Vitamin D Supplement for Prevention of Alzheimer's Disease: A Systematic Review and Meta-Analysis.

BACKGROUND: Prevention of Alzheimer's disease (AD) with Vitamin D (VD) supplementation has been studied widely, but the results in the literature are very conflicting. THE STUDY QUESTION: Can VD supplementation really prevent AD? STUDY DESIGN: The literature was searched from PubMed, Cochrane library, Web of Science, and EMBASE to identify relevant randomized clinical trials (RCTs). The titles and abstracts were evaluated independently by 2 of the authors. RESULTS: Nine RCTs with 2345 participants were included. In the meta-analysis, we found no significant difference in the Mini-Mental State Examination, verbal fluency, verbal memory, visual ability, and attention scores between the VD intervention group and comparison group [standardized mean difference (SMD) = -0.05, 95% confidence interval (CI) = -0.51 to 0.41; SMD = -0.01, 95% CI = -0.13 to 0.11; SMD = 0.12, 95% CI = -0.45 to 0.69; SMD = 0.42, 95% CI = -0.15 to 1.00; and SMD = 0.01, 95% CI = -0.24 to 0.27, respectively]. In subgroup analysis, we found that the intervention with only VD or plus calcium, follow-up duration, and baseline 25(OH)D levels did not explain the cause for high heterogeneity. CONCLUSIONS: Overall, the current evidence did not support the beneficial effect of VD supplement to prevent AD. High quality RCTs and further studies are needed to clarify the effects of VD supplementation on preventing AD.

Reporting and methodological quality of systematic reviews or meta-analyses in nursing field in China.

The aim of this paper was to evaluate reporting and methodological quality of systematic reviews or meta-analyses in the nursing field in China. Over the last decade, evidence-based nursing has been gradually known and accepted by nurses in China, and the number of systematic reviews or meta-analyses of nursing flied has steadily increased, but the quality of these reviews is unsatisfactory. The Chinese Journal Full-Text Database, the Chinese Biomedicine Literature Database and the Wanfang Database were searched for systematic reviews or meta-analyses in the nursing field, from inception through December 2011. The Preferred Reporting Items of Systematic Reviews and Meta-analyses and the Assessment of Multiple Systematic Reviews checklists were used to assess reporting characteristics and methodological quality, respectively. A total of 63 systematic reviews or meta-analyses were identified. The deficiencies of methodological quality were mainly in literature searches, heterogeneity handling, recognition and assessment of publication bias. In addition, the deficiencies of reporting characteristics were reflected in incomplete reporting of literature search, quality assessment, risk of bias and results. Focusing on improving the quality of reporting and methodological quality of systematic reviews or meta-analyses in the nursing field in China is urgently needed.

Status and influencing factors of elder neglect by geriatric nursing assistants in Chinese nursing homes: a cross-sectional survey.

Background: In nursing homes, elder neglect has come to the forefront. Currently, few studies have examined the impact of personal and organizational factors of geriatric nursing assistants on elder neglect. From the perspective of geriatric nursing assistants, this study aims to explore the current situation and influencing factors of elder neglect in Chinese nursing homes. Methods: A convenience sampling method was used to recruit 412 geriatric nursing assistants from 50 nursing homes in China. Participants were surveyed using a demographic questionnaire, the Elder Neglect Scale for Geriatric Nursing Assistants, the General Self-Efficacy Scale (GSES), and the Proactive Personality Scale (PPS). Spearman correlation analysis and multiple linear regression were used to analyze the factors influencing elder neglect. Results: Geriatric nursing assistants scored a median of 74 out of 85 on the Elder Neglect Scale. Multiple linear regression analyses showed that the main personal factors influencing geriatric nursing assistants' elder neglect were general self-efficacy (ß = 0.312), proactive personality (ß = 0.180), and advanced qualification (ß = 0.084), while the main organizational factors included monthly salary ≤ 1,900 RMB (ß = -0.256), no regular training after induction (ß = -0.253), and the number of days off per month (3-4 days off ß = 0.192, ≥ 5 days off ß = 0.101). Conclusion: Although geriatric nursing assistants are at low levels of elder neglect, it remains a cause for concern. Among the personal factors, geriatric nursing assistants who possessed proactive personalities, high self-efficacy and advanced qualifications, exhibited low levels of elder neglect. Among the organizational factors, those who possessed a high number of days off per month portrayed low levels of elder neglect. Conversely, those who received low monthly salaries and no regular training after induction portrayed high levels of elder neglect. To reduce the risk of elder neglect, nursing homes should give due consideration to candidates' self-efficacy and proactive personality traits when recruiting, and focus on fostering these personality traits in their employees during their work. In addition, strengthening regular training for geriatric nursing assistants, optimizing the salary structure, and arranging rest days in a reasonable manner are also necessary measures.

The prevalence of elder abuse and neglect in rural areas: a systematic review and meta-analysis.

PURPOSE: Many epidemiological studies have reported that elder abuse and neglect were prevalent in rural areas. However, none of them has synthesized the literature in this field. Therefore, we aimed to estimate the overall prevalence of elder abuse and neglect in rural areas through a systematic review and meta-analysis. METHODS: PubMed, EMBASE, Web of Science, and Cochrane Library were systematically searched to identify eligible articles, with no language restrictions. Statistical analyses were conducted using Review Manager software (version 5.3). Meta-analyses and sensitivity analysis were performed using a random-effects model. All results were reported as the pooled prevalence of elder and neglect with their 95% confidence intervals (CIs). The quality of the included studies was evaluated by strengthening the reporting of observational studies in epidemiology (STROBE) checklist. Potential publication bias was assessed by the funnel plot. RESULTS: 13 cross-sectional studies involving 10,313 participants were eligible. The prevalence of elder abuse and neglect ranged from 4.5 to 61.7% across the rural areas, and pooled prevalence estimate was 33% (95% CI 23-43). The prevalence of physical abuse was estimated at 7% (95% CI 5-9), financial abuse at 5% (95% CI 4-7), psychological/emotional abuse at 17% (95% CI 11-23), and neglect at 26% (95% CI 17-35). There was significant heterogeneity among the included studies. Stratified analyses revealed that sampling design was part of the heterogeneity source. WHO regions, gender, countries' income classification, and study quality could not explain the potential reasons for heterogeneity. CONCLUSIONS: The pooled prevalence of elder abuse and neglect was relatively high in rural areas. Early and targeted screening and prevention are needed. There is an urgent need for high quality studies using agreed definition of elder abuse and neglect to protect the potential high risk populations.

[Mechanism of Hematopoietic Reconstruction in Mice Treated with Danggui Buxue Decoction combined with Muscle-Derived Stem Cell Transplantation].

OBJECTIVE: To investigate the mechanism of hematopoietic reconstruction in mice treated with Danggui Buxue Decoction (DBD) combined with the muscle-derived stem cell transplantation (MDSCT). METHODS: Female Kunming mice were randomly divided into the 6 groups: irradiation model, the bone marrow transplantation, the MDSC transplantation, the DBD 1 (4.5 g/kg), 2 (13.5 g/kg), and 3 (22.5 g/kg) + MDSC transplantation. After a week of oral administration of normal saline or different doses of DBD, The mice were exposied to 8 Gy 137Cs γ ray and were followed by bone marrow or MDSC transplantation. The expression levels of Notch1, Jagged1 and Hes1 in bone marrow, thymus and spleen were measured at 3 and 8 weeks after irradiation and transplantation. RESULTS: In the bone marrow, 3 weeks after above-mentioned treatment, the expression of Notch1 mRNA increased obviously and the expression of Jagged1, Hes1 mRNA decreased obviously in each intervention group, compared with the irradiation model group. 8th week after treatment, the expression of Notch1 mRNA decreased obviously in each intervention group, the Jagged1 mRNA expression decreased obviously except the bone marrow group, and Hes1 mRNA expression increased (P＜0.05) in each intervention group. 3 weeks after treatment, compared with the irradiation model group, the expression of Notch1 mRNA in the thymocytes increased only in DBD1+MDSC group, Jagged1, Hes1 mRNA was increased in the MDSC transplantation group and the DBD1、2+MDSC group. 8th week after treatment, the expression of Notch1, Jagged1 mRNA expression decreased in each intervention group, the expression of Hes1 mRNA increased obviously in the MDSC transplantation group and the DBD1、2+MDSC group (P＜0.05). In the spleen, 3 weeks after treatment, the expression of Notch1, Jagged1 mRNA in the spleen of each intervention group decreased obviously, compared with the irradiation model group. The expression of Jagged1, Hes1 mRNA in each intervention group were increased obviously 8th week after treatment (P＜0.05). CONCLUSION: MDSC transplantation after pretreatment of DBD can improve the hematopoietic reconstitution in mice with lethal dose radiation damage. Notch1、Jagged1 and Hes1 play different roles in this process, but the concrete mechanism needs to be further studied.

Nursing students' knowledge, willingness, and attitudes toward the first aid behavior as bystanders in traffic accident trauma: A cross-sectional survey.

OBJECTIVES: The purpose of the study was to investigate the nursing students' levels of the knowledge, willingness, and attitudes toward first aid behavior as bystanders in road traffic accident and the related factors. METHODS: A total of 475 nursing students were recruited by convenience choosing in Tianjin University of Traditional Chinese Medicine. The nursing students' self-efficacy, core self-evaluation, knowledge, willingness and attitudes toward first aid behavior as bystanders in traffic accidents were investigated with a self-designed questionnaire. RESULTS: The scores of knowledge, willingness, and attitudes toward first aid behavior in traffic accident trauma were 7.51 ±â€¯1.93, 15.54 ±â€¯5.03, and 7.73 ±â€¯1.56, respectively. Students who once gained training of first aid showed lower levels of attitude toward first aid behavior than those untrained (t = -2.345, P = 0.019). It was found that self-efficacy was correlated to the knowledge (r = 0.150, P < 0.001), willingness (r = 0.182, P < 0.004) and attitudes toward behavior of the first aid (r = 0.371, P < 0.001) among nursing students. Core self-evaluation was correlated to knowledge (r = 0.193, P < 0.001) and attitudes toward behavior of the first aid (r = 0.199, P < 0.001). CONCLUSIONS: The first aid knowledge among nursing students was not satisfactory. The study suggested that an unsustainable short first-aid training program may bring negative effects. Countermeasures should be taken to ensure both quality and continuity of first aid training. Meanwhile, more attention should be paid to improving the self-efficacy and core self-evaluation of the nursing students.

Association between genetic variants and characteristic symptoms of type 2 diabetes: A matched case-control study.

OBJECTIVE: To examine the association of genetic variants with characteristic symptoms of type 2 diabetes mellitus (T2DM). METHODS: A matched case-control study was performed to investigate the association between common variants in four genes (CDKAL1, GLIS3, GRK5, and TCF7L2) and symptoms of T2DM. Symptoms were examined with questionnaire for 710 subjects. Genomic DNA was extracted from peripheral blood mononuclear cell by salting-out procedure. Genotyping was carried out by direct sequencing of the unpurified polymerase chain reaction products. RESULT: Most of the T2DM patients pressented characteristic symptoms, such as feeling weak in limbs (P =0.0057), hand tremor (P =0.0208), bradymasesis (P =0.0234), and polyuria (P =0.0051). Some of the T2DM patients shared characteristic symptoms, such as desire for cold drinks (P =0.0304), polyphagia (P =0.0051), and furred tongue (P =0.028). The impaired glucose regulation (IGR) cases took only one characteristic symptom of frequent micturition (P =0.0422). GLIS3 rs7034200 and GRK5 rs10886471 were significantly associated with increased T2DM risk (GLIS3 rs7034200 under dominant model: P=0.0307; GRK5 rs10886471 under recessive model: P=0.0092). However, only the rs10886471 polymorphism in GRK5 showed a significant effect on both differentiated symptoms and T2DM risk. The C-allele was involved in both dampness-heat encumbering Pi (Spleen) syndrome (P =0.047) and qi-yin deficiency syndrome (P =0.002) via increased GRK5 expression. CONCLUSIONS: Both T2DM and IGR exhibited its corresponding characteristic symptoms. The variants of GRK5 were involved with both qi-yin deficiency syndrome and dampness-heat encumbering Pi syndrome.

[Progress of Experimental Research on Differentiation of Muscle-Derived Stem Cells into Haematopoietic Lineages in Vitro -Review].

Muscle-derived stem cells (MDSC) are a population of multipotent stem cells in the muscular tissue. It provide an excellent prospect of hemopathy treatment due to their superiorities, such as rich sources, convenient material resource and a high survival rate after transplantation and so on. However, there are great differences in sampling, separation, purification, and proliferation when MDSC were cultured in vitro. In addition, the proliferation conditions of the MDSC in vitro are yet unclear. The related regulatory mechanisms, which MDSC transformed into haematopoietic cells, need to be investigated. In this article, the experimental researches on the differentiation of MDSC into haematopoietic lineages are reviewed, the concrete problems discussed in this review are culture of MDSC in vitro, identification of MDSC, proleferation of MDSC, differention of MDSC in to hematopoietic lineages and so on.

[Research Progress on Muscle-derived Stem Cells Capable of Hematopoiesis].

Muscle-derived stem cells (MDSC) are defined as myogenic stem cells endowed with their ability to self-renew and differentiate into multiple cell types of their derivative tissue, and are proved to be over 10 times more efficient in hematopoiesis than hematopoietic stem cells (HSC). Although the mechanism which MDSC differentiate into blood cells is still unclear, MDSC were considered to replace HSC to treat the patients suffering from bone marrow diseases such as aplastic anemia and tumor. MDSC are different from HSC in a variety aspects like biological characteristics, protein expression and cell proliferation. On the other hand, MDSC contain multiple distinct stem cell populations. Among these, there is only a small part with the ability to repopulate hematopoietic cells, and it is still uncertain whether their origin is same as HSC. This review summarizes the difference between MDSC and HSC, the ability of MDSC to repopulate hematopoietic cells, and the prospect of MDSCs' transplantation.

The association between gene polymorphism of TCF7L2 and type 2 diabetes in Chinese Han population: a meta-analysis.

In recent years, it has been widely accepted that transcription factor 7-like 2 (TCF7L2) is associated with type 2 diabetes mellitus (T2DM) in multiple ethnic groups, especially its single nucleotide polymorphisms of rs7903146C/T, rs12255372G/T and rs290487T/C. However, the results previously obtained in Chinese Han population are often inconsistent. For clearing this issue, herein we performed meta-analysis based on the reports that can be found to assess the association. In the meta-analysis, Odds ratio (OR) and 95% confidence interval (95% CI) were calculated with random-effect model or fixed-effect model based on the heterogeneity analysis. The quality of included studies was evaluated by using the Newcastle-Ottawa Scale. The sensitivity analysis was used to confirm the reliability and stability of the meta-analysis. In total, 20 case-control studies with 9122 cases of T2DM and 8017 controls were included. Among these case-control studies, we selected 13 ones on rs7903146 C/T, 5 ones on rs12255372 G/T, 8 ones on rs290487 T/C. The results indicated that rs7903146C/T polymorphism was significantly associated with T2DM (T vs. C, OR = 1.73, 95% CI = 1.39-2.16). There was no evidence that rs12255372G/T and rs290487T/C polymorphisms increased T2DM risk (T vs. G, OR = 1.77, 95% CI = 0.88-3.56; C vs. T, OR = 1.08, 95% CI = 0.93-1.25). Subgroup analysis of different regions proved the relationship between rs7903146C/T polymorphism and T2DM risk in both the northern and the southern China. The association of rs290487 with T2DM was affected by body mass index, whereas the association of rs7903146 and rs290487 with T2DM was influenced neither by age nor by sex. In conclusion, this study indicated that the rs7903146C/T polymorphism of the TCF7L2 gene had a significant effect on T2DM risk in Chinese Han population, with rs12255372G/T and rs290487T/C polymorphisms showing no significant effect.