骨质疏松症评估方法的研究进展

骨质疏松症主要是由于骨量丢失与降低、骨组织微结构破坏、骨脆性增加而引起的、容易导致骨折的一种全身代谢性骨病,它是影响我国中老年人骨骼健康的重要隐患。如何准确评估并及时预防骨质疏松症至关重要,近几年越来越多的学者关注于各种影像检查技术对骨质疏松症的评估,包括双能X线、计算机断层扫描、定量超声、磁共振成像等技术,本文对骨质疏松症评估的研究进展进行综述,为临床医生提供参考。     

骨质疏松症药物治疗的有限元分析研究进展

骨微结构改善是骨质疏松症药物治疗的目标,可以增加骨强度,降低骨折风险,但目前来看骨微结构和骨强度的评估手段相对不足。利用有限元分析(finite element analysis,FEA)能够很好地模拟各种类型药物治疗骨质疏松症后有限元模型的各种力学状况,分析其生物力学作用机制、验证骨微结构参数变化对骨强度的影响,优化治疗方案,为药物治疗骨质疏松症的骨微结构和生物力学特性研究提供有效的研究方法。本文通过回顾近年来药物治疗骨质疏松症的有限元分析研究,探讨不同种类药物治疗骨微结构参数变化对骨强度的影响,结果发现目前关于药物治疗骨质疏松症的有限元研究有待于对骨微结构有限元模型建立进行标准化和精确化,同时进一步推广有限元研究思路,需要更多大样本的临床随机对照试验来验证疗效,更好的指导药物治疗骨质疏松症的临床运用。     

骨质疏松骨折诊疗指南

一、概述 骨质疏松症是一种以骨量降低、骨微结构破坏、骨脆性增加、骨强度下降、骨折风险性增大为特征的全身性、代谢性骨骼系统疾病,可分为原发性骨质疏松症和继发性骨质疏松症.     

血中骨代谢生化指标在骨质疏松症诊治中的意义

骨质疏松症(OP)是一种以骨量减少和(或)骨组织微结构破坏为特征,进而导致骨强度降低,骨脆性增加,易发骨折的全身性骨骼疾病。“骨量减少”指骨内有机质和无机质均成比例减少,临床常用骨密度(BMD)表示骨量。“骨组织微结构破坏”是由于骨组织形成和吸收失衡所引起的病变,松质骨表现为骨小梁变细,数量减少,皮质骨则表现为皮质变薄。在骨质疏松症的形成和发展过程中,必然伴随着骨代谢生化指标的变化。这种变化不仅可以反映骨吸收与形成的平衡状况,而且在骨质疏松症早期诊断、临床疗效评价和指导临床用药方面具有重要价值,若与BMD检查相结合…     

骨代谢标志物在骨质疏松症中医药诊疗中的应用研究进展

骨质疏松症是一种以骨代谢异常,骨微结构破坏,导致脆性骨折危险性增高为特征的慢性全身性骨病,对人体的健康有着重要的影响。传统中医学对骨质疏松症有着深刻的认识,骨质疏松属于中医"骨痿"、"骨痹"的范畴,其发病多以肾虚为本,血瘀为标,中医药在预防、治疗治骨质疏松症方面的的作用举足轻重。骨代谢生化标志物是从血液、尿液中可检测出的骨代谢生化产物或相关激素,可反映人体骨代谢状态,是协助代谢性骨病的诊断、鉴别诊断、治疗以及疗效评价的重要指标,目前已广泛应用于骨质疏松症的中医体质辨识、证候的诊断及药物疗效评价等方面。本文通过文献综述的方式,对近些年来骨代谢标志物在骨质疏松症中医诊疗中的应用研究进行归纳,以期为今后的研究提供参考。     

原发性骨质疏松症的骨科临床诊治——骨科专家讨论会纪要

骨质疏松症（osteoporosis,OP）是一种以骨量低下,骨微结构损坏,导致骨脆性增加,易发生骨折为特征的全身性骨病（世界卫生组织,WHO）。2001年美国国立卫生研究院（NIH）提出骨质疏松症是以骨强度下降、骨折风险性增加为特征的骨骼系统疾病。骨质疏松症分为原发性和继发性二大类。     

MRI扩散加权成像在骨肌系统疾病的应用进展

扩散加权成像是一种从分子水平评价组织病理生理变化的磁共振功能成像技术。近年来,弥散加权成像在骨肌系统疾病的诊断、鉴别诊断、疗效评价方面均有较多的应用,本文主要介绍扩散加权成像的原理以及近年来其在骨肌系统的临床应用进展与前景。     

MRI新技术在中枢神经系统疾病中的临床应用

磁共振的技术进步已经取得了解剖结构的高分辨率成像,并且提供了评价组织的生理和功能的方法.磁共振成像提供了无创、无辐射的研究人类大脑生理学的方式.利用这些新的成像方法,我们可以对疾病作出更具体的诊断,以及预测和评估疾病治疗后的反应.本文对磁共振较新的技术DWI、MRS、SWI在中枢神经系统疾病中的应用作一综述.     

骨质疏松症影像学检查的进展

骨质疏松症是以骨量减少、骨组织微细结构被破坏、骨强度下降、骨脆性增加、极易发生骨折为特征的全身性骨骼疾病.随着老龄人口的增加,骨质疏松成为了一个严峻的公共健康问题.二维双能X线骨密度仪(DXA)是目前临床上检查骨质疏松症的主要手段.近年来,影像学技术进展迅速,特别是三维定量计算机断层扫描(QCT)为进一步检测松质骨及皮质骨骨密度、骨微结构、骨几何特性与其他生物力学参数,探索骨质疏松症的病理生理过程,敏感地进行临床诊断、监控病程变化与疗效提供了技术支持.放射影像学技术与生物力学有限元模型相结合,有利于评价骨强度和骨的力学性能.     

OPG-RANKL-RANK信号通路——绝经后骨质疏松症的重要作用机制

骨质疏松症是一种较为多见的全身性代谢性骨病,其主要特征为骨量低、骨组织微结构损坏,从而导致骨脆性增加、易发生骨折。随着我国人口的老龄化,骨质疏松症和骨质疏松性骨折越来越严重威胁着人民群众的身体健康。通过对我国骨质疏松症诊疗现状、OPG-RANKL-RANK信号通路在骨质疏松症病理生理中的作用、地舒单抗在绝经后骨质疏松症...     

定量MRI用于强直性脊柱炎研究进展

强直性脊柱炎(AS)是免疫介导的慢性炎性关节炎,早期诊断及治疗可控制病情进展和改善预后。根据定量MRI技术各参数值可定量观察AS患者骶髂关节(SIJ)特定物质含量及结构变化,为早期诊断AS及评价治疗效果提供更准确的信息。本文对定量MRI用于AS的研究进展进行综述。     

Uroscopy in the 21st century: high-field NMR spectroscopy

From the experiments described, it can be seen that there are different research approaches that can be taken and these are summarized in Table 1. Whereas much scientific research is principally hypothesis led, there remains, nevertheless, an important place for exploratory research. High resolution NMR can measure, directly and simultaneously, a wide range of endogenous metabolites in biological fluids and has the unique capability of providing structural information on the metabolites detected. It has proved to be a powerful research tool with which to study inherited metabolic diseases, renal disease, drug metabolism, and toxicity, and can be used to monitor the effects of drug therapy. For instance, by using a library of experimental toxins one can map the metabolic profile of site-specific nephron injury. With this approach in man one could eventually take an unknown disease such as Balkan nephropathy and predict the initial site of tubular injury, the mode of injury and therefore the kind of toxin capable of producing that injury. NMR spectroscopic techniques are still advancing rapidly, with ever increasing sensitivity and sophistication of NMR pulse sequences to enhance structural elucidation in complex mixtures. Given the advances in directly coupled HPLC-NMR and even HPLC-NMR-mass spectroscopy it is likely that these technologies in conjunction with pattern recognition will make major contribution to our understanding of renal processes and provide new diagnostic insights in the 21st century.      

Paranasal sinus radiology, Part 2B: ethmoidal sinuses

The clinician must have a high level of suspicion in order to detect ethmoidal sinus disease. Survey plain film radiographic examination may provide information about gross changes in ethmoidal sinus transparency and the sinus walls. Conventional tomographic study will often aid evaluation of the ethmoidal sinus walls which may be obscured by overlying structures on plain films. Computerized tomography adds a new dimension to ethmoidal sinus study. By revealing not only bone changes but soft-tissue abnormality as well, more complete understanding of the disease process is gained. Computerized tomography is particularly useful in evaluating orbital structural change due to ethmoidal sinus abnormality.     

Paranasal sinus radiology,part 2A: Ethmoidal sinuses

The clinician must have a high level of suspicion in order to detect ethmoidal sinus disease. Survey plain film radiographic examination may provide information about gross changes in ethmoidal sinus transparency and the sinus walls. Conventional tomographic study will often aid evaluation of the ethmoidal sinus walls which may be obscured by overlying structures on plain films. Computerized tomography adds a new dimension to ethmoidal sinus study. By revealing not only bone changes but soft-tissue abnormality as well, more complete understanding of the disease process is gained. Computerized tomography is particularly useful in evaluating orbital structural change due to ethmoidal sinus abnormality.     

双功彩超、静脉穿刺造影、光电容积描记检查下肢静脉倒流的比较

目的 了解双功彩超、经皮Ｇｅ静脉穿刺造影、光电容积描记（ＰＰＧ）在检测下肢静脉倒流中的优缺点及相对适应证。方法 对４０例下肢慢性静脉疾病的患者,术前应用双功彩超、经皮Ｇｅ静脉穿刺造和ＰＰＧ的方法进行检测,并对检测的结果进行比较分析。结果 双功彩超与经皮Ｇｅ静脉穿刺造影探测股－Ｇｅ静脉段静脉倒流性疾病的结果差异无显著性意义。与双功能超相比性 ＰＰＧ探测下肢静脉倒流性疾病的精度度６７％。结论 ＰＰＧ可     

The utility of prostate-specific antigen as a surrogate marker for identification of high-risk cohorts and assessing response in chemoprevention trials.

Serum prostate-specific antigen (PSA) is the most important tumor marker in oncology practice. It may assume a similar role in chemoprevention strategies. It is a simple and reproducible blood test that can both identify a high-risk cohort and provide meaningful information regarding the response to intervention. A wealth of information is available regarding the relationship of PSA to age, race and velocity. Free and total values may serve to further define high-risk cohorts and provide a barometer for response and disease presence in chemoprevention trials.     

Insights From the Eye for Patients With Kidney Transplant

The eye and the kidney share structural and developmental similarities on a cellular and clinical level, and they are often affected by the same disease processes. Performing an eye exam to look for signs of conditions such as hypertension and diabetes can provide a helpful window into the health of the kidney.Patients with kidney transplants (KT) are a unique population that require close monitoring. These patients are maintained on a number of immunosuppressive medications and may face complications such as medication side effects, infections, and graft rejection. Patients with KT are at higher risk of both infectious and noninfectious eye conditions related to underlying systemic disease or use of immunosuppressive medications.Screening for eye conditions is important because preserving visual function is integral to quality of life, and also because the eye exam can help with early detection and treatment of systemic conditions. Here we describe some of the common eye findings and conditions in patients with KT. We recommend that patients with KT receive annual eye exams, and we hope that the information provided here can help nephrologists become more familiar with eye findings and identify situations where a referral to ophthalmology is warranted.     

Diagnostic considerations in occlusive arterial disease

The diagnostic approaches to the problem of occlusive arterial disease have been reviewed. The history and physical examination are most useful in establishing the diagnosis, localizing the most proximal level of the arterial involvement, and categorizing the patient's stage of disease. Functional evaluation of limb blood pressures and flow velocity at rest and after exercise provide useful data for estimating the degree of the arterial involvement, and this information can be used as the baseline for evaluating the effects of therapy.     

Clinical Imaging of Bone Microarchitecture with HR-pQCT

Osteoporosis, a disease characterized by loss of bone mass and structural deterioration, is currently diagnosed by dual-energy x-ray absorptiometry (DXA). However, DXA does not provide information about bone microstructure, which is a key determinant of bone strength. Recent advances in imaging permit the assessment of bone microstructure in vivo using high-resolution peripheral quantitative computed tomography (HR-pQCT). From these data, novel image processing techniques can be applied to characterize bone quality and strength. To date, most HR-pQCT studies are cross-sectional comparing subjects with and without fracture. These studies have shown that HR-pQCT is capable of discriminating fracture status independent of DXA. Recent longitudinal studies present new challenges in terms of analyzing the same region of interest and multisite calibrations. Careful application of analysis techniques and educated clinical interpretation of HR-pQCT results have improved our understanding of various bone-related diseases and will no doubt continue to do so in the future.