Comparison of the effect of gluconate, lactose, and xylitol on bone recalcification in calcium-deficient rats

The therapeutic value of three calcium absorption promoting carbohydrates, lactose, gluconate and xylitol, in bone calcification was evaluated in 7-week-old male rats which were fed on a semisynthetic Ca-deficient diet for 3 weeks. Lactose + CaCO₃, xylitol + CaCO₃, Ca-gluconate, or CaCO₃ alone were administered to the Ca-deficient rats for 2 weeks; the carbohydrate and Ca contents of the diets were 5% and 0.5%, respectively. The Ca-deficient rats showed a decrease in serum total Ca and ionized Ca²⁺ and in tibial Ca, Mg, P and density, with a concomitant increase in bone hydroxyproline concentration. Bone and serum tartrateresistant acid phosphatase activities were increased 2-fold and the serum 1,25(OH)₂D₃ level 5-fold. Smaller increases were found in serum calcitonin, PTH, alkaline phosphatase and osteocalcin levels. These changes (except calcitonin) were reversed by the administration of Ca and the carbohydrates. It was observed that all three agents improved the recalcification of bones compared with the effect of CaCO₃ alone. The effect of lactose and xylitol was superior to that of gluconate. These results suggest advantages in the use of xylitol in Ca-supplements.     

Risk of Calcium Oxalate Nephrolithiasis after Calcium or Combined Calcium and Calcitriol Supplementation in Postmenopausal Women

Although calcium supplementation can cause hypercalciuria, the risk of nephrolithiasis has been shown to decrease rather than increase among subjects who had a higher calcium intake. Hypercalciuria is also a well-established side effect of calcitriol administration. However, the risk of nephrolithiasis is not well defined. The present study was undertaken to prospectively determine the effect of calcium with or without calcitriol on physicochemical risk factors associated with calcium oxalate nephrolithiasis in Thai postmenopausal women with osteoporosis. Subjects consisted of 53 Thai women more than 10 years postmenopausal who were randomly allocated to receive 750 mg of calcium carbonate supplement alone (n= 28) or 750 mg of calcium carbonate plus 0.5 mg calcitriol (n= 25) daily. Mean ± SEM for age was 65.3 ± 1.1 years, body weight 53.5 ± 1.3 kg. Urine samples for biochemical assays were collected at baseline and 3 months after treatment. Supersaturation for calcium oxalate stone formation was assessed from the 24 h urine constituents by the Tiselius’s index, AP(CaOx). Three months of calcium supplement alone resulted in a modest, but not significant, increase in urinary calcium (baseline, 2.90 ± 0.43 mmol/day; after treatment 3.58 ± 0.54 mmol/day) with no change in urinary oxalate, citrate or magnesium. In contrast, calcium together with calcitriol caused a significant increase in urinary calcium (baseline, 2.87 ± 0.41 mmol/day; after treatment, 4.08 ± 0.57 mmol/day; p<0.05). No significant change in other urine constituents after treatment with calcium and calcitriol was detected. Therefore, AP(CaOx) did not significantly increase either after calcium alone (baseline, 1.17 ± 0.39; after treatment, 1.36 ± 0.28) or after calcium plus calcitriol (baseline, 1.09 ± 0.17; after treatment, 1.09 ± 0.19). However, after treatments, 12 subjects (23%) – 6 receiving calcium supplement alone and 6 receiving calcium plus calcitriol supplement – had high AP(CaOx) values (greater than the upper limit of 95% CI for AP(CaOx) derived from non-stone-forming Thai women). The post-treatment/baseline ratio was 3.21 ± 0.74 for urinary calcium, 1.01 ± 0.19 for urinary oxalate, and 2.23 ± 0.42 (median 1.15) for AP(CaOx). The post-treatment/baseline ratio of calcium, but not for urinary oxalate, had a significant correlation with the post-treatment/baseline ratio of AP(CaOx). Our findings suggest that the alteration in the risk of calcium oxalate nephrolithiasis based on urinary composition is related to the alteration in urinary calcium. The risk of calcium oxalate nephrolithiasis does not increase significantly after calcium or combined calcium and calcitriol supplement in the majority of postmenopausal women with osteoporosis. Received: 10 March 1999 / Accepted: 16 November 1999     

Calcium supplement necessary to correct hypocalcemia after total parathyroidectomy for renal osteodystrophy

BACKGROUND: Prediction of the extent of calcium supplement will facilitate safe and efficient management of hypocalcemia in the early postoperative stage of total parathyroidectomy with autotransplantation (PTXa) in patients with renal osteodystrophy. METHODS: The correlation between the extent of calcium deficiency, estimated by the amount of calcium supplement over 48 h after PTXa and using various parameters such as carboxy terminal parathyroid hormone (c-PTH), intact PTH (i-PTH), alkaline phosphatase (ALP), serum calcium, serum phosphorus, duration of hemodialysis, total weight of resected parathyroid glands and degree of subperiosteal resorption of the middle phalanx was examined in 49 patients who underwent PTX with subcutaneous autotransplantation. Bone mineral density (BMD) was also determined before, 3 months and 1 year after PTXa with dual energy X-ray absorptiometry (DEXA) in 13 patients. RESULTS: There was a positive correlation between pre-operative i-PTH level (r=0.56, P<0.0005) or ALP level (r=0.50, P<0.0005) and the amount of calcium supplement over 48 h after PTXa in these patients. Furthermore, the degree of subperiosteal resorption, determined by Jensen's classification, was significantly correlated with the amount of calcium supplement after PTX (P<0.05). Bone mineral density 3 months after (P<0.0005) and 1 year after PTXa (P<0.001) significantly increased compared with BMD before PTXa in all patients examined. CONCLUSION: These findings suggest that the pre-operative determination of i-PTH, ALP levels and degree of subperiosteal resorption allow the management of hypocalcemia safely and efficiently in renal osteodystrophy patients after PTXa.     

维生素对动脉粥样硬化危险因素损伤血管内皮的保护作用

目的:探讨4种维生素联合应用,对动脉粥样硬化危险因素损伤血管内皮是否具有保护作用。方法:24只雄性家兔被随机分成3组。对照组喂普通饲料,模型组在普通饲料中加入胆固醇、猪油和甲硫氨酸,维生素组饲料同模型组,每天再另外灌胃给予维生素E、C、B6和叶酸,连续8周。第8周末,取血检测相关指标。结果:与对照组相比,模型组血脂(除HDL-C以外)、同型半胱氨酸和内皮素水平均显著升高(t=2.412,P<0.05;t=3.802～5.830,P<0.01),血清一氧化氮虽有降低,但在两组间没有显著差异;HDL-C/LDL-C比值明显减少(t=6.622P<0.01)。与模型组比较,维生素组血清总胆固醇、LDL-C.同型半胱氨酸和血浆内皮素水平均显著降低(t=2.514～2.726,P<0.05),而血清一氧化氮显著升高,HDL-C/LDL-C比值也明显增加(t=4.128～5.076,P<0.01)。结论:维生素E、C、B6和叶酸联合运用,能够降低血中多种危险因子的水平,调节血中内皮素和一氧化氮的平衡,减少或阻断危险因素对内皮功能的损伤,对血管内皮有保护作用。     

低钾血症病人的诊断、治疗及护理进展

介绍了低钾血症的诊断、治疗及护理进展。重点阐述了饮食补钾、口服补钾、雾化吸入补钾、肛注补钾、静脉补钾在临床的应用及高浓度快速静脉补钾的安全护理。     

Role of a combination dietary supplement containing mucopolysaccharides,vitamin C,and collagen on tendon healing in rats

Objective

The aim of this study was to investigate the effect of mucopolysaccharide, vitamin C, and collagen supplementation on the healing of Achilles tendon in rats.

益气活血法在肺心病急性发作期的临床应用

肺心病基本病理生理改变特点是肺血管痉挛、肺循环阻力增高,以及红细胞增多、血液黏稠度增加、血小板聚集等.结合本病反复发作、久病必虚的特点,中医学将其病机归结为气虚血瘀,临床采用益气活血法治疗.通过对应用益气活血法临床研究进展的综述,旨在探讨此法对临床疗效、改善心肺功能及血液流变学指标等方面的影响.     

Identification of novel sildenafil-analogues in an adulterated herbal food supplement

A new herbal product advertised as potency pill was sent for analysis by the local authority. The product was tested for the presence of potential derivatives of PDE-5 inhibitors, such as sildenafil, vardenafil, and tadalafil. Sildenafil analogues were identified, in which the piperazine ring and the sulfonyl group were replaced by a piperazinone and a hydroxyethyl structure, respectively. The chemical structures were established by LC-MS in ESI negative mode, UV and NMR spectroscopy (including DEPT, HSQC, HMBC, H,H-COSY, H,H-TOCSY and H,H-NOESY experiments). This is the first report of piperazinonafil and isopiperazinonafil as adulterant in an herbal food supplement.     

Curalin supplement for patients with type 2 diabetes mellitus

Objective

To examine the efficacy and safety of Curalin supplement in patients with type 2 diabetes.

Research design and methods

Adult patients with type 2 diabetes were randomized 1:1 to receive Curalin supplement or placebo. The primary endpoint was HbA1c decrease at 1 month. The secondary endpoint was a decrease in HbA1c by more than 0.5% and 1% and a change in 7 daily blood glucose measurements. A satisfaction questionnaire was used as an exploratory endpoint. Safety variables and adverse events were assessed.

Results

After 1 month of intervention, HbA1c was reduced by 0.94% in the Curalin arm versus 0.4% in the placebo arm (P = 0.008). 72% of Curalin patients had decreased HbA1c levels >0.5% versus 35% in the placebo arm (P < 0.05). The Treatment Satisfaction Questionnaire indicated that Curalin arm patients reported higher overall satisfaction.

Conclusions

Curalin treatment significantly reduced HbA1c over a 1-month period and was well-tolerated.     

激素补充治疗卵巢早衰的疗效观察

目的探讨卵巢早衰（premature ovarian failure，POF）患者性激素补充的规范治疗。方法将40例POF患者根据发病至就诊时间分为短病程组和长病程组，均接受性激素补充治疗，比较治疗前及治疗半年后更年期症状评分（Kupperman评分）、血清促卵泡刺激素（sF）水平、雌二醇（E2）水平、子宫体积、子宫内膜厚度及卵巢体积的变化情况。结果短病程组患者治疗后SF下降（P〈0．01），E2升高（P〈0．05）；长病程组患者治疗后虽然SF有所下降，E2升高，但差异无统计学意义。两组受试患者治疗后均有规律性撤退性出血，短病程组中有1例于治疗后5个月自然妊娠，伴有低雌激素症状者均得到不同程度改善。短病程组Kupperman评分均值由治疗前29．11分降低至3．41分，长病程组Kupperman评分均值由治疗前22．17分隆低军4．13分．结论早期发现POF日存闭经1年内讲行激素补充治疗可以取得更好的疗效。