Background: We aimed to comprehensively explore the associations between serum 25(OH)D deficiency and risk of dementia and Alzheimer's disease(AD). Methods: We systematically searched Pubmed, the Cochrane Library, Embase and the reference lists of pertinent review articles for relevant articles published from database inception up until January 2019. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with random effects models using the Stata 12.0 statistical software package. Results: Twelve prospective cohort studies and four cross-sectional studies were included in this meta-analysis. The pooled HRs of dementia and AD, respectively, were 1.32 (95%CI: 1.16, 1.52) and 1.34 (95%CI: 1.13, 1.60) for vitamin D deficiency (< 20 ng/ml). In the subgroup analyses, the pooled HRs of dementia and AD, respectively, were 1.48 (95%CI: 1.19, 1.85) and 1.51 (95%CI: 1.04, 2.18) for moderate vitamin D deficiency (10-20 ng/ml) and 1.20 (95%CI: 0.99, 1.44) and 1.36 (95%CI: 1.01, 1.84) for severe vitamin D deficiency (< 10 ng/ml). Conclusion: There are significant associations between vitamin D deficiency and both dementia and AD. There are stronger associations between severe vitamin D deficiency (< 10 ng/ml) and both dementia and AD compared to moderate vitamin D deficiency (10-20 ng/ml).
Background Neuromyelitis optica (NMO) is a severe inflammatory autoimmune disorder of the central nervous system and often results in paralysis or blindness. Rituximab (RTX) is a mouse–human chimeric monoclonal antibody specific for the CD20 antigen on B lymphocytes and used to treat many autoimmune diseases. Disability and relapses were measured using the Expanded Disability Status Scale (EDSS) and annualized relapse rate (ARR) ratio to evaluate the effectiveness of RTX. This review performed a meta-analysis of the efficacy of RTX in NMO. Methods We searched through the databases of PubMed, Embase, and Cochrane Library. We compiled 26 studies, in which 18 used ARR ratio, 22 used EDSS score, and 14 used both variables. Differences in the ARR ratio and EDSS score before and after RTX therapy were used as the main efficacy measures. Publication bias was evaluated after the consistency test, and a sensitivity analysis was performed with mean difference (MD) of the efficacy of RTX. Results A meta-analysis of 26 studies with 577 participants was conducted. Antibodies against aquaporin-4 autoantibody were recorded in 435 of 577 (75.39%) patients with NMO. RTX therapy resulted in a mean (WMD) − 1.56 (95% CI, − 1.82 to − 1.29) reduction in the mean ARR ratio and a mean (WMD) − 1.16 (95% CI, − 1.36 to − 0.96) reduction in the mean EDSS score. A total of 330 of 528 patients (62.9%) reached the relapse-free state. A total of 95 of 577 (16.46%) patients had adverse reactions. Conclusions RTX has acceptable tolerance, reduces the relapse frequency, and improves disability in most patients with NMO. Future studies should focus on reducing the health-care costs, improving the functional outcomes, and reducing the adverse effects associated with RTX treatment.
Alzheimer's disease (AD) is the most common form of dementia; its pathophysiological mechanism remains unclear. Long noncoding RNAs (lncRNAs) play key roles in AD. lncRNA EBF3-AS has been found dysregulated in AD, which is abundantly expressed in the brain. The aim of this study was to investigate the role of EBF3-AS in AD. Results showed that the expressions of lncRNA EBF3-AS and EBF3 (early B cell factor 3) were upregulated in hippocampus of APP/PS1 mice (AD model mice). EBF3-AS knockdown by siRNA inhibited the apoptosis induced by Aβ and okadaic acid (OA) in SH-SY5Y. The expression of EBF3 was downregulated in Aβ- and OA-treated SH-SY5Y, which was reversed by EBF3-AS knockdown. EBF3 knockdown can reverse the Aβ-induced apoptosis in SH-SY5Y. These results revealed that lncRNA EBF3-AS promoted neuron apoptosis in AD, and involved in regulating EBF3 expression. EBF3-AS may be a new therapeutic target for treatment of AD.
Since the novel coronavirus disease 2019 (COVID-19) outbreak, adolescents' emerging mental health and behavior issues have been an international public health concern. This longitudinal study aimed to examine the situation of poor sleep quality, anxiety, and depressive symptoms among Chinese adolescents and to explore the associations between them before and during COVID-19. A total of 1,952 middle and high school students as eligible participants at baseline (pre-COVID-19, Wave 1; response rate: 98.79%), 1,831 eligible students were followed up at Wave 2 (October 2019 to December 2019, pre-COVID-19; retention rate: 93.80%), and 1,790 completed the follow-up at Wave 3 (during the COVID-19; retention rate: 97.80%). The mean age of the baseline students was 13.56 (SD: 1.46) years. The differences in anxiety and depressive symptoms between Wave 1, Wave 2, and Wave 3 were not statistically significant. The proportion of students with poor sleep quality increased over time, from Wave 1 (21.0%) to Wave 3 (26.0%, OR = 1.37, 95% CI = 1.17–1.60, P = 0.001) and from Wave 2 (21.9%) to Wave 3 (OR = 1.29, 95% CI = 1.11–1.51, P < 0.001). The cross-lagged generalized linear mixed models revealed that the concurrent and cross-lagged associations of poor sleep quality with anxiety symptoms across the three waves were significant (P < 0.05) and vice versa. Only a marginally significant positive cross-lagged association between poor sleep quality at Wave 2 and depressive symptoms at Wave 3 was found (standardized β estimate = 0.044, SE = 0.022, P = 0.045). Sleep quality was adversely affected during COVID-19, and the bidirectional associations of poor sleep quality with anxiety symptoms could not be neglected.
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