Bisphosphonates for the Treatment of Postmenopausal Osteoporosis: An Update

Bisphosphonates are potent inhibitors of bone resorption, which prevent bone loss, improve bone strength and decrease the risk of fractures. This article reviews the results of recent studies on the efficacy and safety of bisphosphonates for the treatment of postmenopausal osteoporosis. Results of randomized trials using novel dosing regimens of bisphosphonates are discussed. Outcomes include bone mineral density, bone turnover markers fractures adverse events.     

超声波促骨髓间充质干细胞心肌内归巢的实验研究

目的探讨超声微泡造影剂介导对猪骨髓干细胞（BMSC）心肌内移植归巢的影响。方法选取8只2月龄中国家猪随机分为对照组（A组，4只）和实验组（B组，4只）。分别抽取骨髓，体外分离、纯化，培养BMSC，超顺磁性氧化铁颗粒（SPIO）标记；介入法建立急性心肌梗死模型。B组超声微泡作用下移植Busc（1MHz，2W／cm^2，90s辐射）；A组不采用超声微泡干预BMSC移植过程。两组动物于术后24h活体行磁共振检查，对比BMSC移植，随后处死动物，取心肌梗死区、梗死周边区、正常区做病理切片，行HE染色及普鲁士蓝染色，心肌消化后涂片普鲁士蓝染色后计数BMSC。结果①SPIO成功标记干细胞，因此，活体行磁共振示踪BMSC成为可能。②磁共振：A组及B组在心肌梗死区和梗死周边区均见SHO标记的BMSC形成的低密度区，低信号区B组较A组多。③普鲁士蓝染色：两组心肌消化涂片染色，BMSC在B组较A组有明显地增加（P〈O．05）。结论超声联合微泡剂介导的猪自体BMSC心肌内移植有所增强，该方法为提高干细胞移植归巢效率提供一种新的思路。     

A rare case of paraganglioma of the sella with bone metastases

Sellar paragangliomas are very rare lesions with only 11 previous cases described in the literature. We present a further case of sellar paraganglioma. The patient is a 17-year-old man who developed headache, visual blurring, and diplopia. MRI showed a sellar lesion. Trans-nasal trans-sphenoid biopsy showed features of paraganglioma. He was treated by Stereotactic radiotherapy. Four months after treatment he developed bone metastases which was palliated by radiation, zoledronic acid, and chemotherapy. This is the first case of sellar paraganglioma showing metastases to bone.     

Blood transfusion in marrow graft recipients

Summary Of 182 consecutive patients undergoing allogeneic bone marrow transplantation (BMT), the relative numbers of those who received red blood cells (RBC), platelets (PLT), and granulocytes were 82%, 96%, and 26%, respectively. The transfused patients received an average of 1.26 (SD±2.0) RBC units, 9.41 (SD±13.2) PLT transfusions, and 0.33 (SD±1.1) granulocyte concentrates per week per 50 kg body wt. in the period starting on the day of bone marrow transplantation (BMT) up to 60 days post BMT. The total number of units per transfused patient was 7.7 (range 1–63) RBC, 55.2 (range 2–394) PLT and 6.2 (range 1–36) granulocytes in the same period. Patients with grades II-IV acute graftversus-host disease (GVHD) needed more RBC and PLT (p < 0.001) than patients with grades 0-I acute GVHD. Patients with late engraftment required more granulocyte and PLT transfusion than those with early engraftment (p < 0.05). Patients with high-risk malignancy had greater need for RBC and PLT than low-risk patients (p<0.02 andp<0.01), respectively). Patients with major ABO-incompatible donors showed a greater need for RBC than patients with minor ABO incompatibility (p=0.02) or ABO identical donors (p=0.01). Patients with relatively poor estimated survival required the most RBC and PLT.     

The role of microRNA in periodontal tissue: A review of the literature

MicroRNAs (miRNAs) bind at the 3′UTR of their target mRNA to induce gene silencing. Through this mechanism, number of biological pathways implicated in developmental, physiological, and pathological processes, have been frequently found to involve miRNA functions. MiRNA functions in bone metabolism have also been reported, especially in association with receptor activator of nuclear factor kappa B ligand (RANKL)-induced osteoclastogenesis. Expression of RANKL has been related to several inflammatory mediators, and thus some miRNAs may be implicated in the regulatory mechanism of inflammatory-induced RANKL expression as shown in periodontal resident cells such as gingival fibroblasts or periodontal ligament cells. This review aims to review the current miRNA research relating periodontal tissue and its relevance in periodontal inflammation. In miRNA profiling studies of tissues isolated from individuals with periodontal disease, miR-223 has been consistently identified as a potential candidate miRNA to be further investigated in periodontitis-related processes. Although these studies point to an important role of miRNA-mediated epigenetic changes in tissue inflammation and alveolar bone loss, further investigation is still required to determine the function of miRNAs in the complex processes of periodontal tissue homeostasis and pathogenesis. Knowledge gained from future studies will be beneficial in developing alternative therapeutic approaches, especially ones that use miRNA delivery systems to treat periodontal disease.     

抗环瓜氨酸肽抗体检测在类风湿关节炎中的诊断及预后意义探讨

目的 评价抗环瓜氨酸肽(CCP)抗体和类风湿因子(RF)在鉴别类风湿关节炎(RA)和其他风湿性疾病中的意义．探讨RA骨侵蚀与上述两种抗体之间的相关性。方法采用横断面研究，在125例RA．56例其他风湿性疾病，55例非风湿性疾病中检测上述两种抗体，其中抗CCP抗体采用酶联免疫吸附试验(ELISA)法．IgM-RF采用速率比浊法。分析RA骨侵蚀与上述两种抗体之间的相关性。结果IgM-RF诊断RA的敏感性较抗CCP抗体高(RF58．4％，抗CCP抗体54．4％)(P=0．57)；但抗CCP抗体有更高的诊断特异性(抗CCP抗体94．6％，IgM-RF84．7％)(P=0．015)，且两种检测方法之间无相关性。联合检测抗CCP抗体和IgM-RF有很高的特异性98．2％．较单独检测IgM-RF有更高的阳性预测值(PPV)95．7％(P=0.019)．阴性预测值(NPV)有下降57.7％(P=-0.213)。抗CCP抗体阳性、IgM-RF阳性与RA骨侵蚀相关。结论抗CCP抗体与IgM-RF比较对RA有良好的诊断敏感性与特异性．可视为RA新的血清学诊断指标。抗CCP抗体与RA骨侵蚀的关系值得进一步研究。     

Rosuvastatin 1.2 mg In Situ Gel Combined With 1:1 Mixture of Autologous Platelet‐Rich Fibrin and Porous Hydroxyapatite Bone Graft in Surgical Treatment of Mandibular Class II Furcation Defects: A Randomized Clinical Control Trial

Background: A wide range of regenerative materials have been tried and tested in the treatment of furcation defects. Rosuvastatin (RSV) is a new synthetic, second‐generation, sulfur‐containing, hydrophilic statin with potent anti‐inflammatory and osseodifferentiation mechanisms of action. Platelet‐rich fibrin (PRF) is a platelet concentrate having sustained release of various growth factors with regenerative potential to treat periodontal defects. Porous hydroxyapatite (HA) bone grafting material has a clinically satisfactory response when used to fill periodontal intrabony defects. This double‐masked randomized study is designed to evaluate the potency of a combination of 1.2 mg RSV in situ gel with a 1:1 mixture of autologous PRF and HA bone graft in the surgical treatment of mandibular Class II furcation defects compared with autologous PRF and HA bone graft placed after open‐flap debridement (OFD). Methods: One hundred five mandibular furcation defects were treated with OFD + placebo gel (group 1), PRF + HA with OFD (group 2), or 1.2 mg RSV gel + PRF + HA with OFD (group 3). Clinical and radiologic parameters (i.e., probing depth [PD], relative vertical and relative horizontal clinical attachment level [rvCAL and rhCAL], intrabony defect depth, and percentage of defect fill) were recorded at baseline and 9 months postoperatively. Results: Mean PD reduction was greater in group 2 (3.68 ± 1.07 mm) and group 3 (4.62 ± 1.03 mm) than group 1 (2.11 ± 1.25 mm), and mean rvCAL and rhCAL gain were greater in group 2 (3.31 ± 0.52 and 2.97 ± 0.56 mm, respectively) and group 3 (4.17 ± 0.70 and 4.05 ± 0.76 mm) compared with group 1 (1.82 ± 0.78 and 1.62 ± 0.64 mm). A significantly greater percentage of mean bone fill was found in group 2 (54.69% ± 1.93%) and group 3 (61.94% ± 3.54%) compared with group 1 (10.09% ± 4.28%). Conclusions: Treatment of furcation defects with 1.2 mg RSV in situ gel combined with autologous PRF and porous HA bone graft results in significant improvements of clinical and radiographic parameters compared with OFD alone. These results imply that the combination of RSV, PRF, and HA has synergistic effects, explaining their role as a regenerative material in the treatment of furcation defects.     

人工假体置换治疗股骨上段骨肿瘤

采用全股骨及半股骨人工假体置换治疗股骨上皮骨肿瘤21例，男13例，女8例．其中骨肉瘤4例（3例为皮质分骨肉瘤），软骨肉瘤9例。骨巨细胞瘤7例，恶性纤维组织细胞瘤1例。经1～17年的随访观察，收到了满意治疗效果。作者认为：术中遵守无瘤手术操作、彻底切除是降低复发率、转移率的关键；人工假体置技术对于肢体的骨肿瘤、骨巨细胞瘤的治疗效果优于软骨肉瘤，软骨肉瘤的治疗效果优于骨肉瘤.     

Dynamic down-regulation of Krüppel-like factor 4 in colorectal adenoma-carcinoma sequence

Purpose  To explore the clinical significance of Krüppel-like factors 4 (KLF4) expression in colorectal cancer initiation and progression. Methods  We used quantitative real-time PCR to detect KLF4 mRNA expression in 49 colorectal cancer samples with individual-matched normal mucosa and eight concurrent adenomas. We also analysed the immunostaining pattern of KLF4 in additional 129 colorectal cancers and 48 sporadic colorectal adenomas with matched normal mucosa and correlated KLF4 staining with clinicopathological parameters and prognosis. KLF4 expression change was detected in SW480, SW620 and RKO cell lines after treatment of 5-aza-dC (10 μM) or butyrate sodium (4 mM). Results  The large clinicopathlogical survey with combined methods confirmed a dynamic downregulation of KLF4 in individual-matched normal mucosa, adenoma and cancer (P < 0.05). The quantitative analysis of immunostaining pattern showed that KLF4 staining cells were more frequently seen in the upper zones than that in the lower zones of both normal mucosa and adenoma (P < 0.05). Survival analysis implied a trend toward better overall survival in KLF4-positive colorectal cancer patients with lymph node metastasis than that in KLF4-negative cancer with lymph node metastasis. In vitro study found elevated KLF4 mRNA expression in SW620 and RKO cells with 5-aza-dC treatment, implicating the underlying aberrant epigenetic modifications in regulating KLF4 expression at least in a subset of colorectal cancers. Conclusions  KLF4 is associated with terminal differentiation in colorectal epithelium and drastically downregulated in colorectal adenomas and cancers via possible epigenetic modifications. Loss of KLF4 protein expression might contribute to assessing prognosis in colorectal cancer with lymph node metastasis.