老年男性骨代谢生化指标和骨密度的关系

目的 评估老年男性骨代谢生化指标和骨质疏松的关系.方法 97例老年男性,双能X线测量骨密度,根据测定的T score值将入组患者分为正常对照组(n=32)、骨量减少组(n=30)和骨质疏松组(n=35),同时测定血抗酒石酸酸性磷酸酶(TRACP5b)、骨源性碱性磷酸酶(BALP)、25-羟维生素D等水平.结果 骨量减低...     

骨代谢指标可用于评估炎症性肠病患者骨密度状况吗?

目的探讨我国炎症性肠病(IBD)患者血清维生素D(VitD)和骨密度状况以及评估IBD患者骨密度状况的血清骨代谢指标。方法收集57例溃疡性结肠炎(UC)患者、52例克罗恩病(CD)患者及48例正常对照者的临床资料,检测所有受试者血清25-羟维生素D(25OHD3)、钙(Ca)、磷(P)、血清碱性磷酸酶(ALP)、Ⅰ型前胶原氨基端前肽(PINP)、β-Ⅰ型胶原羧基端肽(β-CTX),检测IBD患者骨密度。结果 UC组和CD组患者血清25OHD3水平较正常组分别下降27.88%和15.31%(P<0.001、P=0.047)。UC患者骨量减少和骨质疏松发病率分别为22.81%和3.51%,CD患者骨量减少和骨质疏松发病率分别为23.08%和3.85%。UC组、CD组和正常组间PINP、ALP、β-CTX差异无统计学意义(均P>0.05);IBD患者骨量正常组和骨量减少和(或)骨质疏松组差异无统计学意义(P>0.05);与25(OH)D3水平及骨密度均无明显相关性(P>0.05)。结论 IBD患者存在VitD缺乏,易出现骨量减少/骨质疏松,但血清骨代谢指标PINP、ALP、β-CTX并非评估和监测我国IBD患者骨密度状况的理想指标。     

唑来膦酸对骨质疏松模型大鼠骨密度及骨代谢的影响

目的探讨唑来膦酸对骨质疏松模型大鼠骨密度及骨代谢的影响。方法将48只雌性SD大鼠按照随机数字法随机分为空白对照组、模型对照组、低剂量组(5 mg/kg)及高剂量组(10 mg/kg),每组12只。治疗结束12 w后,测定大鼠股骨骨密度、股骨抗弯力、子宫指数及双肾指数,检测血清骨钙素、1,25-二羟基维生素D3〔1,25(OH)2D3〕、血钙、血磷水平。结果与空白对照组比较,模型对照组及低剂量组大鼠骨密度、抗弯力、血清骨钙素、1,25(OH)2D3、血钙、子宫指数及双肾指数明显偏低(P<0.05),而高剂量与空白对照组比较无统计学差异(P>0.05);与模型对照组比较,低剂量组和高剂量组大鼠骨密度、抗弯力、血清骨钙素、1,25(OH)2D3、血钙、子宫指数及双肾指数明显偏高(P<0.05);与低剂量组比较,高剂量组明显偏高(P<0.05)。结论唑来膦酸10 mg/kg剂量能明显改善骨质疏松模型大鼠的骨密度及骨代谢水平,升高子宫及双肾指数,对骨质疏松模型大鼠具有较好的治疗效果。     

2型糖尿病患者骨代谢生化指标和钙调激素与骨密度关系的研究

目的 观察2型糖尿病(T2DM)患者骨代谢生化指标、血清25-羟维生素D3[25 (OH)D3]和甲状旁腺激素(PTH)水平,分析其对骨密度的影响并探讨T2DM患者骨量的变化.方法 选择天津医科大学总医院T2DM患者127例(男57例,女70例)作为糖尿病组;另选年龄、性别相匹配的健康体检者68名作为对照组.按糖尿病病程或HbA1c将糖尿病组分为4个亚组,A组:病程≤10年,B组:病程＞10年,C组:HbA1c≤8％,D组:HbA1c＞ 8％;按骨量不同分为3个亚组:骨密度正常组(T值＞-1.0 SD);骨量减少组(-2.5 SD ＜T值≤-1.0 SD);骨质疏松组(T值≤-2.5 SD).测定所有受试者血钙、磷、镁、碱性磷酸酶(ALP)、24 h尿钙、25(OH)D3和PTH,采用双能X线骨密度仪对所有受试者进行骨密度测定.结果 糖尿病组血钙、血镁、25(OH)D3、股骨颈和全髋骨密度较对照组显著降低(t=0.235～ 1.884,P均＜0.05),PTH较对照组显著升高(t=1.067,P＜0.01);A组、B组血钙、血镁、25(OH)D3较对照组显著降低,且B组血镁低于A组(P均＜0.05),PTH显著高于对照组,且B组高于A组(P＜0.01);C组、D组血钙、血镁、25(OH)D3较对照组显著降低(P均＜0.05),PTH显著高于对照组(P ＜0.01);A组、B组股骨颈、全髋骨密度较对照组显著下降(P均＜0.05);D组股骨颈、全髋骨密度较对照组和C组均明显降低(P均＜0.01),全身骨密度低于对照组(P＜0.05);C组各部位骨密度较对照组差异均无统计学意义;糖尿病组骨质疏松和骨量减低[39.37％(50/127),47.24％(60/127)]的比例显著高于对照组[26.47％(18/68),32.35％ (22/68),x2=3.852,4.708,P均＜0.05)],并且糖尿病骨质疏松组糖尿病病程、HbA1c、PTH也均较骨密度正常组和骨量减低组明显升高(P均＜0.05)Logistic回归分析显示糖尿病病程、HbA1c、PTH是糖尿病患者骨密度降低的危险因素.结论 T2DM患者存在骨代谢紊乱,维生素D水平下降,PTH水平升高和骨密度的下降,以糖尿病病程长和血糖控制差者为著.     

甲状腺功能亢进症患者的骨密度改变

对24例甲状腺功能亢进症的血钙(Ca)、磷(P)、碱性磷酸酶(AKP)、25(OH)D、1-25(OH)_2D,24小时尿Ca、P及骨密度进行了测定。结果显示骨密度降低占58.3％(±2s)。骨密度降低组T_3浓度高于骨密度正常组(P<0.05),病程长、病情重者骨密度降低更显著。两组血Ca、P、AKP、25(OH)D、1-25(OH)_2D及尿Ca、P等差异均无显著性,但1-25(OH)_2D比正常人低。     

昆明中老年彝族不同骨量人群25(OH)D3、BGP、PTH、CT含量

目的分析昆明地区中老年彝族不同骨量人群体内25-羟维生素D3[25(OH)D3]、骨钙素(BGP)、甲状旁腺素(PTH)、降钙素(CT)的含量及其与不同骨量的相关性。方法检测受试者血清25(OH)D3、BGP、PTH、OT含量及骨密度T值,分析不同骨量组人群25(OH)D3、BGP、PTH、CT的含量。结果男性25(OH)D3和CT含量随骨量下降呈降低趋势,且骨量正常组25(OH)D3含量与骨量减少组、骨质疏松组差异有统计学意义(P0.05);骨量正常组CT含量与骨量减少组差异有统计学意义(P0.05)。女性25(OH)D3和CT含量均随骨量下降呈降低趋势,且不同骨量组25(OH)D3、CT含量组间比较差异有统计学意义(P0.001)。结论25(OH)D3、CT含量可作为当地彝族中老年人群骨质疏松的协助诊断指标,对其骨质疏松的诊断具有重要的参考价值。     

Graves病患者血尿酸水平与腰椎骨密度的关系

目的探讨Graves病(GD)患者血尿酸(UA)水平与腰椎骨量的关系。方法选取72例GD患者和39例甲状腺功能及UA水平均正常的体检者(正常对照组)为研究对象,GD患者进一步按UA水平分为高尿酸血症组和UA正常组,测定相关生化指标,并用双能X线骨密度仪(DEXA)测定腰椎正位骨密度,比较不同组别间腰椎骨密度水平、骨量减少及骨质疏松(OP)(统称骨量丢失)发生率的差异,分析GD组影响腰椎骨量的主要危险因素。结果 GD伴高尿酸血症组以及GD伴UA正常组UA、TT3、TT4、FT3、FT4、血钙(Ca)、血磷(P)、碱性磷酸酶(ALP)、血清骨特异性ALP(Ostase)均高于正常对照组(P<0.01),而体重指数(BMI)、TSH、肌酐(Cr)、总胆固醇(TC)、血25羟基维生素D(OH)D、腰椎骨密度(BMD)则均低于后者(P<0.01);GD伴高尿酸血症组TT4、FT3、UA、Cr、ALP、Ostase水平显著高于GD伴UA正常组(P<0.05或0.01),而腰椎BMD则显著低于后者(P<0.01)。GD伴高尿酸血症以及GD伴UA正常者骨量减少及OP发生率显著高于正常对照组(P<0.05),而GD伴高UA症组骨量减少发生率显著高于GD伴UA正常组(P<0.05)。二分类Logistic回归分析显示,年龄(OR=1.112,P=0.024)、TT4(OR=1.138,P=0.051)及UA(OR=1.015,P=0.013)为GD患者腰椎骨量丢失的独立危险因素。结论 GD患者UA水平增高,GD伴高UA症者更易发生腰椎骨量丢失,而UA增高是引起GD患者腰椎骨量丢失的主要危险因素之一。     

药物及营养饮食综合治疗对老年骨质疏松患者的疗效

目的 分析老年骨质疏松的诊断方法和预防治疗效果,探讨诊断、治疗的重要性.方法 69例患者经骨密度检测确诊老年骨质疏松,给予药物、营养饮食综合治疗,然后比较治疗前后临床有效率,检测不同部位骨密度(BMD)、血钙、血磷、碱性磷酸酶(AKP).结果 治疗有效率达98.6％.治疗前、后BMD、血钙、血磷、AKP差异显著(P＜0.05).X线比较治疗后无再发椎体压缩骨折.结论 早期诊断并对骨质疏松促进骨形成及抑制骨破坏治疗是预防骨质疏松并发疼痛、骨折的关键.     

几种药物治疗老年骨质疏松模型大鼠股骨骨密度与生化指标测试的效果比较

目的 探讨中药骨疏康、西药羟膦酸钠、VK、碳酸钙+VD对动物股骨骨密度和血清钙、磷碱性磷酸酶水平的影响,确定各种药物治疗动物骨质疏松的效果.方法 以去卵巢法复制动物骨质疏松模型,以骨疏康、羟膦酸钠、VK、碳酸钙+VD进行治疗,饲养15 w后在腹主动脉采血,以日本产T107AHITACHI自动生化分析仪测量各组大鼠血清碱性磷酸酶、血磷、血钙指标.之后处死大鼠,取大鼠股骨,采用中国原子能科学院生产的BMD400型单光子骨密度仪测量股骨骨密度.结果 模型组骨密度低于正常对照组、骨疏康组、羟膦酸钠组、VK组(P<0.05).模型组血钙低于正常对照组、骨疏康组、羟膦酸钠组、VK组(P<0.05),与碳酸钙+VD组差异不显著(P>0.05);模型组血磷高于正常对照组、羟膦酸钠组、VK组(P<0.05),与碳酸钙+VD组差异不显著(P>0.05).模型组大鼠碱性磷酸酶高于正常对照组、骨疏康组、羟膦酸钠组、VK组(P<0.005),与碳酸钙+VD组差异不显著(P>0.05).结论 骨疏康、羟膦酸钠、VK对提高骨密度有一定作用.单独补钙+VD不能提高骨密度.骨疏康、羟膦酸钠、VK具有提高血钙,降低血磷和碱性磷酸酶的作用.     

糖皮质激素诱发骨质疏松的类风湿关节炎患者血清25-羟维生素D的表达与骨密度的关系

目的探讨糖皮质激素诱发骨质疏松的类风湿关节炎患者血清25-羟维生素D[25-(OH)D]的表达与骨密度的关系。方法糖皮质激素诱发骨质疏松的类风湿关节炎患者72例作为研究组,其中活动期32例、稳定期40例,另选同期健康体检的无类风湿关节炎志愿者30例作为对照组。检测各组骨密度、血清25-(OH)D、血钙、血磷、骨钙素,并分析其相关性。结果研究组血清25-(OH)D、骨钙素及腰椎、股骨颈、全髋骨密度值低于对照组(P<0.05),两组血钙、血磷比较无统计学意义(P>0.05)。活动期类风湿关节炎患者血清25-(OH)D、骨钙素及腰椎、股骨颈、全髋骨密度值低于稳定期(P<0.05),两组血钙、血磷比较无统计学意义(P>0.05)。Pearson相关分析显示骨质疏松的类风湿关节炎患者血清25-(OH)D与腰椎、股骨颈、全髋骨密度值呈正相关(r=0.332、0.728、0.731,均P<0.05),骨钙素与腰椎、股骨颈、全髋骨密度值呈正相关(r=0.307、0.630、0.637,均P<0.05)。结论糖皮质激素诱发骨质疏松的类风湿关节炎患者血清25-(OH)D、骨钙素水平明显降低,活动期患者25-(OH)D、骨钙素、骨密度值低于稳定期患者,患者血清25-(OH)D、骨钙素水平与腰椎、股骨颈、全髋骨密度值呈正相关。     

Medical and Psychology Students' Knowledge and Attitudes Regarding Aging and Sexuality

The current study surveys medical and doctoral psychology students (N = 100) from an urban northeastern university regarding knowledge and attitudes toward elderly sexuality and aging using the Facts on Aging Quiz, the Aging Sexuality Knowledge and Attitudes Scale, and measures of interest in gerontology, academic/clinical exposure to aging and sexuality, and contact with elders. The current study found that psychology students demonstrated greater aging knowledge than medical students; however, both groups showed gaps in knowledge about sexuality. Married students had greater academic/clinical exposure and greater knowledge about aging but less permissive attitudes toward elderly sexuality. Generally, knowledge about aging was the strongest correlate of knowledge about sexuality. Level of knowledge about sexuality was not associated with attitudes. Attitudes toward sexuality and aging may be more strongly tied to demographic variables reflective of religious beliefs or adherence to sociocultural norms.     

Leptin and cellular and innate immunity in abstinent alcoholics and controls

BACKGROUND: Basic studies indicate that in vitro and in vivo doses of leptin modulate cellular immune responses. Given evidence that concentrations of leptin are altered in alcoholics who also show immune abnormalities, this study examined the relationships between circulating levels of leptin and markers of cellular and innate immunity. METHODS: Circulating levels of leptin, natural killer cell (NK) activity, interleukin-2 (IL-2)-stimulated NK activity, and concanavalin A-stimulated production of IL-2, IL-6, IL-10, and IL-12 were compared between abstinent DSM-IV alcohol-dependent men (n = 27) and age- and gender-matched controls (n = 34). RESULTS: As compared with controls, alcoholics showed lower NK activity (p < 0.01) and a trend for lower levels of leptin (p = 0.055). In the total sample, leptin predicted NK activity (beta = 0.33; p < 0.05) after controlling for the confounding influence of body mass index, alcohol intake, and smoking. Leptin was not correlated with any of the cytokine measures. To examine whether the effects of leptin were mediated by its direct action on NK, additional studies examined in vitro effects of leptin on NK activity in healthy volunteers (n = 10); leptin doses (0.1, 1, and 10 nM) yielded levels of NK activity comparable to those with media alone. CONCLUSIONS: These data show that circulating levels of leptin are associated with NK activity in humans and suggest that abnormal in vivo concentrations of leptin may contribute to the declines of NK activity in alcoholics who are at risk for infectious diseases.     

自身免疫与动脉粥样硬化的发生发展

在动脉粥样硬化的发生发展过程中,自身免疫具有重要作用,本文就近年有关动脉粥样硬化的免疫机制的研究进展作一简要综述.     

Cement and Concrete Nanoscience and Nanotechnology

Concrete science is a multidisciplinary area of research where nanotechnology potentially offers the opportunity to enhance the understanding of concrete behavior, to engineer its properties and to lower production and ecological cost of construction materials. Recent work at the National Research Council Canada in the area of concrete materials research has shown the potential of improving concrete properties by modifying the structure of cement hydrates, addition of nanoparticles and nanotubes and controlling the delivery of admixtures. This article will focus on a review of these innovative achievements.     

中青年超重和肥胖与高血压及高同型半胱氨酸血症的相关性研究

目的探讨中青年超重和肥胖与高血压及高同型半胱氨酸血症的相关性。方法选取2012年1月—2013年10月在我院进行常规健康体检者750例,测量受试者血压、身高、体质量及血清同型半胱氨酸(Hcy)水平。结果男性超重、肥胖检出率分别为36.87%(198/537)和13.97%(75/537),均高于女性的16.43%(35/213)和7.50%(16/213)(P0.05)。超重者和肥胖者高血压和高同型半胱氨酸血症检出率分别为21.03%(49/233)和11.16%(26/233)、46.12%(42/91)和41.76%(38/91),均高于正常者的9.16%(37/404)和2.23%(9/404),肥胖者高于超重者(P0.01)。收缩压(SBP)、舒张压(DBP)及血清Hcy与BMI呈正相关(r值分别为0.639、0.515、0.497,P0.01)。结论中青年尤其是男性超半数存在超重或肥胖,高血压及高同型半胱氨酸血症与BMI呈正相关,超重和肥胖者高血压及高同型半胱氨酸血症的发生率高,应积极防治。     

Stress and Depression Among HIV-Positive and HIV-Negative Gay and Bisexual AIDS Caregivers

From a survey of 416 gay and bisexual male AIDS caregivers, we examined differences in the stress process and predictors of depressive symptomatology by caregivers' HIV serostatus (n = 164 HIV-positive and n = 252 HIV-negative). Results indicate that HIV-positive caregivers reported higher levels of depressive symptomatology than those who were HIV-negative. Parallel regression analyses revealed that a younger age, role-related stress, and low self-esteem were common predictors of depressive symptomatology for both groups. Group-specific predictors of depression for the HIV-positive caregivers were poorer health and financial concerns. In contrast, the group-specific predictor for the HIV-negative caregivers was higher stress associated with direct acts of caregiving. These results suggest that in order to stem depressive symptomatology, gay and bisexual male caregivers need support directed at reducing stress stemming from their role as caregivers as well as services designed to address low self-esteem. In addition, serostatus should be taken into account when designing service plans because seropositive and seronegative caregivers may require different supportive services.