胰岛素治疗对老年2型糖尿病合并骨质疏松症患者CTX及BGP水平的影响

目的分析胰岛素治疗对老年2型糖尿病并发骨质疏松症患者血清I型胶原竣基末端肽(CTX)和骨钙素(BGP)水平的影响研究。方法确诊的老年2型糖尿病患者150例,患者同时均并发骨质疏松症;患者随机分为2组,观察组包含患者70例;对照组包含80例患者。采用SPSS17.0统计软件针对胰岛素治疗对老年2型糖尿病并发骨质疏松症患者的影响进行分析。结果观察组患者骨密度水平T值为-2.89±0.63,对照组为-2.94±0.71。可见CTX表达水平观察组和对照组比较治疗前差别未见统计学意义,不同年龄段之间差别也未见统计学意义,P> 0. 05;治疗后观察组水平显著减低,与治疗前比较差别有统计学意义;特别是对于年龄75岁以下患者,可见其CTX水平治疗后显著低于75岁及以上患者水平,差别有统计学意义,P<0.05。研究中可见两个不同年龄段水平均分别高于治疗前水平,差别均有统计学意义,P<0.05;对照组患者治疗后与治疗前比较水平差别未见统计学意义,P>0.05。可见BGP表达水平观察组和对照组比较治疗前差别未见统计学意义,不同年龄段之间差别也未见统计学意义,P>0. 05;治疗后观察组BGP水平显著增高,与治疗前比较差别有统计学意义,且两个不同年龄段水平均分别高于治疗前水平,差别均有统计学意义,P<0. 05;对照组患者治疗后与治疗前比较水平差别未见统计学意义,P>0.05。结论胰岛素治疗对于降低破骨状态,促进改善骨质疏松状态具有重要作用,特别是对于年龄75岁以下患者更为显著;对于促进骨形成及提高成骨细胞活性状态也具有临床价值,可以在控制血糖的同时辅助促进改善骨质疏松状态。     

骨友灵搽剂联合塞来昔布治疗膝骨关节炎的临床研究

目的探讨骨友灵搽剂联合塞来昔布治疗膝骨关节炎的临床疗效。方法选取2017年12月—2018年12月在天津市蓟州区人民医院治疗的膝骨关节炎患者90例,随机分为对照组(45例)和治疗组(45例)。对照组口服塞来昔布胶囊,200 mg/次,1次/d;治疗组在对照组基础上外涂骨友灵搽剂,热敷20 min,2 mL/次,3次/d。两组患者均经过5周的治疗。观察两组患者临床疗效,同时比较治疗前后两组患者疼痛评分、西安大略和麦克马斯特大学骨关节炎指数评分(WOMAC)评分、骨钙素(BGP)、抗酒石酸盐酸性磷酸酶异构体(TRACP-5b)和骨特异性碱性磷酸酶(BALP)水平。结果治疗后,对照组和治疗组临床有效率分别为80.00%和91.11%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者疼痛评分以及疼痛、僵硬和日常活动困难3项WOMAC评分均显著降低(P0.05),且治疗组患者疼痛评分和WOMAC评分明显低于对照组(P0.05)。治疗后,两组患者的BGP和BALP水平显著升高(P0.05),TRACP-5b水平显著降低(P0.05),且治疗组患者BGP、BALP和TRACP-5b水平明显好于对照组(P0.05)。结论骨友灵搽剂联合塞来昔布胶囊治疗治疗膝骨关节炎作用显著,具有一定的临床推广应用价值。     

Long-term extensive expansion of mouse hepatic stem/progenitor cells in a novel serum-free culture system

BACKGROUND & AIMS: The liver has high regenerative potential. We attempted to establish a novel culture system for extensive expansion of fetal mouse hepatic stem/progenitor cells and to characterize cultured cells. METHODS: Hepatic spheroids collected from 6-day floating cultures were cultured on collagen-coated dishes in serum-free conditions in medium containing growth factors. Cultured cells were mainly characterized by immunocytochemistry and flow cytometry or transplanted into adult mice. RESULTS: Approximately 400 expanding hepatic spheroids were generated from every 1 x 10(6) fetal liver cells. Subsequently, highly replicative colonies were subcultured with maintaining colony formation on collagen-coated dishes. These colonies consisted of small immature alpha-fetoprotein-positive cells and hepatocytic and cholangiocytic lineage-committed cells. The immature alpha-fetoprotein-positive cells could be expanded in a reproducible manner at least 5 x 10(5)-fold (which involved at least 30 passages over >6 months) without losing differentiation potential. Flow cytometric analysis showed that all cultured cells expressed CD49f, but not CD34, Thy-1, c-kit, or CD45. Nearly 15% of the cells expressed Sca-1, and approximately 5%-20% of the cells were side population cells. Both sorted side population cells and Sca-1-positive cells (especially side population cells) produced a large number of alpha-fetoprotein-positive cells and lineage-committed cells. Expanded cells had bidirectional differentiation potential and improved serum albumin levels in mice with severe liver damage. CONCLUSIONS: Long-term extensive expansion of transplantable hepatic stem/progenitor cells was reproducibly achieved in a novel serum-free culture system. Moreover, this culture system yielded side population and Sca-1-positive cell populations that included hepatic stem/progenitor cells with differentiation and proliferation properties.     

盘龙七片联合骨瓜提取物注射液治疗股骨颈骨折恢复期的临床研究

目的观察盘龙七片联合骨瓜提取物注射液治疗股骨颈骨折恢复期患者的临床效果。方法选择2016年1月—2019年10月在常州市武进中医医院治疗的股骨颈骨折患者65例,随机分成对照组(33例)和治疗组(32例)。对照组静脉滴注骨瓜提取物注射液,50 mg加入生理盐水250 mL,1次/d。治疗组在对照组基础上口服盘龙七片,3片/次,3次/d。两组均连续治疗1个月。观察两组患者临床疗效,同时比较治疗前后两组患者视觉模拟评分(VAS)和Oswestry功能障碍指数问卷表(ODI)评分,及骨形态发生蛋白-2(BMP-2)、碱性磷酸酶(ALP)、骨钙素(BGP)、神经生长因子(NGF)、血小板衍生生长因子(PDGF)和胰岛素样生长因子(IGF-1)水平。结果治疗后,对照组和治疗组临床有效率分别为75.76%、93.75%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者VAS、ODI评分均显著降低(P0.05),且治疗组明显比对照组低(P0.05)。治疗后,两组患者BMP-2、ALP、BGP、NGF、PDGF和IGF-1水平均显著升高(P0.05),且治疗组明显比对照组高(P0.05)结论盘龙七片联合骨瓜提取物注射液治疗股骨颈骨折恢复期患者,可促进患者骨折愈合,改善骨代谢水平,调节细胞因子,降低患者疼痛和术后并发症,改善功能障碍。     

强直性脊柱炎患者血清TNF-a、BGP和CTX水平与骨密度的关系

目的探讨强直性脊柱炎(AS)患者骨质疏松(OP)的发病机制。方法分别测定36例男性AS患者血清肿瘤坏死因子-a(TNF-a)、骨钙素(BGP)I、-型胶原C末端肽(CTX)水平及腰椎和股骨颈的骨密度(BMD)值,并与20例健康者对照。结果AS早期腰椎和股骨颈BMD均低于对照组,晚期股骨颈BMD更低于对照组。AS血清TNF-a、CTX水平较对照组显著增高(P<0.01;P<0.05),而血清BGP水平较对照组无显著差差异(P>0.05)。AS患者中OP组TNF-a、CTX水平较NOP组显著增高(P<0.01;P<0.05),OP组中血清TNF-a与CTX呈正相关,与股骨颈密度呈负相关;与BGP无明显相关性。结论AS患者主要是由于骨吸收增加而导致骨质疏松的发生。血清TNF-α水平的增高可促进骨吸收加强,是AS骨质疏松的重要原因之一。降低血清TNF-a水平,对AS患者骨质疏松的防治可能有积极的意义。     

BGP、ALP、HOP/Cr测定与糖尿病骨代谢的关系

目的 通过测定血清骨钙素（ＢＧＰ），碱性磷酸酶（ＡＬＰ），尿羟脯氨酸与尿肌酐比值（ＨＯＰ／Ｃｒ）等指标，研究其与糖尿病骨代谢之间的关系。方法 将３０例糖尿病病人及１５例正常人作为研究对象，测定ＢＧＰ、ＡＬＰ、ＨＯＰ／Ｃｒ、糖化血红蛋白（ＨｂＡｌｃ）、正腹血浆胰岛素（Ｉｎｓｕｌｉｎ）及血糖等指标。结果 糖尿病组血清ＢＧＰ较正常对照组明显降低，与病程、ＨｂＡｌｃ水平呈负相关，与Ｉｎｓｕｌｉｎ水平呈正相     

Synthetic peptides from the N‐domains of CEACAMs activate neutrophils

Abstract: Four members of the carcinoembryonic antigen family, CEACAM1, CEACAM8, CEACAM6 and CEACAM3, recognized by CD66a, CD66b, CD66c and CD66d monoclonal antibodies (mAb), respectively, are expressed on human neutrophils. CD66a, CD66b, CD66c and CD66d mAb binding to neutrophils triggers an activation signal that regulates the adhesive activity of CD11/CD18, resulting in an increase in neutrophil adhesion to human umbilical vein endothelial cells. Molecular modeling of CEACAM1 using IgG and CD4 as models has been performed, and three peptides from the N‐terminal domain were found to increase neutrophil adhesion to human umbilical vein endothelial cell monolayers. The peptides were 14 amino acids in length and were predicted to be present at loops and turns between β‐sheets. To better understand the amino acid sequences critical for this biological activity, in the present study we examined the other neutrophil CEACAMs and the highly homologous CEACAM, CEA. Molecular modeling of the N‐terminal domains of human CEACAM8, ‐6, ‐3 and CEA was performed. Twenty peptides, each 14 amino acids in length, that were homologous to the previously reported peptides from the N‐domains of CEACAM1, were synthesized and tested for their ability to alter neutrophil adhesion. Only one new peptide, from the N‐domain of CEA, was found to increase neutrophil adhesion, and this peptide differed from the corresponding CEACAM1 peptide by only a single conservative amino acid substitution. Importantly, minor amino acid differences between active and inactive homologous peptides suggest regions of these peptides that are critical for biological activity. The data suggest that the regions SMPF of peptide CD66a‐1, QLFG of peptide CD66a‐2 and NRQIV of peptide CD66a‐3 are critical for the activities of these peptides, and for the native CEACAMs.     

腰椎退行性变患者骨代谢变化与肾虚的关系

研究腰椎退行性变患者骨代谢变化与肾虚的关系。选择腰椎退行性变患者 75例 ,分为绝经前妇女组(15例 )、绝经后妇女组 (30例 )、成年男性组 (30例 ) ;正常人群 5 0例 ,分为三组 (15例、2 0例、15例 ) ,分别作为以上各组对照组。采用酶联免疫吸附法 (ELISA)分别测定各组血清骨钙素 (BGP)及尿Ⅰ型胶原交联C末端肽 (Cross laps)水平 ,对各组患者进行肾虚评分。结果 ,腰椎退行性变患者绝经后妇女组血清BGP水平高于对照组 (P <0 0 5 ) ,绝经前妇女组及成年男性组无此变化 (P >0 0 5 ) ;各组患者尿Crosslaps水平均高于相应对照组 (P <0 0 5 ,P<0 0 1,P <0 0 5 ) ,其中绝经后妇女组差异尤为显著 ;各组患者肾虚评分 ,绝经后妇女组分值最高 (与绝经前妇女组比较 ,P <0 0 1) ,其次是成年男性组 (与绝经前妇女组比较 ,P <0 0 5 )、绝经前妇女组 ,前两组之间无显著性差异 (P>0 0 5 )。腰椎退行性变患者均存在不同程度的肾虚及骨代谢紊乱表现 ,中医病机以肾虚为本 ,骨代谢紊乱可能是中医肾虚的重要改变之一     

穿龙骨刺片联合玻璃酸钠治疗早中期膝骨关节炎的临床研究

目的 探讨穿龙骨刺片联合玻璃酸钠注射液治疗早中期膝骨关节炎的临床效果。方法 选择河南省胸科医院2019年6月到2021年6月收治的早中期膝骨关节炎患者160例，将入选的患者按照随机数字表法分为对照组和治疗组，各80例。对照组膝关节腔内注射玻璃酸钠注射液，1支/次，1次/周。治疗组患者在对照组治疗方法的基础上口服穿龙骨刺片，6～8片/次，3次/d。两组连续治疗5周。比较两组的临床疗效、临床症状、血清指标。结果 治疗后，治疗组的总有效率（93.75%）高于对照组（80.00%，P＜0.05）。治疗后，两组视觉模拟评分法（VAS）评分、西大略和麦克马斯特大学骨关节炎指数（WOMAC）评分均下降（P＜0.05），治疗组VAS评分、WOMAC评分低于对照组（P＜0.05）。治疗后，两组血沉（ESR）、Ｃ反应蛋白（CRP）、Ⅰ型胶原羧基端肽β降解产物（β-CTX）、前列腺素E₂（PGE₂）、P物质（SP）、多巴胺（DA）、5-羟色胺（5-HT）水平下降，Ⅰ型前胶原羧基末端肽（PICP）、骨钙素（BGP）水平升高（P＜0.05），治疗组ESR、CRP、β-CTX、PGE₂、SP、DA、5-HT水平低于对照组，PICP、BGP水平高于对照组（P＜0.05）。结论 穿龙骨刺片联合玻璃酸钠注射液治疗早中期膝骨关节炎可有效改善患者的临床症状，调节骨代谢和疼痛介质水平。     

利维爱对绝经后骨质疏松妇女骨密度及骨代谢的影响

目的探讨利维爱治疗绝经后骨质疏松症的疗效及副反应情况.方法根据骨密度测定的结果,将61例自然绝经的骨质疏松妇女随机分成两组,治疗组（利维爱组）33例,对照组（钙尔奇-D组）28例.治疗组予以利维爱2.5 mg/d,3个月,继以1.25 mg/d,9个月,联合钙尔奇-D 600 mg/d,疗程1年;对照组仅予以钙尔奇-D 600 mg/d,疗程1年.观察治疗前后腰椎（L2-4）、股骨颈（FN）、Ward三角区、大转子（GT）骨密度（BMD）、骨钙素（BGP）、前胶原氨端肽原（PINP）的变化,以及治疗前后体重指数（BMI）、阴道出血、乳房胀痛变化的情况.BGP及PINP均采用放射免疫法测定.结果治疗组应用利维爱联合钙尔奇-D治疗1年后,各部位骨密度均有较显著的上升,BGP及PINP不同程度的下降,与对照组治疗后比较差异有显著性,对照组治疗前后无变化.治疗组与对照组治疗前后体重指数无明显变化,两组间比较无差异.治疗组治疗1年期间,1例患者出现阴道出血,2例出现乳房胀痛,继续服药后症状消失.结论利维爱能有效增加绝经后骨质疏松妇女骨密度,且副反应少,患者耐受性良好.