“骨质疏松公益行”有奖征文

骨质疏松症（Osteoporosis，OP）是一种以骨量低下，骨微结构破坏，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）。该病可发生于不同性别和任何年龄，但多见于绝经后妇女和老年男性。骨质疏松症是一个具有明确的病理生理、社会心理和经济后果的健康问题。骨质疏松症的严重后果是发生骨质疏松性骨折（脆性骨折），大大增加了老年人的病残率和死亡率。     

治糖尿病的长效新药——利拉鲁肽

胰岛B细胞分泌功能缺陷是2型糖尿病发病的主要病理生理机制。不少2型糖尿病患者存在胰高血糖素样肽1（GLP-1）分泌减少,以及葡萄糖依赖性胰岛素释放肽（GIP）效应减低,这是胰岛素分泌减少的原因之一。     

迟发性运动障碍的临床研究进展

迟发性运动障碍（TD）是一种以不自主舞蹈样或徐动样运动为特征的运动障碍,与长期使用多巴胺受体阻断剂有关。本文综述TD的流行病学特征、病理生理机制以及临床诊断和治疗研究进展。     

系统性红斑狼疮患者狼疮抗凝物和纤维蛋白原检测的应用价值

系统性红斑狼疮（systemic lupus erythematosus,SLE）是自身免疫机制引起的以结缔组织纤维蛋白样变性和坏死性血管炎为基本病理改变的一组结缔组织疾病[1].SLE患者的许多临床并发症与血栓形成密切相关.狼疮抗凝物（LA）是一种磷脂依赖性的病理性循环抗凝物质,为IgG、IgM或两者混合型的抗磷脂抗体.LA在体外有抗凝血作用,而在体内产生促凝效果,促进血栓形成.我们分析了38例SLE患者临床资料并结合其LA和纤维蛋白原的检测结果,以了解SLE患者血栓形成的病理生理机制,为有效防止血栓的发生、了解病程发展提供有价值的研究依据.     

内科疾病处方用药解析（66）

7．8骨质疏松症 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,骨强度反映了骨骼的两个主要方面,即骨矿密度和骨质量。骨质疏松症分为原发性和继发性两大类。原发性骨质疏松症又分为绝经后骨质疏松症（I型）、老年性骨质疏松症（Ⅱ型）和特发性骨质疏松（包括青少年型）三种。     

经皮冠状动脉介入治疗急性冠脉综合征患者的围手术期护理

急性冠状动脉综合征（acute coronary syndromes,ACS）,是以冠状动脉粥样硬化斑块破溃,使粥样斑块中具有高促凝作用的脂核部分与血液循环中的血小板及凝血蛋白接触,继发完全或不完全闭塞性血栓形成为病理基础的一组临床综合征。它包括急性ST段抬高型心肌梗死（STEMI）、急性非ST段抬高型心肌梗死（NSTEMI）和不稳定型心绞痛（UA）。近年来,随着对ACS病理生理机制认识的不断深入,治疗方法也有了新的进展。     

急性高山病防治研究进展

高海拔未习服人群快速进入高海拔地区易患急性高山病（acute mountain sickness,AMS）。AMS是一种以头痛为主要症状并伴有肠胃不适、眩晕、疲劳和失眠等症状的自限性疾病。虽然对AMS已经开展了大量研究,但业内对其病理机制以及有效防治等方面的认识还非常有限。深入认识AMS的诊断方法、危险因素和病理生理机制,对提出针对AMS有效的防治措施十分重要。本文基于课题组的前期研究和相关文献,较为系统地综述AMS的临床诊断、危险因素、病理生理机制和防治措施。     

脑缺血再灌注损伤机制研究进展

脑缺血再灌注损伤的发生和发展是一个复杂的病理生理过程,目前科研人员对其致病机制开展了广泛而深入的研究,提出了一系列学说,为解释脑缺血再灌注损伤的病理生理机制奠定了基础。本文综合国内外研究报道,对脑缺血再灌注损伤的病理生理机制进行综述,为其治疗提供参考。     

肾虚骨质疏松症病理机制及补肾方药对其防治作用的实验研究

本实验研究通过复制肾虚骨质疏松症大鼠动物模型，探讨该病证的病理机制以及补肾方药对其的防治作用。结果表明：肾虚骨质疏松症难性大鼠血清Ｅ２、ＰＴＨ含量均明显低于正常对照组（Ｐ〈０．０１）；该病证ＰＫＣ、Ｃａ＾２＋－Ｍｇ＾２＋ＡＴＰａｓｅ、Ｍｇ＾２＋ＡＴＰａｓｅ活性明显降低（Ｐ均〈０．０５）。提示该病证病理机制与较公认的内分泌相关，同时具有细胞膜结构和功能以及受体介导的磷脂－Ｃａ＾２＋系统信息传递的改变     

六味能消胶囊对功能性消化不良患者中医单项症状疗效分析

功能性消化不良（functional dyspepsia,FD）是临床常见病、多发病.流行病学调查显示,FD占消化不良患者的30%～50%[1].随着人们生活节奏的加快,FD发病率逐年攀升.而研究表明胃肠运动障碍可能是FD的主要病理生理机制之一[2],2009年1月至2010年5月,我们采用六味能消胶囊以六味安消胶囊为阳性对照,治疗FD患者108例,比较了六味能消胶囊治疗消化不良症中医症状（饮食停滞症）的疗效,报道如下.     

常见垂体疾病与骨质疏松的研究进展

垂体作为人体重要的内分泌器官,可分泌数种激素参与各项生命活动的调节.下丘脑—垂体疾病众多,外伤、肿瘤、炎症等因素均可造成垂体激素分泌和代谢异常,产生相关临床症状.近年来研究表明,垂体疾病是继发性骨质疏松的重要病因之一,生长激素、泌乳素、促肾上腺皮质激素、促性腺激素等腺垂体激素参与了骨质疏松的发生和发展,现就常见垂体疾病与骨质疏松的研究进展予以综述.     

Novel bone antiresorptive approaches

Inhibition of bone resorption is a mechanism that has been clinically validated as a means to control bone loss in diseases such as postmenopausal osteoporosis. The development of marketable drugs in this area has resulted in significant clinical benefits; however, improvements can still be made. Several novel antiresorptive mechanisms are currently under consideration in the pharmaceutical industry, which will hopefully result in the development of improved bone antiresorptive therapies.     

Bone-targeting macromolecular therapeutics

Musculoskeletal diseases such as osteoporosis are recognized as major public health problems worldwide. Many novel therapeutic agents have been identified for the treatment of these diseases. However, the majority of them are not specific to hard tissue, resulting significant toxicity. Bone-targeting drug delivery systems based on water-soluble polymers can specifically direct candidate drugs to bone thereby reducing side effects due to non-specific tissue interactions. Incorporation of a targeting moiety, a drug release mechanism, drug selection and optimization of the polymer carrier are all essential elements in the development of bone-targeting macromolecular therapeutics. Successful clinical application of this approach can significantly contribute to the development of treatments for many musculoskeletal diseases.     

Controlled ovarian hyperstimulation pharmacogenetics: a simplified model to genetically dissect estrogen-related diseases

The application of pharmacogenetics and pharmacogenomics to assisted reproductive techniques will help clinicians to improve the efficacy of hormone treatments that are being routinely applied during assisted reproductive technique protocols. Genetic markers involving controlled ovarian hyperstimulation pharmacogenetics are being isolated within follicle-stimulating hormone and estrogen receptor signaling pathways using the candidate gene approach. Furthermore, the information obtained during controlled ovarian hyperstimulation pharmacogenetics studies could be applied to other estrogen-related diseases, such as osteoporosis, breast cancer, essential hypertension and many other diseases related to estrogen production or its mechanism of action. The theory that estrogen-related diseases may share some risk factors with controlled ovarian hyperstimulation efficacy, and side effects linked to genetic markers, is discussed.     

基于文献计量学的淫羊藿研究现状及热点分析

为了解中药淫羊藿的研究现状、热点及发展趋势,为后续研究提供直观便捷的数据参考依据和相关建议,收集2000—2020年万方数据知识服务平台、中国学术期刊全文数据库（CNKI）以及Web of Science（WOS）核心合集数据库中淫羊藿相关的研究文献并进行文献计量分析。结果显示,淫羊藿相关研究领域年度发文量总体为波动上升趋势,年发文量相对稳定。其中,中文文献以淫羊藿苷为主的关于淫羊藿有效成分的提取测定、网络药理学研究及对骨质疏松症等骨科疾病的治疗研究为当前淫羊藿相关研究领域的3大热点研究方向;英文文献以淫羊藿苷为主的关于淫羊藿有效成分黄酮类化合物的提取测定及对骨质疏松症等疾病作用机制的动物实验研究可能为未来的研究方向。     

Denosumab治疗绝经后骨质疏松症的临床研究进展

狄诺塞单抗(Denosumab)是首个上市的抗核因子κB受体活化因子配体(RANKL)治疗性单克隆抗体产品,主要用于治疗骨质疏松症和其他骨骼疾病.本文主要综述其近年国外治疗绝经后骨质疏松症的临床研究进展.     

Osteoporosis piece of multi-morbidity puzzle in geriatric care

Osteoporosis frequently coexists with other chronic diseases and syndromes of aging, and therefore multimorbidity interactions can potentially complicate its evaluation and treatment. This article reviews osteoporosis comorbidity interactions with select common diseases of aging including cardiovascular, neurologic, and geriatric syndromes, and select commonly used medications by older adults. Using depression as a case example, we describe the complex relationship between osteoporosis, mood, and antidepressant medications, and the implications of these interactions for patients and clinicians.     

用骨吸收新标志尿吡啶并啉评价内分泌疾病的破骨细胞活性

用竞争性酶免疫分析法（EIA）测定了内分泌疾病患者空腹晨尿中骨吸收新标志吡啶并啉（Pyr）的浓度。结果显示：甲亢和甲状旁眼机能亢进（甲旁亢）患者治疗前尿Pyr浓度显著高于中青年对照组，治疗后均有显著下降；柯兴氏病组和绝经5年以上的骨质疏松患者尿Pyr浓度与中青年对照组没有明显差别。提示尿中游离Pyr能灵敏地反映内分泌疾病的破骨细胞活性变化，有助于分析其发生骨质疏松的机理。     

Section Review: Oncologic,Endocrine & Metabolic: Drugs in development for the treatment of metabolic bone disease

The development of potent inhibitors of bone resorption has revolutionised the treatment of common metabolic bone diseases. In the near future, bisphosphonates provide the best means to achieve appropriate clinical responses in Paget's disease and tumour-related bone diseases. In addition to bisphosphonates, newer forms of oestrogen replacement have a future role for the treatment of osteoporosis, because of potential cardiovascular benefits. In the longer term, agents that directly increase bone formation and density may become available, and have a greater role in the treatment of patients with more established osteoporosis.     

Genetic determinants of susceptibility to osteoporosis

Major advances in our knowledge about the genetic determinants of osteoporosis have been made in recent years. They include the discovery of genes responsible for monogenic bone diseases associated with abnormal bone mass; the identification of quantitative trait loci for bone mass in the general population and in mice; and the characterisation of several candidate genes for osteoporosis. Information from these studies is being used to design new drugs for osteoporosis and to develop genetic markers for fracture risk assessment.