Analyzing Treatment Patterns for Neovascular Age-related Macular Degeneration with Expansion of the Korean Health Insurance Policy

Purpose@#We analyzed the incidence and prevalence of neovascular age-related macular degeneration (AMD) and the treatment patterns of AMD in response to changes in health insurance policies in South Korea. @*Methods@#We retrospectively analyzed the incidence and prevalence of neovascular AMD in patients diagnosed between 2010 and 2019. Data were extracted from the Korean National Health Insurance System database. The incidence and prevalence per 10,000 person-years and corresponding 95% confidence intervals were calculated. Furthermore, we recorded the usage of ranibizumab and aflibercept among newly diagnosed patients with neovascular AMD between 2010 and 2014. @*Results@#In total, 90,012 patients were diagnosed with neovascular AMD between 2010 and 2019. The incidence of neovascular AMD increased with age, except for individuals aged ≥ 90 years. The prevalence of neovascular AMD increased significantly from 30.29 per 10,000 person-years in 2010 to 50.8 per 10,000 person-years in 2019. The rate of intravitreal ranibizumab injections decreased following the introduction of aflibercept in 2014. Patients who switched from ranibizumab to aflibercept exhibited a higher drug switch rate than those who switched from aflibercept to ranibizumab (28.83% vs. 8.40%). Among newly diagnosed patients, approximately 65% received treatment covered by the health insurance system. On average, six injections were administered per year between 2010 and 2019; the number of injections increased in accordance with the maximum limit supported by the government. @*Conclusions@#The incidence and prevalence of neovascular AMD demonstrated an increasing trend. The treatment patterns are influenced by changes in government funding support policies. These findings provide valuable information for planning neovascular AMD treatment.

Association between Inhaled Corticosteroid Use and SARS-CoV-2 Infection: A Nationwide Population-Based Study in South Korea / 결핵및호흡기질환

Background@#Although it is known that inhaled corticosteroid (ICS) use may increase the risk of respiratory infection, its influence on the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains unknown. Thus, the aim of this study was to investigate the association between ICS use and the positivity of SARS-CoV-2 infection among patients with chronic respiratory diseases. @*Methods@#Nationwide data of 44,968 individuals with chronic respiratory diseases tested for SARS-CoV-2 until May 15, 2021 were obtained from the Ministry of Health and Welfare and Health Insurance Review and Assessment Service in Korea. The positivity of SARS-CoV-2 infection was retrospectively analysed according to the prescription, type, and dose of ICS taken one year before SARS-CoV-2 test. @*Results@#Among 44,968 individuals tested, 931 (2.1%) were positive for SARS-CoV-2. A total of 7,019 patients (15.6%) were prescribed ICS one year prior to being tested for SARS-CoV-2. Low, medium, and high doses of ICS were prescribed in 7.5%, 1.6%, and 6.5% of total cases, respectively. Among types of ICS, budesonide, fluticasone, beclomethasone, and ciclesonide were prescribed in 3.7%, 8.9%, 2.3%, and 0.6% of total cases, respectively. A multivariate analysis showed no significant increase in infection with ICS use (odds ratio, 0.84; 95% confidence interval, 0.66–1.03). Moreover, there were no associations between the positivity of infection and the dose or type of ICS prescribed. @*Conclusion@#Prior ICS use did not increase the positivity for SARS-CoV-2 infection. Moreover, different doses or types of ICS did not affect this positivity.

Effects of Socioeconomic Status and Residence Areas on Long-Term Survival in Patients With Early-Onset Dementia: The Korean National Health Insurance Service Database Study

Background@#Early-onset dementia (EOD) is still insufficiently considered for healthcare policies. We investigated the effect of socio-environmental factors on the long-term survival of patients with EOD. @*Methods@#This retrospective cohort study utilized the Korean National Health Insurance Database from 2007 to 2018. We enrolled 3,825 patients aged 40 to 65 years old with all types of dementia newly diagnosed in 2009 as EOD cases. We defined socioeconomic status using the national health insurance premium (NHIP) levels. Residential areas were classified into capital, metropolitan, city, and county levels. All-cause mortality was the primary outcome. Kaplan-Meier curves and log-rank tests were employed. Further, Cox-proportional hazards models were established. @*Results@#The mean survival of the fourth NHIP level group was 96.31 ± 1.20 months, whereas that of the medical-aid group was 85.53 ± 1.30 months (P < 0.001). The patients living in the capital had a mean survival of 95.73 ± 1.34 months, whereas those living in the county had 89.66 ± 1.75 months (P = 0.035). In the Cox-proportional hazards model, the medical-aid (adjusted hazard ratio [aHR], 1.67; P < 0.001), first NHIP level (aHR, 1.26; P = 0.012), and second NHIP level (aHR, 1.26; P = 0.008) groups were significantly associated with a higher long-term mortality risk. The capital residents exhibited a significantly lower long-term mortality risk than did the county residents (aHR, 0.82; P = 0.041). @*Conclusion@#Socioeconomic status and residential area are associated with long-term survival in patients with EOD. This study provides a rational basis for establishing a healthcare policy for patients with EOD.

Improvement in Age at Mortality and Changes in Causes of Death in the Population with Diabetes: An Analysis of Data from the Korean National Health Insurance and Statistical Information Service, 2006 to 2018

Background@#Diabetes is a leading cause of death that is responsible for 1.6 million annual deaths worldwide. However, the life expectancy and age at death of people with diabetes have been a matter of debate. @*Methods@#The National Health Insurance Service claims database, merged with death records from the National Statistical Information Service in Korea from 2006 to 2018, was analyzed. @*Results@#In total, 1,432,567 deaths were collected. The overall age at death increased by 0.44 and 0.26 year/year in the diabetes and control populations, respectively. The disparity in the mean age at death between the diabetes and control populations narrowed from 5.2 years in 2006 to 3.0 years in 2018 (p<0.001). In a subgroup analysis according to the presence of comorbid diseases, the number and proportion of deaths remained steady in the group with diabetes only, but steadily increased in the groups with diabetes combined with dyslipidemia and/or hypertension. Compared to the control population, the increase in the mean death age was higher in the population with diabetes. This trend was more prominent in the groups with dyslipidemia and/or hypertension than in the diabetes only group. Deaths from vascular disease and diabetes decreased, whereas deaths from cancer and pneumonia increased. The decline in the proportion of deaths from vascular disease was greater in the diabetes groups with hypertension and/or dyslipidemia than in the control population. @*Conclusion@#The age at death in the population with diabetes increased more steeply and reached a comparable level to those without diabetes.

Survey and analysis of current situation and influencing factors of self⁃stigma among patients with mental disorders in a district of Shanghai， China / 上海预防医学

Objective To describe the current situation of self-stigma in patients with mental disorders and investigate its related influencing factors. Methods Using cluster sampling method， general situation and self-stigma of 3 926 patients with mental disorders were investigated with a questionnaire. Results The average total score of stigma in patients with mental disorders was 32.81±14.41. There were statistically significant differences between social factors and occupation， economic status， mental symptoms and behavior involving violence， insight， medication compliance， adverse drug reactions， family monitoring， relationship between guardian and patient， and social participation and social function. There were statistically significant differences between ability factors and occupation， education level， marital status， diagnosis， past accidents and dangerous behaviors， mental symptoms involving violence， insight， medication compliance， disability assessment， implementation of guardianship subsidy measures， family guardianship， relationship between guardians and patients， and social participation and social function. There were statistically significant differences between treatment factors and occupation， marriage， diagnosis， mental symptoms involving violence， insight， medication compliance， adverse drug reactions， family supervision， relationship between guardian and patient， and social participation and social function. According to multiple linear stepwise regression analysis， factors with influence on the total score of stigma， in descending order， were adverse drug reactions， family monitoring， mental status and behavior involving violence， employment， medication compliance， and social function and social participation. Conclusion Patients with mental disorders have a high score of self-stigma， which is related to adverse drug reactions， family monitoring， mental status and behavior involving violence， employment， medication compliance， and social function and social participation.

Enzyme-treated date plum leave extract ameliorates atopic dermatitis-like skin lesion in hairless mice

Objective: To evaluate the effect of different extracts of Diospyros lotus leaves in atopic dermatitis Methods: Diospyros lotus leaves were extracted in ethanol and treated with or without hydrochloric acid or α-rhamnosidase to obtain three different extracts-ethanol, acid-hydrolyzed, and enzyme-hydrolyzed leaf extracts of date plum. The myricitrin content in all samples was measured using HPLC analysis. In vitro antioxidant and anti-inflammatory activities of the extracts were determined by measuring DPPH radical scavenging activities and nitric oxide production in RAW264.7 cells, respectively. Seven-week-old male hairless mice were used to evaluate the anti-atopic dermatitis effects of three extracts in vivo. Splenocytes and mast cells were used to further determine the anti-atopic dermatitis effects of the major compound in the ethanol leaf extract. Results: Enzyme-hydrolyzed leaf extract showed significant in vitro antioxidant and anti-inflammatory activities, and attenuated atopic dermatitis-like skin symptoms and clinical signs more significantly than ethanol and acid-hydrolyzed leaf extracts in 1-fluoro-2,4-dinitrobenzene and house dust mite antigen-treated hairless mice. Enzyme-hydrolyzed leaf extract also suppressed the serum level of immunoglobulin E, interleukin (IL)-4, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, thymic stromal lymphopoietin, and thymus and activation-regulated chemokine in mice with atopic dermatitis. Furthermore, histological analysis revealed that enzyme-hydrolyzed leaf extract suppressed the increased epidermal thickness, dermal infiltration of inflammatory cells, and infiltration and degranulation of mast cells more markedly than the other two extracts in atopic dermatitis-like skin lesions. In addition, this extract effectively inhibited the production of IFN-γ, IL-4, and thymus and activation-regulated chemokine compared with the other two extracts in concanavalin A-stimulated splenocytes. Myricitrin, a major compound of enzyme-hydrolyzed leaf extract, suppressed atopic dermatitis biomarkers in stimulated mouse splenocytes and HMC-1 human mast cells.Conclusions: These results suggest that enzyme-hydrolyzed leaf extract might be a potential candidate to treat atopic dermatitis.

The Trend of Clostridioides difficile Infection in Korean Hospitals with the Analysis of Nationwide Sample Cohort / 대한임상미생물학회지

Background@#Clostridioides (Clostridium) difficile is an important pathogen that causes diarrhea in people who take antibiotics. The recent status of C. difficile infection is not wellknown in Korea. @*Methods@#The long-term trend of C. difficile infection in Korean hospitals was analyzed using a nationwide sample cohort. The data also included sociodemographic characteristics, disease severity, and healthcare facilities. C. difficile infection was defined by the prescription of oral vancomycin or all metronidazole prescriptions under C. difficile infectious disease code (A047). @*Results@#The rate of C. difficile infection has steadily increased from 0.030% in 2006 to 0.317% in 2015. The increased rate correlated to age (0.033% for 80 years of age) and the Charlson comorbidity index score (0.048% for zero versus 0.378% for three or more points). It differed by the type of medical institution (0.270 % at referral hospitals versus 0.056 % at general hospitals and mental hospitals). @*Conclusion@#The rate of C. difficile infection in Korea is significant in patients with advanced age and disease severity. The results show that C. difficile infection trend has been increasing steadily in Korea.

The Trend of Clostridioides difficile Infection in Korean Hospitals with the Analysis of Nationwide Sample Cohort / 대한임상미생물학회지

Background@#Clostridioides (Clostridium) difficile is an important pathogen that causes diarrhea in people who take antibiotics. The recent status of C. difficile infection is not wellknown in Korea. @*Methods@#The long-term trend of C. difficile infection in Korean hospitals was analyzed using a nationwide sample cohort. The data also included sociodemographic characteristics, disease severity, and healthcare facilities. C. difficile infection was defined by the prescription of oral vancomycin or all metronidazole prescriptions under C. difficile infectious disease code (A047). @*Results@#The rate of C. difficile infection has steadily increased from 0.030% in 2006 to 0.317% in 2015. The increased rate correlated to age (0.033% for 80 years of age) and the Charlson comorbidity index score (0.048% for zero versus 0.378% for three or more points). It differed by the type of medical institution (0.270 % at referral hospitals versus 0.056 % at general hospitals and mental hospitals). @*Conclusion@#The rate of C. difficile infection in Korea is significant in patients with advanced age and disease severity. The results show that C. difficile infection trend has been increasing steadily in Korea.

Comparison of scaling rate data of Community Health Survey and National Health Insurance Service / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to compare scaling rates in 16 cities and provinces using data from the Community Health Survey (CHS) and National Health Insurance Service (NHIS). METHODS: This study involved cross-sectional secondary data analysis. A total of 16,646,190 subjects who participated in the CHS and 218,184 subjects in the NHIS were included in the final analysis. The dependent variable was the scaling rate, and the independent variables were sex, age, and 16 regions. The study included individuals aged 19 years or older who received scaling between August 2014 and August 2015 in the past year in the CHS and codes U2232 (scaling) and U2233 (scaling before periodontal treatment) in the NHIS. The total scaling rates were compared between the CHS and NHIS. The differences in scaling rates according to sex, age, and 16 regions were analyzed. RESULTS: The CHS (42.6%) scaling rates were 17.5% higher than the NHIS (25.1%) scaling rates in 16 regions in 2015. The median in the CHS data was in Busan (41.5%), while that in the NHIS data was in Jeonbuk (23.5%). There was no significant difference between scaling rates above and below the median region in the CHS and NHIS. CONCLUSIONS: The results suggested that CHS data, which show a higher rate, should be used to assess and monitor the dental needs of community residents. NHIS data should be used to evaluate community oral health projects. It is necessary to develop health indicators for the community oral health project of input, process, and outcome evaluation.

Intervention effect of family support services in Changning district of Shanghai on family members of patients with severe mental disorders / 中华疾病控制杂志

Objective To explore the effect of family support service intervention on improving the rehabilitation of patients with severe mental disorders in community and the mental health status and family burden of family members. Methods Using multi-stage random sampling method, 100 patients who met the diagnostic criteria of severe mental disorders were randomly selected from two communities, and then 100 patients who met the diagnostic criteria of severe mental disorders were randomly matched according to gender, age and diagnosis in other communities into the control group. The control group and intervention group were set up strictly according to the inclusion criteria of patients and their families. Results The average age of the 200 groups was (48.27±12.67) years, and the average age of the family members was (63.61±13.19) years. After intervention, the activity dailyliving scale (ADL) scores of the control group were higher than those of the intervention group at all time points (all P0.05). After intervention, the SCL-90(self-reporting inventory) scores of the mental health of the family members in the control group were higher than those in the intervention group at all times (all P<0.05). After intervention, the family burden scale of diseases (FBS) scores of the control group were higher than those of the intervention group at all time points (all P<0.05). Conclusions The intervention measures did improve the rehabilitation effect of severe mental disorder patients in community and the psychological and family burden of family members. A professional family support service team should be established.

The Ethanol Extract of Croton Seed Inhibits the Oral Pathogen, Streptococcus mutans

It is noted that Streptococcus mutans (S. mutans) triggers dental caries establishment by two major factors: the synthesis of organic acids, which demineralize dental enamel, and the synthesis of glucans, which mediate the attachment of bacteria to the tooth surface. Therefore, it is noted that the development of a more effective, substantial and safe preventive agent that works against dental caries and periodontal disease is required at this time. For this reason, the present study was designed to investigate the effect of croton seed ethanol extracts on the growth, acid production, adhesion, and insoluble glucan synthesis of S. mutans. In this case, the ethanol extract of croton seed showed concentration dependent inhibitory activity against the growth, acid production and adhesion of S. mutans. Especially, it is important to note that it has produced significant inhibition at the concentration of 0.1 and 0.2 mg/ml as compared to the control group. Moreover, these results suggest that the application of croton seed extract may be considered to be a useful method for the prevention of dental caries.

Anti-cariogenic Properties of α-Pinene, a Monoterpene in Plant Essential Oil

Dental caries is the most common chronic disease in the dental field. Streptococcus mutans (S. mutans) is the most important bacteria in the formation of dental plaque and dental caries. In a previous study, we confirmed that the essential oil of Chrysanthemum boreale has antibacterial activity against S. mutans. Alpha-pinene is one of the major chemical components of Chrysanthemum boreale essential oil. In the present study, we investigated the inhibitory effects of α-pinene on cariogenic properties such as growth, acid production, biofilm formation, and bactericidal activity on S. mutans. Alpha-pinene at a concentration range of 0.25-0.5 mg/mL significantly inhibited the growth of S. mutans and acid production of S. mutans. Biofilm formation was significantly inhibited at < 0.0625 mg/mL α-pinene, similar to the data from scanning electronic microscopy. Under confocal laser scanning microscopy, the bacterial viability was decreased by α-pinene in a dose-dependent manner. These results suggested that α-pinene may be a useful agent for inhibiting the cariogenic properties of S. mutans.

Effect of the Ethanol Extract of Propolis on Formation of Streptococcus mutans Biofilm

Streptococcus mutans (S. mutans) is one of the most important bacteria in the formation of dental plaque and dental caries. S. mutans adheres to an acquired pellicle formed on the tooth surface, and aggregates with many oral bacteria. It initiates plaque formation by synthesizing glucan from sucrose, which is catalyzed by glucosyltransferases. Propolis is a resinous mixture produced by honeybees, by mixing saliva and beeswax with secretions gathered from wood sap and flower pollen. Bees prevent pathogenic invasions by coating the propolis to the outer and inner surface of the honeycomb. Propolis has traditionally been used for the treatment of allergic rhinitis, asthma and dermatitis. We investigated the inhibitory effects of propolis ethanol extract on biofilm formation and gene expression of S. mutans. The biofilm formation of S. mutans was determined by scanning electron microscopy (SEM) and safranin staining. We observed that the extract of propolis had an inhibitory effect on the formation of S. mutans biofilms at concentrations higher than 0.2 mg/ml. Real-time PCR analysis showed that the gene expression of biofilm formation, such as gbpB, spaP, brpA, relA and vicR of S. mutans, was significantly decreased in a dose dependent manner. The ethanol extract of propolis showed concentration dependent growth inhibition of S. mutans, and significant inhibition of acid production at concentrations of 0.025, 0.05, 0.1 and 0.2 mg/ml, compared to the control group. These results suggest that the ethanol extract of propolis inhibits gene expression related to biofilm formation in S. mutans

Delay aversion test between the male children with obsessive-compulsive disorder and ones with attention-deficit/hyperactivity disorder / 中国心理卫生杂志

Objective:To clarify the characteristics and differences between obsessive-compulsive disorder (OCD)and attention-deficit/hyperactivity disorder (ADHD)in male children.Methods:Forty boys with OCD and 40 boys with ADHD were selected from out-patient department,and 40 normal boys matched with age,gender and IQ were recruited as the controls.Patients'diagnosis was made according to the International Statistical Classifica-tion of Diseases and Related Health Problems,Tenth Revision (ICD-10).The choice delay tasks (CDT1 /2)were assessed respectively for the measurements of normal or high ecological validity of delay aversion.In CDT1 /2, waiting time and scores of the tasks were indicators reflecting the delay aversion.Results:The scores of CDTs were higher in children with OCD than in the controls [CDT1,(30.9 ±3.2)vs.(27.6 ±3.8);CDT2,(31.3 ±4.4)vs. (28.5 ±4.9);P <0.01].The scores of CDTs were lower in children with ADHD than in the controls [CDT1, [(25.0 ±4.3)vs.(27.6 ±3.8)];CDT2,[(26.2 ±4.6)vs.(28.5 ±4.9);P <0.001].Conclusion:The results in-dicate that the children with OCD have a trend to choose the task with longer waiting time and higher score,and the children with ADHD trend to choose the task with shorter waiting time and lower score.The results suggest that the pathogenesis of hyperactivity/impulse control may be different between OCD and ADHD in delay aversion.

Response inhibition and fine-motor coordination in male children with Tourette syndrome comorbid attention-deficit/hyperactivity disorder / 中国心理卫生杂志

Objective:To explore the differences and similarities of the neuropsychological functioning defi-cits in children between Tourette syndrome (TS)and attention-deficit/hyperactivity disorder (ADHD). Methods:Thirty boys with TS-only,36 with TS-plus-ADHD,36 with ADHD were selected from out-patient department,and 50 normal boys (NC)matched with gender,age and IQ were recruited as the controls. Patients'diagnosis was made according to the International Statistical Classification of Diseases and Related Health Problems,Tenth Revision (ICD-10). They were assessed with the Stroop Color-Word Interference Test (Stroop)and Purdue Pegboard Test (Purdue)to evaluate the response inhibition and fine-motor coordination respectively. Results:The Stroop scores were higher in children with ADHD than in other groups (P0. 05 ). All Purdue scores were higher in children with disease than in normal children (P<0. 05 ). Conclusion:The results indicate that the response inhibition deficit may be found in children with ADHD,but not in those with TS-only and TS-plus-ADHD. The neural compensatory mechanism may be re-sponsible for the response inhibition function in children with TS whilst the fine-motor coordination deficit was as-sociated with the disease groups.

Stability of an Aspirin in the Aspirin+Curcumin Admixture at Different Storage Conditions.

Aims: The pure stability of aspirin in the aspirin (100 μg/mL) only and aspirin (100 μg/mL) +curcumin (600 μg/mL) admixture without any ingredient under two solvents (distilled water, DW and normal saline, NS), three storage temperatures (25ºC, 4ºC and -20ºC) and periods (1st, 3rd and 7th days) was evaluated. Study Design: The injectable DW- and NS-aspirin containing solutions in the laboratory cap polyethylene bottle were stored and evaluated at controlled temperature (25ºC, 4ºC and -20ºC) during 7 days. Methodology: Effects of admixture compounds, periods of storage and temperature of storage on the concentrations of active compound (aspirin) were analyzed. The concentration of aspirin in each solution was determined by stability-indicating highperformance liquid chromatography (HPLC)-ultraviolet (UV) detection. A 1.0 mL volume of each sample was withdrawn and reconstituted with 3.0 mL of ethanol and directly injected into HPLC system immediately after filtration at 1st, 3rd and 7th days for analysis. The stability of the solutions was determined by calculating the percentage of the initial aspirin concentrations remaining at each test condition and periods. Stability was defined as the retention of at least 90% of the initial aspirin concentration. Results: The concentration of aspirin of the aspirin only and aspirin+curcumin admixture solutions remained at least 90% of original without any color change or precipitation in the DW and NS solution at 4ºC and -20ºC throughout 7 day period and showed instability that decreased gradually below 90% of original concentrations after 1 day at 25ºC in the two solutions. Conclusion: Two kinds of solutions of only aspirin and aspirin+curcumin admixture, in DW and NS, showed different stability dependence on temperature of storage that means maintained stability at 4ºC and -20ºC and did not show effect of admixture of curcumin on aspirin stability during 7 days except 25ºC.

Factors related to busyness of practicing dentists / 대한구강보건학회지

OBJECTIVES: This study investigated the busyness of dentists and analyzed factors related to busyness in these professionals. METHODS: The subjects were 243 practicing dentists. Surveys were carried out via mail. Busyness was measured by using the Mumma scale. The data were analyzed using the Kruskal-Wallis test. RESULTS: The dentists' busyness index was 1.91. Of the participants, 40% of practicing dentists wanted more patients, 30.8% did not overwork but did not want more patients, and 27.1% overworked and did not want more patients. The busyness index was significantly related to the number of dental hygienists and dentists. However, it did not differ with respect to the number of assistant nurses. CONCLUSIONS: The busyness index should be considered when developing relevant human resource plans.

Staphylococcus Species in the Dental and Medical Environment

Staphylococcus species are one of prevalent pathogens found in hospitals. Microbes that are a primary cause of nosocomial infection were isolated from a dental and medical environment it may assist the reader to explain what this is and how it differs from the 'dental health care providers and ward health care providers'. To investigate the distribution of staphylococcus species in this environment, we used vitek II to measure drug sensitivity, and further performed biochemical testing. The isolation rate of staphylococcus species from the dental and medical environment was 100% but from dental health care providers and ward health care providers were 44.4% and 33.3%, respectively. In the analyses, staphylococcus species showed resistance to diffusion of cefoxitin and oxacillin discs. These staphylococci may be sufficiently positive for the mecA gene. Our results suggest that staphylococci might be an important cause of nosocomial infection in the dental clinic.

Relationship between serum 25(OH) D level and cognitive function in patients with Alzheimer's disease / 中华临床营养杂志

Objective To explore the relationship between serum 25 (OH)D level and cognitive function in patients with Alzheimer's disease (AD).Methods Totally 113 AD impatients were enrolled in this study.Their serum 25 (OH) D2,25 (OH) D3,and total 25 (OH) D levels were determined by liquid chromatography-tandem mass spectrometry (LC-MS/MS).Patients were divided into Vitamin D severe deficiency group [25 (OH)D level≤25 nmol/L],deficiency group [25 (OH)D levels:25-50 nmol/L],insufficiency group [25 (OH) D level:50-75 nmol/L],and sufficiency group [25 (OH) D level ≥ 75 nmol/L] according to the criteria proposed by US Institute of Medicine.The cognitive function was assessed by MMSE score.The association between serum 25 (OH) D level and cognitive function was systematically analyzed.Results The serum levels of 25 (OH) D,25 (OH) D2,and 25 (OH) D3 were (27.08 ± 15.33) nmol/L,(1.23 ± 0.93) nmol/L and (24.50 ± 13.04) nmol/L in AD patients.The proportions of severe deficiency,deficiency,insufficiency,and sufficiency were 60.18％ (68/113),30.97％ (35/113),7.97％ (9/113),and 0.88％ (1/113),respectively,among these AD patients.A positive correlation was found between serum 25 (OH) D concentration and MMSE score in AD patients.Conclusions Impatients with AD often have severe vitamin D deficiency and need vitamin D supplementation.Serum 25 (OH) D concentration is associated with cognitive function,and therefore vitamin D supplementation may improve cognitive function.

Retinoic Acid Increases the Cell Cycle Progression of Human Gingival Fibroblasts by Increasing Cyclin E and CDK 2 Expression and Decreasing p21WAF1/CIP1 and p16INK4A Expression

Retinoic acid plays an important role in the regulation of cell growth and differentiation. In our present study, we evaluated the effects of all-trans retinoic acid (RA) on cell proliferation and on the cell cycle regulation of human gingival fibroblasts (HGFs). Cell proliferation was assessed using the MTT assay. Cell cycle analysis was performed by flow cytometry, and cell cycle regulatory proteins were determined by western blot. Cell proliferation was increased in the presence of a 0.1 nM to 1 microM RA dose range, and maximal growth stimulation was observed in cells exposed to 1 nM of RA. Exposure of HGFs to 1 nM of RA resulted in an augmented cell cycle progression. To elucidate the molecular mechanisms underlying cell cycle regulation by RA, we measured the intracellular levels of major cell cycle regulatory proteins. The levels of cyclin E and cyclin-dependent kinase (CDK) 2 were found to be increased in HGFs following 1 nM of RA treatment. However, the levels of cyclin D, CDK 4, and CDK 6 were unchanged under these conditions. Also after exposure to 1 nM of RA, the protein levels of p21WAF1/CIP1 and p16INK4A were decreased in HGFs compared with the control group, but the levels of p53 and pRb were similar between treated and untreated cells. These results suggest that RA increases cell proliferation and cell cycle progression in HGFs via increased cellular levels of cyclin E and CDK 2, and decreased cellular levels of p21WAF1/CIP1 and p16INK4A.