significant differences among the three groups (F=6.315, 35.813, 31.285, all P 0.05). Regarding the TIgE level and EOS%, severe group>moderate group>mild group(t=8.318, 8.788, all P<0.01; t=4.322, 4.784, all P<0.01). The value of 25-(OH)D3 was negatively correlated with the TIgE level(r=-302, P<0.01) and EOS%(r=-508, P<0.01) in the AD group. Conclusion Vitamin D deficiency or insufficiency exists in adolescents with AD.Low level of vitamin D is correlated with high TIgE level and EOS%.The severity of AD is closely correlated with increased serum levels of TlgE and EOS%, as well as decreased serum levels of vitamin D. Key words: Dermatitis, atopic; Adolescents; Vitamin D; Severity of illness index; IgE; Eosinophilia cell