潍坊地区骨密度异常患病率调查及影响因素分析

目的 了解潍坊地区体检人群骨密度异常（低骨量及骨质疏松）发病情况及影响因素，为该地区低骨量和骨质疏松的防治提供依据。方法 用DXA骨密度仪对潍坊地区2010—2021年15 180例50岁及以上男性和绝经后女性体检人群进行骨密度（BMD）测量及问卷调查，排除骨代谢性疾病，分析性别、年龄、体质指数、骨折史、家族骨折史、生育数、行经年数、绝经年龄、烟龄、长期饮酒、饮浓茶、喝牛奶、运动、服用钙片、常服维生素D（VitD）等因素对骨密度异常的影响。结果 ①本研究总体人群BMD异常率为42.22 %，其中OP率为15.68 %。男、女BMD异常（25.21 %、58.62 %）和OP发生率（6.07 %、24.95 %）。男性及绝经后女性各年龄段BMD异常及OP患病率整体随年龄增长而上升，且各年龄段男性患病率均低于绝经后女性，其差异有统计学意义。其中男性BMD异常率最高的70~79岁年龄段（32.96 %），OP患病率最高的是≥80岁组（13.61 %）；女性BMD异常率及OP率最高的均为≥80岁组，分别为77.47 %及43.96 %。②对于≥50岁的男性，体质指数、常运动是BMD异常的保护性因素；骨折史、烟龄、常服钙片则是其危险因素。体质指数、家族骨折史与T值呈正相关，烟龄、常服VitD、常饮酒与之呈负相关（P＜0.05）。③对于绝经后女性，体质指数、绝经年龄、行经年数、常喝牛奶是BMD异常的保护性因素，年龄、骨折史、生育数则为危险因素。体质指数、行经年数、绝经年龄、常喝奶与T值有正相关关系，年龄、骨折史、生育数与之呈负相关（P＜0.01）。结论 潍坊地区体检人群低骨量和骨质疏松的患病率低于全国水平，年龄、性别、生活习惯、饮食习惯、女性月经和生育情况、骨折史和家族骨折史等因素对骨密度变化有一定影响。     

京城区居民骨密度随年龄变化的特点--3285例骨密度测定结果分析

目的 了解北京城区居民骨密度(BMD)的变化规律和骨质疏松症(OP)的患病率.方法 应用法国MEDILINK公司牛产的OSTEOCORE1型双能X线骨密度仪对北京市城区3285名20～89岁人群进行股骨近端及腰L2-L4椎的BMD测定.结果 北京市城区男、女性人群的股骨近端及腰椎的BMD峰值均出现在20～29岁年龄组,峰值后随着年龄的增长骨密度BMD降低,女性在50～59岁BMD下降明显加速,男性没有出现下降加速现象.北京市城区中国人40岁以后OP患病率男性23.19%,女性OP患病率28.7%.结论 通过对北京市城区中国人群的BMD变化规律及患病率研究,为北京市城区中国人群的骨质疏松症预防、诊断及治疗提供客观有效的依据.     

乌鲁木齐地区2711例骨密度调查研究

目的了解新疆乌鲁木齐地区正常汉族人群骨密度(BMD)的变化规律和骨质疏松症(OP) 的患病率。方法应用法国DMS公司生产的CHALLENGER型双能X线骨密度仪对乌鲁木齐地区汉族人群共2711名20～80岁居民进行腰椎2～4及股骨近端的骨密度测定。结果乌鲁木齐地区汉族人群男性、女性的腰椎及股骨近端的BMD峰值均出现在20～29岁年龄组,峰值后随着年龄的增长,而骨密度BMD降低,女性在50～59岁明显加速下降,男性没有加速下降现象。乌鲁木齐地区40岁以后OP患病率男性28．3％,女性OP患病率45．2％。男女性50～59岁以上,组间患病率有显著差异(P<0．05)。结论通过对乌鲁木齐地区汉族人群的骨密度变化规律及患病率研究, 为乌鲁木齐地区汉族人群的骨质疏松症诊断及治疗提供客观有效的依据。     

长春地区女性骨密度与年龄、绝经年限、体重指数的相关性研究

目的调查吉林省长春地区4613例25~79岁女性腰椎正位L1-L4 TOTAL骨密度(BMD),分析长春地区女性骨质疏松患病率,研究女性腰椎BMD与年龄、绝经年限、体重指数的相关关系。方法采用美国Hologic公司Discovery WA型骨密度仪检测受试者腰椎正位L1-L4 TOTAL骨密度。将4613例受试者腰椎BMD检测结果按5岁为一年龄段分组,应用SPSS19.0统计学分析软件进行分析。腰椎BMD和骨质疏松患病率与年龄、绝经年限、体重指数的相关性采用直线相关分析。结果30岁以后,随着年龄增长,腰椎BMD值呈下降趋势,骨质疏松患病率升高,年龄与腰椎BMD呈负相关,与OP患病率呈正相关;随绝经年限延长,BMD值降低,OP患病率升高,绝经年限与腰椎BMD呈负相关,与OP患病率呈正相关。低体重指数组,腰椎BMD值最低,OP患病率最高;随体重指数增加,腰椎BMD增加,骨质疏松患病率降低,体重指数与腰椎BMD呈正相关,与骨质疏松患病率呈负相关。结论年龄、绝经年限、体重指数是骨密度的重要影响因素,增龄、绝经年限延长与低体重指数是骨质疏松发生的危险因素。     

甲状腺疾病对绝经后女性骨量丢失的影响

目的 探讨甲状腺疾病对自然绝经女性骨密度的影响。方法 通过回顾性病例对照研究，选取甲状腺疾病（包括甲状腺功能亢进、减退、结节、瘤和癌）患者144例，按同年龄和体质量指数（BMI）匹配288例无甲状腺疾病者。运用SPSS 24.0进行统计分析。结果 ①甲状腺疾病组和无甲状腺疾病组比较，年龄、绝经年龄、身高、体质量和BMI差异无统计学意义，初潮年龄、怀孕次数、哺乳次数差异存在统计学意义（P＜0.01）。②甲状腺疾病组股骨颈、大转子和Ward区骨密度均显著低于无甲状腺疾病组（P＜0.05或P＜0.01），两组腰椎骨密度比较无差异。甲状腺疾病组的骨质疏松症患病率49.31 %，显著高于无甲状腺疾病组39.24 %（P＜0.05），甲状腺疾病组的骨折发生率21.53 %高于无甲状腺疾病组16.67 %，但比较差异无统计学意义。③在甲状腺疾病类分组中，甲状腺结节组较其他甲状腺疾病组股骨颈骨密度低，甲状腺结节组显著低于甲亢组和甲状腺瘤组（P＜0.05）。结论 患有甲状腺疾病的绝经后女性具有股骨颈低骨密度的风险，而甲状腺结节患者较甲亢和甲状腺瘤患者股骨颈低骨密度风险更大。     

山东省胶东半岛多中心人群骨密度分析研究

目的探讨山东省胶东半岛沿海地区健康人群骨密度正常参考值、骨密度变化规律和骨质疏松的患病率。方法采用双能X线骨密度仪(DEXA)对胶东半岛沿海地区多中心多阶段整群抽样调查3879名21～89岁居民进行骨密度测量。结果确定了胶东半岛沿海地区21～89岁人群不同性别、年龄别腰椎L2～L4和股骨近端的骨密度正常参考值、骨峰值和患病率。男性腰椎L2～L4骨密度峰值在30～39岁,女性腰椎骨密度峰值在21～29岁;男性股骨近端骨密度峰值在21～29岁,女性股骨近端(Neck和Ward’s)骨密度峰值在31～39岁,Troch区骨密度峰值在21～29岁。随着年龄的增加(40岁以上),男女性各部位BMD逐渐下降,女性更为明显,男性腰椎BMD下降程度较轻。男性腰椎50～岁组与60～岁组比较和60～岁组与70～岁组比较、女性腰椎60～岁组与70～岁组比较,差异无统计学意义(P>0.05),其余各组比较差异有显著性意义。腰椎的OP患病率最高,40～岁组和50～岁组男女患病率差异无显著性,60岁以后女性明显高于男性(P<0.001)。50～89岁人群腰椎和股骨骨质疏松症发病率男性为13.37%和2.87%,女性为28.03%和7.0%,男女比较差异有非常显著性(P<0.001)。结论获得胶东半岛健康人群骨质疏松症诊断和治疗的骨密度参考值,为骨质疏松纵向流行病学研究奠定基础。     

颅内动脉粥样硬化与绝经后女性骨密度相关性研究

目的观察颅内动脉粥样硬化与绝经后女性骨密度(bone mineral density,BMD)相关性。方法研究人群包括100名绝经后妇女,对受试者进行腰椎双能X线扫描,通过脑三维磁共振血管造影来评估受试者基底动脉、中脑、颅内颈内动脉和颅内椎动脉的粥样硬化情况。T值-1被定义为低骨量。所有分析均通过颅内动脉粥样硬化定位分层。结果 100名绝经后女性年龄范围为55～75岁。颅内动脉粥样硬化中颅内后循环(PC)动脉和颅内前循环(AC)动脉患病率分别为64%和67%。颅内动脉粥样硬化中AC与女性患者的低BMD相关。颅内动脉粥样硬化中PC的女性血磷水平显著升高,而T值显著低于颅内动脉粥样硬化中无PC的女性,高脂血症和低BMD在PC颅内动脉粥样硬化女性中更为常见,低BMD与PC中的颅内动脉粥样硬化显著相关。结论低BMD与女性亚临床颅内PC和AC动脉粥样硬化有关。     

腔镜甲状腺手术的病理生理变化

甲状腺结节患者占我国人口的20％～70％。逐年上升的甲状腺疾病的患病率仍然未能真实反映甲状腺疾病患病人群的潜在规模。甲状腺疾病作为内分泌领域的第二大疾病，女性发病是男性的6倍以上，40岁以上女性中约有20％患有甲状腺疾病，但治疗率在我国还不到2％。由于其症状隐匿，很多患者对自己的病情并不知晓。     

宁夏地区回族正常人群骨密度及骨质疏松患病率研究

目的 调查宁夏地区回族正常人群骨密度值及骨质疏松患病率,建立宁夏地区回族人群各年龄组的骨密度正常值范围为骨质疏松的预防提供科学依据.方法 384名回族健康人群采用美国Lunar公司生产的双能x线骨密度仪测试受试者的右侧桡骨远端的骨密度(BMD)值.按年龄、性别进行分组,以10岁作为1个年龄段.结果 ①男女性BMD峰值均出现于30～39岁组,且BMD随年龄增加而逐渐降低,进入50～59岁组,女性的骨量丢失速度明显加快;50岁后OP患病率(WHO),男性为28.8%,女性为41.9%;②未见礼拜对BMD的影响;③男女性身高与BMD呈正相关;男性体重与BMD呈正相关.结论 ①BMD随年龄增长而下降,骨质疏松发病率也随之增加,女性发病率明显高于男性;②礼拜不是影响BMD的重要因素;③身高、体重是BMD的影响因素.     

大庆地区老年人对骨质疏松症的认知程度及患病率调查

目的调查大庆地区60岁以上老年人对骨质疏松的认知情况及骨质疏松患病率。方法对来我院就诊的361名60岁以上患者进行骨质疏松危险因素问卷调查,并行骨密度检查。骨密度检查采用美国GE公司生产的Luner Prodigy Advance型骨密度仪,检测受试者腰椎和股骨颈骨密度。将361例检测结果按不同性别每5岁为一年龄组,应用SPSS19.0软件统计分析骨密度测量指标及骨质疏松患病率。结果大庆地区60岁以上老年人对于骨质疏松危险因素的知晓率由高到低依次是钙饮食少或素食40.2%,长期使用激素34.9%,光照少29.9%,运动少25.5%,吸烟16.1%,饮酒15.5%,身体瘦小7.2%,骨质疏松家族史6.1%,肝肾功能不全4.2%,器官移植1.4%,绝经后或绝经过早1.1%。60~64岁年龄段男性骨质疏松症发生率为15.2%,女性为28.3%;65~69岁年龄段男性骨质疏松发生率为26.7%,女性为29.4%;70~74岁年龄段男性骨质疏松发生率为25.0%,女性为44.4%;75~79岁年龄段男性骨质疏松发生率为36.4%,女性为77.8%;80岁以上男性骨质疏松发生率为66.7%,女性为83.3%。结论大庆地区60岁以上人群对于骨质疏松危险因素的知晓率较低,骨质疏松患病率较高,提醒广大医务工作者应广泛开展骨质疏松健康教育。     

Soluble Fas and Fas-ligand in bladder cancer in vitro and in vivo

Circulating soluble Fas (sFas) and expression of Fas-ligand on cancer cells are mechanisms of immune escape. The aim of the present study was to investigate expression and production of Fas and Fas-ligand on bladder cancer cell lines of different grade as a basic mechanism of their secretion in vivo. sFas and sFas-ligand serum levels of patients with different stage of bladder cancer were examined to determine the possible clinical use of these molecules as tumor markers. Bladder cancer cell lines RT4 (G1), RT112 (G1), T24 (G3) and SUP (G4) were analyzed by flowcytometry for Fas and Fas-ligand expression. To determine if the Fas-ligand gene is transcribed in these bladder cancer cell lines, RT-PCR was performed on mRNA extracted from these cell lines. Production of sFas and sFas-ligand was examined in cell culture supernatants of the cancer cells as well as in the serum of 62 patients with bladder cancer by a specific ELISA test. We demonstrate that Fas is expressed in similar levels on all human bladder carcinoma cell lines. In T24 (G3) and SUP (G4) cell lines we were able to detect the Fas-ligand protein, whereas no Fas-ligand protein could be found in RT4 and RT112 (G1) cells. Fas-ligand mRNA was expressed in all bladder cancer cell lines. Furthermore, all bladder cancer cell lines produce sFas but no sFas-ligand in spite of mRNA expression. The range of sFas levels in the serum of all patients with bladder cancer was large and did not show a correlation to the histopathological stage of bladder cancer. Although there is in vitro evidence that sFas and Fas-ligand play a role in bladder cancer, no correlation between the sFas and s Fas-ligand serum levels and the histopathological stage of bladder cancer could be found. Therefore, serum sFas and sFas-ligand have to date limited clinical relevance.     

Predominantly posterior instrumentation and fusion in neuromuscular and neurogenic scoliosis in children and adolescents

We studied the results in 46 patients with neuromuscular and neurogenic scoliosis (average age 13.5 years, range 6–19 years) who had had posterior fusion with a modified Luque technique between May 1985 and June 1992. The main criteria to recommend surgery were curve progression, loss of balance when sitting, control of the head and difficulties in wearing an external orthotic support. The mean preoperative curve was 63°, the postoperative value was 24°, representing a correction of about 62%. The average number of stabilized segments was 13. In 39 out of 46 patients, lumbosacral fixation was included in the construct. Failure of implants, pseudarthroses and major losses of correction in purely neuromuscular scolioses could be avoided by using rigid segmental fixation and a dorsolateral fusion with a mixture of autologous and allogenous bone. The scoliosis most difficult to influence was found to be Friedreich's ataxia. In Duchenne muscular dystrophy the best method of treatment was surgery performed as early as possible, i.e. at the time of loss of walking capacity in the case of a scoliosis exceeding 20° and with two consecutive X-rays proving curve progression. Analysis of our series does not confirm the morbidity and complication rates of previous studies.     

Culture and characterisation of human urothelium in vivo and in vitro

The aim of this study was to culture human urothelium and generate enough cells for subsequent reconstructive surgery. Using a modification of the Rheinwald-Green method for the routine culture of keratinocytes from patients with burns, we successfully cultured 91% of 57 biopsies from the renal pelvis, ureter, bladder and urethra of paediatric patients. The cells could be split one to three up to 9 times at 7–10 day intervals, giving a surface area of 1000 cm² after a 2 month culture period. Primary cultures could not be initiated in defined medium MCDB153, although cells initiated using the Rheinwald-Green method could subsequently be propagated in this medium. Cytokeratin patterns in vitro were similar to those in vivo in the expression of keratins 7, 18 and 19 (characteristic of simple epithelia) and keratin 13 (characteristic of non-cornified stratified epithelia). Cultured urothelium also expressed keratin 14 (characteristic of cornified stratified epithelium) in about 25% of cells and keratin 16 (characteristic of fast-growing cells). These findings indicate that urothelial cells can be propagated in vitro for autologous grafting, and the next step is to identify substrates suitable for urothelial cell growth and differentiation and surgical manipulation.     

Overweight in childhood and bone density and size in adulthood

Summary  

We evaluated the adult bone structural traits in relation to childhood overweight in 832 men and women. Childhood overweight was associated with larger cross-sections at long bones in both sexes. Excess weight in childhood may also lead to higher trabecular density in females and somewhat lower cortical density in men.