骨代谢指标与骨关节炎及绝经后骨质疏松症的关系

背景：研究显示,在绝经后骨质疏松症及骨关节炎状态下,原本正常的骨转换平衡状态被破坏,血清、尿液中一些特异性指标可以较敏感地反映出骨转换的具体变化过程。 目的：测量绝经后原发性膝骨关节炎及绝经后骨质疏松症患者的骨密度及骨代谢指标,分析两疾病骨密度及骨代谢指标的变化特点。 方法：选取248例绝经女性受试者,行骨密度、膝关节X射线片检查,最终选出180例进入试验,分为骨关节炎组、骨质疏松组及对照组。对比分析各组观察对象的骨代谢指标：骨碱性磷酸酶、骨钙素、Ⅰ型胶原交联C末端肽、血清抗酒石酸酸性磷酸酶5b。通过二元Logistic回归分析判断两疾病发病与各项指标间的相关性。 结果与结论：与对照组比较,骨关节炎组腰椎骨密度升高,Ⅰ型胶原交联C末端肽值降低;骨质疏松组腰椎及全髋部骨密度降低,骨钙素、Ⅰ型胶原交联C末端肽、血清抗酒石酸酸性磷酸酶5b升高。血清Ⅰ型胶原交联C末端肽水平的降低与骨关节炎发病具有显著相关性;血清骨钙素、Ⅰ型胶原交联C末端肽、血清抗酒石酸酸性磷酸酶5b水平的升高与骨质疏松发病具有显著相关性。提示绝经女性骨关节炎患者骨吸收速率减低,骨质疏松患者骨转换率加快,骨代谢水平的差异导致两疾病患者骨密度呈现出负相关趋势。监测Ⅰ型胶原交联C末端肽、血清抗酒石酸酸性磷酸酶5b、骨钙素,特别是Ⅰ型胶原交联C末端肽血清水平对骨关节炎及骨质疏松的早期诊断及治疗有一定的参考价值。 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：     

骨折合并脑损伤对骨愈合和骨代谢的影响

背景：骨折周围神经损伤能够有效抑制破骨细胞活动,促进骨折早期愈合。目的：观察了大鼠肢体骨折合并脑损伤对骨密度、骨微结构、骨生物力学特征和骨代谢影响。 方法：63只大鼠随机分为假手术组、单纯骨折组和脑损伤合并骨折组。在术后3周、6周和3个月分批麻醉处死动物保存骨骼和血清标本,检测骨密度、骨微结构和生物力学性能以及血清Ⅰ型胶原氨基末端肽和骨钙素水平的变化。 结果与结论：与单纯骨折组相比,在造模3周和6周后,脑损伤合并骨折组胫骨近端的骨密度、松质骨微结构骨体积分数、骨小梁厚度、胫骨皮质骨截面总面积和骨髓腔面积、胫骨极限载荷和极限应力、血清原氨基末端肽和骨钙素水平均显著增高(P < 0.05),造模后3个月,3组间上述指标均差异无显著性意义。结果证实,脑损伤可增加骨折局部骨密度,改善骨微结构,提高生物力学性能,以此促进骨折局部的骨愈合和骨代谢。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     

骨折愈合过程中原始骨折血肿的潜在作用

背景：临床实践中闭合性骨折内固定过程中,骨折原始血肿很少视为骨折愈合的重要因素,常被有意清除,非常可惜。目的：对比分析骨折血肿在骨折愈合过程中所发挥的机制及作用。方法：采用随机数字表将96例四肢骨折患者随机分成试验组和对照组各48例,实施闭合性骨折切开复位内固定术。试验组中先将内固定过程中取出的血肿块放置于特制无菌塑料袋中,每块血肿体积均为1.0-2.0 mL,于内固定装置固定完毕后将三四块骨折血肿重新填塞于骨折断端结合处周围,逐层缝合;对照组将固定过程中取出的骨折断端血肿丢弃,作为空白对照。内固定后1个月随访,抽血检测所有患者骨生化代谢指标;同时分别在术后第1,3,6个月行X射线检查,观察骨折愈合情况。结果与结论：X射线检查提示,内固定后3个月,试验组与对照组骨折愈合率分别占95%,75%(P < 0.05)。骨代谢指标结果显示,试验组骨钙素、Ⅰ型前胶原羧基端肽、血清骨碱性磷酸酶水平较对照组显著增高(P < 0.01或P < 0.05)。结果说明原始骨折血肿可有效促进骨折断端骨痂形成,提示加强骨诱导,提供骨折断端营养,参与血管重建,是促进骨折愈合及预防骨折不愈合的有效途径。 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     

绝经后妇女骨代谢过程中血清基质金属蛋白酶3和骨桥蛋白的变化

背景：骨桥蛋白和基质金属蛋白酶3具有高度的亲和力,此二者的表达可能与骨代谢有关。 目的：观察绝经后妇女血清基质金属蛋白酶3和骨桥蛋白水平,并观察其与骨保护蛋白、骨保护蛋白配体及骨代谢指标的关系。 方法：将120名绝经后妇女分为骨密度正常组、低骨量组和骨质疏松组3 组,对其血清基质金属蛋白酶3、骨桥蛋白、骨保护蛋白、骨保护蛋白配体及骨碱性磷酸酶、骨钙素、Ⅰ型胶原交联C端肽和尿Ⅰ型胶原交联N端肽进行测定,计算骨桥蛋白/基质金属蛋白酶3比值。 结果与结论：骨质疏松组中血清骨桥蛋白和基质金属蛋白酶3的水平高于正常组(P < 0.05)。绝经后妇女血清基质金属蛋白酶3、骨桥蛋白和骨桥蛋白/基质金属蛋白酶3比值与血清骨保护蛋白配体、骨碱性磷酸酶和骨钙素水平呈明显负相关 (P < 0.05),与骨保护蛋白、尿尿Ⅰ型胶原交联N端肽/肌酐比值呈明显正相关性(P < 0.05)。骨质疏松组中血清基质金属蛋白酶3、骨桥蛋白和骨桥蛋白/基质金属蛋白酶3比值与血清骨保护蛋白配体、骨碱性磷酸酶和骨钙素水平呈明显负相关 (P < 0.05),与骨保护蛋白、尿尿Ⅰ型胶原交联N端肽/肌酐水平比值存在明显正相关性(P < 0.05)。提示绝经后妇女血清骨桥蛋白水平和骨桥蛋白/基质金属蛋白酶3比值升高与绝经后骨质疏松症伴随骨代谢转换过程增快有关。     

骨代谢指标在骨质疏松患者椎体变形中的意义

背景：骨质疏松常导致胸腰段椎体变形,鉴于骨代谢指标可灵敏的反映个体骨转换过程,结合骨密度可减少漏诊,预测骨折风险,提前干预可降低重度椎体畸形的发生率。 目的：分析骨代谢指标在骨质疏松患者椎体变形中的意义。 方法：将157例老年人骨质疏松患者按是否存在椎体变形分为椎体变形组和椎体形态正常组,椎体变形组中根据骨密度的不同分为骨密度正常和骨密度减低亚组,进行骨密度和总Ⅰ型胶原氨基端前肽、β胶原特殊序列、N端骨钙素骨代谢指标进行检测,比较了2组间及椎体变形组内骨密度正常和骨密度减低亚组间各骨代谢指标的差异。 结果与结论：椎体变形组总Ⅰ型胶原氨基端前肽、β胶原特殊序列、N端骨钙素水平较椎体形态正常组增高(P < 0.05);骨密度正常亚组总Ⅰ型胶原氨基端前肽与β胶原特殊序列水平较骨密度减低亚组增高(P < 0.05),N端骨钙素在2亚组间差异无显著性意义(P > 0.05)。结果表明骨质疏松患者中椎体变形者总Ⅰ型胶原氨基端前肽、β胶原特殊序列、N端骨钙素的骨代谢水平高于无椎体变形者,在存在椎体变形的患者中,骨密度正常者总Ⅰ型胶原氨基端前肽、β胶原特殊序列的骨代谢水平高于骨密度降低者,骨代谢水平增高结合骨密度及椎体变形可用于骨质疏松的诊断和椎体脆性骨折的预测。 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：     

老年髋部骨折后对侧髋部的再骨折

背景：老年髋部骨折后发生对侧髋部再骨折数目在逐年增加。 目的：阐述老年髋部骨折后对侧髋部再骨折的临床特征,提高对再次对侧髋部骨折的认识。 方法：于2001-01/2011-07对老年单侧髋部骨折患者567例和老年再发对侧髋部骨折患者30例,分析再发对侧骨折病例的发生率、骨折类型、年龄、性别、骨密度、骨质疏松、再骨折时间间隔和合并症。 结果与结论：单侧髋部骨折与再发对侧髋部骨折患者年龄、性别比例和骨密度值接近。老年髋部骨折患者中,对侧髋部再骨折发生率为5.0%。转子间骨折再发对侧髋部骨折率高于股骨颈骨折再发对侧髋部骨折率(P=0.018)。再发对侧骨折组骨质疏松发生率高于单侧骨折组(P=0.032)。初次骨折后发生对侧骨折的间隔时间平均2.4年,其中1年发生的最多,占40.1%。提示老年髋部骨折患者对侧髋部再骨折发生率较高,对于伴有骨质疏松和合并症的转子间骨折患者在术后1年内应加强预防,防止对侧髋部骨折的再次发生。 关键词：再发对侧髋部骨折;髋部骨折;股骨颈骨折;转子间骨折;骨密度;骨质疏松 doi:10.3969/j.issn.1673-8225.2012.04.042     

抗骨质疏松药物应用的依据：骨生化代谢标志物及骨组织病理学

背景：目前国际上公认双能X射线吸收测定法为诊断骨质疏松症的金标准,但常由于测量部位异位骨化、骨质增生等因素使得测量结果存在误差。目的：探讨骨代谢标志物在老年骨质疏松骨折诊疗中的临床意义以及它与骨密度和骨组织形态病理学改变的相关性。方法：选取50例需行手术治疗的老年骨质疏松骨折患者,行骨生化4项检测,其中抗酒石酸酸性磷酸酶5b(TRACP 5b)检测值明显增高患者25例(标记为抗酒石酸酸性磷酸酶5b升高组),骨碱性磷酸酶(BAP)检测值明显升高患者25例(标记为骨碱性磷酸酶升高组)。术中抽取两组各8例患者骨折断端部分骨组织,苏木精-伊红染色普通光镜检查和扫描电镜检查病理学改变。术后,抗酒石酸酸性磷酸酶5b升高组患者使用鲑鱼降钙素抗骨质疏松治疗,骨碱性磷酸酶升高组患者使用骨肽注射液抗骨质疏松治疗,6个月后再次检测骨密度和骨生化4项。结果与结论：两组患者术前骨密度和骨生化4项检查结果相比较差异无显著性意义(P > 0.05)。抗酒石酸酸性磷酸酶5b升高组患者骨折断端骨组织病理检查示成骨细胞减少、破骨细胞增多;骨碱性磷酸酶升高组患者骨折断端骨组织病理检查示成骨细胞减少;两组骨小梁/骨面积比值均降低,且抗酒石酸酸性磷酸酶5b升高组较骨碱性磷酸酶升高组降低程度差异有显著性意义(P < 0.05)。扫描电镜检查示两组破骨细胞都较正常组活跃,抗酒石酸酸性磷酸酶5b升高组骨小梁较骨碱性磷酸酶升高组稀松明显,吸收空泡增大。两组于术后使用抗骨质疏松药物治疗,两组治疗前与治疗后骨密度和骨生化4项检测结果差异有显著性意义(P < 0.05)。结果显示：①骨代谢标志物检测能明确患者骨组织是以成骨细胞功能和数量减低还是以破骨细胞功能和数量增加为主,以便指导临床针对性使用抗骨质疏松药物。②骨折断端骨组织形态病理学检查能更好地反映患者骨组织内成骨细胞、破骨细胞和骨小梁等状况。骨质疏松患者针对性使用抗骨质疏松药物治疗能提高疗效、降低相关并发症。     

骨转化标志物评价富血小板血浆辅助治疗胫骨骨折手术后的不愈合

背景:富血小板血浆凭借其超强的促进愈合作用在临床上逐渐得到应用,但目前缺少高质量临床对比研究来明确其对骨折不愈合的作用及作用机制。目的:比较富血小板血浆联合手术治疗与单纯手术治疗胫骨干骨折术后不愈合的效果,分析相应骨折修复实验室指标。方法:收集2017年1月至2020年1月青岛大学附属威海市中心医院连续收入的胫骨干骨折术后不愈合患者30例,根据二次手术方式分为富血小板血浆联合手术组16例(术后每隔1周注射自体富血小板血浆1次,共注射3次)和单纯手术组14例。手术当日(术前)及术后2,4,8,12周时抽取两组患者血液标本,检测骨钙素、骨性碱性磷酸酶及β-Ⅰ型胶原羧基末端肽水平;观察两组患者手术切口愈合情况;术后3,6,9个月时对两组患者进行骨痂和骨折线影像学评分及目测类比评分,记录两组患者骨折临床愈合及骨性愈合时间。研究方案经青岛大学附属威海市中心医院伦理委员会批准(2016-伦审-07)。结果与结论:(1)两组患者术后血清骨钙素、骨性碱性磷酸酶及β-Ⅰ型胶原羧基末端肽水平均呈升高趋势,富血小板血浆联合手术组患者术后2,4周的骨钙素水平高于单纯手术组(P <0.05),术后2,4,...     

2 Hz极低频脉冲电磁场可促进金属植入物内固定四肢新鲜骨折的愈合

背景：骨折内固定后易发生骨延迟愈合及骨不愈合。 目的：观察金属植入物骨折内固定后联合不同极低频率脉冲电磁场治疗四肢新鲜骨折的疗效。 方法：将四肢新鲜骨折患者随机分为4组,对照组内固定后给予常规治疗,其他3组内固定后第3天起分别配合2,16,32 Hz脉冲电磁场治疗,4组患者分别于内固定后4,8,12周行骨折部位的X射线检查,固定前及固定后联合脉冲电磁场治疗完成时,分别检测4组患者骨钙素、骨特异性碱性磷酸酶水平及Ⅰ型前胶原羧基末端前肽,并进行疗效评定。 结果与结论：随治疗时间延长,4组骨痂生成均增多(P < 0.01);在相同时间点上,2,16,32 Hz治疗组骨痂生成情况及骨代谢生化指标均明显高于对照组(P < 0.01);2 Hz治疗组骨痂生成情况及骨代谢生化指标均高于16,32 Hz治疗组(P < 0.05)。结果证实,脉冲电磁场促进骨痂生长从而促进骨折愈合,2 Hz极低频脉冲电磁场促进金属植入物内固定骨折愈合的疗效优于16,32 Hz。     

金雀异黄酮对去卵巢大鼠骨质疏松性骨折愈合的实验研究

目的研究金雀异黄酮对去势大鼠发生骨质疏松性骨折愈合的影响。方法成年SD大鼠卵巢摘除后3个月开始制作左侧股骨中段闭合骨折内固定手术模型,并分为骨折组和骨折用药组,每组各20只骨折用药组注射金雀异黄酮,分别于大鼠折骨后15和30dX射线摄片、检测血清骨碱性磷酸酶(B鄄ALP)、I型前胶原羧基端肽(PICP)、骨钙素(BGP)等骨形成生化指标,并与骨折组比较。结果骨折用药组骨痂形成量多,骨折线模糊或消失,B鄄ALP、PICP和BGP水平显著下降(P<0.01)。结论金雀异黄酮可调节骨代谢,促进骨形成,加快大鼠骨折愈合的作用。     

Differences in the bone mineral density in patients with Kanemi Yusho treated before and after the age of 18 years

This study examined patients with Kanemi Yusho. The patients' height, weight, and bone mineral density were measured. The density of the distal end of the radius was measured using dual energy X-ray absorptiometry and the calcaneum was measured with ultrasound. We also measured urine levels of cross-linked N-telopeptides of type I collagen, serum tartrate-resistant acid phosphatase 5b, serum bone-specific alkaline phosphatase, serum Ca, serum P and blood PCB level. The patient group that took PCBs when they were 0 to 18 years old (such patients were 42 to 60 years old at the time of the study) showed no correlation between the bone density of the radius and calcaneum in spite of treatment received when they were over 18 years of age (> 60 years of age at the time of the study). The bone mineral density in Kanemi Yusho was not different from the control group. The levels of only serum bone-specific alkaline phosphatase were correlated with the bone mineral density of the radius and calcaneum in patients treated when they were over 18 years of age (currently over 60 years old). PCBs might have had an effect on bone density and bone metabolism.     

Esterified estrogen therapy in postmenopausal women. Relationships of bone marker changes and plasma estradiol to BMD changes: a two-year study

OBJECTIVE: To determine the relationships among bone mineral density changes, bone marker changes, and plasma estrogens in postmenopausal women receiving estrogen replacement therapy. DESIGN: A total of 406 postmenopausal women received 1,000 mg calcium and continuous esterified estrogens (0.3 mg, 0.625 mg, or 1.25 mg) or placebo daily for up to 24 months. Bone mineral density and bone marker measurements were determined at 6-month intervals; plasma estrogens were measured in a subset after 12, 18, and 24 months. RESULTS: Esterified estrogens produced significant increases in bone mineral density (lumbar spine, hip) compared with baseline and placebo at 6, 12, 18, and 24 months. Bone markers decreased from baseline with all esterified estrogen doses relative to placebo. Bone marker changes at 6 months correlated negatively with bone mineral density changes at 24 months (correlation coefficient range = -0.122 to -0.439). The strongest correlation was noted for spine bone mineral density changes and serum osteocalcin. Mean plasma estrogen levels increased with esterified estrogen dose, and bone mineral density changes correlated positively with plasma estrogen levels. Positive bone mineral density changes were noted in treatment groups with plasma estradiol levels at and above 25 pg/mL. CONCLUSIONS: Esterified estrogens, at doses from 0.3 mg to 1.25 mg/day, unopposed by progestin, increase bone mineral density of the spine and hip in postmenopausal women. These bone mineral density changes correlated significantly with bone marker changes at 6 months and with plasma estrogens at 12, 18, or 24 months. Data variability minimizes the predictive value of the bone marker changes in monitoring individual therapy.     

骨密度与骨折合并颅脑损伤患者骨折愈合的评价

背景：颅脑损伤患者下肢骨折愈合过程中,骨折周围新生骨形成加速现象在临床上较为常见。这种快速形成的骨痂或异位骨化是否是颅脑损伤合并下肢骨折患者的常见并发症,至今仍有争论。 目的：利用骨密度检测来评估创伤性脑损伤对股骨干骨折愈合的影响。 方法：纳入创伤性脑损伤合并股骨干骨折患者和单纯股骨干骨折患者各25例,以切开复位后钢板螺钉内固定。术后第6,12周行X射线测量骨痂体积。术后1,3,5周利用双能X射线骨密度测定仪测定两组患者骨折区骨密度值。 结果与结论：单纯股骨干骨折患者术后第12周较第6周骨痂体积明显增加。合并颅脑损伤患者术后第6,12周骨痂体积均有明显增加,且大于单纯骨折组骨痂体积。在第1,3,5周时骨折区骨密度值逐渐增大,并且高于同时间点单纯骨折组骨折区骨密度值。说明创伤性脑损伤可增加股骨干骨折愈合时的骨痂体积,提高骨折区骨密度值,缩短骨折愈合时间。     

辛伐他汀对合并高胆固醇血症非手术治疗老年髋臼骨折愈合的影响

目的 调查口服辛伐他汀是否可以改善骨密度、促进髋臼骨折愈合.方法 收集2017年1月～2019年12月冀中能源峰峰集团有限公司总医院诊断为髋臼骨折共98例患者的信息:年龄、性别、肝功能、肾功能、血糖、血脂、凝血功能、心电图、骨密度.随机将患者分别对照组和实验组:对照组给予唑来膦酸钠注射液静脉滴注5mg;实验组给予唑来膦...     

Ⅰ型胶原N末端肽和定量CT骨密度早期测定实验性骨不连

BACKGROUND: Currently, X-ray examination is mainly used for diagnosis of nonunion. However, this method that relies only on the clinician’s experience and degree of callus mineralization has less accuracy because it is vulnerable to projection, processing conditions and subjective factors. OBJECTIVE: To establish an animal model of nonunion and to detect the variation of biochemical markers and bone mineral density.   METHODS: Twenty New Zealand white rabbits were randomly divided into two groups, and bone defect and fracture models were made in the midshaft of the forearm radius, respectively. X-ray examination of the forearm, quantitative CT measurement of bone mineral density and serological test were carried out before and at 2, 3, 4, 5, 6, 7, 8, 10, 12 weeks after surgery. RESULTS AND CONCLUSION: Postoperative X-ray films showed that the in the bone defect group, a little callus formed in three rabbits at 2 weeks, the callus formed stably at 5 weeks, but there was still no healing at 8 weeks; in the fracture group, the fracture line was blurred at 2 weeks and a large number of calluses formed at 6-8 weeks. Compared with the fracture group, the value of bone mineral density in the bone defect group began to decrease significantly at 5 weeks after surgery. Results from the serological test showed that in the bone defect group, the activity of bone-specific alkaline phosphatase increased after surgery, reached peak at 4 weeks, began to decrease at 5 weeks and became stable at 6 weeks; the activity of tartrate-resistant acid phosphatase 5b increased after surgery, peaked at 4 weeks, then decreased and stabilized basically; the expression of N-terminal telopeptide of type I collagen decreased significantly at 5 weeks after surgery and became stable at 6 weeks. These findings indicate that the systematic monitoring of changes in bone mineral density and biochemical indicators such as bone-specific alkaline phosphatase, tartrate-resistant acid phosphatase 5b and type I collagen N-terminal telopeptides may help to reflect the early progress of rabbit nonunion.       

不同运动强度干预2型糖尿病模型大鼠的骨密度变化

BACKGROUND:More than 50% of patients with diabetes are accompanied by osteoporosis. Exercise is the main method to treat diabetes, but whether it has an impact on diabetes osteoporosis is unclear. OBJECTIVE:To analyze the different exercise intensities and changes in bone mineral density in type 2 diabetic rat models. METHODS:Forty rats were randomly divided into model group and low-, medium- and high-intensity exercise groups. All rats received intraperitoneal injection of streptozotocin to establish models of type 2 diabetes. Rats in the low-, medium- and high-intensity exercise groups did treadmill training at 10, 20, 30 m/min, 1 hour per day, 6 days as a cycle. They had a rest for 1 day after each cycle, for 8 consecutive cycles. Rats in the model group did not do any exercise. RESULTS AND CONCLUSION:Compared with the model group, the weight of rats was decreased; blood glucose levels were reduced; osteocalcin and serum calcium levels and biomechanical indexes of femur increased; serum phosphorus and alkaline phosphatase decreased in the low-, medium- and high-intensity exercise groups. Bone mineral density increased in the medium- and high-intensity exercise groups. These findings confirmed that different exercise intensities have a certain influence on bone mineral density and bone metabolism in type 2 diabetic rat models. When using a method of treating movement, proper physical exercise can increase serum osteocalcin content, improve bone metabolism, prevent diabetic osteoporosis, and have a high clinical value.     

脉冲电磁场磁疗与骨硬化蛋白单克隆抗体联合干预绝经后新西兰大白兔骨代谢和骨微结构的变化

文题释义：低频脉冲电磁场(pulsed electromagnetic fields,PEMFs)疗法：是目前常用的骨质疏松症物理治疗方法。脉冲电磁场治疗骨质疏松症的原理是采用低频脉冲电磁场改变人体生物电、改善生物场,促使成骨细胞增生,增强成骨能力,提高骨密度治疗骨质疏松。 骨硬化蛋白的单克隆抗体(sclerostin antibody,Scl-Ab)：对骨代谢的影响集中体现在对骨硬化蛋白的拮抗作用上。骨硬化蛋白单克隆抗体在刺激成骨活动的同时,不会刺激破骨活动,对骨合成代谢有显著刺激作用,其已经成为治疗骨质疏松的潜在方法。 背景：脉冲电磁场与骨硬化蛋白单克隆抗体皆能对绝经后新西兰大白兔骨代谢产生良好影响,但关于两者联合干预的效果至今少有报道。 目的：探讨脉冲电磁场联合骨硬化蛋白单克隆抗体对绝经后新西兰大白兔骨代谢的影响,探索其对骨质疏松症的治疗价值。 方法：采用卵巢切除法建立新西兰大白兔绝经后骨质疏松动物模型。将实验动物随机分为4组：卵巢切除组、脉冲电磁场组、骨硬化蛋白单克隆抗体组和脉冲电磁场+骨硬化蛋白单克隆抗体组,每组10只。术后第1天起,脉冲电磁场组给予脉冲电磁场磁疗每天1次;骨硬化蛋白单克隆抗体组给予骨硬化蛋白单克隆抗体皮下注射每周2次;脉冲电磁场+骨硬化蛋白单克隆抗体组接受脉冲电磁场磁疗每天1次、每周5次,骨硬化蛋白单克隆抗体皮下注射每周2次;卵巢切除组皮下注射相同剂量的生理盐水每周2次,干预共8周。8周后行骨代谢指标检查、骨密度测定、MicroCT骨微结构参数检测。动物研究中的所有程序经复旦大学实验动物科学部批准(20171263A193)。 结果与结论：①卵巢切除6个月新西兰大白兔骨密度显著下降,提示骨质疏松模型建立成功;②与卵巢切除组相比,3个治疗组L₃椎体的骨密度均显著增加(P < 0.05);③3个治疗组血清骨特异性碱性磷酸酶水平均显著高于卵巢切除组,血清抗酒石酸酸性磷酸酶5b水平均显著低于卵巢切除组;脉冲电磁场+骨硬化蛋白单克隆抗体组血清抗酒石酸酸性磷酸酶5b的水平明显低于脉冲电磁场组、骨硬化蛋白单克隆抗体组;④脉冲电磁场+骨硬化蛋白单克隆抗体组骨微结构参数(骨体积分数､骨小梁厚度､骨小梁数量､骨小梁分离度)均优于脉冲电磁场组、骨硬化蛋白单克隆抗体组(均P < 0.05);⑤骨硬化蛋白单克隆抗体和脉冲电磁场联合治疗可以增强去势新西兰大白兔骨密度,改善骨代谢和骨微结构。 ORCID: 0000-0001-7052-4262(钱光) 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     

兔胫骨平台骨折愈合中的骨密度变化

背景：目前对胫骨平台骨折的基础研究多集中在生物力学方面,对于其愈合过程中骨密度变化规律的研究很少。 目的：观察胫骨平台骨折愈合过程中的骨密度变化情况。 方法：选择18只新西兰大白兔制作胫骨平台骨折动物模型,骨折复位后用螺钉加压固定,分别于术后1,2,3,4,6,8周取胫骨标本。另取3只正常兔的胫骨标本作为对照。 结果与结论：双能X射线骨密度测量显示,术后1周骨密度值较对照组略有降低,2周时骨密度值明显增大且差异显著(P < 0.05)。3周时骨密度值陡然降低,3,4,6周时测得的骨密度值总体差异不大,4周时略为增高,8周时骨密度值又略微降低,3,4,6,8周数据比较差异无显著性意义。提示在良好的复位固定条件下,术后2周时骨折区域的骨密度值最高、成骨作用最强。     

Prevention of postmenopausal bone loss by pulsed estrogen therapy: comparison with transdermal route

OBJECTIVE: To compare the efficacy of pulsed estrogen therapy following intranasal 17beta-estradiol (E2) (S21400) with patch E2 in preventing postmenopausal bone loss and on bone turnover. METHODS: In this multinational open study, 361 postmenopausal women aged 51.5 (S.D. 4.6) years were treated with S21400 300 microg per day or patch E2 (delivering 50 microg per day), two patches per week, for 56 weeks. Bone mineral density (BMD) was assessed at the spine and hip using dual X-ray absorptiometry at baseline and week 56 (W56). Bone turnover markers (osteocalcin, bone alkaline phosphatase, urinary type I collagen C-telopeptides) were measured at baseline and weeks 12, 28 and 56. RESULTS: Spine and hip bone mineral density significantly increased in both groups (P < 0.001 versus baseline). Mean (S.D.) percent increases were 2.1 (3.0) at the spine (both groups), and 1.2 (2.4) and 1.1 (2.2) at the hip in the S21400 and patch E2 groups, respectively. Bone mineral density also significantly increased (P < 0.001 versus baseline) in osteopenic patients following S21400 and patch E2: 3.1 (3.5) and 2.4 (3.5) at the spine, and 2.0 (2.6) and 1.2 (2.7) at the hip, respectively. Bone metabolism was normalized at week 56 with a significant decrease (P < 0.001) from baseline in all markers: 56% and 53% for type I collagen C-telopeptides, and 24% and 25% for osteocalcin in the S21400 and patch E2 groups, respectively. CONCLUSION: Pulsed estrogen therapy was as effective in normalizing bone turnover and preventing postmenopausal bone loss as a reservoir patch.