健骨颗粒对骨质疏松模型大鼠垂体-肾上腺轴的影响

目的：从垂体—肾上腺轴角度探讨健骨颗粒治疗I型原发性骨质疏松症的作用机制。方法：通过切除SD大鼠双侧卵巢建立I型原发性骨质疏松模型，随机分成3组，分别喂服健骨颗粒、骨松宝和生理盐水。用药12周后处死取材，检测血清皮质醇(COR)浓度，取脑垂体行ACTH细胞免疫化学染色(S—P法)并形态计量，肾上腺行HE染色。结果：切除卵巢12周后大鼠出现骨质疏松，血清COR浓度以及垂体ACTH阳性细胞数和染色面积均明显高于假手术组(行腹部切口，但不切除卵巢)。用药12周后健骨颗粒组血清COR水平、垂体ACTH阳性细胞数和染色面积均较生理盐水组降低或减少。结论：补。肾健脾中药健骨颗粒可有效调节去卵巢骨质疏松模型大鼠垂体肾上腺轴的病理变化和功能状态，抑制雌激素水平降低后的异常骨吸收。     

健骨颗粒对去卵巢骨质疏松模型鼠钙调节激素的影响

目的:探讨健骨颗粒对骨质疏松模型鼠三种主要钙调节激素水平的影响.方法:切除雌性大鼠卵巢建立绝经后骨质疏松症病理模型,分别喂服健骨颗粒、骨松宝和生理盐水,用放射免疫测定法检测血清甲状旁腺激素(PTH)、1,25-二羟维生素D3[1,25-(OH)2D3]、降钙素(CT)和雌二醇(E2)水平.结果:卵巢切除后随着血清E2水平的下降,1,25-(OH)2D3、CT含量明显下降(P＜0.01或P＜0.05),而PTH却显著上升(P＜0.01).用药后健骨颗粒组血清1,25-(OH)2D3、CT水平显著回升(P＜0.01或P＜0.05),而PTH浓度出现下降(P＜0.01).E2与CT、1,25-(OH)2D3呈正相关,而与PTH呈负相关;PTH与1,25-(OH)2D3、CT呈负相关,1,25-(OH)2D3与CT呈正相关.结论:健骨颗粒能通过协调骨质疏松模型鼠血清PTH、1,25-(OH)2D3、CT三种钙调节激素浓度,改善因E2下降对骨代谢产生的副作用,这可能是健骨颗粒有效防治骨质疏松症的主要作用机制之一.     

健骨颗粒对去卵巢骨质疏松模鼠血清TNF-α、TGF-β1的影响

目的 探讨补肾健脾中药健骨颗粒对去卵巢骨质疏松模鼠血清TNF-α与TGF-β1含量的变化。方法 切除卵巢建立大鼠骨质疏松模型。随机分成三组，分别喂服健骨颗粒，骨松宝，生理盐水，用药12周后检测各组血清TNF-α，TGF-β1及E2含量。结果 大鼠去卵巢后12周，随着E2水平下降，血清TNF-β含量明显升高，而TGF-β1浓度却明显降低，当喂服健骨颗粒12周后，血清E2水平和TGF-β1浓度回升明显，而TGF-α含量却出现下降，与同期生理盐水组相比有明显统计学意义，血清TGF-β1，E2含量与TNF-α呈负相关，而TGF-β1含量与E2水平高度正相关，结论 E2对TNF-α有一定的抑制作用，而TGF-β1的分泌可能需要雌激素等刺激，健骨颗粒通过综合调整作用以提高模鼠E2水平，既制约了TNF-α的合成，分泌及其活性，又解除了对TGF-β1的抑制作用，使破骨细胞的骨吸收活动减弱，成骨细胞的骨形成作用增强，改善骨代谢的负平衡。     

健骨颗粒抗去卵巢大鼠骨质疏松的血清代谢组学研究

目的 运用代谢组学方法从物质代谢角度探讨健骨颗粒治疗绝经后骨质疏松症的机制。 方法 60只大鼠随机分为正常组、模型组和健骨颗粒组，健骨颗粒组给予健骨颗粒药液灌胃，其余组分别给予等量生理盐水灌胃干预。分别于术后6周和12周取股骨、胫骨、腰椎骨进行骨密度及骨生物力学检测，取腹主动脉血进行液相色谱-质谱（LC-MS）检测，综合单变量和多变量统计分析，鉴定并筛选血清代谢物。结果 模型组较正常组骨密度和骨最大载荷显著下降，健骨颗粒组与模型组相比明显恢复，表明造模成功且健骨颗粒组有恢复正常的趋势。模型组血清代谢谱与正常组分离，健骨颗粒组接近正常组。筛选出硬脂酸、皮质酮及泛酸等27个差异代谢物，分别与不饱和脂肪酸、类固醇激素的生物合成及泛酸和辅酶A生物合成等通路有关，涉及脂代谢、核酸代谢及氨基酸代谢等。结论 健骨颗粒可能通过调节多种代谢通路改善绝经后骨质疏松症。     

壮骨颗粒对去卵巢骨质疏松模兔BMD和血清TRAP、BALP影响的实验研究

目的本文从骨密度（BMD）和血清TRAP、BALP的角度探讨壮骨颗粒对原发性骨质疏松症的作用机制。方法建立6月龄雌性兔卵巢摘除骨质疏松模型，模型成立后随机分成壮骨颗粒组、钙尔奇-D组和生理盐水组，分别喂服壮骨颗粒、钙尔奇-D和生理盐水。喂药12周后处死取材，检测BMD和血清TRAP、BALP等浓度。结果壮骨颗粒组BMD明显高于对照组，兔血清TRAP活性均较对照组降低，而BALP较对照组升高。结论壮骨颗粒可以提高骨质疏松模兔的BMD，抑制破骨细胞活性，提高成骨细胞的活性。     

健骨颗粒含药血清对体外破骨细胞CA Ⅱ、CK、MMP- 9mRNA表达的影响

目的 通过观察补肾健脾中药健骨颗粒含药血清对体外破骨细胞CAⅡ、CK、MMP-9mRNA表达的影响,进一步揭示健骨颗粒有效防治绝经后骨质疏松症的作用机制。方法 用M-CSF和RANKL诱导破骨前体细胞RAW264.7分化为成熟破骨细胞,alamar Blue法检测破骨细胞血清干预的最佳浓度,于破骨细胞培养第7天开始干预,分别用25%浓度的健骨颗粒含药血清和25%浓度的生理盐水血清干预,培养48小时后抽提总RNA,采用逆转录-聚合酶链反应（RT-PCR)、实时荧光定量SYBR GREEN法检测CAⅡ、CK、MMP-9mRNA表达,并取骨片行甲苯胺蓝染色,计算分析骨陷窝数和骨吸收面积,同时运用氧化显色法检测破骨细胞培养液中TRAP含量,ELISA法检测骨磨片培养液中CTX含量。结果 健骨颗粒含药血清组破骨细胞CA Ⅱ、 CK、MMP-9mRNA表达水平明显低于生理盐水血清组（P <0. 05),含药血清组骨磨片的骨陷窝数和骨吸收面积以及TRAP和 CTx含量均低于生理盐水血清组（P<0.05)。结论 健骨颗粒能有效抑制破骨细胞CAII、CK、MMP-9mRNA表达,降低破骨细胞功能活性,抑制破骨细胞对骨基质的分解,从而抑制骨吸收。     

荣骨颗粒对去卵巢大鼠骨质疏松症治疗作用的实验研究

目的 探索补肾中药“荣骨颗粒”治疗骨质疏松症的作用机理。方法 摘除大鼠双侧卵巢，正常喂养3个月后造成骨质疏松大鼠模型，按大、中、小剂量分组并灌服荣骨颗粒，对照组分别灌服己烯雌酚和中药骨疏康。3个月后处死所有大鼠，眼球取血，测定血清骨钙素(BGP)、碱性磷酸酶(ALP)、白介素1(IL-1)、白介素6(IL-6)、雌二醇(E2)。结果 荣骨颗粒能使血清BGP、ALP、IL-1、IL-6含量降低，使血清E2水平升高。结论 该药对骨质疏松症之骨吸收．骨形成偶联具有一定的调节作用；能够抑制IL-1、IL-6的分泌，具有促进雌激素分泌效应或类雌激素样作用。本实验从激素和细胞因子层面初步阐述了荣骨颗粒治疗骨质疏松症的作用机理。     

应用microCT技术对中药干预去卵巢小鼠骨组织微结构的分析

目的应用micro CT技术观察健骨颗粒对C57小鼠去卵巢骨质疏松模型骨组织骨量、骨微结构及生物力学的影响。方法将4周龄清洁级C57小鼠30只随机分为三组(假手术组10只、卵巢切除小鼠两组各10只),两组卵巢切除小鼠术后1周开始,分别用健骨颗粒和生理盐水进行灌胃,假手术组用生理盐水灌胃。2个月后,小鼠左胫骨行micro CT检测及图像分析、右胫骨行生物力学三点抗压最大载荷检测。结果与假手术组比较,去卵巢组BMC、BMD、Mean、BV、BS显著下降(P0.01),TMC下降(0.01P0.05);与去卵巢组比较,去卵巢中药组BMC、BMD、Mean指标显著提高(P0.01);图像分析结果显示去卵巢组较假手术组骨皮质薄,骨小梁数量少,形态细小、不连续呈扭曲或断裂状等明显骨质疏松病理特征,去卵巢中药组介于两者之间。生物力学结果显示三组胫骨三点抗压最大载荷均具有明显差异(P0.01)。结论去卵巢2月成功建立小鼠绝经后骨质疏松症模型;健骨颗粒抗骨质疏松作用明显,主要通过增加骨量和改善骨小梁微结构来最终提高骨强度;micro CT对骨质疏松参数分析简洁、高效,图像多维、全面,与传统的检测方法相比,具有一定的优势。     

荣骨颗粒对卵巢切除后骨质疏松大鼠骨形态计量的影响

目的 探索补肾中药荣骨颗粒对去势大鼠骨质疏松症的防治作用。方法 摘除大鼠双侧卵巢造成骨质疏松症模型，分别灌服大、中、小剂量的荣骨颗粒，并与己烯雌酚和骨疏康组作对照，3个月后，进行骨形态计量测定和分析。结果 大中剂量的荣骨颗粒能使切除卵巢大鼠骨小梁体积百分比显著增高，骨小梁吸收表面百分比、骨小梁形成表面百分比、活性生成表面百分比、骨小梁矿化率、类骨质平均宽度及骨皮质矿化率均明显降低。结论 大、中剂量的荣骨颗粒对卵巢切除后的大鼠骨质疏松症具有一定的治疗作用；小剂量荣骨颗粒无明显作用，而大剂量则优于中剂量组的治疗作用。     

铸骨胶囊对去势大鼠骨质疏松症的治疗作用

目的:研究铸骨胶囊对去势大鼠骨质疏松症的治疗作用。方法:选用雌性6月龄SD大鼠60只,随机分为Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅵ组(分别为假手术组,模型组,模型 骨疏康颗粒组,模型 铸骨胶囊高、中、低剂量组),Ⅰ组在双侧卵巢位置切除与卵巢同等大小的脂肪块,其他各组(Ⅱ~Ⅵ)切除双侧卵巢造成绝经后骨质疏松症动物模型。Ⅰ、Ⅱ组按1ml/100g体重灌胃(1·33%的β-环糊精水溶液),Ⅲ组按2·7g/kg体重灌胃(骨疏康颗粒水溶液),Ⅳ、Ⅴ、Ⅵ组分别按400、200、100mg/kg体重灌胃(铸骨胶囊水溶液)。给药3个月后,检测各组动物的左侧股骨及第2腰椎骨密度(bonemineraldensity,BMD),股骨生物力学强度(用三点弯曲实验检测),对胫骨切片进行骨组织形态计量学分析,采用放免法测血清中雌二醇(estradiol,E2)、降钙素(calcitonin,CT)、骨钙素(bonegalprotein,BGP)含量。结果:切除雌性大鼠双侧卵巢3个月后,腰椎及股骨BMD明显降低,与Ⅰ组比差异有显著性统计意义(P<0·05),提示绝经后骨质疏松症动物模型复制成功。铸骨胶囊各组(Ⅳ、Ⅴ、Ⅵ)与Ⅱ组比较,Ⅳ组腰椎和股骨BMD增加,差异有显著性统计意义(P<0·05,P<0·01)。Ⅳ组股骨生物力学强度各项指标及胫骨骨组织形态计量参数明显改善,差异有显著性统计意义(P<0·05);CT、BGP含量升高,差异有显著性统计意义(P<0·001,P<0·01)。Ⅳ组与Ⅲ组比较,最大桡度增加,差异有显著性统计意义(P<0·05);骨小梁形成表面(trabeculaformationsurface,TFS)百分比增加,差异有显著性统计意义(P<0·01);CT、BGP含量升高,差异有显著性统计意义(P<0·05,P<0·01)。结论:铸骨胶囊可以增加切除双侧卵巢大鼠的BMD,提高骨的力学性能,降低骨折的发生率,对去势大鼠有一定的抑制骨丢失作用。     

甲状腺扫描对甲状腺结节的诊断价值

通过对425例甲状腺结节患者的甲状腺扫描与术后病理结果的分析，发现热、温、凉、冷结节中发生甲状腺癌的机会分别为4．8％、11．1％、8．1％和5．9％；而扫描所显示的结节位置与手术所见的符合率为88．9％。认为，甲状腺扫描对甲状腺结节的定位有帮助，但无鉴别肿瘤良、恶性的临床价值。     

Anatomy of the salivary glands

The salivary glands comprise the parotid, the submandibular and the sublingual glands as well as small subsidiary glands scattered beneath the mucosa of the buccal cavity. The largest, the parotid, drains by its duct into the mouth at the level of the second upper molar tooth. It is traversed by the facial nerve, which may be invaded by a parotid carcinoma or damaged during parotid surgery. The submandibular gland has a superficial part, at the angle of the jaw, wedged between the mandible and the mylohyoid muscle. Its deep part projects deep to mylohyoid along the hyoglossus. Its duct opens alongside the fraenum of the tongue, where it is easily visible, and is crossed by the lingual nerve. The sublingual gland lies in the floor of the mouth into which it drains directly by a series of short ducts.     

Salivary gland disease in the era of COVID‐19 pandemic

Coronavirus disease 2019 (COVID‐19) pandemic forced significant changes in current approach to outpatient evaluation of common otolaryngology complaints as hospitals around the world are trying to limit the spread of the virus and to preserve health care resources. These changes raise a lot of questions regarding patient triage and treatment decisions in clinical situations when it is unclear if the workup and management can be postponed. In this communication, we present our approach to evaluation and triage of new patients with complaints concerning for salivary gland disease.     

AHNS series: Do you know your guidelines? Diagnosis and management of salivary gland tumors

This article is the next installment of the series “Do you know your guidelines” presented by the Education Committee of the American Head and Neck Society. Guidelines for the workup and management of tumors of the major and minor salivary glands are reviewed.     

A neglected gland: a review of Cowper's gland

Cowper's glands are pea sized glands present inferior to the prostate gland in the male reproductive system. They produce thick clear mucus prior to ejaculation that drains into the spongy urethra. Though it is well established that the function of the Cowper's gland secretions is to neutralize traces of acidic urine in the urethra, knowledge regarding the various lesions and associated complications of this gland is scarce. This review provides a comprehensive report on the development, function and various lesions associated with Cowper's gland.     

Effect of Pineal Gland on Testosterone Release in Vitro

We studied the effect of hCG, aminoglutethimide and pineal effluent on the basal testosterone secretion by superfused adult rat interstitial cells. The period used to determine the mean rates of release was 120-240 min. after the start of superfusion i.e. when basal secretory rate was stable. A 2 h administration of hCG (10 mUI/ml) induced a rapid increase in testosterone output while aminoglutethimide (100 microM) decreased it. Basal testosterone release was not modified when interstitial cells were superfused with effluent of a chamber containing 1, 2 or 4 pineal glands. These results suggest that pineal secretory products exert no direct acute action on testosterone biosynthesis by rat interstitial cells.     

Thymic teratoma masquerading as a thyroid lump

Teratomas are germ cell tumours commonly found in the sacrococcygeal region, ovary, testicle or, infrequently, the mediastinum. In very rare circumstances, these tumours are found in the neck. This case represents a thymic teratoma presenting as what appeared to be an intrathyroid lesion. This has not been described previously and demonstrates an unusual presentation of a neck lump necessitating two operations and a multidisciplinary approach for management. We would also like to highlight that while patients undergo imaging to guide surgery, the surgeon must always be prepared for the unexpected and recognise situations where the operation should be converted to an exploratory procedure instead of full resection. Often, combined surgical care is the best option for difficult congenital cases.