针刺血清对体外培养破骨细胞数量的影响

目的:探讨针刺抑制骨吸收的细胞学机制。方法:40只12月龄雌性SD大鼠,随机分为假手术组、模型组、针刺预防组和针刺治疗组。针刺预防组和针刺治疗组分别在造模术后的3d、3个月开始针刺。取“肾俞”“脾俞”“足三里”“大椎”。自新生SD大鼠四肢长骨分离破骨细胞,接种于24孔培养板中,加入含10%上述各组大鼠血清的培养液培养48h后,抗酒石酸酸性磷酸酶(TRAP)染色并计数TRAP( )多核细胞数。结果:与假手术组比较,模型组TRAP( )多核细胞数明显增加(P<0.01);与模型组比较,针刺预防组和针刺治疗组TRAP( )多核细胞数明显减少(P<0.05)。结论:针刺血清能够减少破骨细胞的数量,预防组和治疗组之间的作用无统计学差异。     

Bone loss during oestriol therapy in postmenopausal women

In contrast to all other oestrogens examined thus far oestriol hemisuccinate (12 mg/day) did not prevent bone loss in 28 postmenopausal women. The average bone loss, however, was somewhat less than expected from placebo studies, while the bone loss achieved by a group taking 4–6 mg/day was equal to that achieved by previous placebo groups. To be an effective agent for prevention of post-menopausal osteoporosis oestriol would have to be prescribed in daily doses considerably in excess of 12 mg.     

尼尔雌醇用于绝经后取宫内节育器

20例绝经后宫内节育器取出失败者,给予尼尔雌醇4mg顿服,7天后皆顺利取出宫内节育器。     

绝经后妇女2型糖尿病性激素变化与冠心病并发症关系

目的 探讨绝经后妇女2型糖尿病患者血清性激素水平变化与冠心病并发症关系。方法 测定25例绝经后妇女2型糖尿病并发冠心病（A组）、23例2型糖尿病未并发冠心病（B组）、20例绝经后正常妇女（C组）的血清雌二醇（E2）、孕激素（P）、促卵泡刺激素（FSH）、促黄体生成素（LH）、睾酮（T）;同时测定了血浆总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）及低密度脂蛋白胆固醇（LDL-C）。结果 A组与B组、C组比较显示、E2、HDL-C水平显著降低。P、FSH、LH、TC、LDL-C水平显著半高,线性相关分析显示E2与FSH、LH、TC、TG、LDL-C呈显著负相关,而与HDL-C呈显著正相关。结论 绝经后妇女2型糖尿病合并冠心病患者存在着严重的性激素失调及脂代谢异常,可能为绝经后妇女2型糖尿病并发症冠心病的原因之一。     

Effects of conjugated equine estrogen vs. raloxifene on serum insulin-like growth factor-i and insulin-like growth factor binding protein-3: a 2-year, double-blind, placebo-controlled study

OBJECTIVE: To assess and compare the effect of conjugated estrogen and of the selective estrogen receptor modulator raloxifene on serum levels of insulin-like growth factor-I (IGF-I) and insulin-like growth factor binding protein-3 (IGFBP-3) and on the IGF-I/IGFBP-3 ratio. DESIGN: A 2-year randomized, double-blind, placebo-controlled study. SETTING: Endocrinology outpatient department. PATIENT(S): Fifty-six postmenopausal, hysterectomized women. INTERVENTION(S): Women received raloxifene hydrochloride in doses of 60 mg/day (n = 15) or 150 mg/day (n = 13), conjugated equine estrogen (CEE) in doses of 0.625 mg/day (n = 15), or a placebo (n = 13) over the course of 2 years. MAIN OUTCOME MEASURE(S): At baseline and after 6, 12, and 24 months of treatment, serum levels of IGF-I, IGFBP-3, and insulin were measured, and an IGF-I/IFGBP-3 ratio was calculated. RESULT(S): Both raloxifene and CEE decreased serum IGF-I concentration. In contrast to CEE, which had no effect, both raloxifene doses of 60 and 150 mg/day significantly increased serum IGFBP-3 during the 2 years. Compared with placebo, the decrease in IGF-I/IGFBP-3 ratio was -32.5% (95% CI: -20.1; -44.8%) for CEE; -16.4% (95% CI: -3.6; -29.2%) for raloxifene at 150 mg/day; and -15.4% (95% CI: -1.0; -29.8%) for raloxifene at 60 mg/day. No effect of CEE or raloxifene was found on insulin concentration at any time point. CONCLUSION(S): Long-term use of both CEE and raloxifene decreases serum IGF-I and the IGF-I/IGFBP-3 ratio, but, unlike CEE, raloxifene produced a significant yet small increase in IGFBP-3.     

Vitamin A intake and the risk of hip fracture in postmenopausal women: the Iowa Women’s Health Study

Excessive intake of vitamin A is postulated to have a detrimental effect on bone by inducing osteoporosis. This may lead to an increased risk of fracture, particularly in persons who are already at risk of osteoporosis. However, few studies have specifically examined the association of vitamin A intake through diet and supplement use, with fractures in a cohort of older, community-dwelling women. We prospectively followed a cohort of 34,703 postmenopausal women from the Iowa Womens Health Study to determine if high levels of vitamin A and retinol intake through food and supplement use were associated with an increased risk of hip or all fractures. A semiquantitative food frequency questionnaire was used to obtain the participants baseline vitamin A and retinol intake. Participants were followed for a mean duration of 9.5 years for incident self-reported hip and nonhip fractures. After multivariate adjustment, it was revealed that users of supplements containing vitamin A had a 1.18-fold increased risk of incident hip fracture (n=525) compared with nonusers (95% CI, 0.99 to 1.41), but there was no evidence of an increased risk of all fractures (n=6,502) among supplement users. There was also no evidence of a dose-response relationship in hip fracture risk with increasing amounts of vitamin A or retinol from supplements. Furthermore, our results showed no association between vitamin A or retinol intake from food and supplements, or food only, and the risk of hip or all fractures. In conclusion, we found little evidence of an increased risk of hip or all fractures with higher intakes of vitamin A or retinol among a cohort of older, postmenopausal women.     

绝经后高血压危险因素的Meta分析

背景 流行病学研究表明,绝经后女性的高血压患病率高于老年男性。近年来,有关绝经后高血压的临床表现、病理特征、发病机制、治疗方法等受到越来越多的关注,但由于受到研究设计、样本量、人群特征、资源不足等因素的影响,其危险因素的研究结果不一致且缺乏全面报道。目的 运用系统评价方式探讨女性绝经后高血压的危险因素,为更好地预防和管理绝经后高血压提供循证证据。方法 于2022年1—5月,计算机检索中国知网、万方数据知识服务平台、中国生物医学文献服务系统、PubMed、EmBase、the Cochrane Library、Web of Science电子数据库,获取与绝经后高血压危险因素相关的队列及病例对照研究。检索时限为建库起至2022-05-20。由2名研究者独立根据纳入和排除标准筛选文献、提取资料,采用纽卡斯尔-渥太华量表（NOS）对所提取的文献进行偏倚风险评估,将得分≥6分（高质量）的文献纳入研究,最后采用RevMan 5.3对其进行Meta分析。结果 共纳入10篇文献,5篇为队列研究,5篇为病例对照研究,共涉及16个危险因素,总样本量为34 864,且均为高质量文献。Meta分析结果显示,...     

绝经后阴道出血380例分析

分析引起绝经后阴道出血的病因及诊断方法,方法对３８０例绝经后阴道出血患者进行临床及病理分析。结果因良性疾患引起的出血占５３．４２％,非器质性疾病占２６．８４％,恶性肿瘤占１９．７４％。子宫内膜病理检查显示破碎宫内膜和经期宫内膜４０例,增生反应４８例,萎缩宫内膜６例及分泌反应８例,因宫内膜及宫颈上非典型增生引起的出血２４例。恶性肿瘤以宫颈癌和宫体癌为主。患者出血时年龄大、绝经年限长及子宫增大、宫腔深     

The contribution of bone loss to postmenopausal osteoporosis

We have addressed the relative importance of peak bone mass and subsequent rate of loss in determining postmenopausal women's bone mass in old age, by examining longitudinal measurements of radial mid-shaft bone mass on various samples of healthy white postmenopausal women. Using both the variance estimate of age-specific rates of bone loss and the population variance in bone mass, we determined that rates of loss could contribute importantly to future bone mass. However, since we found a small negative correlation between initial bone mass and rate of loss, it was necessary to estimate the effect of bone loss as the complement of the contribution of initial bone mass. We found that the influence of bone loss (relative to initial bone mass) increases as the women age, such that by about age 70, the contribution of initial bone mass and rate of loss approached equality. However, estimated rates of bone loss were not very stable over time, so it was difficult to identify long-term fast-losers. We conclude that the rate of postmenopausal bone loss is an important contributor to osteoporosis at old age, but it is difficult to identify long-term fast-losers, thereby reducing the clinical value of assessments of rates of change in bone mass early in the postmenopause.