鲑鱼降钙素在老年糖尿病并发骨质疏松中的疗效

目的观察对老年糖尿病并发骨质疏松患者应用鲑鱼降钙素治疗的临床效果。方法搜集2013年4月~2014年4月我院接收的老年糖尿病并发骨质疏松58例患者,按照就诊日期单双号分为实验组、对照组。对对照组29例应用钙尔奇D,对实验组29例应用钙尔奇D的同时给予鲑鱼降钙素。观察实验组、对照组的治疗效果,并比较。结果实验组BMD、BGP、SOD改善情况优于对照组,治疗有效率高于对照组,差异显著,有统计学意义(P<0.05)。结论鲑鱼降钙素治疗老年糖尿病并发骨质疏松的效果较好,BMD、BGP、SOD改善明显,疗效显著,应予以重视。     

鲑鱼降钙素预防老年性骨质疏松患者发生胸腰椎压缩性骨折的研究

目的研究鲑鱼降钙素在老年性骨质疏松治疗中对胸腰椎骨折的预防作用。方法 84例老年性骨质疏松患者,随机分成A,B两组,其中A组肌注鲑鱼降钙素和口服钙剂3个月,B组口服钙剂3个月;之后3年间每月随诊并行胸腰椎X线检查,统计A,B两组发生胸腰椎压缩性骨折的例数。结果 64人得到随诊,其中A组34例,发生骨折为6例;B组30例,发生骨折为12例;经皮尔逊卡方检验,两组间差异无统计学意义（P〈0.05）。结论鲑鱼降钙素能有效预防老年性骨质疏松患者发生胸腰椎压缩性骨折,并能有效缓解骨质疏松引起的胸腰背部疼痛,安全性好。     

质子泵抑制剂FR167356对骨质疏松模型兔种植体骨整合的影响

背景：破骨细胞质膜上的空泡型质子泵是骨组织溶解必不可少的关键酶,空泡型质子泵抑制剂对体外培养的破骨细胞有明显的抑制作用。 目的：观察质子泵抑制剂FR167356对骨质疏松家兔种植体周围骨整合的影响。 方法：将24只5月龄雌性家兔随机分成单纯卵巢切除组、质子泵抑制剂组及假手术组,每组8只,前2组家兔切除双侧卵巢,假手术组只切除卵巢周围等量的脂肪组织。卵巢摘除12周后,在所有家兔的双侧胫骨近心端各置入1枚纯钛种植体(长8 mm,直径3.3 mm)。质子泵抑制剂组在种植体周围肌注FR167356,其他2组肌注等量的生理盐水。在种植后4,12周进行X射线片、组织形态学观察及拔出力学实验。 结果与结论：X射线片检查结果显示种植后第4周时,单纯卵巢切除组种植体的高阻射影像、种植体螺纹间隙的低密度影像、骨组织的界限明显比其他2组清楚;12周时,与单纯卵巢切除组相比,假手术组和质子泵抑制剂组种植体螺纹间隙的密度与周围骨组织更接近,种植体与周围骨组织的界限消失的更明显,2组无明显差异。组织学观察结果发现,4周时假手术组和质子泵抑制剂组种植体周围骨质多孔,平行于种植体表面的骨小梁排列紧密,小梁间连接较多,2组无明显差异;12周时假手术组和质子泵抑制剂组种植体周围骨组织量比4周时明显增加,骨小梁增粗且粗细均匀,连接紧密且间隙减小,单纯卵巢切除组没有观察到这种现象。在力学实验中,第4,12周,单纯卵巢切除组的最大拔出力值明显低于其他2组。提示局部应用质子泵抑制剂FR167356对骨质疏松家兔种植体骨整合有显著的促进作用。 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程全文链接：     

锌离子改善骨质疏松状态下钛植入体的稳定性

背景：有研究表明,锌可通过调节成骨细胞活性起到改善骨质疏松状态下骨对钛植入体反应的作用。 目的：观察锌离子对改善骨质疏松状态下钛植入体稳定性的作用。 方法：摘除28只雌性SD大鼠卵巢,饲养12周获得骨质疏松效果,后随机分为2组,实验组于双侧股骨干骺端植入含锌羟基磷灰石涂层的钛植入体,对照组于双侧股骨干骺端植入羟基磷灰石涂层钛植入体。两组分别随机选择3只大鼠进行双重荧光标记,于术后6周末计算矿物沉积率;术后12周末,两组分别随机选择4只大鼠进行植入体及其周围组织组织形态学分析;术后12周,对两组剩余大鼠行推出实验,计算最大推出力与最大剪切力。 结果与结论：荧光标记检测发现在术后3-5周,两组中植入体周围均有活跃的骨生成,实验组矿物质沉降率显著高于对照组(P < 0.05)。两组中均可见新骨形成,但实验组新骨形成量、骨面积比率、骨-植入体接触率、最大推出力及最大剪切力均优于对照组(P < 0.05或P < 0.01)。表明锌离子在去势大鼠骨植入体中具有促进骨生成和改善植入体稳定性的作用。     

依降钙素治疗绝经后骨质疏松性髋部骨折：前瞻性随机对照试验

背景：依降钙素作为抗骨质疏松的经典药物,已经广泛应用于临床抗骨质疏松治疗中,越来越多的研究发现其在骨质疏松性骨折的治疗中也有着显著的疗效。目的：评估依降钙素治疗绝经后骨质疏松性髋部骨折的临床疗效和安全性。方法：采用前瞻性随机对照方法,纳入60例绝经后骨质疏松性髋部骨折老年患者,采用随机信封法按1∶1比例随机分配至试验组和对照组,试验组给予国产依降钙素(每周1次)联合碳酸钙+维生素D(1次/d)治疗,对照组给予碳酸钙+维生素D(1次/d)治疗,疗程6个月。通过对比骨代谢指标、骨折愈合率、骨密度、血钙、血磷及不良反应来系统评估依降钙素的临床疗效及安全性。结果与结论：(1)试验组有26例患者,对照组有28例患者完成试验,两组患者基线数据基本一致;(2)依降钙素组在8,12,24周能明显抑制骨吸收指标β-Ⅰ型胶原交联C末端肽质量浓度(P <0.01),以及改善4,8周患者的疼痛目测类比评分(P <0.01),并对骨折愈合、血钙及血磷无影响;(3)两组的骨密度及不良反应发生率相比差异无显著性意义;(4)提示依降钙素能够降低绝经后骨质疏松性骨折患者术后的高转化状态,减少急性骨丢失,缓解...     

羟基磷灰石基人工骨的研究进展

目的研究羟基磷灰石基人工骨作为最有发展前途的生物硬组织替代材料之一,在生物医用材料和医学研究领域的应用.方法制备具有良好生物相容性、力学性能、骨诱导性与治疗功能的羟基磷灰石基人工骨,用于人体骨组织的缺失的修复,及相关疾病的治疗.结果通过制备性能优良的羟基磷灰石粉体,结合纳米技术、组织工程技术和生物技术将不同材料通过合适的方法组合成羟基磷灰石人工骨,从而获得良好的临床应用性能.结论从临床角度,综合了国内外近十年相关文献的基础上,评述了羟基磷灰石人工骨的研究进展.     

卵巢切除股骨骨折大鼠骨愈合中降钙素的作用

背景：降钙素可活化腺苷酸环化酶蛋白激酶A通路及磷脂酶C通路,抑制破骨细胞的活性,可能治疗骨质疏松性骨折。 目的：观察降钙素对去卵巢大鼠股骨骨折愈合的作用。 方法：构建双侧卵巢切除骨质疏松右股骨骨折SD大鼠模型,然后分别皮下注射生理盐水和降钙素(16 IU/kg),隔日1次,于骨折后3周和6周测量右股骨行骨密度,苏木精-伊红及抗酒石酸酸性磷酸酶染色,骨形态发生蛋白2及血管内皮生长因子免疫组化染色。 结果与结论：骨折后给予降钙素治疗的大鼠抗酒石酸酸性磷酸酶染色阳性细胞积分吸光度值较生理盐水治疗的大鼠显著减少(P < 0.05)。骨折后3周,两组骨折线均较清晰,骨痂体积无明显差别,骨折愈合以软骨内化骨过程为主,骨密度无显著性差异(P > 0.05)。骨折后6周,两组骨折线较模糊,骨痂体积无差别,骨小梁排列较有序,用药组股骨骨密度较对照组升高(P < 0.05)。两组在骨折后3周和6周的骨形态发生蛋白2及血管内皮生长因子差异无显著性意义(P > 0.05)。证实降钙素可以抑制去卵巢大鼠骨折部位破骨细胞活性,但无明显促进大鼠股骨骨折愈合的作用。     

骨质疏松性骨力学性能的预测研究

骨力学性能是发现与评价骨质疏松重要而直接的参考指标,但临床目前尚难对骨质疏松患者的骨力学性能做出非侵入性的直接评估。因此,研究通过间接手段进行骨力学性能的预测已成为骨质疏松研究领域的一个重要课题,并具有重要的临床应用价值。本文综述了对骨质疏松性骨力学性能进行预测的研究进展,并展望了该领域研究的发展前景。     

核素骨显像评价组织工程骨修复骨缺损效果的价值

目的 应用放射性核素骨显像评价组织工程骨修复兔股骨髁骨缺损的效果。方法 取人白兔15只，抽取骨髓，行骨髓间充质干细胞分离、培养、骨向诱导。双侧股骨髁制作0．6×1．2cm的骨缺损，将诱导的成骨细胞复合珊瑚羟基磷灰石植入左侧，右侧单纯植入羟基磷灰石为对照组。术后4间、8周和12周分别行静态核素骨显像评价骨缺损的修复能力。结果表明术后4、8、12周实验组ROI计数（单位像素）均较对照组有显著性增高（P〈0．001）。实验组ROI计数随时间的延长呈明显的上升趋势，但术后8周始增长放缓；对照组ROI也有卜升趋势，但术后8周始增长加快，均在12周达到峰值。结论 骨髓间充质干细胞诱导后复合珊瑚羟基磷灰石可有效的修复股骨髁松质骨缺损。放射性核素骨显像在骨修复过程中具有动态评价血管化和骨生长的作用。     

羟基磷灰石涂层改善骨内植物界面促进骨整合

BACKGROUND: We have designed and manufactured a novel artificial cervical vertebra and intervertebral complex (ACVC) which combines the cervical titanium cage with the artificial cervical disc, and also developed the ACVC with a hydroxyapatite biocoating (ACVC-HA). OBJECTIVE: To evaluate biomechanical properties of the joint system, and the role of HA coating in promoting osseointegration and long-term stability. METHODS: Twenty-four goats were randomly divided into three groups and underwent the anterior C _2/3 and C _3/4 discectomy, and C₃ subtotal corpectomy, followed by ACVC implantation (group 1) and ACVC-HA implantation (group 2), and given no intervention (black control group), respectively. group. At 12 weeks after surgery, C _1-5 samples were collected to undergo biomechanical tests and histological staining. RESULTS AND CONCLUSION: Prior to the fatigue test, compared with the blank control group, the range of motion and neural zone of groups 1 and 2 in the directions of flexion-extension and lateral bending showed no significant differences, but the above indicators were significantly increased in the direction of rotation (P < 0.05). Additionally, the stiffness in all three directions was significantly lower than that in the blank control group (P < 0.05). There were no significant differences in the range of motion and neural zone in all directions between groups 1 and 2. Similar results were found after the fatigue test. The histological staining showed that both two implants had good biocompatibility and abradability, but more new bone formed on the ACVC-HA. These results suggest that ACVC can effectively reconstruct the motor function of the cervical spine after decompression. Furthermore, HA coating can markedly improve bone-implant interface to promote osseointegration.     

A new electrochemically graded hydroxyapatite coating for osteosynthetic implants promotes implant osteointegration in a rat model

Hydroxyapatite (HAP) is widely used as an osteoconductive coating for orthopedic implants. So far standard coating methods like plasma spraying produce a relatively thick coating layer (>30 microm). In addition, the chemical structure of the HAP may be altered because of the heating throughout the coating process. This may have negative effects on the coating stability, implant fixation, and induction of bone formation. The relatively thick layer may detach from the implant with the risk of wear debris. In the present study the potential of a newly developed HAP coating of implants on osteointegration was investigated in a rat model. The coating method, based on an electrochemical process, is applied in a graded manner and results in a biodegradable HAP coating with a thickness of approximately 2 mum. Coated versus uncoated titanium Kirschner wires (1.4-mm diameter) were inserted into the medullary cavity of the right femora of 5-month old female Sprague Dawley rats (n=36) in a retrograde fashion. Throughout an experimental period of 2 months the osteointegration was traced radiologically. After this time the animals were sacrificed and the implant integration was tested biomechanically with the use of a push-out test. To analyze the bone-implant interface, histological sections (80 mum) were investigated with an image analyzing system. The biomechanical testing revealed a significantly higher implant fixation in the group treated with the HAP-coated implant (shear strength: 27.8 +/- 6.7 MPa) compared to control (shear strength: 8.08 +/- 3.4 MPa). The histological analyses demonstrated a better ingrowth of the implants in the HAP group with significantly more direct bone-implant contacts compared to the control group. The results demonstrate that the HAP coating promotes implant osteointegration in a rat model.     

Calcitonin secretion in postmenopausal osteoporosis

Calcitonin deficiency has been implicated in the pathogenesis of accelerated bone loss, especially in postmenopausal osteoporosis. To investigate this issue, we studied 25 patients with untreated postmenopausal osteoporosis, 14 age-matched and sex-matched healthy controls (spinal bone mineral density greater than or equal to age-specific and sex-specific mean), and 5 women who had undergone total thyroidectomy. Each subject received an intravenous infusion of 2 mg of elemental calcium per kilogram of body weight over 5 minutes, to test the C-cell secretory reserve. We measured calcitonin by radioimmunoassay in whole plasma and in silica-cartridge extracts of plasma, the latter method providing greatly improved sensitivity and specificity for monomeric calcitonin. Basal immunoreactive calcitonin concentrations, whether measured in whole plasma or in extracts, were significantly higher in the subjects with osteoporosis (P less than 0.01) than in the healthy controls. The calcitonin secretory reserve, as assessed by calcium stimulation, was normal in the osteoporotic group but virtually absent in the thyroidectomy group. We conclude that postmenopausal osteoporosis is not associated with and does not result from calcitonin deficiency. On the contrary, excessive skeletal calcium release may stimulate calcitonin secretion in patients with the disorder.     

Calcitonin treatment of immobilization osteoporosis in rats

We studied changes in bone mass induced by immobilization and the ability of salmon calcitonin to inhibit immobilization osteoporosis in rat. The bone mass of the immobilized hind leg of rat was compared with the contralateral non-treated leg. Neurectomy and cast immobilization reduced the bone mineral mass to an equal extent. However, the dose-response of calcitonin was different with these immobilization techniques. Calcitonin 15 IU kg^-1 administered once daily reduced bone ash weight difference significantly after 2 weeks' neurectomy (P < 0.001). This had no significant effect on the bone loss induced by cast immobilization, but the dose had to be delivered as two injections given every 12 h. Two weeks' immobilization decreased the incorporation of ⁴⁵Ca into bones. Calcitonin could not prevent this. However, calcitonin tended to inhibit the overall incorporation of 45Ca into bones in immobilized rats but yet had no effect on ⁴⁵Ca incorporation in non-immobilized rats. Immobilization decreased serum alkaline phosphatase activity in cast-immobilized animals. Neurectomy did not change serum alkaline phosphatase activity from a sham operation level. The tartrate-resistant acid phosphatase to total acid phosphatase ratio in the serum increased significantly in neurectomized rats and in cast-immobilized calcitonin-treated rats.     

Mechanical testing and osteointegration of titanium implant with calcium phosphate bone cement and autograft alternatives

The purpose of this study was to evaluate the osteointegration of a titanium (Ti) implant with the calcium phosphate cement (CPC) and autograft prostheses by pull-out test and histological examination. Stems of sixty Ti cylinders were bilaterally inserted into femoral medullary canals in 30 rabbits at the 1st, 4th, 12th, 26th and 70th postoperative weeks. The bone autograft and CPC were filled into the pre-trimmed bone marrow cavity with a polymethyl methacrylate retarder in the distal end, and then a Ti cylinder was inserted into femurs. The CPC group was significantly (p<0.05) associated with a larger pull-out force at 4th (37%) and 12th (62%) weeks compared to the autograft group. The bone area and the bone-to-implant contact ratios of the CPC groups were significantly higher than that of the autograft groups at early healing stage. The histological exams suggest that the CPC enhanced the earlier bone formation around the implant at a period not longer than 12 weeks postoperation. We conclude that CPC graft has the higher ability to facilitate the osteointegration and stabilize the Ti implant at a relatively early stage than the autograft in vivo.     

Calcitonin gene-related peptide promotes transient radiocalcium uptake into chick bone in vivo

We have examined the in vivo effects in chicks of intravenously injected chicken (c-) and rat (r-) calcitonin gene-related peptides (CGRP) on uptake into bone of a simultaneously administered 45Ca label. Both peptides caused transient (10 min) increases in 45Ca uptake into a variety of bone types. In dose-response experiments at 10 min, CGRP doses of 0.26-1.04 nmol/100 g body wt were found to give maximal responses. These were well developed in chicks fasted for 22 h but absent in those which were continuously fed. This contrasts with the hypercalcaemic effect of CGRP which is apparent in fed rather than fasted chicks.     

葛根素可促进老年女性骨质疏松症患者成骨细胞的增殖

背景：近年来,葛根素作为植物雌激素其抗骨质疏松作用对实验动物及成骨细胞的研究较多,但对老年骨质疏松症患者成骨细胞作用的研究甚少,缺乏实验资料。 目的：观察葛根素对体外培养老年女性骨质疏松症患者成骨细胞增殖的影响。 方法：选择老年女性骨质疏松症股骨颈骨折行人工股骨头置换患者,采集术中取下的股骨颈松质骨,采用骨组织块培养法原代培养松质骨成骨细胞,将细胞传代至所需数量。对照组给予不含葛根素的培养液,0.01,0.1,1 μmol/L葛根素组分别给予含相应浓度葛根素的培养液。成骨细胞与不同浓度葛根素共培养1,3,5 d,观察成骨细胞增殖情况。 结果与结论：共培养不同时间点,0.01-1.00 μmol/L的葛根素随浓度增加,成骨细胞增殖活性不断增强(P < 0.05);培养第3 天,各浓度葛根素组细胞吸光度值均最高。结果提示0.01,0.1,1 μmol/L的葛根素可呈浓度依赖性促进老年女性骨质疏松症患者成骨细胞增殖。 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

Sandblasted titanium osteointegration in young, aged and ovariectomized sheep

To evaluate how aging and estrogen deficiency influence the success rate of Sandblasted Titanium (Ti/SA) implants, the osteointegration of Ti/SA rods was studied in the cortical and trabecular bone of 5 young, 5 aged and 5 ovariectomized (OVX) sheep. The characterization of the host bone by transiliac biopsies of the iliac crest showed a progressive rarefaction of trabecular bone in aged and OVX animals when compared to young ones. A significant reduction, both in cortical and trabecular bone, of the osteointegration rate of Ti/SA rods in the presence of estrogen deficiency compared to young animals was observed, while only a minor reduction was observed in aged animals. These results were confirmed by the pushout test in cortical bone. Bone quality affected the biological response of bone to Ti/SA implants in both trabecular and cortical bone; consequently, strategies to maximize the bone osteogenic properties of osteoporotic patients should be adopted.