Association between serum vitamin D concentrations and inflammatory markers in the general adult population

Objective

In recent years links among vitamin D deficiency, inflammation and cardio-metabolic disease were proposed. As information regarding the associations between vitamin D and inflammatory markers in the general population is sparse, we investigated the associations of 25-hydroxy vitamin D [25(OH)D] with high-sensitivity C-reactive protein (hs-CRP), fibrinogen and white blood cell count (WBC).

Materials/Methods

The study population comprised 2723 men and women aged 25–88 years from the first follow-up of the Study of Health in Pomerania. Analyses of variance, linear and logistic regressions were performed to assess the associations between 25(OH)D and the three inflammatory markers. The models were adjusted for age, sex, waist circumference, diabetes mellitus, dyslipidemia, anti-inflammatory medication and month of blood sampling. The association between 25(OH)D and WBC was assessed separately in smokers (n = 718) and non-smokers (n = 2005) as effect modification was observed.

Results

We detected a U-shaped association between 25(OH)D and hs-CRP with a nadir of 21–25 ng/ml in fully-adjusted linear regression models with restricted cubic splines (p < 0.01; p’ < 0.01). We further detected an inverse association between 25(OH)D and fibrinogen (p < 0.01). In addition, there was an inverse association between 25(OH)D and WBC in smokers (p = 0.02) but no association in non-smokers (p = 0.73).

Conclusion

Our study confirms a potential role of 25(OH)D in chronic inflammation. Yet, different inflammatory biomarkers are differently associated with 25(OH)D. Beneficial effects of increasing 25(OH)D were observed for fibrinogen and WBC (in smokers only). In contrast, the U-shaped association between 25(OH)D and hs-CRP indicates that ever-increasing 25(OH)D concentrations may also be related to proinflammatory states.     

2019 ATC器官移植国际前沿热点及新进展概述

本文概述了2019年美国移植年会（ATC）器官移植临床及应用基础与转化医学研究前沿热点内容,涉及移植科医师普遍关切的移植临床重点及难点,包括供体特异性抗体（DSA）及抗体介导的排斥反应（AMR）的免疫学机制、风险因素、预后评估及重要生物学标志,高致敏患者的去致敏策略及AMR防治进展,临床免疫耐受的现状及发展方向,移植相关感染的热点及防治进展,对供肾机械灌注方法的简要评价等。     

2020年ATC肾移植相关基础与转化医学研究国际前沿热点

美国移植年会（ATC）是移植学领域一年一度的国际学术盛会,其报道的内容囊括了世界各地学者在移植领域的最新成果,也引领了移植相关研究的前沿方向。本文就2020年ATC中与肾移植相关的基础与转化医学研究国际前沿热点进行概述,包括免疫记忆性细胞功能和免疫记忆机制的新发现,排斥反应和免疫耐受机制的最新探索,异种移植的研究现状,抗体介导的排斥反应（AMR）的潜在解决策略,纳米医学、单细胞RNA测序等新型技术在肾移植中的应用前景等。     

ATC分类编码和中成药分类编码比较分析

目的 通过比较世界卫生组织（WHO）药物的Anatomical-Therapeutic-Chemical （ATC）分类编码与中成药分类编码的异同,为中成药分类编码的标准化、信息化、国际化提供建议和参考。方法 采用描述性分析方法,比较ATC分类编码和《中药分类与代码》、中国药房医药经济信息网（CPPN）及日本汉方等几种中成药分类编码在分类层次、分类依据等编码方法方面的差异,以及对中成药分类编码的启示与影响。结果 中成药传统的病证分类法、功效分类法及综合分类法在逐步借鉴ATC的分类模式,采用逻辑性更严密的编码和分类,部分实现了与ATC的接轨。结论 中成药的分类应在保持中医药特色的基础上借鉴ATC分类编码方法,逐步探索出与国际接轨的中成药分类编码。     

急性创伤性凝血病患者活化蛋白C血管性假血友病因子D-二聚体的动态变化及其临床意义

目的 探讨急性创伤性凝血病(ATC)患者活化蛋白C(APC)、血管性假血友病因子(vWF)、D-二聚体在受伤后不同时间点血浆水平的动态变化规律及其临床意义.方法 将40例多发伤患者,根据是否发生ATC分为ATC组20例和非ATC组20例,并引入正常对照组,分别于入院后6h内、24h、48 h及72 h,采用酶联免疫吸附法(ELISA)检测血浆APC、D-二聚体、vWF含量水平,观察其动态变化.结果 多发伤患者血浆APC、vWF、D-二聚体水平均高于正常对照组.ATC组患者APC值持续偏高,非ATC组患者APC有逐渐下降趋势,在48、72 h明显下降(P＜0.05);ATC组患者APC含量各时间点均较非ATC组明显升高(P＜0.05);ATC组患者D-二聚体、vWF含量各时间点均较非ATC组明显升高(P＜0.05).两组患者在入院48 h后血浆vWF含量均有逐渐下降趋势(P＜0.05).结论 血中APC、vWF及D-二聚体含量对急性创伤性凝血病的早期诊断、发展趋势及评估、预后判断具有一定的临床意义.     

Posterior tibial slope measurement on lateral knee radiographs as a risk factor of anterior cruciate ligament injury: A cross-sectional study

Introduction

The posterior tibial slope (PTS) is believed to be a risk factor for anterior cruciate ligament (ACL) injury. The aim of this study was to reveal the differences in terms of PTS measurements on lateral knee radiographs between ruptured and non-injured cases as well as between males and females in regard to ACL alignment.

Prevalence of heart attack and stroke and associated risk factors among Inuit in Canada: A comparison with the general Canadian population

Background

It is generally believed that cardiovascular disease (CVD) is rare in the Inuit population because of their traditional marine-based diet, but the evidence is inconsistent.

Gal‐3 is stimulated by gain‐of‐function p53 mutations and modulates chemoresistance in anaplastic thyroid carcinomas

Galectin‐3 (Gal‐3) is an anti‐apoptotic molecule of the β‐galactoside‐binding lectin family. Gal‐3 is down‐regulated by wt‐p53 and this repression is required for p53‐induced apoptosis. Since poorly differentiated thyroid carcinomas (PDTCs) and anaplastic thyroid carcinomas (ATCs) frequently harbour p53 mutations, we asked whether Gal‐3 expression and activity could be influenced by such mutations in these tumours. We found a positive correlation between Gal‐3 expression and p53 mutation in human thyroids and in thyroid carcinoma cell lines (TCCLs) harbouring different p53 mutations. Gal‐3 was over‐expressed in most ATCs and TCCLs, especially those with the most frequently detected p53 mutation (p53^R273H). Over‐expression of p53^R273H in two p53‐null cells (SAOS‐2 and SW‐1736) as well as in two wt‐p53‐carrying TCCLs (TPC‐1 and K1), stimulated Gal‐3 expression, while interference with p53^R273H endogenous expression in ARO cells down‐regulated Gal‐3 expression. Conversely, over‐expression of wt‐p53 in ARO cells restored the inhibitory effect on Gal‐3 expression. ARO cells are highly resistant to apoptosis and express both p53 and Gal‐3, which are increased upon cisplatin treatment. Interference with Gal‐3 expression in these cells stimulated their chemosensitivity. In conclusion, gain‐of‐function p53 mutant acquires the de novo ability to stimulate Gal‐3 expression and to increase chemoresistance in ATCs. Copyright © 2008 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.     

The modular operation of the cerebral neocortex considered as the material basis of mental events

The module of the neocortex forms a unit that is central to the various conceptual developments here formulated. Its structure and its modes of operation and communication are described in some detail. The attempt is made to see if the known synaptic excitatory and inhibitory mechanisms of the module would give it unique properties as a unitary component of that part of the brain specially related to mental events. Particular reference is made to the important new discoveries, axo-axonic synapses inhibiting pyramidal cell axons and the disinhibitory action of the celluleàdouble bouquet of Ramón y Cajal. There seems to be no internal system of reverberatory communication within the module. However, the complexities of reverberatory operation are given with the module as a unit in three communication systems of the brain: the cortico-cortical, the thalamo-cortical and the horizontal fibre systems.It is argued that all mental experiences are embedded in memories. An hypothesis is developed in respect of the generation of modular patterns in relation to memory and its retrieval that is based on the conjunction hypothesis of Marr. The horizontal fibres of lamina I play a key role. These patterns would also be the modular patterns correlated with self-consciousness in all of its manifestations. Diagrams of modular patter ns illustrate the hypothesis and could give rise to experimental testing. It is pointed out that this hypothesis leads to concepts of modular patterning that are not at variance with the conjectures of Mountcastle, Sperry and Szentágothai with respect to the neural events in correlation with mental events, though here the dualist-interactionist hypothesis is favoured.     

Outpatient Use of Systemic Antibiotics in Croatia

Objective: The aim was to estimate the outpatient utilization of antibacterials for systemic use in Zagreb, Croatia, and to define the antibiotic utilization characteristics and consequences.Method: Using the WHO ATC/DDD methodology, the number of defined daily doses per 1000 inhabitants per day (DDDs/TID) was calculated for each individual antibiotic and ATC system levels were calculated from data collected on the number and size of packages prescribed and dispensed from pharmacies. The Drug Utilization 90% (DU90%) method was used to evaluate the quality of drug prescribing.Results: The total utilization of antibiotics was found to be extremely high, 55.0 DDDs/TID. The leading antibiotic was amoxicillin + clavulanic acid with 14.7 DDDs/TID. Penicillins accounted for the highest utilization (46.3%) expressed in DDDs/TID (25.4), followed by cephalosporins and macrolides 25 and 12.5% of utilization, respectively expressed in DDDs/TID), tetracyclines, quinolones, aminoglycosides and other agents. Nine of 27 antibiotics fell within the DU90% segment. The cost/DDD foldrugs within DU90% segment was 1.2 EUR, for drugs beyond DU90% segment was 1.4 EUR, and the average was 1.2 EUR.Conclusion: Irrational prescribing and preference to more expensive drugs have been reported in Zagreb. Therefore, the risk of resistance of microorganisms to beta-lactamase antibiotics, macrolides and quinolones could be expected. Prescribing patterns should be changed by introducing national guidelines on rational antibiotic prescribing, monitoring and evaluation of their implementation. Additional continuing education of physicians and pharmacists from independent sources should be organized and proper education should be provided to patients.